ZA200601638B - Orally administered small peptides synergize statin activity - Google Patents

Description

ORALLY ADMINISTERED SMALL PEPTIDES SYNE-RGIZE STATIN

ACTIVITY

CROSS-REFERENCE TO RELATED APPLICATIONS

[0001] This application is a continuation-in-part of USSN 10/649,378, filed on 5S August 26, 2003, which claims benefit of and priority to USSN 60/49=4,449, filed on

August 11, 2003, all of which are incorporated herein by reference in their entirety for all purposes.

STATEMENT AS TO RIGHTS TO INVENTIONS MADE UNDER FEDERALLY

SPONSORED RESEARCH AND DEVELOPMECNT

[0002] This work was supported by United States Public Heal th Service and

National Heart, Lung, and Blood Institute Grants HI.30568 and HL34-343. The

Government of the United States of America may have certain rights an this invention.

FIELD OF THE INVENTION

[0003] This invention relates to the field of atherosclerosis. Ir particular, this invention pertains to the identification of a class of peptides that are o_rally administrable and that ameliorate one or more symptoms of atherosclerosis.

BACKGROUND OF THE INVENTION

[0004] Cardiovascular disease is a leading cause of morbidity and mortality, particularly in the United States and in Western European countries. Several causative factors are implicated in the development of cardiovascular disease in cluding hereditary predisposition to the disease, gender, lifestyle factors such as smoking and diet, age, hypertension, and hyperlipidemia, including hypercholesterolemia. S everal of these factors, particularly hyperlipidemia and hypercholesteremia (high blo od cholesterol concentrati ons) provide a significant risk factor associated with atherosclerosis.

[0005] Cholesterol is present in the blood as free and esterified cholesterol within lipoprotein. particles, commonly known as chylomicrons, very low density lipoproteins (VLDLs), Row density lipoproteins (LDLs), and high density lipoproteins (HDLs).

Concentration of total cholesterol in the blood is influenced by (1) absorption of cholesterol from the digestive tract, (2) synthesis of cholesterol frorm dietary constituents such as c arbohydrates, proteins, fats and ethanol, and (3) removal of cholesterol from blood by tissues, especially the liver, and subsequent conversion of the cholesterol to bile acids, steeroid hormones, and biliary cholesterol. .

[0006] Maintenance of blood cholesterol concentrations is i nfluenced by both genetic and environmental factors. Genetic factors include concentration of rate-limiting ) enzymes in cholesterol biosynthesis, concentration of receptors for low density lipoproteins in the liver, concentration of rate-limiting enzymes for conversion of cholester-ols bile acids, rates of synthesis and secretion of lipoproteins and gender of person. Environmental factors influencing the hemostasis of blood. cholesterol concentration in humans include dietary composition, incidence of smoking, physical activity, and use of a variety of pharmaceutical agents. Dietary variables include amount and type- of fat (saturated and polyunsaturated fatty acids), amount of cholesterol], amount and type of fiber, and perhaps amounts of vitamins such as vitamirx C and D and minerals such as calcium.

[0007] Epidemiological studies show an inverse correlatiora of high density lipoprotein (HDL) and apolipoprotein (apo) A-I levels with the occurrence of atherosc lerotic events (Wilson et al. (1988) Arteriosclerosis 8: 737-741). Injection of

HDL into rabbits fed an atherogenic diet has been shown to inhibit atherosclerotic lesion formation (Badimon et al. (1990) J. Clin. Invest. 85: 1234-1241).

[0008] Human apo A-I has been a subject of intense study because of its anti- atherogenic properties. Exchangeable apolipoproteins, including apo A-I, possess lipid- associating domains (Brouillette and Anantharamaiah (1995) Biochim. Biophys. Acta 1256:103-129; Segrest er al. (1974) FEBS Lert. 38: :247-253). Apo A-I has been postulat ed to possess eight tandem repeating 22mer sequences, most of which have the potential to form class A amphipathic helical structures (Segrest er al. (1974) FEBS Lett. 38: 1247-253). Characteristics of the class A amphipathic helix include the presence of positively charged residues at the polar-nonpolar interface and negatively charged residues at the center of the polar face (Segrest et al. (1974) FEBS Lett. 38: 247-253; Segrest et al (199 0) Proteins: Structure, F unction, and Genetics 8: 103-117). Apo A-1 has been shown to strongly associate with phospholipids to form complexes and to promote cholesterol efflux from cholesterol-enriched ceslls. The delivery and maintenance of serum levels of apo A-I to effectively mitigate one or more symptoms of atherosclerosis has heretofore proven elusive.

SUMMARY OF THE INVENTION

[0009] This invention provides novel peptides and amino acid pairs, administration of which mitigates one or more symptoms of atherosclerosis and other inflammatory conditions such as rheumatoid arthritis, lupus erythematous, polyarteritis nodosa, osteoporosis, Alzheimer’s disease, congestive heart failure, endothelial dysfunction, viral illnesses such as influenza A, and diseases such as multiple sclerosis. In certain embodiments, it was a discovery of this invention that peptides comprising a class A amphipathic helix when formulated with "D" amino acid residue(s) and/or having protected amino and carboxyl termini can be o rally administered to an organism, are readily taken up and delivered to the serum, amd are effective to mitigate one or more symptoms of atherosclerosis. In certain embodiments, the peptides can be formulated with all "L" amino acid residues and are still effecti ve, particular when administered by routes other than oral administration.

[0010] It was also a discovery that "snmxall” peptides (e.g., ranging in length from about three amino acides to about 11 amino acids) having hydrophobic terminal amino acids or terminal amino acids rendered hydrop hobic by one or more hydrophobic blocking goups and having internal acidic and/or basic, and/or aliphatic, and/or aromatic amino acids as described herin are also capable of mitigating one or more symptoms of atherosclerosis or other pathologies characterized by an inflammatory response.

[0011] The peptides, and/or amino acid pairs, of this invention are typically effective to stimulate the formation and cycling of pre-beta high density lipoprotein-like particles and/or to promote lipid transport and detoxification.

[0012] The peptides, and/or amino acid pairs, described herein are also effective : for preventing the onset or inhibiting or elimimating one or more symptoms of osteoporosis.

[0013] It was also a surprising discovexy that the peptides, and/or amino acid pairs, can be used to enhance (e.g., synergically enhance) the activity of statins and/or Ezetimibe or other cholesterol uptake inhibitors, thereby permitting the effective use of statins or cholesterol uptake inhibitors at lower dosages and/or cause the statins or cholesterol uptake inhibitors to be significamtly more anti-inflammatory at any given dose.

[0014] In certain embodi ments, this invention provides peptides or a combinati on . of peptides, and/or amino acid pairs, that ameliorates one or more symptoms of an inflammatory condition (e.g., atherosclerosis atherosclerosis, rheumatoid arthritis, luptas ’ erythematous, polyarteritis nodo sa, osteoporosis, Altzheimer’s disease, a viral illnesses, asthma, diabetes, erc.). Certain preferred peptides range in length from 3 to about 5 amnino acids; are soluble in ethyl acetate at a concentration greater than about 4mg/mL; are soluble in aqueous buffer at pH “7.0; when contacted with a phospholipid in an aqueous environment, forms particles with a diameter of approximately 7.5 nm and/or form stacked bilayers with a bilayer dimension on the order of 3.4 to 4.1 nm with spacing between the bilayers in the stack of approximately 2 nm; have a molecular weight less than about S00 daltons; convert pro-inflammatory HDL to anti-inflammatory HDL or makes anti- inflammatory HDL more anti-imflammatory; and do not have the amino acid sequences

Lys-Arg-Asp-Ser (SEQ ID NO: 238) in which Lys-Arg-Asp and Ser are all L amino acids.

In certain embodiments, these p eptides protects a phospholipid (e.g., 1-palmitoyl-2- arachidonoyl-sn-glycero-3-phosphorylcholine (PAPC), 1-stearoyl-2-arachidonoyl-sn- glycero-3-phosphorylcholine (S APC)), and 1-stearoyl-2-arachidonyl-sn-glycero-3- phosphorylethanolamine (SAPE). In certain embodiments, these peptides can includes, but need not be limited to any of the small peptides described herein.

[0015] In certain embocliments, this invention provides peptides or a combination of peptides, and/or amino acid pairs, that ameliorates one or more symptoms of an inflammatory condition (e.g., atherosclerosis atherosclerosis, rheumatoid arthritis, lupus erythematous, polyarteritis nodosa, osteoporosis, Altzheimer’s disease, a viral illnesses, asthma, diabetes, efc.). Certain. preferred peptides are characterized by the formula: >'-

X2X3,-X* where nis 0 or 1; X1 is a hydrophobic amino acid and/or bears a hydrophobic protecting group; X* is a hydrophobic amino acid and/or bears a hydrophobic protecting group; and, when n is 0, X?2 is an amino acid selected from the group consisting of an acidic amino acid, a basic amino acid, and a histidine; and, when when n is 1: X? and. X3 are independently an acidic amino acid, a basic amino acid, an aliphatic amino acid, er an aromatic amino acid such that when X is an acidic amino acid; X3 is a basic amino acid,

an aliphatic amino acid, or an aromatic amino acid; when X is a basic amino acid; X3is an acidic amino acid, an aliphatic amino acid, or an aromatic amino acid; and when X* is an aliphatic or aromatic amino acid, X> is an acidic amino acid, or a basic amino acid.

Certain preferred peptides convert pro-inflammatory HDL to anti-inflammatory HDL or make anti-inflammatory HDL more anti—inflammatory. In certain embodiments, the peptide does not have the amino acid sequence Lys-Arg-Asp-Ser (SEQ ID NO:238) in which Lys, Arg, Asp, and Ser are all L amino acids. Peptides of this invention include peptides according to the formula above , and/or peptides comprising a peptide of the formula above and/or concatamers of su ch peptides.

[0016] In certain embodiments, X' and X* are independently selected from the group consisting of alanine (Ala), valine (Val), leucine (Leu), isoleucine (Ile), proline (Pro), phenylalanine (Phe), tryptophan ("Itp), methionine (Met), serine (Ser) bearing a hydrophobic protecting group, beta-naphthyl alanine, alpha-naphthyl alanine, norleucine, cyclohexylalanine, threonine (Thr) bearing a hydrophobic protecting group, tyrosine (Tyr) bearing a hydrophobic protecting group, lysine (Lys) bearing a hydrophobic protecting group, arginine (Arg) bearing a hydroph obic protecting group, ornithine (Om) bearing a hydrophobic protecting group, aspartic acid (Asp) bearing a hydrophobic protecting group, cysteine (Cys) bearing a hydrophobic protecting group, and glutamic acid (Glu) bearing a hydrophobic protecting group.

[0017] In certain embodiments, ghe peptide is a tri-mer (i.e., nis 0). In certain tri- mers, X' is Glu, Leu, Lys, Orn, Phe, Trp, or norLeu; X? is acidic (e.g., aspartic acid, glutamic acid, etc.), or basic (e.g., lysine, arginine, histidine, etc.) and X* is Ser, Thr, Ile,

Leu, Trp, Tyr, Phe, or norleu. In certaim embodiments, the peptide comprises the amino acid sequence of a peptide listed in Table 3. In certain embodiments, the peptide isa protected trimer as shown in Table 3.

[0018] In certain embodiments, mis 1 and the peptide is or comprises a tetramer in which X2 and X° are independently an acidic amino acid or a basic amino acid such that = when X? is an acidic amino acid, X° is a basic amino acid and when X is a basic amino acid, X2 is an acidic amino acid. X' and X* can include independently selected amino ) 30 acids, e.g., as indicated above. In certaim embodiments, X? and x3 are independently selected from Asp, Glu, Lys, Arg, and His. In certain embodiments, the peptide comprises the amino acid sequence of a peptide listed in Table 4. In certain embodiments, the peptide is a protected tetramer as show in Table 4.

[0019] In still another embodiment, n is 1 and the peptide is or comprises a tetramer in which X? and X° are independently an acidic, a basic, or a aliphatic amino acid . with one of XorX being an acidic or a basic amino acid such that when X? is an acidic or a basic amino acid, X3is an aliphatic amino acid, and when X° is an acid or a basic amino acid, X” is an aliphatic amino acid. X' and X* can include independently selected amino acids, e.g., as indicated above. In certain embodiments, X? and X3 are independently selected from the group consisting of Asp, Glu, Lys, Arg, His, and Je, more preferably from the group consisting of Asp, Arg, Leu, and Glu. In certain embodiments, the peptide comprises the amino acid sequence of a peptide listed in Table 5. In certain embodiments, the peptide is a protected tetramer as show in Table 5.

[0020] In another embodiment, n is 1 and the peptide is or comprises a tetramer in which X2, X3 are independently an aci dic, a basic, or an aromatic amino acid with one of

X?or X? being an acidic or a basic amino acid such that when X* is an acidic or a basic amino acid, X° is an aromatic amino acid; and when X3 is an acid or a basic amino acid,

X2 is an aromatic amino acid. X' and X* can include independently selected amino acids, e.g., as indicated above. In certain embodiments, X? and X° are independently selected from the group consisting of Asp, Arg, Glu, Trp, Tyr, Phe, and Lys. In certain embodiments, the peptide comprises the amino acid sequence of a peptide listed in Table 6. In certain embodiments, the pepticle is a protected tetramer as show in Table 6.

[0021] This invention also provides for peptides that are or comprise a pentamer (5-mer) characterized by the formulaz X' X2X3-XAX5, where X is a hydrophobic amino acid and/or bears a hydrophobic protecting group; X’ is a hydrophobic amino acid and/or bears a hydrophobic protecting group; and X2, X32, and X* are independently selected aromatic amino acids or histidine; an d the peptide converts pro-inflammatory HDL to anti- inflammatory HDL or makes anti-inflammatory HDL more anti-inflammatory. In certain embodiments, X' and X° are independently selected from the group consisting of alanine (Ala), valine (Val), leucine (Leu), isoleucine (Ile), proline (Pro), phenylalanine (Phe), tryptophan (Trp), methionine (Met), phenylalanine (Phe), tryptophan (Trp), methionine (Met), serine (Ser) bearing a hydrophobic protecting group, beta-naphthyl alanine, alpha-

Coa A168 naphthyl! alanine, norleucine, cyclohexylalanine, threonine (Thr) bearing a hydrophobic protecting group, tyrosine (Tyr) bearing a hydrophobic protecting group, lysine (Lys) bearing a hydrophobic protecting group, arginine (Arg) bearing a hydrophobic protecting group, ornithine (Om) bearing a hydrophobic protecting group, aspartic acid (Asp) bearing a hydrophobic protecting group, cysteine (Cys) bearing a hydrophobic protecting group, and glutamic acid (Glu) bearing a hydrophobic protecting group. In certain embodiments

X2, X3, and X* are independently is selected from the group consisting of Phe, Val, Trp,

Tyr, and His. In certain embodiments, the peptide comprises the amino acid sequence of a peptide listed in Table 7. In certain embodiments, the peptide is a protected tetramer as show in Table 7.

[0022] This invention also provides for larger peptides that ameliorate one or more symptoms of an inflammatory condition. In certain embodiments, the peptide ranges in length from 5 to 11 amino aci ds; the terminal amino acids are hydrophobic amino acids and/or bear hydrophobic protecting groups; the non-terminal amino acids form at least one acidic domain and at least one basic domain; and the peptide converts pro-inflammatory

HDL to anti-inflammatory HIDL or makes anti-inflammatory HDL more anti- inflammatory.

[0023] In certain emb odiments, the peptide ranges in length from 5 to 11 amino acids; the terminal amino acids are hydrophobic amino acids and/or bear hydrophobic protecting groups; the non-terminal amino acids form at least one acidic domain or one basic domain and at least one aliphatic domain; and the peptide converts pro-inflammatory

HDL to anti-inflammatory HIDL or makes anti-inflammatory HDL more anti- inflammatory.

[0024] In other embodiments, the peptide ranges in length from 5 to 11 amino acids; the terminal amino acids are hydrophobic amino acids and/or bear hydrophobic protecting groups; the non-texminal amino acids form at least one acidic domain or one basic domain and at least ones aromatic domain; and the peptide converts pro-inflammatory ’ HDL to anti-inflammatory HEDL or makes anti-inflammatory HDL more anti- inflammatory.

[0025] In still other embodiments, the peptide ranges in length from 6 to 11 amino acids; the terminal amino aci ds are hydrophobic amino acids and/or bear hydrophobic protecting groups; the non-terminal amino acids form at least one aromatic domain or two or more aromatic domains separated by one or more histidines; and ihe peptide converts pro-inflammatory HDL to anti-inflammatory HDL. or makes anti-inflammatory HDL more anti-inflammatory. .

[0026] This invention also provides for peptides that ameliorate one or more symptoms of an inflammatory condition and that comprise one or more amphipathic ) helices. Thus, this invention includes a peptide or a concatamer of a peptide that ranges in length from about 10 to about 30 amino acids, preferably from about 18 to about 30 amino acids; that comprises at least one class A amphipathic helix; that comprises one or more aliphatic or aromatic amino acids at the center of the non-polar face of said amphipathic helix; that protects a phospholipid against oxidation by an oxidizing agent; and that is not the D-18A peptide. In certain embodiments, the peptide comprises the amino acid sequence of a peptide listed in Table 2 or Table 12. In certain embodiments, the peptide is a protected tetramer as show in Table 2 or Table 12.

[0027] In certain embodiments, the peptides of this invention protect a phospholipid (e.g, 1-palmitoyl-2-arachidonoyl-sn-glycero-3-phosphorylcholine (PAPC), 1-stearoyl-2-arachidonoyl-sn-glycero-3-phosphorylcholine (SAPC)), 1-stearoyl-2- arachidonyl-sn-glycero-3-phosphorylethanolamine (SAPE)) against oxidation by an oxidizing agent (e.g., 13(S)-HPODE, 15(S)-HPETE, HPODE, HPETE, HODE, HETE, etc).

[0028] Any of the peptides described herein can bear one or more hydrophobic protecting groups on the amino terminal amino acid (e.g., X") and/or the carboxyl terminal amino acid (e.g., X* X3, etc.). The protecting group(s) can be attached to the amino or carboxyl terminus and/or to a side chain (R group) of the amino acid. The protecting group(s) can be directly coupled (e.g., through a covalent bond) or indirectly coupled (e.g. through a linker). Preferred hydrophobic protecting groups include, but are not limited to t-butoxycarbonyl (Boc), Fmoc, nicotinyl, OtBu, a benzoyl group, an acetyl (Ac), a carbobenzoxy, methyl, ethyl, a propyl, a butyl, a pentyl a hexyl ester, an N-methyl anthranilyl, and a 3 to 20 carbon alkyl, amide, a 3 to 20 carbon alkyl group, 9- fluoreneacetyl group, 1-fluorenecarboxylic group, 9-fluorenecarboxylic group, 9- fluorenone-1-carboxylic group, benzyloxycarbomyl (is also called carbobenzoxy -§-

oe . 2006/ 01638 mentioned above), Xanthyl (Xan), Trityl (Trt), 4-methyltrityl (Mitt), 4-methoxytrityl (Mmt), 4-methoxy-2,3,6-trimethyl-benzenesulphonyl (Mtr), Mesitylene-2-sulphonyl (Mts), 4,4-dimethoxybenzhydryl (Mbh), Tosyl (Tos), 2,2.5,7,8-pentamethyl chroman-6- ) sulphonyl (Pmc), 4-methylbenzyl (MeBzl), 4-methoxybenzyl (MeOBzl), Benzyloxy (BzlO), Benzyl (Bzl), Benzoyl (Bz), 3-nitro-2-pyriclinesulphenyl (Npys), 1-(4,4-dimethyl- 2,6-dioxocyclohexylidene)ethyl (Dde), 2,6-dichlorobenzyl (2,6-DiCl-Bzl), 2- chlorobenzyloxycarbonyl (2-Cl-Z), 2-bromobenzyloxycarbonyl (2-Br-2), benzyloxymethyl (Bom), cyclohexyloxy (cHxO),t-butoxymethyl (Bum), t-butoxy (tBuO), t-Butyl (tBu), trifluoroacetyl (TFA), 4[N-{ 1-(4,4-dimethyl-2,6-dioxocyclohexylidene)-3- methyldibutyl)-amino}benzyl ester (ODmab), a-all yl ester (OAL, 2-phenylisopropyl ester (2-PhiPr), 1-[4 4-dimethyl-2,6-dioxycyclohex-1-yl—idene)ethyl (Dde), and the like. In certain embodiments, the said hydrophobic protecting group is selected from the group consisting of Boc, Fmoc, nicotinyl, and OtBu. In certain embodiments, the N-terminus of the peptide is blocked with a protecting group selected from the group consisting of Boc-,

Fmoc-, and Nicotinyl- and/or the C-terminus of thes peptide is blocked with a protecting group selected from the group consisting of tBu, arad OtBu.

[0029] The peptides can also, optionally, in clude at least one D amino acid. In certain embodiments, the peptides include a plurali ty of D- amino acids or can even compirse all D-amino acids. In certain embodiments, the peptide comprise alternating D- and L- amino aicds. The peptides can also be all L.-form amino acids. The peptides can be isolated (e.g., substanitaly pure), dry or in soluti on, and/or combined with a pharmacologically acceptable excipient. In certain embodiments, the peptide is mixed with a pharmacologically acceptable excipient suit able for oral administration to a mammal (e.g., a human or a non-human mammal)- The peptide can be provided as a unit formulation in a pharmaceutically acceptable excipient and/or as a time release formulation.

[0030] The peptides can also be coupled tow one or more biotins (e.g., directly, - through a linker, and/or through the amino acid side chain). In certain embodiments, the biotin is coupled to a lysine (Lys).

[0031] In certain embodiments, this invention also provides pairs of amino acids that ameliorate one or more symptoms of an inflarmmatory condition. The amino acid pair typically comprises a first amino acid bearing at least one protecting group; and a seconcl amino acid bearing at least one protecting group; where the first amino acid and the second amino acid are diffe rent species of amino acid, and where the pair of amino acids converts pro-inflammatory HDL to anti-inflammatory HDL or makes anti-inflammatory :

HDL more anti-inflammatory. In various embodiments the pair of amino acids, when contacted with a phospholipid in an aqueous environment, forms particles with a diameter ) of approximately 7.5 nm an.d forms stacked bilayers with a bilayer dimension on the order of 3.4 to 4.1 nm with spacing between the bilayers in the stack of approximately 2 nm. Xn certain embodiments, the first and second amino acids are independently selected from the group consisting of an acidic amino acid, a basic amino acid, and a non-polar amino acid.

In certain embodiments, the first amino aicd is acidic or basic and the second amino acid is non-polar, or the first amino acid is non-polar and said second amino acid is acidic or basic. In certain embodime=nts, both amino acids are acidic or basic. The first and secorid amino acid can, optionaly, be covalently coupled together, e.g., directly or through a linker. In certain embodiments, the amino acids are joined through a peptide linkage thereby forming a dipeptide. In certain embodiments, the first amino acid and the second amino acid are mixed together, but not covalently linked. The protecting groups include, but are not limited to any of the protecting groups described herein. In certain embodiments, the first amino acid is blocked with a protecting group selected from the group consisting of Boc-, F'moc-, and nicotinyl-, and the second amino acid is blocked with a protecting group selected from the group consisting of /Bu, and OrBu. In certain embodiments, each amino acid bears at least two protecting groups. In certain embodiments, each amino acid is blocked with a with a first protecting group selected from the group consisting of Boc-, Fmoc-, and nicotinyl-, and a second protecting group selected from the group consisting of /Bu, and OBu. In certain embodiments, each ami no acid is blocked with a Boc and an OtBu. In various embodiments the pair of amino acids form a dipeptide selected from the group consisting of Phe-Arg, Glu-Leu, and Arg-Glu. In certain embodiments, the p air of amino acids form a dipeptide selected from the group consisting of Boc-Arg-OtB u, Boc-Glu-OtBu, Boc-Phe-Arg-OtBu, Boc-Glu-Leu-OtBu, and Boc-Arg-Glu-OtBu.

[0032] This invention also provides a pharmaceutical formulation comprising ore or more of the peptides, and/or amino acid pairs described herein, and a pharmaceutical 1y gel V 67° acceptable excipient. Typically the peptide(s) , and/or amino acid pairs, are pxesent in an ‘effective dose. The peptide(s) , and/or amino acid pairs, can also be provided as a time release formulation and/or as a unit dosage formulation. In certain embodimemts, the ’ formulation is formulated for oral administration. In certain embodiments, the formulation is formulated for administration by a route selected from the group consisting of oral administration, inhalation (e.g., nasal administration, oral inhalation, etc.), rectal administration, intraperitoneal injection, intravascular injection, subcutaneous injection, transcutaneous administration, inhalation administration, intramuscular injection, and the like.

[0033] Also provided is a kit comprising a container containing one or" more of the peptides, and/or: amino acid pairs described herein, and instructional materials teaching the use of the peptide(s) , and/or amino acid pairs, in the treatment of a pathology characterized by inflammation (e.g., atherosclerosis atherosclerosis, rheumatoeid arthritis, lupus erythematous, polyarteritis nodosa, asthma, osteoporosis, Altzheimer’s disease, a viral illnesses, etc.).

[0034] This invention also provides a method of mitigating (e.g., redu cing or eliminating) one or more symptoms of atherosclerosis in a mammal (human or non-human mammal). The method typically involves administering to the mammal an effective amount of one or more of the peptides, and/or amino acid pairs described herein,. The peptide, and/or amino acid pair, can be administered in a in a pharmaceuticall y acceptable excipient (e.g., for oral administration) and can, optionally be administered in. conjunction (e.g., before, after, or simultaneously) with a lipid. The administering can coxmprise administering the peptide, and/or amino acid pair, by a route selected from the group consisting of oral administration, inhalation (e.g. nasal administration, oral inhalation, etc.), rectal administration, intraperitoneal injection, intravascular injection, Subcutaneous injection, transcutaneous administration, and intramuscular injection. In certain embodiments, the mammal is a mammal diagnosed as having one or more symmptoms of . atherosclerosis. In certain embodiments, the mammal is a mammal diagnosed as at risk for stroke or atherosclerosis. ) 30 [0035] In another embodiment, this invention provides method of mitigating one or more symptoms of an inflammatory pathology (e.g., atherosclerosis, rheumatoid axthritis, lupus erythematous, polyarteritis nodosa, osteoporosis , multiple sclerosis, diabetes, asthma, Altzheimer’s disease, a viral illnesses, ezc.). The method typically ifwvolves administering to the mammal an effective amount of one or more of the peptides, and/or amino acid pairs, described herein. The peptide, and/or amino acid pair, can be : administered in ain a pharmaceutically acceptable excipient (e. g., for oral administration) and can, optionally be administered in conjunction (e.g., before, after, or simultaneously) : with a lipid. The administering can comprise administering the peptide, and/or amino acid pairs, by a route selected from the group consisting of oral administration, inhalation, rectal administration, intraperitoneal injection, intravascular inj ection, subcutaneous imjection, transcutaneous administration, and intramuscular injection. In certain embodiments, the mammal is a mammal diagnosed as having one or more symptoms of of the inflammatory pathology. In certain embodiments, the mammal is a mammal diagnosed as at risk for the inflammatory pathology.

[0036] The peptides, and/or amino acid pairs, of this invention also act synergistically with statins and/or with a selective cholesterol uptake inhibitor (e.g.,

Ezetimibe). The method typically involves coadministering with the statin and/or cholesterol uptake inhibitor an effective amount of one or more of the peptides described herein. In certain embodiments, the statin is selected from the group consisting of cerivastatin, atorvastatin, simvastatin, pravastatin, fluvastatin, Jovastatin. rosuvastatin, and pitavastatin. The peptide can be administered before, after, or simultaneously with the statin and/or the cholesterol uptake inhibitor. The peptide and/or said statin and/or cholesterol uptake inhibitor can be administered as a unit dosage formulation. In certain embodiments, the administering comprises administering said peptide and/or said statin by a route selected from the group consisting of oral administration, nasal administration, wectal administration, intraperitoneal injection, intravascular injection, subcutaneous injection, transcutaneous administration, and intramuscular inj ection. The mammal includes, but is not limited to a mammal diagnosed as having one or more symptoms of atherosclerosis or diagnosed as at risk for stroke or atherosclerosis. 10037] This invention also provides a method of mitigating one or more symptoms associated with atherosclerosis in a mammal. The method typically involves administering a statin and/or a selective cholesterol uptake inhibitor; and an effective amount of one or more peptides, and/or amino acid pairs, described herein, where the the effective amount of the statin and/or cholesterol uptake inhibitor is lowe than the effective amount of a statin or a cholesterol uptake inhibitor administered without- the peptide(s) and/or amino acid pairs. In certain embodiments, the effective amount of the peptide(s) : and/or amino acid pairs, is lower than the effective amount of the peptid <, and/or amino acid pairs, administered without the statin and/or cholesterol uptake inhi bitor. In certain embodiments, thae statin is selected from the group consisting of cerivastatin, atorvastatin, simvastatin, prawastatin, fluvastatin, lovastatin. rosuvastatin, and pitavas-tatin. The peptide can be administered before, after, or simultaneously with the statin and/or the cholesterol uptake inhibitor. The peptide, and/or amino acid pair, and/or the statin &and/or cholesterol uptake inhibitor can be administered as a unit dosage formulation. In certain embodiments, the administering comprises administering the peptide, amd/or amino acid pair, and/or said statin by a route selected from the group consisting of oral administration, inhalation, recta’ administration, intraperitoneal injection, intravascular dnjection, subcutaneous injection, transcutaneous administration, and intramuscular injection. The mammal includes, but is not limited to a mammal diagnosed as having One or more symptoms of atherosclerosis or diagnosed as at risk for stroke or atherosclerosis. The mammal includes, but is not limited to a mammal diagnosed as having One or more symptoms of atherosclerosis or diagnosed as at risk for stroke or atherosclerosis.

[0038] Im still another embodiment, this invention provides a method of reducing or inhibiting one or more symptoms of osteoporosis in a mammal. The method typically involves admini stering to the mammal one or more peptide(s) , and/or a_mino acid pairs, described hereira, where peptide, and/or amino acid pair, is administered in a concentration sufficient to reduce or eliminate one or more symptoms of osteoporosis. In certain embodiments, the peptide(s), and/or amino acid pair(s), are administered in a concentration sufficient to reduce or eliminate decalcification of a bone . In certain embodiments, the peptide(s) , and/or amino acid pair(s), are administered in a concentration stafficient to induce recalcification of a bone. The peptide(s) , and/or amino acid pairs, can be combined with a pharmacologically acceptable excipaent (e.g., an : excipient suitab Ie for oral administration to a mammal).

[0039] In certain embodiments, the methods and/or peptides of this invention exclude any one or more peptides disclosed in WO 97/36927, and/or U .S. Patents 6,037,323, and/«or 6,376,464, and/or 6753,313, and/or in Garber et al. (1992)

Arteriorsclerosis and Thrombosis, 12: 886-894. In certain embodiments this invention excludes any one or more peptides disclosed in U.S. Patent 4,642,988 and/or in Garber et al (199 2) that were synthesized with all enantiomeric amino ac ids being L amino acids or synthesized with D amino acids where the peptides are blocking groups. In certain embodiments, this invention excludes peptides having the formula A;-B;-B»-C;-D-B3-Bys-

Ar-Cy-Bs-Bg-As-C3-Br-Ca-As-Bs-Bo (SEQ ID NO: (SEQ ID NQO:1) wherein Aj, Az, Az and :

A, are independently aspartic acid or glutamic acid, or homolo zues or analogues thereof;

By, Ba, Bs, By, Bs, Bg, By, Bg and By are independently tryptophan, phenylalanine, alanine, leucine, tyrosine, isoleucine, valine or o-naphthylalanine, or homologues or analogues thereof; Cy, Ca, Cs and C4 are independently lysine or arginine , and D is serine, threonine, alanine, glycine, histidine, or homologues or analogues thereof; provided that, when A; and A> are aspartic acid, A; and A4 are glutamic acid, B; and By are leucine, Bs and B- are phenyl alanine, Bg is tyrosine, Bs is valine, Be, Bs, and D are al anine, and Cy, C3, C3 and C4 are lys ine, By is not tryptophan. In certain embodiments, while this invention may exclude one or more of the peptides described above, the peptide of SEEQ ID NO:8 (4F or D4F) will bes expressly included. [0040 In certain embodiments, this invention excludes any one or more peptides in WO 97/36927 and/or D variants thereof. Particular embodi ments exclude one or more of the following: apoprotein A, apoprotein A-1, apoprotein A—2, apoprotein A4, apoprotein B, apoprotein B-48, apoprotein B-100, apoprotein C, apoprotezin C-1, apoprotein C-2, apoprotein C-3, apoprotein D, apoprotein E as described in W O 97/36927.

[00417] In certain embodiments, also excluded are any one or more peptides disclo sed in U.S. Patent 6,037,323 and/or D variants thereof. Particular embodiments exclucle apo A-I agonist compounds comprising (i) an 18 to 272-residue peptide or peptide analogue that forms an amphipathic .alpha.-helix in the preserice of lipids and that compmises the formula: Z, -X-Xa-X5-X4-Xs-X6-X7-Xg-Ko-Xmo-X11-X12-X13 -X14-X15-X16-

X7-X18-Z2, (SEQ ID NO:2), where X is Pro (P), Ala (A), Gly (G), Asn (N), Gln (Q) or

D-Pro (p); Xz is an aliphatic amino acid; X3 is Leu (L); X4 is &an acidic amino acid; Xs is

Leu (IL) or Phe (F); Xs is Leu (L) or Phe (F); X is a basic amino acid; Xg is an acidic amino acid; Xp is Leu (L) or Trp (W); Xjo is Leu (L) or Trp CW); Xj is an acidic amino acid or Asn (N); X;2 is an acidic amino acid; Xi3 is Leu (L), Trp (W) or Phe (F); Xisis a basic amino acid or Leu (L); Xis is Gln (Q) or Asn (N); Xj¢is a basic amino acid; X;7 18

Leu (L); 3s is a basic amino acid; Z; is H, N-- or RC(O)NH--; Z; is -—C(O)NRR, --

C(O)OR Or --C(O)OH or a salt thereof; each R is independently --H, (C;-Cy) alkyl, (Cs-

Cs) alkenyl, (C1-Cs) alkynyl, (Cs-Cyp) aryl, (Cs -Cas) alkaryl, 5-20 membered heteroaryl or 6-26 membered alkheteroaryl or a 1 to 4-residue peptide or peptide analogue in which one or more b onds between residues 1-7 are independently a substituted armide, an isostere of an amide or an amide mimetic; and each "-" between residues X; throvagh Xs independently designates an amide linkage, a substituted amide linkag €, an isostere of an amide or an amide mimetic; or (ii) an altered form of formula (I) in which at least one of residues 3, Xa, Xs, Xa, Xs, Xe, X7, Xs, Xo, X10, X11, X12, X13, X14, Xa 5, Xi, X17 01 Xyg is conservatively substituted with another residue, and/or D variants ther<of.

[0042] In certain embodiments, this invention excludes peptides having the sequence Lys-Arg-Asp-Ser (SEQ ID NO:238) and in certain embodiments, this invention excludes peptides having the sequence Lys-Arg-Asp-Ser (SEQ ID NO-:238) in which Lys-

Arg-Asp and Ser are all L amino acids.

[0043] In certain embodiments the peptides of this invention show less than 38%, preferably less than about 35%, more preferably less than about 30% or less than about 25% LCAT activation activity as measured by the assays provided in W.S. Patent 6,376,464.

Definitioms.

[0044] The terms "polypeptide", "peptide" and "protein" are ussed interchangeably herein to refer to a polymer of amino acid residues. The terms apply to amino acid polymers in which one or more amino acid residues is an artificial chesmical analogue of a corresponding naturally occurring amino acid, as well as to naturally occurring amino acid polymers .

[0045] The term " class A amphipathic helix" refers to a protedn structure that forms an o-helix producing a segregation of a polar and nonpolar faces with the positively charged residues residing at the polar-nonpolar interface and the negatively charged residues residing at the center of the polar face (see, e.g., ” Segrest et al. (1990) Proteins:

Structure, Function, and Genetics 8: 103-117).

[0046] The term "ameliorating" when used with respect to "ameliorating one or more syanptoms of atherosclerosis" refers to a reduction, prevention, or elimination of one or more symptoms characteristic of atherosclerosis and/or associated. pathologies. Such a reduction includes, but is not limited to a reduction or elimination of oxidized . phospholipids, a reduction in atherosclerotic plaque formation and rapture, a reduction in clinical events such as heart attack, angina, or stroke, a decrease in h ypertension, a : decrease in inflammatory protein biosynthesis, reduction in plasma cholesterol, and the like. "Ameliorating one or more symptoms of atherosclerosis” can also refer to improving blood fLow to vascular beds affected by atherosclerosis.

[0047] The term "enantiomeric amino acids" refers to amino acids that can exist in at least two forms that are nonsuperimposable mirror images of eacha other. Most amino acids (except glycine) are enantiomeric and exist in a so-called L-foxrm (L amino acid) or

D-form (D amino acid). Most naturally occurring amino acids are "1." amino acids. The : terms "ID amino acid" and "L amino acid" are used to refer to absolute configuration of the 1S amino acid, rather than a particular direction of rotation of plane-polarized light. The usage herein is consistent with standard usage by those of skill in the art.

[0048] The term "protecting group” refers to a chemical group that, when attached to a furactional group in an amino acid (e.g., a side chain, an alpha amino group, an alpha carboxyl group, etc.) blocks or masks the properties of that functiorxal group. Preferred 50 amino-terminal protecting groups include, but are not limited to acetyl, or amino groups.

Other amino-terminal protecting groups include, but are not limited to alkyl chains as in fatty acids, propionyl, formyl and others. Preferred carboxyl terminal protecting groups includes, but are not limited to groups that form amides or esters. The term “side chain protection groups” refers to protecting groups that protect/block a side-chain (i.e. an R group) of an amino acid. Side-chain protecting groups include, but are not limited to amino protecting groups, carboxyl protecting groups and hydroxyl protecting groups such as aryl ethers and guanidine protecting groups such as nitro, tosyl etc.

[0049] The phrase "protect a phospholipid from oxidation by an oxidizing agent" refers wo the ability of a compound to reduce the rate of oxidation of a phospholipid (or the amount of oxidized phospholipid produced) when that phospholipid is contacted with an oxidizing agent: (e.g., hydrogen peroxide, 13-(S)-HPODE, 15-(S)-HPETEE, HPODE,

HPETE, HODES, HETE, etc.).

[0050] “The terms "low density lipoprotein" or "LDL" is defined im accordance with common tasage of those of skill in the art. Generally, LDL refers to the lipid-protein complex which when isolated by ultracentrifugation is found in the density range d = 1.019 to d = 1.063.

[0051] “The terms "high density lipoprotein” or "HDL" is defined in accordance with common tasage of those of skill in the art. Generally "HDL" referst oa lipid-protein complex which when isolated by ultracentrifugation is found in the density range of d = 1.063tod=1.21

[0052] “The term "Group I HDL" refers to a high density lipoprotein or components thereof (e.g., apo A-I, paraoxonase, platelet activating factor acetylhydrolase, etc.) that reduce oxidized lipids (e.g., in low density lipoproteins) or that protect oxidized lipids from oxidation by oxidizing agents.

[0053] "The term "Group II HDL" refers to an HDL that offers reduced activity or no activity in protecting lipids from oxidation or in repairing (e.g., reduci ng) oxidized lipids.

[0054] “The term "HDL component” refers to a component (e.g., rmolecules) that comprises a high density lipoprotein (HDL). Assays for HDL that protect lipids from oxidation or that repair (e.g., reduce oxidized lipids) also include assays for components of

HDL (e.g., apo A-I, paraoxonase, platelet activating factor acetylhydrolasse, erc.) that display such activity.

[0055] “The term "human apo A-I peptide" refers to a full-length lauman apo A-I peptide or to a fragment or domain thereof comprising a class A amphipathic helix. [0056} _A "monocytic reaction" as used herein refers to monocyte activity characteristic of the "inflammatory response" associated with atheroscler otic plaque formation. Thes monocytic reaction is characterized by monocyte adhesion to cells of the vascular wall (e.g., cells of the vascular endothelium), and/or chemotaxis into the subendothelial space, and/or differentiation of monocytes into macrophages, and/or monocyte chemotaxis as measured in vitro {e.g., utilizing a neuroprobe chamber).

[0057] The term "absence of change" when referring to €he amount of oxidized phospholipid refers to the lack of a detectable change, more preferably the lack of a statistically significant change (e.g., at least at the 85%, preferably at least at the 90%, more “preferably at least at the 95%, and most preferably at least at the 98% or 99% . confidence level). The absence of a detectable change can also refer to assays in which oxidized phospholipid level changes, but not as much as in the absence of the protein(s) : described herein or with reference to other positive or negative controls.

[0058] The following abbreviations are used herein: PAPC: L-0-1-palmitoyl-2- arach idonoyl-sn-glycero-3-phosphocholine; POVPC: 1-palmitoyl-2-(5-oxovaleryl)-si- glycero-3-phosphocholine; PGPC: 1-palmitoyl-2-glutaryl-sn-gl ycero-3-phosphocholine;

PEIP<C: 1-palmitoyl-2-(5,6-epoxyisoprostane E,)-sn-glycero-3-phsophocholine; ChC18:2: cholesteryl linoleate; ChC18:2-OOH: cholesteryl linoleate hydwoperoxide; DMPC: 1,2- ditetadecanoyl-rac-glycerol-3-phosphocholine; PON: paraoxomase; HPF: Standardized high power field; PON: paraoxonase; BL/6: C57BL/6]; C3H:C3H/Hel.

[0059] The term "conservative substitution" is used in xeference to proteins or peptides to reflect amino acid substitutions that do not substantially alter the activity (specificity (e.g., for lipoproteins))or binding affinity (e.g., for lipids or lipoproteins)) of the molecule. Typically conservative amino acid substitutions involve substitution one amino acid for another amino acid with similar chemical properties (e.g., charge or hydrophobicity). The following six groups each contain amin«© acids that are typical conservative substitutions for one another: 1) Alanine (A), Serine (S), Threonine (T); 2)

Aspartic acid (D), Glutamic acid (E); 3) Asparagine (N), Glutamine (Q); 4) Arginine (R),

Lysine (K); 5) Isoleucine (I), Leucine (L), Methionine (M), Valine (V); and 6)

Phemylalanine (F), Tyrosine (Y), Tryptophan (W).

[0060] The terms “identical” or percent "identity," in the context of two or more nucleic acids or polypeptide sequences, refer to two or more sequences Or subsequences that. are the same or have a specified percentage of amino acicl residues or nucleotides that are the same, when compared and aligned for maximum correspondence, as measured using one of the following sequence comparison algorithms or by visual inspection. With respect to the peptides of this invention sequence identity is determined over the full length of the peptide.

[0061] For sequence comparison, typically one sequence acts as a reference sequence, to which test sequences are compared. When using a sequence comparison algorithm, test and reference sequences are input into a computer, subsequence coordinates are designated, if necessary, and sequence algorithm program parameters are designated. The sequen.ce comparison algorithm then calculates the percent sequence identity for the test sequuence(s) relative to the reference sequence, based on the desigrated program parameters.

[0062] Optimal alignment of sequences for comparison can be conducted, e.g. , by the local homology algorithm of Smith & Waterman, Adv. Appl. Math. 2:482 (1981), by the homology alignmen t algorithm of Needleman & Wunsch, J. Mol. Biol. 48:443 (1970), by the search for similaxity method of Pearson & Lipman (1988) Proc. Natl. Acad. Sci.

USA 85:2444, by computerized implementations of these algorithms (GAP, BESTFIT,

FASTA, and TFASTA in the Wisconsin Genetics Software Package, Genetics Computer

Group, 575 Science Dr. , Madison, WI), or by visual inspection (see generally Ausube=] et al, supra).

[0063] One exaxmple of a useful algorithm is PILEUP. PILEUP creates a multiple sequence alignment fromm a group of related sequences using progressive, pairwise alignments to show relationship and percent sequence identity. It also plots a tree or dendogram showing the clustering relationships used to create the alignment. PILEUP uses a simplification of the progressive alignment method of Feng & Dooliitle (1987) J.

Mol. Evol. 35:351-360. The method used is similar to the method described by Higgi ns &

Sharp (1989) CABIOS 5: 151-153. The program can align up to 300 sequences, each of a maximum length of 5,0 00 nucleotides or amino acids. The multiple alignment proceclure begins with the pairwise alignment of the two most similar sequences, producing a cluster of two aligned sequences. This cluster is then aligned to the next most related sequemce or cluster of aligned sequesnces. Two clusters of sequences are aligned by a simple extersion of the pairwise alignment of two individual sequences. The final alignment is achieved by a series of progressive, pairwise alignments. The program is run by designating specific sequences and their amino acid or nucleotide coordinates for regions of sequence : 30 comparison and by designating the program parameters. For example, a reference sequence can be compared to other test sequences to determine the percent sequence identity relationship using the following parameters: default gap weight (3.00), default gap length weight (0.10), and weighted end gaps.

[0064] Another example of algorithm that is suitable for determining percent sequence identity and sequence similarity is the BLAST algorithm, which is described in

Altschul ez al. (1990) J. Mol. Biol. 215: 403-410. Software for performing BLAST analyses is publicly available through the National Center for Biotechnology Information (http://www .ncbi.nlm.nih.gov/). This algorithm involves first identifying high scoring sequence pairs (HSPs) by identifying short words of length W in the query sequence, which either match or satisfy some positive-valued threshold score T when aligned with a word of the same length in a database sequence. T is referred to as the neighborhood word score threshold (Altschul ef al, supra). These initial nei ghborhood word hits act as seeds for initiating searches to find longer HSPs containing them. The word hits are then extended in both directions along each sequence for as far as the cumulative alignment score can be increased. Cumulative scores are calculated using, for nucleotide sequences, the parameters M (reward score for a pair of matching residues; always > 0) and N (penalty score for mismatching residues; always < 0). For amino acid sequences, a scoring matrix is used to calculate the cumulative score. Extension of the word hits in each direction are halted when: the cumulative alignment score falls off by the quantity X from its maximum achieved value; the cumulative score goes to zero or below, due to the accumulation of one or more negative-scoring residue alignments; or the end of either sequence is reached. The BLAST algorithm parameters W, T, and X determine the sensitivity and speed of the alignment. The BLASTN program (for nucleotide sequences) uses as defaults a wordlength (W) of 11, an expectation (E) of 10, M=5, N=-4, and a comparison of both strands. For amino acid sequences, the BLASTP program uses as defaults a wordlength (W) of 3, an expectation (E) of 10, and the BLOSUMBS62 scoring matrix (see Henikoff & Henikoff (1989) Proc. Natl. Acad. Sci. USA 89:10915).

[0065] In addition to calculating percent sequence identity, the BLAST algorithm also performs a statistical analysis of the similarity between two sequences (see, e.8.,

Karlin & Altschul (1993) Proc. Natl. Acad. Sci. USA ,90: 5873-5787). One measure of similarity provided by the BLAST algorithm is the smallest sum probability (P(N)), which provides an indication of the probability by which a match between two nucleotide or amino acid sequences would occur by chance. For example, a nucleic acid is considered similar to a reference sequence iff the smallest sum probability in a comparison of the test nucleic acid to the reference nucleic acid is less than about 0.1, more preferably less than about 0.01, and most preferably Jess than about 0.001.

[0066] The term "D-18A_ peptide" refers to a peptide having the sequence: D-W-

L-K-A-F-Y-D-K-V-A-E-K-L-K-E-A-F (SEQ ID NO:3) where all of the enantiomeric amino acids are D form amino a<cids.

[0067] The term "coadm inistering” or "concurrent administration”, when used, for example with respect to a peptidie of this invention and another active agent (e.g., a statim), refers to administration of the peptide and the active agent such that both can simultaneously achieve a physiological effect. The two agents, however, need not be administered together. In certaim embodiments, administration of one agent can precede administration of the other, how-ever, such coadministering typically results in both agen ts being simultaneously present in the body (e.g., in the plasma) at a significant fraction (e. g, 20% or greater, preferably 30% or 40% or greater, more preferably 50% or 60% or greater, most preferably 70% or- 80% or 90% or greater) of their maximum serum concentration for any given dose.

[0068] The term "detoxify" when used with respect to lipids, LDL, or HDL refers the removal of some or all oxidizing lipids and/or oxidized lipids. Thus, for example, thee uptake of all or some HPODE and/or HPETE (both hydroperoxides on fatty acids) will prevent or reduce entrance of thaese peroxides into LDLs and thus prevent or reduce LDL oxidation.

[0069] The term "pre-beta high density lipoprotein-like particles” typically refers to cholesterol containing particles that also contain apoA-I and which are smaller and relatively lipid-poor compared to the lipid: protein ratio in the majority of HDL particles.

When plasma is separated by FPLC, these "pre-beta high density lipoprotein-like particles” are found in the FPLC fractions containing particles smaller than those in the main HDL peak and are located to the right of HDL in an FPLC chromatogram as shown in related application USSN 108/423,830. : [0070] The phrase "rev erse lipid transport and detoxification" refers to the removal of lipids including cholesterol, other sterols including oxidized sterols, phospholipids, oxidizing agents, and oxidized phospholipids from tissues such as arteries and transport out of these peripheral tissues to organs where they can be detoxified and excreted such as excretion by the liver into bile and excretion by the kidneys into urine. Detoxification also refers to preventing the formation and/or destroying oxidized phospholipids as explained herein.

[0071] The term "biological sample" as used herein refers to any sample obtained from a living organism or from an organism that has died. Examples of biological samples include body fluids, tissue specimens , cells and cell lines taken from an organism (e.g., a human or non-human mammal).

[0072] The term "amide" when referring to a hydrophobic protecting group or a hydrophobic blocking group includes a simple amide to methylamide or ethylamide. The term also includes alkyl amides such as CO-N'H-R where R is methyl, ethyl, ezc. (e.g., up to 7, preferably 9, more preferably 11 or 13 carbons).

[0073] The term "D-peptide" refers to a peptide in which one or more of the enantiiomeric amino acids comprising the pepetide are D form amino acids. In certain embodiments, a plurality of the enantiomeric amino acids are D form amino acids. In certain embodiments, at least half of the enantiomeric amino acids are D form amino acids. In certain embodiments, the peptide co mprises alternating D- and L-form amino acids. In certain embodiments, all of the enaratiomeric amino acids are D form amino acids.

[0074] The term "L-peptide” refers to a peptide in which all of the amino acids (enantiomeric amino acids) are L-form amino acids.

[0075] A peptide that "converts pro-iraflammatory HDL to anti-inflammatory HDL or makes anti-inflammatory HDL more anti-imflammatory" refers to a peptide that when administered to a mammal (e.g., a human, a rat, a mouse, etc.), or that when used in an appropriate ex vivo assay (e.g., as described herein), converts HDL to an HDL that reduces or blocks lipid oxidation by an oxidizing agent (e.g., as described in USSN 6,596,544), and/or that has increased paraoxo-nase activity, and/or that decreases LDL- induced monocyte chemotactic activity generated by artery wall cells as compared to HDL in a control assay (e.g., HDL from a control animal or assay administered a lower dose of the peptide or a negative control animal or assay lacking the peptide). The alteration of

HDL (conversion from non-protective to protective or increase in protective activity) is preferably a detectable change. In preferred embodiments, the change is a statistically significant change, e.g., as determined using any statistical test suited for the data set provided (e.g., t-test, analysis of variance (ANOVA), semiparametric techniques, non- parametric techniques (e.g., Wilcoxon Mann-Whitney Test, Wilcoxon Signed Ranks Test,

Sign Test, Kruskal-Wallis Test, ezc.). Preferably the statistically significant change is significant at least at the 85%, more preferably at least at the 90%, still more preferably at least at the 95%, and most preferably at least at the 98% or 99% confidence level. In certain embodiments, the change is at least a 10% change, preferably at least a 20% change, more preferably at least a 50% change and mo st preferably at least a 90% change.

[0076] The phrase "in conjunction with" when used herein, e.g. in reference to the administration of two amino acids comprising an amino acid pair, in reference to the use of combinations of peptides of this invention, in reference to the use of peptides/amino acid pairs of this invention with other pharmacologically active agent(s) (e.g., one or more statins), and the like, indicates that the two (or more) agents are administered so that there is at least some chronological overlap in their physiological activity on the organism.

Thus the two or more agents can be administered simultaneously and/or sequentially. In sequential administration there may even be some sub stantial delay (e.g., minutes or even hours or days) before administration of the second agent as long as the first administered agent has exerted some physiological alteration on the organism when the second administered agent is administered or becomes active in the organism.

BRIEF DESCRIPTION OF THIE DRAWINGS

[0077] Figure 1 illustrates a synthesis scheme for the solution phase synthesis of peptides according to this invention.

[0078] Figure 2 illustrates the process for synthesizing a tetrapeptide using the process outlined in Figure 1.

[0079] Figure 3 shows that pre-incubation (pre-treatment) but not co-incubation (Co-inc) of Boc-Lys(Boc)-Arg-Asp-Ser(tBu)-OtBu (synthesized from all D-amino acids) (SEQ ID NO:238 in Table 4) inhibited LDL-induced monocyte chemotactic activity produced by human artery wall cells (HAEC). The cells were either pre-incubated with

125 pg/ml, 250 ug/ml, or 500 pg/ml of the peptide, the peptide was then removed and

LDL at 100 pg/ml cholesterol with fresh medium was added or the same concentrations of peptide were added together with the LDL and monocyte chemotactic activity determined.

[0080] Figure 4 shows that the addition of the tetrapeptide described in Figure 3 to the drinking water of apoE null mice converted HDL and the post-HDL FPLC fractions from pro-inflammatory to anti-inflammatory similar to D-4F. The tetrapeptide or D-4F were added to the drinking water of the mice (n= 4 for each condition) at a concentration of 5 pg/ml for 18 hours. The mice were bled and their lipoproteins were separated by

FPLC. A control human LDL at 100 pg/ml of Cholesterol was added (LDL) or not added (No Addition) to human artery wall cocultures or was added together with HDL at 50 ug/ml from a normal human control subject (+Control HDL) or HDL at 50 pg/ml from apoE null mice that received drinking water without peptide (+Water Control HDL) or received the tetrapeptide (+D-Tetra HDL) or D-4F (+D4F HDL) or the post-HDL FPLC fractions from apoE null mice that did not receive the peptide (+Water Control post HDL.) or from mice that did receive the tetrapeptide (+D-Tetra post HDL) or received D-4F (+D4F post HDL)were added at 20 ug/ml together with the control human LDL at 100 ug/ml of Cholesterol. A fter 8 hours the supernatants were assayed for monocyte chemotactic activity.

[0081] Figure 5 -shows that apoE null mice receiving D-tetrapeptide or D-4F in their drinking water have LDL that induces less monocyte chemotactic activity. The LDE. from the FPLC fractions of the mice described in Figure 4 was added to the cocultures at 100 pg/ml. After 8 hours the supernatants were assayed for monocyte chemotactic activity.

[0082] Figure 6 shows that SEQ ID NO:258 from Table 4 (designated D-11 in the figure) when synthesized from all D-amino acids or D-4F given orally renders HDL anti- inflammatory in apoE null mice but a peptide containing the same D-amino acids as in D - 4F but arranged in a scrambled sequence that prevents lipid binding did not. Five hundred micrograms of SEQ ID NO:258 synthesized from D-amino acids (D-11) or 500 pg of D- 4F (D-4F) or 500 pg of scrambled D-4F (Scramb. Pept.) were instilled via a tube into the stomachs of female, 3 month old apoE null mice, (n=4) and the mice were bled 20min 20 min after gavage) or 6 hours later (6 hr after gavage). Plasma was separated and HDL was isolated by FPLC. Cultures of human aortic endothelial cells received medium alone (No

Addition/Assay Controls), standard normal human LDL at 100 ugm/mL chol esterol without (LDL/Ass ay Controls) or together with standard control human HDL (LDL+Control HII./Assay Controls) at S50 pgm/mL cholesterol, or control heaman LDL at 100 pgmy/mL cholesterol was added with mouse HDL at 50 ugm/mL cholesterol obtained from mice that received the scrambled D-4F peptide (LDL+ Scramb.Pept. HIDL), or D-4F (LDL+ D-4F HDI) or SEQ ID NO:258 made from all D-amino acids .DL+D-11 HDL).

The cultures were incubated for 8 hrs. The supernatants were then assayed fo r monocyte chemotactic activity. The values are mean +/- SD of the number of migrated monocytes in 9 high power field s. * indicates p<0.001.

[0083] Figure 7 shows that apoE null mice receiving D-4F or SEQ I> NO:258 from Table 4 synthesized from D-amino acids (designated D-11) (but not from mice that received scrambled D-4F) have LDL that induces less monocyte chemotactic activity. The

LDL from the FPI_C fractions of the mice described in Figure 6 was added to the cultures at 100 pg/ml. After 8 hours the supernatants were assayed for monocyte chemotactic activity.* indicates p<0.001, **indicates p<0.01.

[0084] Fig ure 8 shows that HDL was converted from pro-inflammatory to anti- inflammatory aftew addition of SEQ ID NO:238 in Table 4 synthesized from 1D amino aicids (designated D-1)_to the chow of apoE null mice (200 pg/gm chow for 18 hours).

Assay Controls: No Addition, no addition to the cocultures; LDL ,a standard control human LDL was added to the cocultures; + Control HDL, a control normal hhuman HDL was added to the cocultures. Chow LDL, LDL from mice that received chow alone; +Chow Autolog. FIDL, HDL from the mice that received Chow alone was aclded together with the LDL from these mice; + D-1 Autolog. HDL, HDL from the mice receiving the peptide was added together with the LDL from these mice to the cocultures and monocyte chemotactic activi ty was determined.

[0085] Figure 9 shows that the tetrapeptide (SEQ ID NO:258 in Table 4) was ten times more potent than SEQ ID NO:238 in vitro. The tetrapeptide was added or not added in a pre-incubatiom to human artery wall cell cocultures at 100, 50, 25 or 12.5 pgm/mL and incubated for 2 hrs. The cultures were then washed. Some wells then received medium alone (No Addition). The other wells either received standard normal human

W/O 2005/016280 PCT/US2004/026288 co .

LIDL at 100 pgm/mL cholesterol (LDL) or received this LDL. together with a standard control human HDL (LDL+ Control HDL) at 50 pgm/mL cholesterol and were incubated for 8 hrs. Culture supernatants were then assayed for monocyte chemotactic activity. The values are mean +/- SD of the number of migrated monocytes in 9 high power fields. The : wells that received the tetrapeptide in the 2 hr pre-incubation at the concentrations noted above followed by the addition of LDL at 100 pgm/mL cholesterol are indicated in the fi gure (LDL+tetrapeptide, in jlgm/ml).

[0086] Figure 10 shows that SEQ ID NOs:243, 242, and 256 from Table 4 (designated Seq No.5, Seq No.6, and Seq No. 9, respectively in the figure) convert pro- inflammatory HDL from apoE null mice to anti-inflammatoxy HDL. Two month old female apo E null mice (n=4 per treatment) fasted for 18 hrs, were injected intraperitoneally with L-tetrapeptides at 20 ugm peptide/mosuse or were injected with the saline vehicle (Saline Vehicle). Two hours later, blood was collected from the retroorbital sinus under mild anesthesia with Isofluorine. Plasma was separated and HDL was isolated by FPLC. HDL inflammatory / anti-inflammatory properties were then determined.

Cultures of human aortic endothelial cells received medium. alone (No Addition), standard mormal human LDL at 100 pgm/mL cholesterol without (LIDL) or together with standard control human HDL (LDL+Control HDL) at 50 pgm/mL cholesterol, or standard control muman LDL at 100 ugm/mL cholesterol with mouse HDL at 50 pgm/mL cholesterol obtained from mice that received the tetrapeptides or the saline vehicle (LDL+HDL from mice injected intraperitoneally). The cultures were incubated for 8 hrs. The supernatants were then assayed for monocyte chemotactic activity. The values are mean +/- SD of the number of migrated monocytes in 9 high power fields. £0087] Figure 11 shows that SEQ ID NO:258 from Table 4 (designated S-11 in the

Figure) converts pro-inflammatory HDL from apoE null mice to anti-inflammatory HDL better than SEQ ID NO:254 and SEQ ID NO:282 (designated S-7 and S-35, respectively in the Figure). Two-month-old female apo E null mice (n==4 per treatment) fasted for 18 hrs, were injected intraperitoneally with S-7 or S-11 or S-3 5, at 20 ugm peptide/mouse or were injected with the saline vehicle (Saline Vehicle). Two hours later, blood was collected from the retroorbital sinus under mild anesthesia with Isofluorine. Plasma was separated and LDL and HDL were isolated by FPLC. HDL inflammatory / anti-

inflammatory properties were then determined. Cultures of human aortic endothelial cells received medium alone (No Addition/ Assay Controls), standard normal human LDL at 100 pgm/mL cholesterol without (LDI/Assay Controls) or together with standard control human HDL (+Control HDL/Assay C ontrols) at 50 pgm/mL cholesterol, or mouse LDL at 100 pgm/mL cholesterol with mouse HDL at 50 pugm/mL cholesterol obtained from mice that received S-7, or S-11 or S-35 (LDL + S-7 HDL. LDL+ S-11 HDL, LDL+S-35 HDL, respectively) or the saline vehicle (LIDL+Saline HDL)). The cultures were incubated for 8 hrs. The supernatants were then assay ed for monocyte chemotactic activity. The values are mean +/- SD of the number of migrated monocytes in 9 high power fields. *p<0.001.

[0088] Figure 12. The LDL fxom the FPLC fractions of the mice described in

Figure 11 was added to the cells at 100 pg/ml. After 8 hours the supernatants were assayed for monocyte chemotactic activity. Assay Controls are as described in Figure 11.

Saline LDL, LDL from mice injected with the saline vehicle; S-7 LDL, LDL from mice injected with SEQ ID NO:254 from Table 4 as described in Figure 11; S-11 LDL, LDL from mice injected with SEQ ID NO: 258 from Table 4 as described in Figure 11;S-35,

LDL from mice injected with SEQ IID NO:282 as described in Figure 9. # p<0.001.

[0089] Figure 13 shows serurm Amyloid A (SAA) plasma levels after injection of peptides. SAA levels in plasma were measured 24 hours after injection of the peptides described in Figures 11 and 12. * p << 0.001.

[0090] Figure 14 shows that SEQ ID NO:258 from Table 4 when synthesized from all L-amino acids and given orally converts pro-inflammatory HDL from apoE null mice to anti-inflammatory HDL. Female, 3 month old apoE null mice, (n=4), were given 200 micrograms in water of the peptide described as SEQ ID NO:258 from Table 4, which was synthesized from all L-amino acids ( designated S-11 in the figure). The peptide or water without peptide was administered by stomach tube and the mice were bled 4 hours later. A second group of four mice were givesn access to standard mouse chow in powdered form and containing 200 micrograms of the S-11, which was synthesized from all L-amino acids and added per1.0 gram of powdered mouse chow in a total of 4 grams of powdered mouse chow containing a total of 80 0 micrograms of the peptide for the cage of four mice or they were given the same powdered mouse chow without peptide. The chow was available to the mice overnight and by morning the chow was consumed and the mice were bled. Plasma was separated and HDL was isolated by FPLC. HDL inflammatory / anti-inflammatory properties were then determined. Cultures of human aortic endothelial cells received medium alone (No Additiom/Assay Controls), standard normal human LDL at 100 pg/mL cholesterol without (LDL./Assay Controls) or together with standard . control human HDL (LDL+Cont.HDL/Assay Controls) at 50 pgm/mL cholesterol, or control human LDL at 100 pgm/mL cholesterol wit mouse HDL at 50 pgm/mL cholesterol obtained from mice that received no peptide (LDL+ No Peptide HDL) or L-S- 11 (LDL+L-S-11 HDL) by stomach tube (By gastric gavage) or in the mouse chow (Powdered diet). The cultures were incubated for 8 hrs. The supernatants were then assayed for monocyte chemotactic activity. The values are mean +/- SD of the number of migrated monocytes in 9 high power fields. p<0.001.

[0091] Figure 15 shows that L-S- 11, when synthesized from all L-amino acids and given orally increased plasma paraoxonase activity. The plasma from the mice described in Figure 14 was assayed for paraoxonase activity (PON Activity, which is shown in the figure as Units per 500 pl of plasma). No peptide, mice that received water or food alone without peptide. L-S-11, mice given 200 micrograms in water or food of the peptide described as SEQ ID NO:256 from Table 4 as described in Figure 14. P<0.001.

[0092] Figure 16 shows that SEQ ID NO:238 (designated D-1) and SEQ ID

NO:258 (designated D-11) from Table 4 when synthesized from all D-amino acids and given orally renders HDL anti-inflammatory in apoE null mice but SEQ ID NO:238, when synthesized from all L-amino acids (L-1) and given orally did not. Female, 3 month old apoE null mice, (n=4), were given access to standard mouse chow in powdered form and containing 0.5 milligram of each peptide added per1.0 gram of powdered mouse chow in a total of 4 grams of powdered mouse chow containing a total of 2.0 milligrams of the peptide for the cage of four mice or they were given the same powdered mouse chow without peptide. The chow was available to the mice for 24 hrs at which time the chow was consumed and the mice were bled. Plasma was separated and HDL was isolated by

FPLC. Cultures of human aortic endothelial cells received medium alone (No

Addition/Assay Controls), standard normnal human LDL at 100 pgm/mlL cholesterol without (LDL/Assay Controls) or together with standard control human HDL (LDL+Control HDL/Assay Controls) at 50 pgm/mL cholesterol, or control human LDL at i WO 2005/016280 PCT/US2004/026288 100 pgm/mL cholesterol was added with mouse FIDL at 50 pgm/mL cholesterol obtained from mice that received no peptide (LDL+ No Pe-p. HDL), or SEQ ID NO:238 made from all L-amino acids (LDL+L-1 HDL),or SEQ ID N0:238 made from all D-amino acids ‘ (LDL+D-1 HDL) or SEQ ID NO:258 made from all D-amino acids (LDL+D-11 HDL).

The cultures were incubated for 8 hrs. The supermatants were then assayed for monocyte chemotactic activity. The values are mean +/- SID of the number of migrated monocytes in 9 high power fields. * indicates p<0.01 and ** indicates p<0.001.

[0093] Figure 17 shows that SEQ ID NO: 238 (D-1) and SEQ ID NO:258 (D-11) from Table 4 when synthesized from all D-amino acids and given orally renders HDL anti-inflammatory and reduces LDL-induced morocyte chemotactic activity in apoE null mice but SEQ ID NO:238, when synthesized fromm all L-amino acids and given orally, did not. Plasma from the mice described in Figure 16 was separated and HDL and LDL were isolated by FPLC. Cultures of human aortic endothelial cells received medium alone (No

Addition/Assay Controls), standard normal human LDL at 100 ugm/mL cholesterol without (LDL/Assay Controls) or together with standard control human HDL (LDL+Control HDL/Assay Controls) at 50 pgm/rnL cholesterol, or autologous mouse

LDL at 100 pgm/mL cholesterol alone (mLDL) owr with mouse HDL at 50 pgm/mL cholesterol obtained from mice that received no peeptide (mLDL+ No Pep. HDL),or SEQ

ID NO:238 made from all L-amino acids (mLDL—+L-1 HDL), or SEQ ID NO:238 made from all D-amino acids (mLDL+D-1 HDL) or SEEQ ID NO:258 made from all D-amino acids (mLDL+D-11 HDL). The cultures were incubated for 8 hrs. The supernatants were then assayed for monocyte chemotactic activity. “The values are mean +/- SD of the number of migrated monocytes in 9 high power faelds. * indicates p<0.05, ** indicates p<0.01 and *** indicates p<0. 001.

[0094] Figure 18 shows that SEQ ID NO: 258 from Table 4 synthesized from all D- amino acids (D-11), when given orally to mice, raised HDL cholesterol concentrations while giving SEQ ID NO:238 synthesized from either L- or D-amino acids (L-1or D-1, : respectively) orally did not. Plasma HDL-cholesterol concentrations from the mice that are described in Figures 16 and 17 were determin ed. No Peptide HDL, plasma HDL- cholesterol in mice that received no peptide; L-1 JHDL, plasma HDL-cholesterol in mice that received SEQ ID NO:238 synthesized from I_-amino acids; D-1 HDL, plasma HDL.

cholesterol in mice that received SEQ ID NO:238 synthesized from D-amino acids; D-11

HDL, plasma HDL-cholesterol in mice that received SEQ ID NO:258 synthesized from D- amino acids. *indicates p<0.0 01.

[0095] Figure 19 shovws that SEQ ID NO:258 from Table 4 synthesized from all D- : amino acids (D-11) when given orally to mice raised HDL paraoxonase (PON) activity while giving SEQ ID NO:23& synthesized from either L- or D- amino acids (L-1, D-1, respectively) orally did not. FParaoxonase activity in the HDL described in Figure 18 was determined. The values are activity per 500 microliters of plasma. *indicates p<0.001.

[0096] Figure 20 showvs that pravastatin and D-4F act synergistically to reduce aortic lesions as determine in en face preparations in apoE null mice. Five week old female apoE null mice were given in their drinking water either no additions (water control), pravastatin 50 pg/m 1, pravastatin 20 ng/ml or D-4F 2 ug/ml, or D-4F 5 ug/ml, or pravastatin (PRAVA.) 20 ugs/ml together with D-4F 2 pg/ml, or pravastatin (PRAVA.) 50 ug/ml together with D-4F 5 pg/ml. After 11 weeks the mice were sacrificed and lesions determined in en face aortic goreparations.

[0097] Figure 21 sho ws that pravastatin and D-4F act synergistically to reduce aortic sinus lesions in apoE null mice. Five week old female apoE null mice were given in their drinking water either no additions (water control), pravastatin 50 pg/ml, pravastatin ug/ml or D-4F 2 pg/ml, or D-4F 5 ug/ml, or pravastatin (P) 50 pg/ml together with D- 20 4F 5 pg/ml, or pravastatin (P°) 20 pg/ml together with D-4F 2 pg/ml. After 11 weeks the mice were sacrificed and aortic sinus lesions were determined.

[0098] Figure 22 shows that D-4F and SEQ ID NO:242 and SEQ ID NO:258 from

Table 4 dramatically reduce lipoprotein lipid hydroperoxides in apoE null mice. Fifty pg/gm of SEQ ID NO:242 (D-198 in the drawing) or SEQ ID NO:258 (D-203 in the drawing) or D-4F (the peptides were synthesized from all D-amino acids) were added to the chow of apoE null mice or the mice were continued on chow without additions (None).

Eighteen hours later the mice were bled, their plasma fractionated by FPLC and the lipid hydroperoxide (LOOH) coratent of their low density lipoproteins (LDL) and high density lipoproteins (HDL) were destermined. *indicates p<0.01.

[0099] Figure 23 shows the solu bility of peptides in ethyl acetate. SEQ ID NO 254: Boc-Lys(eBoc)-Glu-Arg-Ser(Bu)-<OBu; and SEQ ID NO 258: Boc-Lys(eBoc)-Arg-

Glu-Ser(tBu)-OrBu._Also shown is the solubility in ethyl acetate of SEQ ID NO: 250.

[0100] Figure 24 SEQ ID NO:258 forms 7.5 nm particles when mixed with DMPC in an aqueous environment. To Img/ml of DMPC suspension in phosphate buffered saline (PBS) was added 10% deoxycholate until the DMPC was dissolved. SEQ ID NO:258 or

SEQ ID NO:254 were added (DMPC: peptide; 1:10; wt:wt) and the reaction mixture dialyzed. After dialysis the solution remained clear with SEQ ID NO:258 but was turbid after the deoxycholate was removed by dialysis in the case of SEQ ID NO:254. The figure is an electron micrograph prepared with negative staining and at 147,420x magnification.

The arrows indicate SEQ ID NO:258 particles measuring 7.5 nm (they appear as small white particles).

[0101] Figure 25 SEQ ID NO:258 added to DMPC in an aqueous environment forms particles with a diameter of approximately 7.5 nm (large open), and stacked lipid- peptide bilayers (large striped arrow) (small arrows pointing to the white lines in the cylindrical stack of disks) with a bilayer dimension on the order of 3.4 to 4.1 nm with spacing between the bilayers (black lines between white lines in the stack of disks) of approximately 2 nm. The conditions ancl magnifications are the same as described in

Figure 24.

[0102] Figure 26 shows that the peptide of SEQ ID NO:258added to DMPC in an aqueous environment forms stacked lipi d-peptide bilayers (striped arrow) and vesicular structures of approximately 38 nm white arrows).

[0103] Figure 27 shows that DMIPC in an aqueous environment without SEQ ID

NO:258 does not form particles with a diameter of approximately 7.5 nm, or stacked lipid- peptide bilayers, nor vesicular structures of approximately 38 nm. The DMPC vesicles shown are 12.5 — 14 nm. The conditions and magnifications are the same as described in

Figure 24.

[0104] Figure 28 shows a molecular model of the peptide of SEQ ID NO:254 - compared to the peptide of SEQ ID NO :258. Red represents oxygen, blue represents nitrogen, gray represents carbon, and white represents hydrogen molecules.

[0105] Figure 29 shows a space—filling molecule model of SEQ ID NO:254 compared to SEQ ID NO:258. The arrows in this space filling molecular model identify the polar and non-polar portions of the smolecules. The color code is the same as in Figure 28.

[0106] Figure 30 illustrates peptide backbones (in the bottom panels) for the orientations given in the top panels.

[0107] Figure 31 shows molecu lar models of SEQ ID NO:254 compared to SEQ

ID NO:258 identifying the Ser(tBu)-OtBu groups. The color code is as in Figure 28.

[0108] Figure 32 shows molecular models of SEQ ID NO:254 compared to SEQ

ID NO 258 identifying various blocking groups. The color code is as in Figure 28.

[0109] Figure 33 shows that SEQ ID NO:258 (but not SEQ ID NO:254) renders apoE null HDL anti-inflammatory.

[0110] Figure 34 shows that SEQ ID NO:258 but not SEQ ID NO:254, significantly decreases aortic root atherosclerosis in apoE null mice. The aortic root (aortic sinus) lesion score was determined in the apoE null mice described in Figure 33.

The number of mice in each group is shown (n=) at the bottom of the figure and a representative section for each group is shown at the top of the figure.

[0111] Figure 35 shows that SEQ ID NO:258 but not SEQ ID NO:254 significantly decreases aortic atherosclerosis in en face preparations in apoE null mice.

The percent aortic surface containing atherosclerotic lesions was determined in en face preparations in the apoE null mice des cribed in Figure 33. The number of mice in each group is shown (n=) at the bottom of the left panel and a representative aorta for mice fed chow alone or chow supplemented with. SEQ ID NO:258 is shown in the right panel.

[0112] Figure 36 shows that SEQ ID NO:250 synthesized from all L-amino acids significantly decreases atherosclerosis . ApoE null mice (20 per group) were maintained on a chow diet (Chow) or on chow supplemented with 200 pg/gm chow of SEQ ID NO:250 (250) synthesized from all L-amino acids. After 12 weeks the mice were sacrificed and the 9% Aortic Surface Area with Lesions was determined in en face preparations. * p = 0.012

DETAILED DESCRIPTION

[0113] This invention pertains to the discovery that synthetic peptides desi gned to mimic the class A amphipathic helical motif (Segrest ez al. (1990) Proteins: Structure,

Function, and Genetics 8: 103-117) are able to associate with phospholipids and exhibit many biological properties similar to hum an apo-A-1. In particular, it was a discovery of this invention that when such peptides are- formulated using D amino acids, the peptides show dramatically elevated serum half-lives and, particularly when the amino and/or carboxy termini are blocked, can even be orally administered.

[0114] It was also a surprising discovery that these peptides can stimulate the formation and cycling of pre-beta high demsity lipoprotein-like particles. In addition, the peptides are capable of enhancing/synergt zing the effect of statins allowing statins to be administered as significantly lower dosages or to be significantly more anti-inflammatory at any given dose. It was also discovered that the peptides described herein can inhibit and/or prevent and/or treat one or more symptoms of osteoporosis. The peptides can also 1S increase pre-beta HDL; and/or increase HDL paroxynase activity.

[0115] Moreover, it was a surprising discovery of this invention that such D-form peptides retain the biological activity of the corresponding L-form peptide. In vivo animal studies using such D-form peptides showed effective oral delivery, elevated serum half- life, and the ability to mitigate or prevent/inhibit one or more symptoms of atherosclerosis.

[0116] It was also a surprising discovery that certain small peptides consisting of a minimum of two amino acids, or pairs of single amino acids, preferentially (but not necessarily) with one or more of the amino acids being the D-sterioisomer of the amino acid, and possessing hydrophobic domains to permit lipid protein interactions, and hydrophilic domains to permit a degree of water solubility also possess significant anti- inflammatory properties. Without being bound to a particular theory, it is believed that the peptides, or pairs of amino acids, described herein bind the “seeding molecules” required for the formation of pro-inflammatory oxidized phospholipids such as Ox-PAPC, POVPC,

PGPC, and PEIPC. Since many inflammatory conditions are mediated at least in part by oxidized lipids, we believe that the pepticies, or pairs of amino acids, of this invention are effective in ameliorating conditions that are known or suspected to be due to the formation of biologically active oxidized lipids. These include, but are not limited to atherosclerosis,

rheumatoid arthritis, lupus erythematous, polyarteritis nodosa, multiple sclerosis, asthma, diabetes, Alzheimer's disease, and osteoporosis. The “small peptides” typically range in length from 2 or 3 amino acids to about 15 amino acids, more preferably from about 4 amino acids to about 10 or 11 amino acids, and most preferably from about 4 to about 8 or , amino acids. The peptides are typically characterized by having hydrophobic terminal amino acids or terminal amino acids rendered hydrophobic by the attachment of one or more hydrophobic “protecting” groups. The internal structures of the peptides are described in more detail herein.

[0117] In addition, it was a surprising finding of this invention that a number of 10 physical properties predict the ability ©f the small peptides (e.g., less than 10 amino acids, perferably less than 8 amino acids, more preferably from about 2 or 3 to about 5 or 6 amino acids) , or pairs of amino acids, of this invention to render HDL more anti- inflammatory and to mitigate atherosclerosis and/or other pathologies characterized by an inflammatory response in a mammal. The physical properties include high solubility in ethyl acetate (e.g., greater than about 4mg/mL), and solubility in aqueous buffer at pH 7.0.

Upon contacting phospholipids such as 1,2-Dimyristoyl-sn-glycero-3-phosphocholine (DMPC), in an aqueous environment, the particularly effective small peptides form particles with a diameter of approximately 7.5 nm (20.1 nm), and/or form stacked bilayers with a bilayer dimension on the order of 3.4 to 4.1 nm with spacing between the bilayers in the stack of approximately 2 nm, amd/or also form vesicular structures of approximately 38 nm). In certain preferred embodiments, the small peptides, or pairs of amino acids, have a molecular weight of less than about 900 Da.

L Stimulating the formation and cvcling of pre-beta high density lipoprotein- like particles.

[0118] Reverse cholesterol transport is considered to be important in preventing the build up of lipids that predisposes to atherosclerosis (Shah et al. (2001) Circulation, 103: 3047-3050.) Many have believed the lipid of consequence is cholesterol. Our laboratory has shown that the key lipids are oxidized phospholipids that initiate the inflammatory response in atherosclerosis (Navab et al.(2001) Arterioscler Thromb Vasc

Biol., 21(4): 481-488; Van Lenten et al. (001) Trends Cardiovasc Med, 11: 155-161;

Navab M et al. (2001) Circulation, 104: 2386-2387).

[0119] This inflammatory response is also likely responsible for plaque erosion or rupture that leads to heart attack and stroke. HDL-cholesterol levels are inversely correlated with risk for heart attack and stroke (Downs et al. (1998) JAMA 279: 1615- 1622; Gordon et al. (1977) Am J Med., 62: 707-714; Castelli ez al. (1986) JAMA, 256: 2835-2838).

[0120] Pre-beta HDL is generally considered to be the most active HDL fraction in promoting reverse cholesterol transport (e.g., picking up cholesterol from peripheral tissues such as arteries and carrying it to the liver for excretion into the bile; see, Fielding and Fielding (2001) Biochim Biophys Acta, 1533(3): 175-189). However, levels of pre- beta HDL can be increased because of a failure of the pre-beta HDL to be cycled into mature alpha-migrating HDL e.g., LCAT deficiency or inhibition (O'Connor ez al. (1998)

J Lipid Res, 39: 670-678). High levels of pre-beta HDL have been reported in coronary artery disease patients (Miida et al. (1996) Clin Chem., 42: 1992-1995). }

[0121] Moreover, men have been found to have higher levels of pre-beta HDL than women but the risk of men for coronary heart disease is greater than for women (O’Connor et al. (1998) J Lipid Res., 39: 670-678). Thus, static measurements of pre-beta

HDL levels themselves are not necessarily predictive of risk for coronary artery disease.

The cycling, however, of cholesterol through pre-beta HDL into mature HDL is universally considered to be protective against atherosclerosis (Fielding and Fielding (2001) Biochim Biophys Acta, 1533(3): 175-189). Moreover, we have demonstrated that the removal of oxidized lipids from artery wall cells through this pathway protects against

LDL oxidation.

[0122] Despite relatively low absorption rates when orally administered, the peptides of this invention (e.g., D-4F) were highly active.

[0123] In studies of Apo-E null mice orally administered D-4F, we determined that 20 min after absorption from the intestine, D-4F forms small pre-beta HDL-like particles : that contain relatively high amounts of apoA-I and paraoxonase. Indeed, estimating the amount of apoA-I in these pre-beta HDL-like particles from Western blots and comparing the amount of apoA-I to the amount of D-4F in these particles (determined by radioactivity or LC-MRM) suggests that as D-4F is absorbed from the intestine, it acts as a catalyst causing the formati on of these pre-beta HDL-like particles. This small amount of intestinally derived D-4F appears to recruit amounts of apoA-I, paraoxonase, and cholesterol into these partic les that are orders of magnitude more than the amount of D—4F .

S (see, e.g., Navab et al. (2004) Circulation, 109: r120-r125).

[0124] Thus, following absorption, D-4F, and other peptides, or pairs of amino acids, of this invention, rapidly recruit relatively large amounts of apoA-I and paraoxornase to form pre-beta HDL-like particles which are very likely the most potent particles for both promoting reverse cholesterol transport and for destroying biologically active oxidized lipids. We believe that the formation of these particles and their subsequent rapid incorporation into mature HDL likely explains the dramatic reduction in atherosclerosis that we observed in LDL receptor null mice on a Western diet and in apoE-null mice om a chow diet independent of changes in plasma cholesterol or HDL-cholesterol (Id.).

[0125] Thus, in one embodiment, this invention provides methods of stimulating the formation and cycling of pre-beta high density lipoprotein-like particles by administration of one or more peptides, or pairs of amino acids, as described herein. The peptides, or pairs of amino acids, can thereby promote lipid transport and detoxification.

IL. Mitigation of a symptom of atherosclerosis.

[0126] We discovered that normal HDL inhibits three steps in the formation of mildly oxidized LDL. In those studies (see, copending application USSN 09/541,468, filed on March 31, 2000) we demonstrated that treating human LDL in vitro with apo A-T or an apo A-1 mimetic peptide (37pA) removed seeding molecules from the LDL that included HPODE and HPETE. These seeding molecules were required for cocultures of human artery wall cells to be able to oxidize LDL and for the LDL to induce the artery wall cells to produce monocyte chemotactic activity. We also demonstrated that after injection of apo A-I into mice or infusion into humans, the LDL isolated from the mice or human volunteers after injection/infusion of apo A-I was resistant to oxidation by human artery wall cells and did not induce monocyte chemotactic activity in the artery wall cell cocultures.

[01277] The protective function of certain peptides «of this invention is illustrated in the p arent applications (09/645,454, filed August 24, 2000», 09/896,841, filed June 29, 2001 , and WO 02/15923 (PCT/US01/26497), filed June 29, 2001, see, e.g., Figures 1-51in : WO 02/15923. Figure 1, panels A, B, C, and D in WO 02./15923 show the association of !C-ID-5F with blood components in an ApoE null mouse. It is also demonstrated that

HDL from mice that were fed an atherogenic diet and inje<cted with PBS failed to inhibit the oxidation of human LDL and failed to inhibit LDL-incluced monocyte chemotactic activity in human artery wall coculures. In contrast, HDL from mice fed an atherogenic diet and injected daily with peptides described herein was as effective in inhibiting human

LDL oxidation and preventing LDL-induced monocyte chemotactic activity in the cocultures as was normal human HDL (Figures 2A and 2B in WO 02/15923). In addition,

LDL. taken from mice fed the atherogenic diet and injected daily with PBS was more readily oxidized and more readily induced monocyte chermotactic activity than LDL taken from mice fed the same diet but injected with 20 pg daily of peptide SF. The D peptide did not appear to be immunogenic (Figure 4 in WO 02/15 923).

[01228] The in vitro responses of human artery walll cells to HDL and LDL from mice fed the atherogenic diet and injected with a peptide according to this invention are consistent with the protective action shown by such peptides in vivo. Despite, similar levels of total cholesterol, LDL-cholesterol, IDL+VLDL- cholesterol, and lower HDL- choKesterol as a percent of total cholesterol, the animals fed the atherogenic diet and injected with the peptide had significantly lower lesion scores (Figure 5 in WO 02/15923).

The peptides thus prevented progression of atheroscleroti ¢ lesions in mice fed an athesrogenic diet. f01229] Thus, in one embodiment, this invention perovides methods for ameliorating andJor preventing one or more symptoms of atherosclerosis and/or other conditions chawacterized by an inflammatory response. 111. Mitigation of a symptom of atheroscloerosis associated with an acute infl ammatory response.

[0130] The peptides, or pairs of amino acids, of this invention are also useful in a number of contexts. For example, we have observed that cardiovascular complications (e.g, atherosclerosis, stroke, etc.) frequently accompany or follow the onset of an acute

WQ 2005/016280 PCT/ WS2004/026288 . phase inflammatory response. Such an acute phase inflammatory response is often associated with a recu rrent inflammatory disease (e.g., leprosy, tuberculosis, systemic lupus erythematosus, and rheumatoid arthritis), a viral infection (e.g., influenza), a bacterial infection, a fungal infection, an organ transplant, a wound or othex trauma, an . implanted prosthesis, a biofilm, and the like.

[0131] It was = surprising discovery of this invention that administration of one or more of the peptides described herein, can reduce or prevent the formation of oxidized phospholipids during or following an acute phase response and thereby mitigate or eliminate cardiovascular complications associated with such a condition.

[0132] Thus, For example, we have demonstrated that a consequence of influenza infection is the diminwition in paraoxonase and platelet activating acetylhydrolase activity in the HDL. Without being bound by a particular theory, we believe that, &xs a result of the "loss of these HDL enzymatic activities and also as a result of the association of pro- oxidant proteins with HDL during the acute phase response, HDL is no lorager able to prevent LDL oxidatiosn and was no longer able to prevent the LDL-induced production of monocyte chemotactic activity by endothelial cells.

[0133] We observed that in a subject injected with very low dosages of the polypeptides of this izavention (e.g, 20 micrograms for mice) daily after in fection with the influenza A virus paraoxonase levels did not fall and the biologically activ e oxidized phospholipids were n ot generated beyond background. This indicates that D-4F (and/or other peptides of this invention) can be administered (e.g., orally or by injection) to patients with known coronary artery disease during influenza infection or other events that can generate an acutes phase inflammatory response (e.g., due to viral infection, bacterial infection, trauma, tramsplant, various autoimmune conditions, etc.) and thtas we can prevent by this short term treatment the increased incidence of heart attacks and stroke associated with pathologies that generate such inflammatory states.

[0134] Thus, in certain embodiments, this invention contemplates administering one or more of the pesptides, or pairs of amino acids, of this invention to a subject at risk for, or incurring, an acute inflammatory response and/or at risk for or incurring a symptom of atherosclerosis.

[0135] Thus, for example, a person having or at risk for coronary disease may prophylactically be administered a polypeptide, ox pair of amino acids, of this invention during flu season. A person (or animal) subject tO a recurrent inflammatory condition, ‘ e.g., rheumatoid arthritis, various autoimmune diseases, efc., can be treated with a polypeptide of this invention to mitigate or prevent the development of atherosclerosis or stroke. A person (or animal) subject to trauma, e. g., acute injury, tissue transplant, etc. can be treated with a polypeptide of this invention to mitigate the development of atherosclerosis or stroke.

[0136] In certain instances such methods will entail a diagnosis of the occurrence or risk of an acute inflammatory response. The acute inflammatory response typically involves alterations in metabolism and gene regulation in the liver. It is a dynamic homeostatic process that involves all of the major systems of the body, in addition to the immune, cardiovascular and central nervous system. Normally, the acute phase response lasts only a few days; however, in cases of chronic or recurring inflammation, an aberrant continuation of some aspects of the acute phase response may contribute to the underlying tissue damage that accompanies the disease, and mmay also lead to further complications, for example cardiovascular diseases or protein de position diseases such as amyloidosis.

[0137] An important aspect of the acute p-hase response is the radically altered biosynthetic profile of the liver. Under normal circumstances, the liver synthesizes a characteristic range of plasma proteins at steady State concentrations. Many of these proteins have important functions and higher plasma levels of these acute phase reactants (APRs) or acute phase proteins (APPs) are required during the acute phase response following an inflammatory stimulus. Although most APRs are synthesized by hepatocytes, some are produced by other cell types, including monocytes, endothelial cells, fibroblasts and adipocytes. Most APRs are induced between 50% and several-fold over normal levels. In contrast, the major APRs can increase to 1000-fold over normal levels. This group includes serum amyloid A (SAA) and either C-reactive protein (CRP) ) in humans or its homologue in mice, serum amyloid P component (SAP). So-called negative APRs are decreased in plasma concentration during the acute phase response to : 30 allow an increase in the capacity of the liver to synthesize the induced APRs.

[0138] In certain embodiments, the acute phase response, or risk therefore is evaluated by measuring one Or more APPs. Measuring such markers is well known to those of skill in the art, and commercial companies exist that provide such measurement (e.g., AGP measured by Carcdiotech Services, Louisville, KY). )

IV. _ Synergizing the actiwity of statins. :

[0139] It was also discovered that, adding a low dosage of D-4F (1 ug/ml) to the drinking water of apoE null rmice for 24 hours did not significantly improve HDL function (see, e.g., related application USSN 10/423,830). In addition, adding 0.05 mg/ml of atorvastatin or pravastatin alone to the drinking water of the apoE null mice for 24 hours did not improve HDL function. However, when D-4F 1 pg/ml was added to the drinking water together with 0.05 mg#/ml of atorvastatin or pravastatin there was a significant improvement in HDL function). Indeed the pro-inflammatory apoE null HDL became as anti-inflammatory as 350 pg/ml of normal human HDL (h, HDL see, e.g., related application USSN 10/423,830).

[0140] Thus, doses of D-4F alone, or statins alone, which by themselves had no effect on HDL function when given together acted synergistically. When D-4F and a statin were given together to apo E null mice, their pro-inflammatory HDL at 50 ng/ml of

HDL-cholesterol became as effective as normal human HDL at 350 pg/ml of HDL- cholesterol in preventing the inflammatory response induced by the action of HPODE oxidizing PAPC in cocultures of human artery wall cells. }

[0141] Thus, in certain embodiments this invention provides methods for enhancing the activity of statins. The methods generally involve administering one or more peptides, or pairs of a¥nino acids, as described herein concurrently with one or anore statins. The D-4F or other similar peptides as described herein achieve synergistic action between the statin and the Orally peptide(s) to ameliorate atherosclerosis. In this con text statins can be administered at significantly lower dosages thereby avoiding various harmful side effects (e.g., muscle wasting) associated with high dosage statin use and/or the anti-inflammatory properties of statins at any given dose are significantly enhanced.

V. Inhibiting/treating osteoporosis.7

[0142] Vascular calcification and osteoporosis often co-exist in the same subjects (Ouchi et al. (1993) Ann NY Acad Sci., 676: 29 7-307; Boukhris and Becker ("1972)

JAMA, 219: 1307-1311; Banks ef al. (1994) Eum J Clin Invest., 24: 813-817; Laroche er al. (1994) Clin Rheumatol., 13: 611-614; Broulik and Kapitola (1993) Endocr Regul., 27: 57- 60; Frye et al. (1992) Bone Mine., 19: 185-194; Barengolts et al. (1998) Calcif Tissue Int., 62: 209-213; Burnett and Vasikaran (2002) Anz Clin Biochem., 39: 203-210. Parhami et al. (1997) Arterioscl Thromb Vasc Biol., 17: 630-687, demonstrated that mildly oxidized

LDL (MM-LDL) and the biologically active lipids in MM-LDL [i.e. oxidized 1-palmitoyl- 2-arachidonoyl-sn-glycero-3-phosphorylcholines) (Ox-PAPC)], as well as the isoprostane, 8-iso prostaglandin E; but not the unoxidized pkospholipid (PAPC) or isoprostane 8-iso progstaglandin F,, induced alkaline phosphatase activity and osteoblastic differentiation of calcifying vascular cells (CVCs) in vitro, butt inhibited the differentiation of MC3T3-

El bone cells.

[0143] The osteon resembles the artery wwall in that the osteon is centered on an endothelial cell-lined lumen surrounded by a subendothelial space containing matrix and fibroblast-like cells, which is in turn surrounded by preosteoblasts and osteoblasts occupying a position analogous to smooth muscle cells in the artery wall (Id). Trabecular bone osteoblasts also interface with bone marrow subendothelial spaces (Id.). Parhami ez al. postulated that lipoproteins could cross the endothelium of bone arteries and be deposited in the subendothelial space where they could undergo oxidation as in coronary arteries (Id.). Based on their in vitro data they predicted that LDL oxidation in the subendothelial space of bone arteries and in bore marrow would lead to reduced osteoblastic differentiation and mineralization vwhich would contribute to osteoporosis (Id). Their hypothesis further predicted that LIDL levels would be positively correlated with osteoporosis as they are with coronary calcification (Pohle ez al. (2001) Circulation, 104: 1927-1932), but HDL levels would be negatively correlated with osteoporosis (Parham et al. (1997) Arterioscl Thromb Vasc &Biol., 17: 680-687).

[0144] In vitro, the osteoblastic differen tiation of the marrow stromal cell line M2- 10B4 was inhibited by MM-LDL but not native LDL (Parhami ez al. (1999) J Bone Miner

Res., 14: 2067-2078). When marrow stromal c ells from atherosclerosis susceptible

C57BL/6 (BL6) mice fed a low fat chow diet were cultured there was robust osteogeric differentiation (Id.). In contrast, when the marrow stromal cells taken from the mice after a high fat, atherogenic diet were cultured they did not undergo osteogenic differentiation (Id.). This observation is partic ularly important since it provides a possible explanation for } the decreased osteogenic potertial of marrow stromal cells in the development of osteoporosis (Nuttall and Gimble (2000) Bone, 27: 177-184). In vivo the decrease in : osteogenic potential is accomp anied by an increase in adipogenesis in osteoporotic b one (1d.).

[0145] It was found that adding D-4F to the drinking water of apoE null mice for 6 weeks dramatically increased trabecular bone mineral density and it is believed that the other peptides of this invention will act similarly..

[0146] Our data indica te that osteoporosis can be regarded as an "atherosclerosis of bone". It appears to be a result of the action of oxidized lipids. HDL destroys theese oxidized lipids and promotes Osteoblastic differentiation. Our datat indicate that administering peptide(s) of this invention to a mammal (e.g., in the drinking water o f apoE null mice) dramatically increases trabecular bone in just a matter of weeks.

[0147] This indicates that the peptides, or pairs of amino acids, described he rein are useful for mitigation one or more symptoms of osteoporosis (e.g., for inhibiting decalcification) or for inducin g recalcification of osteoporotic bone. The peptides axe also useful as prophylactics to prewent the onset of symptom(s) of osteoporosis in a manamal (e.g., a patient at risk for osteoporosis).

[0148] We believe similar mechanisms are a cause of coronary calcification, e.g., calcific aortic stenosis. Thus, in certain embodiments, this invention contemplates the use of the peptides, or pairs of amuino acids, described herein to inhibit or prevent a symptom 75 of a disease such as coronary calcification, calcific aortic stenosis, osteoporosis, and the like.

[0149] Without being bound to a particular theory, we also belive the pepti des, or pairs of amino acids, describeed herein are useful, prophylactically or therapeutically, to mitigate the onset and/or more or more symptoms of a variety of other conditions i} WO 2005/016280 PCT/US2004/026288 including, but not limited to polymyalgia rheumatic a, polyarteritis nodosa, scleroderma, lupus erythematosus, multiple sclerosis, idiopathic goulmonary fibrosis, chronic obstructive pulmonary disease (e.g., asthma), Alzheimers Disease, AIDS, and diabetes. Typically, the ‘ peptides will be useful in mitigation a symptom caused by or associated with an inflammatory response in these conditions.

VII. Peptide/amino acid pair administration.

[0150] The methods of this invention typically involve administering to an organism, preferably a mammal, more preferably a human one or more of the peptides, or pairs of amino acids, of this invention (or mimetics of such peptides, or pairs of amino acids). The peptide(s), or pairs of amino acids, can. be administered, as described herein, according to any of a number of standard methods -including, but not limited to injection, suppository, inhalation (e.g., nasal spray, oral inhal ation, etc.), time-release implant, transdermal patch, and the like. In one particularly” preferred embodiment, the peptide(s) are administered orally (e.g., as a syrup, capsule, powder, gelcap, or tablet).

[0151] The methods can involve the administration of a single peptide or pair of amino acids of this invention or the administration of two or more different peptides or or pairs of amino acids. The peptides, or pairs of amino acids, can be provided as monomers or in dimeric, oligomeric or polymeric forms. In certain embodiments, the multimeric forms may comprise associated monomers (e.g., iosnically or hydrophobically linked) while certain other multimeric forms comprise cov-alently linked monomers (directly linked or through a linker).

[0152] While the invention is described wi th respect to use in humans, it is also suitable for animal, e.g., veterinary use. Thus preferred organisms include, but are not limited to humans, non-human primates, canines, equines, felines, porcines, ungulates, largomorphs, and the like.

[0153] The methods of this invention are raot limited to humans or non-human ¢ animals showing one or more symptom(s) of ather-osclerosis (e.g., hypertension, plaque formation and rupture, reduction in clinical events: such as heart attack, angina, or stroke, high levels of plasma cholesterol, high levels of low density lipoprotein, high levels of very low density lipoprotein, or inflammatory proteins such as CRP, erc.), but are useful in a prophylactic context. Thus, the peptides of this invention, or pairs of amino acids, (or mimetics thereof) can be administered to organisms to prevent the onset/development of one or more symptoms of atherosclerosis and/or one of the other indications described herein. Particularly preferre-d subjects in this context are subjects showing one or more . risk factors for atherosclerosis (e.g., family history, hypertension, obesity, high alcohol consumption, smoking, hig blood cholesterol, high blood triglycerides, elevated blood .

LDL, VLDL, IDL, or low HLDL, diabetes, or a family history of diabetes, high blood lipids, heart attack, angina o I stroke, etc.) and/or one of the other conditions described herein.

[0154] In certain em bodiments, the peptides, or pairs of amino acids, of this invention can also be administered to stimulate the formation and cycling of pre-beta high density lipoprotein-like particles and/or to promote reverse lipid transport and detoxification.

[0155] The peptides , or pairs of amino acids, are also useful for administration im conjunction with statins where they enhance (e.g., synergize) the activity of the statin at typically administered dosages and/or permit the statin(s) to be administered at lower dosages.

[0156] In addition, the peptides, or pairs of amino acids, can be administered to reduce or eliminate one or rmore symptoms of osteoporosis and/or diabetes, and/or any of the other conditions describ ed herein, and/or to prevent/inhibit the onset of one or more symptoms of osteoporosis.and/or any of the other indications described herein.

VIII. Certain preferred peptides and their preparation.

A) Class A amphipathic helical peptides.

[0157] Tt was a discovery of this invention that peptides comprising a class A amphipathic helix ("class A. peptides”), are capable of mitigating one or more symptoms of atherosclerosis. Class A peptides are characterized by formation of an o-helix that produces a segregation of polar and non-polar residues thereby forming a polar and a nonpolar face with the posi tively charged residues residing at the polar-nonpolar interface and the negatively charged residues residing at the center of the polar face (see, e.g.,

Anantharamaiah (1986) Meth. Enzymol, 128: 626-668). It is noted that the fourth exon of apo A-1, when folded into 3.667 residues/turr produces a class A amphipathic helical structure.

[0158] One particularly preferred class A peptide, designated 18A (see, e.g.,

Anantharamaiah (1986) Meth. Enzymol, 128: 626-668) was modified as described herein to produce peptides orally administratable an d highly effective at inhibiting or preventing one or more symptoms of atherosclerosis. Without being bound by a particular theory, it is believed that the peptides of this invention may act in vivo may by picking up seeding molecule(s) that mitigate oxidation of LDL.

[0159] We determined that increasing the number of Phe residues on the hydrophobic face of 18A would theoretically increase lipid affinity as determined by the computation described by Palgunachari et ad. (1996) Arteriosclerosis, Thrombosis, &

Vascular Biology 16: 328-338. Theoretically, a systematic substitution of residues in the nonpolar face of 18A with Phe could yield six peptides. Peptides with an additional 2, 3 and 4 Phe would have theoretical lipid affini ty (A) values of 13, 14 and 15 units, respectively. However, the A values jumped. four units if the additional Phe were increased from 4 to 5 (to 19 A units). Increasing to 6 or 7 Phe would produce a less dramatic increase (to 20 and 21 A units, respectively). Therefore, we chose 5 additional Phe (and hence the peptides designation as 5F). In ome particularly preferred embodiment, the SF peptide was blocked in that the amino termimal residue was acetylated and the carboxyl terminal residue was amidated.

[0160] The new class A peptide anallog, SF, inhibited lesion development in atherosclerosis-susceptible mice. The new peptide analog, SF, was compared with mouse apo A-I MoA-I) for efficacy in inhibiting d iet-induced atherosclerosis in these mice using peptide dosages based on the study by Levine et al. (Levine et al. (1993) Proc. Natl.

Acad. Sci. USA 90:12040-12044).

[0161] A number of other class A peptides were also produced and showed varying, but significant degrees of efficacy 3n mitigating one or more symptoms of atherosclerosis. A number of such peptides are illustrated in Table 1.

[0162] Table 1. Illustrative mimetics of the amphipathic helix of Apo A-I for use in this invention.

Peptide Amino Acid Sequence SEQ ID

Name NO. . 18A D-W-L-K-A-EF-Y-D-K-V-A-E-K-L-K-E-A-F 4 2F Ac-D-W-L-K-A-EF -Y-D-K-V-A-E-K-L-K-E-A-F-NH; 5 . 3F Ac-D-W-F-K-A-E'-Y-D-K-V-A-E-K-L-K-E-A-F-NH, 6 3F14 Ac-D-W-L-K-A-E-Y-D-K-V-A-E-K-F-K-E-A-F-NH 7 4F Ac-D-W-F-K-A-E-Y-D-K-V-A-E-K-F-K-E-A-F-NH; 8 5F Ac-D-W-L-K-A-E-Y-D-K-V-F~E-K-F-K-E-F-F~NH; 9 6F Ac-D-W-L-K-A-E-Y-D-K-F-F-E-K-F-K-E-F-F-NH; 10

TF AC-D-W-F-K-A-E-Y-D-K-F-F-E-K-F-K-E-F-F-NH; 11

Ac-D-W-L-K-A-E'-Y-D-K-V-A-E-K-L-K-E-F-F-NH; 12

Ac—D-W-L-K-A-E~Y-D-K-V-F-E-K-F-K-E-A-F-NH; 13

AC-D-W-L-K-A-E-Y-D-K-V-F-E-K-L-K-E-F-F-NH; 14

Ac-D-W-L-K-A-F-Y-D-K-V-A-E-K-F-K-E-F-F-NH; 15

Ac-D-W-L-K-A-F-Y-D-K-V-F-E-K-F-K-E-F-F-NH; i6

AC-E-W-L-K-L-¥-Y-E-K-V-L-E-K-F-K-E-A-F-NH; 17

AC-E-W-L-K-A-F-Y-D-K-V-A-E-K-F-K-E-A-F-NH; 18

AC-E-W-L-K-A-F-Y-D-K-V-A-E-K-L-K-E-F-F-NH; 19

AC-E-W-L-K-A-F-Y-D-K-V-F-E-K-F-K-E-A-F-NH; 20

AC-E-W-L-K-A- F-Y-D-K-V-F-E-K-L-K-E-F-F-NH; 21

Ac-E-W-L-K-A-F-Y-D-K-V-A-E-K-F-K-E-F-F-NH; 22

AC-E-W-L-K-A-F-Y-D-K-V-F-E-K-F-K-E-F-F-NH; 23

AC-A- F-Y~D-K-V-A-E-K-L~K-E-A-F-NH; 24

Ac-A- F-Y-D-K-V-A-E-K-F-K-E-A-F-NH 25

Ac-A- F-Y-D-K~V-A-E-K-F-K-E-A-F-NH; 26

Ac-A- F-Y-D-K-F-F-E-K-F-K-E-F-F-NH; 27

AC-A- F-Y-D-K-F-F-E-K-F-K-E-F-F-NH; 28

Ac-A- F-Y-D-K-V-A-E-K-F-K-E-A-F-NH; 29

Ac-A- F-Y-D-K-V-A-E-K-L-K-E-F-F-NH; 30

Ac~A— F-Y-D-K-V-F-E-K-F-K-E-A-F-NH; 31

Ac—A— F-Y-D-K-V-F-E-K~L-K-E-F-F-NH; 32

Ac-A— F-Y-D-K-V-A-E-K-F-K-E-F-F-NH; 33

Ac-K—A-F-Y-D-K-V-F-E-K-F-K-E-F-NH 34

Ac-L—F-Y-E-K-V-L-E-K-F-K-E-A-F-NHz 35

Ac-A—F-Y-D-K-V-A-E-K-F-K-E-A-F-NH; 36

AC-A—F-Y-D-K-V-A-E-K-L-K-E-F-F-NH 37

AC-A—F-Y-D-K-V-F-E-K-F-K-E-A-F-NH> 38

AC-A-F-Y-D-K-V-F~E-K-L-K-E-F-F-NH; 39

Ac-A-F-Y-D-K-V-A-E-K-F-K-E-F-F-NH; 40

AC-A-F-Y-D-K-V-F-E-K-F-K-E-F-F-NH; 41 } AC~D-W-L-K-A-L-Y-1-K-V-A-E-K-L-K-E-A-L-NH; 42

AC-D-W-F-K-A-F-Y-E-K-V-A-E-K-L-K-E-F-F-NH; 43

AC-D-W-F-K-A-F-Y-E-K-F-F-E-K-F-K-E-F-F-NH; 44

AC-E-W-L-K-A-L-Y-E-K-V-A-E-K-L-K-E-A-L-NH; 45

AC-E-W-L-K-A-F-Y-E-K-V-A-E-K-L-K-E-A-F-NH; 46

AcC-E-W-F-K-A-F-Y~ E-K-V-A-E-K-L-K-E-F-F-NH; 47

AC-E-W-L-K-A-F-Y~ E-K-V-F-E-K-F-K-E-F-F-NH» 48

AC-E-W-L-K-A-F-Y~ E-K-F-F-E-K-F-K-E-F-F-NH; 49

Ac-E-W-F-K-A-F-Y- E-K-F-F-E-K-F-K-E-F-F-NH 50

Ac-D-F-L-K-A-W-Y~ D-K-V-A-E-K-L-K-E-A-W-NH; 51

AC-E-F-L-K-A-W-Y~ E-K-V-A-E-K-L~K-E-A-W-NH; 52

Ac-D-F-W-K-A-W-Y- D-K-V-A-E-K-L~-K-E-W-W-NH; 53

AC-E-F-W-K-A-W-Y- E-K-V-A-E-K-L-K-E-W-W-NH; 54

Ac-D-K-L-K-A-F-Y- D-K-V-F-E-W-A-K-E-A-F-NH; 55

Ac-D-K-W-K-A-V-Y— D-K-F-A-E-A-F-K-E-F-L-NH; 56

Ac-E-K-L-K-A-F-Y— E-K-V-F-E-W-A-K-E-A-F-NH» 57

Ac-E-K-W-K-A-V-Y—E-K-F-A-E-A-F-K-E-F-L-NH; 58

AC-D-W-L-K-A-F-V—D-K-F-A-E-K-F-K-E-A-Y-NH; 59

AC-E-K-W-K-A-V-Y—E-K-F-A-E-A-F-K-E-F-L-NH; 60

Ac-D-W-L-K-A-F-V—Y-D-K-V-F-K-L-K-E-F-F-NH; 61

AC-E-W-L-K-A-F-V—Y-E-K-V-F-K-L-K-E-F-F-NH; 62

Ac-D-W-L-R-A-F-Y—D-K-V-A-E-K-L-K-E-A-F-NH; 63

AC-E-W-L-R-A-F-Y—E-K-V-A-E-K-L-K-E-A-F-NH; 64

Ac-D-W-L-K-A-F-Y—D-R-V-A-E-K-L-K-E-A-F-NH, 65

Ac-E-W-L-K-A-F-Y—E-R-V-A-E-K-L-K-E-A-F-NH; 66

AcC-D-W-L-K-A-F-Y—D-K-V-A-E-R-L-K-E-A-F-NH 67

Ac-E-W-L-K-A-F-Y—E-K-V-A-E-R-L-K-E-A-F-NH; 68

AC-D-W-L-K-A-F-Y—D-K-V-A-E-K-L-R-E-A-F-NH; 69

AC-E-W-L-K-A-F-Y—E-K-V-A-E-K-L-R-E-A-F-NH; 70

Ac-D-W-L-K-A-F-Y—D-R-V-A-E-R-L-K-E-A-F-NH; 71

AC-E-W-L-K-A-F-Y—~E-R-V-A-E-R-L-K-E-A-F-NH; 72

Ac-D-W-L-R-A-F-Y—D-K-V-A-E-K-L-R-E-A-F-NH, 73

AC-E-W-L-R-A-F-Y—E-K-V-A-E-K-L-R-E-A-F-NH; 74

AC-D-W-L-R-A-F-Y—D-R-V-A-E-K-L-K-E-A-F-NH; 75

AC~E-W-L-R-A-F-Y—E~R-V~-A-E-K-L-K-E-A-F-NH; 76

Ac-D-W-L-K-A-F-Y—D-K-V-A-E-R-L-R-E-A-F-NH; 77

Ac-E-W-L-K-A-F-Y~ E-K-V-A-E-R-L-R-E-A~F-NH> 78

Ac-D-W-L-R-A-F-Y~ D-K-V-A-E-R-L-K-E-A-F-NH; 79

Ac-E-W-L-R-A-F-Y~ E-K-V-A-E-R-L-K-E-A-F-NH2 80

D-W-L-K-A-F-Y-D-K-V-A-E-K-L-K-E-A-F-P-D-W- 81

L-K~-A-F-Y-D-K-V-A-E-K-L-K-E-A-F }

D-W-L-K-A-F-Y-D-K-V-A-E-K-L-K-E-F-F-P-D-W- 82

L-K-A-F-Y-D-K-V-M-E-K-L-K-E-F-F

D-W-F-K-A-F-Y-D-K-V-A-E-K-L-K-E-A-F-P=D-W- 83

F-K-A-F-Y-D-K-V-A-E-K-L-K~E-A-F

D-K-L-K-A-F-Y-D-K-V-F-E-W-A-K-E-A-F-P-D-K- 84

L-K-A-F-Y-D-K-V-F -E-W-L-K-E-A-F

D-K-W-K-A-V-Y-D-K-F-A-E-A-F-K-E-F-L-P-D-K- 85

W-K-A-V-Y-D-K-F-A-E-A-F-K-E-F-L

D-W-F-K-A-F-Y-D-K-V-A-E-K-F-K-E-A-F-P-D-W- 86

F-K-A-F-Y-D-K-V-A-E-K-F-K-E-A-F

D-W-L-K-A-F-V-Y-D-K-V-F-K-L-K-E-F-F-P-D-W- 87

L-K-A-F-V-Y-D-K-WU-F-K-L-K-E-F-F

D-W-L-K-A-F-Y-D-K-F-A-E-K-F-K-E-F-F-P-D-W- 88

L-K-A-F-Y-D-K-F-A-E-K-F-K-E-F-F

AC-E-W-F-K-A-F- —E-K-V-A-E-K-F-K-E-A-F-NH; 89

Ac-D-W-F-K-A-F-Y—D-K-V-A-E-K-F-NH; 90

Ac-F-K-A-F-Y-D-K—V-A-E-K-F-K-E-NH> 91

Ac-F-K-A-F-Y-E-K—V-A-E-K-F-K-E-NH; 92

NMA-F-K-A-F-Y-D-K-V-A-E-K-F-K-E-NH> 93

NMA-F-K-A-F-Y-E-K-V-A-E-K-F-K-E-NH> 94

NMA-D-W-F-K-A-F-Y¥-D-K-V-A-E-K-F-K-E-A-F-NH; 95

NMA-E-W-F~K-A-F-¥-E-K-V-A-E-K-F-K-E-A-F-NH> 96

NMA-A-F-Y-D-K-V-A-E-K-F~-K-E-A-F-NHa 97

NMA-D-W-F-K-A-F-Y-D-K-V-A-E-K-F-NHy 98

Ac-D-W-L-K-A-F-Y—D-K-V-F-E-K-F-K-E-F-F-NH; 99

NMA-D-W-L-K-A-F-¥-D-K-V-F-E-K-F-K-E-F-F-NH;

Ac-E-W-L-K-A-F-Y-E-K-V-F-E-K-F-K-E-F-F-NH; 100

NMA-E-W-L~K-A~F-Y-E-K-V-F-E-K-F-K-E-F-F-NH;

Ac-A-F-Y-D-K-V- F-E-K-F-K-E-F-F-NH; 101

NMA-A-F-Y-D-K-V- F-E-K-F-K-E-F-F-NH;

Ac-A-F-Y-E-K-V- F-E-K-F-K-E-F-F-NH; 102

NMA-A-F-Y-E-K-V- F-E-K-F-K-E-F-F-NH;

AC-D-W-L-K-A~F- Y-D-K-V-F-E-K-F-NH; 103

NMA-D-W-L-K-A-F- ¥Y-D-K-V-F-E-K-F-NH;

Ac-E-W-L-K-A-F-Y ~E-K-V-F-E-K-F-NH; 104

NMA-E-W-L-K-A-F- Y-E-K-V-F-E-K-F-NH;

Ac-L-K-A-F-Y—D-K-V-F-E-K-F-K-E-NH; 105

NMA -I,-K-A-F—Y-D-K-V-F-E-K-F-K-E-NH;

Ac-L-K-A-F-Y—E-K-V-F-E-K-F-K-E-NH, 106 . : NMA-L-K-A-F-¥-B-K-V-F-E-K-F-R-E-NH, "Linkers are underlined.

NMA is N-Methyl Anthranilyl.

[0163] In certain preferre d embodiments, the peptides include variations of 4F (SEQ ID NO:8 in Table 1) or D-<{F where one or both aspartic acids (D) are replaced by glutamic acid (E). Also contempelated are peptides (e.g., 4F or D-4F) where 1,2,3,or 4 amino acids are deleted from the carboxyl terminus and/or 1, 2, 3, or 4 amino acids are deleted from the carboxyl terminus and/or one or both aspartic acids (D) are replaced bry glutamic acid (E). In any of the gpeptides described herein, the N-terminus can be blocked and labeled using a mantyl moiety (e.g., N-methylanthranilyl).

[0164] While various peptides of Table 1, are illustrated with an acetyl group o-ran

N-methylanthranilyl group protecting the amino terminus and an amide group protecting the carboxyl terminus, any of thesse protecting groups may be eliminated and/or substituted with another protecting group as described herein. In particularly preferred embodiments, the peptides comprise one or moze D-form amino acids as described herein. In certain embodiments, every amino acid (e.g., every enantiomeric amino acid) of the peptides Of

Table 1 is a D-form amino acid.

[0165] It is also noted that Table Table 1 is not fully inclusive. Using the teaching provided herein, other suitable class A amphipathic helical peptides can routinely be produced (e.g., by conservative Or semmi-conservative substitutions (e.g., D replaced by E), extensions, deletions, and the likze). Thus, for example, one embodiment utilizes truncations of any one or more o»f peptides shown hwerein (e.g., peptides identified by

SEQ ID Nos:5-23 and 42- in Table 1). Thus, for example, SEQ ID NO:24 illustrates a peptide comprising 14 amino acids from the C-terminus of 18 A comprising one or mosre D ’ 25 amino acids, while SEQ ID NOS:25-41 illustrate other truncations.

[0166] Longer peptides are also suitable. Such longer peptides may entirely form a class A amphipathic helix, or the class A amphipathic helix (helices) can form one ox more domains of the peptide. Irm addition, this invention contemplates multimeric versions of the peptides. Thus, for example, the peptides illustrated heren can be coupled together (directly or through a linker (e.g., a carbon linker, or one or more amino acids) with one or more intervening amino acids). Illustrative polymeric peptides include 18A-Pro-18A and the peptides of SEQ ID NOs:81-88, in certain embodiments comprising one or more D . amino acids, more preferably with every amimo acid a D amino acid as described herein and/or having one or both termini protected. :

B) Other class A amphipathic helical peptide mimetics of apoA-I having

Aromatic or aliphatic residues in the non-polar face.

[0167] In certain embodiments, this imvention also provides modified class A amphiphathic helix peptides. Certain preferred peptides incorporate one or more aromatic residues at the center of the nonpolar face, e.g, 3F", (as present in 4F), or with one or more aliphatic residues at the center of the nonpolar face, e.g., 3F™. Without being bound to a particular theory, we believe the central aromatic residues on the nonpolar face of the : peptide 3S" due to the presence of 7 electroms at the center of the nonpolar face, allow water molecules to penetrate near the hydrophobic lipid alkyl chains of the peptide-lipid complex, which in turn would enable the entry of reactive oxygen species (such as lipid hydroperoxides) shielding them from the cell surface. Similarly, we also believe the peptides with aliphatic residues at the center of the nonpolar face, e.g., 3F™, will act similarly but not quite as effectively as 3°",

[0168] Preferred peptides will convert pro-inflammatory HDL to anti- inflammatory HDL or make anti-inflammatoxy HDL more anti-inflammatory, and/or decrease LDL-induced monocyte chemotacti ¢ activity generated by artery wall cells equal to or greater than D4F or other peptides shovwn in Table 1. Peptides showing this activity are useful in ameliorating atherosclerosis and other inflammatory conditions such as rheumatoid arthritis, lupus erythematous, pollyarteritis nodosa, osteoporosis, Alzheimer’s disease, congestive heart failure, endothelial dysfunction, and viral illnesses such as influenza A and diseases such as multiple sclerosis.

[0169] Table 2. Examples of certain preferred peptides.

Nemes Segweme ________ SEQDNO

TGF AcDKWKAVYDKFABAFKEELNH, 107 ! (3F™ Ac-DKLKAFYDKVFEWAKEAF-NH, 108

EC — . C) Smaller peptides.

[0170] It was also a surprising discovery that certain small peptides consisting of a minimum of three amino acids preferential ly (but not necessarily) with one or more of the amino acids being the D-sterioisomer of the amino acid, and possessing hydrophobic domains to permit lipid protein interactions, and hydrophilic domains to permit a degree of water solubility also possess significant anti-inflammatory properties. Without being bound to a particular theory, it is believed that the peptides bind the “seeding molecules” required for the formation of pro-inflammatory oxidized phospholipids such as Ox-PAPC,

POVPC, PGPC, and PEIPC. Since many inflammatory conditions are mediated at least in part by oxidized lipids, we believe that the peptides of this invention are effective in ameliorating conditions that are known or suspected to be due to the formation of biologically active oxidized lipids. These include, but are not limited to atherosclerosis, rheumatoid arthritis, lupus erythematous, polyarteritis nodosa, pulmonary disease, asthma, multiple sclerosis, Alzheimer's disease, diabetes, and osteoporosis. The “small peptides” typically range in length from 3 amino acids to about 15 amino acids, more preferably from about 4 amino acids to about 10 or 1 1 amino acids, and most preferably from about 4 to about 8 or 10 amino acids. The peptides are typically characterized by having hydrophobic terminal amino acids or term inal amino acids rendered hydrophobic by the attachment of one or more hydrophobic “protecting” groups.

[0171] In certain embodiments, th peptides can be characterized by Formula I, below:

XXX XA I where, nis 0 or 1, X! is a hydrophobic amino acid and/or bears a hydrophobic protecting group, X* is a hydrophobic amino acid and/or bears a hydrophobic protecting group; and ‘ 25 whennisO X? is an acidic or a basic amimo acid; when nis 1: X? and X° are independently an acidic amino acid, a basic amino acid, an aliphatic amino acid, or an aromatic amino acid such that when X” is an acidic amino acid; X is a basic amino acid, an aliphatic amino acid, or an aromatic arnino acid; when X? is a basic amino acid; X° is an acidic amino acid, an aliphatic amino acid, or an aromatic amino acid; and when X? is an aliphatic or aromatic amino acid, X° is an acidic amino acid, or a basic amino acid.

[0172] Longer peptides (e.g., up to 10, 11, or 15 amino acids)are also contemplated within the scope of thi s invention. Typcially where the shorter peptides : (e.g. peptides according to formula T) are characterized by an acidic, basic, aliphatic, or aromatic amino acid, the longer peptides are characterized by acidic, basic, aliphatic, or ) aromatic domains comprising two ox" more amino acids of that type. 1) Functional pwroperties of active small peptides.

[0173] It was a surprising firading of this invention that a number of physical properties predict the ability of smal 1 peptides (e.g., less than 10 amino acids, preferably less than 8 amino acids, more prefer ably from about 3 to about 5 or 6 amino acids) of this invention to render HDL more anti-i nflammatory and to mitigate atherosclerosis and/or other pathologies characterized by am inflammatory response in a mammal. The physical properties include high solubility in ethyl acetate (e.g., greater than about 4 mg/mL), and solubility in aqueous buffer at pH 7. 0. Upon contacting phospholipids such as 1,2-

Dimyristoyl-sn-glycero-3-phosphocholine (DMPC), in an aqueous environment, the particularly effective small peptides induce or participate in the formation of particles with a diameter of approximately 7.5 nm (% 0.1 nm), and/or induce or participate in the formation of stacked bilayers with a_ bilayer dimension on the order of 3.4 to 4.1 nm with spacing between the bilayers in the stack of approximately 2 nm, and/or also induce or . participate in the formation of vesicular structures of approximately 38 nm). In certain preferred embodiments, the small peptides have a molecular weight of less than about 900 ~ Da.

[0174] Thus, in certain embodimements, this invention contemplates small peptides that ameliorate one or more symptoms of an inflammatory condition, where said peptide(s): ranges in length from about 3 to about 8 amino acids, preferably from about 3 to about 6, or 7 amino acids, and more preferably from about 3 to about 5 amino acids; are soluble in ethyl acetate at a concentration greater than about 4mg/mL,; are soluble in aqueous buffer at pH 7.0; when contacted with a phospholipid in an aqueous environment, form particles with a diameter of approximately 7.5 nm and/or form stacked bilayers with a bilayer dimension on the order of 3.4 to 4.1 nm with spacing between the bilayers in the stack of approximately 2 nm; have a molecular weight less than about 900 daltoras; convert pro-inflammatory HDL to anti-inflammatory HDL or make anti-inflammatory H DL more anti-inflammatory; and do not have the amino acid sequence Lys-Arg-Asp-Ser (SEQ ID } NO:238) in which Lys-Arg-A_sp and Ser are all L amino acids. In certain embodiments, these small peptides protect a phospholipid against oxidation by an oxidizing agent.

[0175]. While these small peptides need not be so limited, in certain embodiments, these small peptides can include the small peptides described below. 2) Tripepetides.

[0176] It was discovered that certain tripeptides (3 amino acid peptides) <an be synthesized that show desirabsle properties as described herein (e.g, the ability tO convert pro-inflammatory HDL to anti-inflammatory HDL, the ability to decrease LDL-dnduced monocyte chemotactic activity generated by artery wall cells, the ability to incre-ase pre- beta HDL, etc.). In certain ernbodiments, the peptides are characterized by formula, wherein N is zero, shown below as Formula II: xxx II where the end amino acids (3X' and X*) are hydrophobic either because of a hydmophobic side chain or because the sides chain or the C and/or N terminus is blocked with «one or more hydrophobic protecting: group(s) (e.g., the N-terminus is blocked with Boc-, Fmoc-,

Nicotinyl-, etc., and the C-terminus blocked with (1Bu)-OrBu, erc.). In certain embodiments, the X*> amino acid is either acidic (e.g., aspartic acid, glutamic acid, etc.) or basic (e.g., histidine, arginine, lysine, efc.). The peptide can be all L- amino aci ds or include one or more or all D—amino acids.

[0177] Certain preferred tripeptides of this invention include, but are no t limited to the peptides shown in Table 3.

[0178] Table 3. Exammples of certain preferred tripeptides bearing hydrophobic blocking groups and acidic, basic, or histidine central amino acids. —_—r = 3 X¥ QS rO

X X X X SEQ

ID NO

Boc-Lys(eBoc) Arg Sex (tBu)-OrBu 109

Boc-Lys(eBoc) Arg Ther(rBu)-OrBu 110 .

Boc-Trp Arg [le-OtBu 111

Boc-Trp Arg Leu-OfBu 112

Boc-Phe Asg lle ~O1Bu 113 -

Boc-Phe Arg Leu-OrBu 114

Boc-Lys(eBoc) Glu Ser(rBu)-OrBu 115 }

Boc-Lys(eBoc) Glu Thr(Bu)-OrBu 116

Boc-Lys(eBoc) Asp Seer(rBu)-OrBu 117

Boc-Lys(eBoc) Asp Thar(zBu)-OrBu 118

Boc-Lys(eBoc) Arg Seer(1Bu)-OrBu 119

Boc-Lys(eBoc) Arg Thr(tBu)-OrBu 120

Boc-Leu Glu Ser(zBu)-OrBu 121

Boc-Leu Glu Thhr(tBu)-OBu 122

Fmoc-Trp Arg Sesr(zBu)-O7Bu 123

Fmoc-Trp Asp Sesr(Bu)-OrBu 124

Fmoc-Trp Glu Ser(rBu)-OrBu 125

Fmoc-Trp Arg Ser(zBu)-OrBu 126

Boc-Lys(eBoc) Glu Leu-01Bu 127

Fmoc-Leu Arg Ser(tBu)-OrBu 128

Fmoc-Leu Asp Ser(tBu)-OBu 129

Fmoc-Leu Glu Ser(:Bu)-0OBu 130

Fmoc-Leu Arg Ser(tBu)-OrBu 131

Fmoc-Leu Arg Thr(tBu)-OrBu 132

Boc-Glu Asp Tyr(rBu)-OtBu 133

Fmoc-Lys(eFmoc) Arg Ser(tBu)-OrBu 134

Fmoc-Trp Arg lle-O1Bu 135

Fmoc-Trp Arg Leu-OrBu 136

Fmoc-Phe Arg lle-OtBu 137

Fmoc-Phe Arg Leu-OrBu 138

Boc-Trp Arg Phe-OrBu 139

Boc-Trp Arg Tyr-OBu 140

Fmoc-Trp Arg Phe-OBu 141

Fmoc-Trp Arg T yr-OrBu 142

Boc-Om(dBoc) Arg Ser(zBu)-OrBu 143

Nicotinyl Lys(eBoc) Arg Ser(tBu)-OtBu 144

Nicotinyl Lys(eBoc) Arg T hr(zBu)-OzBu 145

Fmoc-Leu Asp T hr(zBu)-OtBu 146

Fmoc-Leu Glu T hr(zBu)-OtBu 147

Fmoc-Leu Arg T hr(:Bu)-OtBu 148

Fmoc-norLeu Arg S er(#Bu)-OtBu 149

Fmoc-norLeu Asp Ser(rBu)-OtBu 150

Fmoc-norLeu Glu Ser(rBu)-OtBu 151

Fmoc-Lys(eBoc) Arg Ser(#Bu)-OtBu 152

Fmoc-Lys(eBoc) Arg Thr(zBu)-OtBu 153 ’ Fmoc-Lys(eBoc) Glu Ser(rBu)-OtBu 154

Fmoc-Lys(eBoc) Glu Thr(:Bu)-OtBu 155 : Fmoc-Lys(eBoc) Asp Ser(/Bu)-OtBu 156

Fmoc-Lys(eBoc) Asp Thr(Bu)-OtBu 157

Fmoc-Lys(eBoc) Glu Leu-OtBu 158

Fmoc-Lys(eBoc) Arg Leu-OtBu 159

Fmoc-Lys(eFmoc) Arg Thr(zBu)-OtBu 160

Fmoc- Lys(eFmoc) Glu Ser(Bu)-OtBu 161

Fmoc- Lys(eFmoc) Glu Thr(rBu)-OtBu 162

Fmoc- Lys(e¢Fmoc) Asp Ser(fBu)-OtBu 163

Fmoc- Lys(eFmoc) Asp Thr(tBu)-OtBu 164

Fmoc- Lys(eFmoc) Arg Ser(zBu)-OtBu 165

Fmoc- Lys(eFmoc)) Glu Leu-OtBu 166

Boc-Lys(eFmoc) Asp Ser(zBu)-OtBu 167

Boc-Lys(eFmoc) Asp Thr(tBu)-OtBu 168

Boc-Lys(eFmoc) Arg Thr(rBu)-OtBu 169

Boc-Lys(¢Fmoc) Glu Leu-OtBu 170

Boc-Om(dFmoc) Glu Ser(:Bu)-OtBu 171

Boc-Om(6Fmoc) Asp Ser(rBu)-OtBu 172

Boc-Om(0Fmoc) Asp Thr(zBu)-OtBu 173

Boc-Orn(6Fmoc) Arg Thr(rBu)-OtBu 174

Boc-Orn(8Fmoc) Glu Thr(zBu)-OtBu 175

Fmoc-Trp Asp Ile-OtBu 176

Fmoc-Trp Arg Ile-OtBu 177

Fmoc-Trp Glu Ile-OtBu 178

Fmoc-Trp Asp Leu-OtBu 179

Fmoc-Trp Glu Leu-OtBu 180

Fmoc-Phe Asp Ile-OtBu 181

Fmoc-Phe Asp Leu-OtBu 182

Fmoc-Phe Glu Leu-OtBu 183

Fmoc-Trp Arg Phe-OtBu 184

Fmoc-Trp Glu Phe-OtBu 185

Fmoc-Trp Asp Phe-OtBu 186

Fmoc-Trp Asp Tyr-OtBu 187

Fmoc-Trp Arg Tyr-OtBu 188

Fmoc-Trp Glu Tyr-OtBu 189

Fmoc-Trp Arg Thr(zBu)-OtBu 190

Fmoc-Trp Asp Thr(fBu)-OtBu 191

Fmoc-Trp Glu Thr(fBu)-OtBu 192

Boc-Phe Arg norLewu-OtBu 193

Boc-Phe Glu norLeu-OtBu 194

Fmoc-Phe Asp norLeu-OtBu 195 .

Boc-Glu His Tyr(fBu)-OrBu 196

Boc-Leu His Ser(fBBu)-OrBu 197

Boc-Leu His Thr(fBu)-OtBu 198

Boc-Lys(eBoc) His Ser(1Bu)-OtBu 199

Boc-Lys(eBoc) His Thr(/Bu)-OtBu 200 " Boc-Lys(eBoc) His Leu-O1Bu 201

Boc-Lys(eFmoc) His Ser(fBu)-OtBu 202

Boc-Lys(eFmoc) His Thr(/Bu)-OtBu 203

Boc-Lys(eFmoc) His Leu-O1tBu 204

Boc-Om(dBoc) His Ser(rBu)-OrBu 205

Boc-Om(0Fmoc) His Thr(zBu)-OtBu 206

Boc-Phe His Ile —~O1rBu 207

Boc-Phe His Leu-O:fBu 208

Boc-Phe His norLeu-OtBu 209

Boc-Phe Lys Leu-OrBu 210

Boc-Trp His Ile-OvtBu 211

Boc-Trp His Leu-OrBu 212

Boc-Trp His Phe-OrBu 213

Boc-Trp His Tyr-OtBu 214

Boc-Phe Lys Leu- OrBu 215

Fmoc- Lys(¢Fmoc) His Ser(zBu)-OtBu 216

Fmoc- Lys(¢Fmoc) His Thr(zBu)-OtBu 217

Fmoc- Lys(eFmoc)) His Leu-OrBu 218

Fmoc-Leu His Ser(zZBu)-OtBu 219

Fmoc-Leu His Thr(zBu)-OtBu 220

Fmoc-Lys(eBoc) His © Ser(zBu)-OtBu 221

Fmoc-Lys(eBoc) His Thr(zBu)-OtBu 222

Fmoc-Lys(eBoc) His Leu-OtBu 223

- WVO 2005/016280 PCT/US2004/026288

Fmoc-Lys(eFmoc) His Ser(:Bu)-OtBu 224

Fmoc-Lys(eFmoc) His Thr(:Bu)-OtBu 225

Fmoc-norLeu His Ser(zBu)-OtBu 226

Fmoc-Phe His Tle-O7Bu 227

Fmoc-Phe His Leu-OtBu 228

Fmoc-Phe His norLeu-OtBu 229

Fmoc-Trp His Ser(Bu)-O7Bu 230

Fmoc-Trp His Ile-OrBu 231

Fmoc-Trp His Leu-OrBu 232

Fmoc-Trp His Phe-OrBu 233

Fmoc-Trp His Tyr-OtBu 234

Fmoc-Trp His Thr(tBu)-OtBu 235

Nicotinyl Lys(¢Boc) His Ser(Bu)-O/Bu 236

Nicotinyl Lys(eBoc) His Thr(fBu)-OrBu 237

[0179] While the pepides of Table 3 are illustrated with particular protecting groups, it is noted that these groups may be substituted with other protecting groups as described herein and/or one or more of the shown protecting gzroup can be eliminated. 3) Small peptides with central acidic and basic amino acids.

[0180] In certain embodiments, the peptides of this invention range from four amino acids to about ten amino acids. The terminal amino aci ds are typically hydrophobic either because of a hydrophobic side chain or because the terminal amino acids bear one or rnore hydrophobic protecting groups end amino acids (X' and X*) are hydrophobic either because of a hydrophobic side chain or because the side chain or the C and/or N terminus i s blocked with one or more hydrophobic protecting group(s) €e.g., the N-terminus is blocked with Boc-, Fmoc-, Nicotinyl-, efc., and the C-terminu s blocked with (zBu)-OrBu, etc.). Typically, the central portion of the peptide comprises a basic amino acid and an acidic amino acid (e.g., in a 4 mer) or a basic domain and/or am acidic domain in a longer @nolecule.

[0181] These four-mers can be represented by Formul.aI in which X' and X* are hydrophobic and/or bear hydrophobic protecting group(s) as dlescribed herein and X%is acidic while X° is basic or X2 is basic while X° is acidic. The peptide can be all L- amino acids or include one or more or all D-amino acids.

[0182] Certain preferred of this invention include, but are not limited to the peptides shown in Table 4. .

[0183] Table 4. Illustrative examples of small peptides with central acidic and basic amino acids.

X' XX xX xX? SEQ ID

NO

Boc-Lys(eBoc) Arg Asp Ser(Bu)-OrBu 238

Boc-Lys(eBoc) Arg Asp Thr(sBu)-OrBu 239

Boc-Trp Arg Asp Ile-OrBu 240

Boc-Trp Arg Asp Leu-OrBu 241

Boc-Phe Arg Asp Leu-OrBu 242

Boc-Phe Arg Asp Ile-OtBu 243

Boc-Phe Arg Asp norLeu-OrBu 244

Boc-Phe Arg Glu norLeu-OrBu 245

Boc-Phe Arg Glu Ile-OtBu 246

Boc-Phe Asp Arg Ile-OBu 247

Boc-Phe Glu Arg Ile-OBu 248

Boc-Phe Asp Arg Leu-OrBu 249

Boc-Phe Arg Glu Leu-OrBu 250

Boc-Phe Glu Arg Leu-OrBu 251

Boc-Phe Asp Arg norLeu-OrBu 252

Boc-Phe Glu Arg norLeu-OrBu 253

Boc-Lys(eBoc) Glu Arg Ser(:Bu)-OiBu 254

Boc-Lys(eBoc) Glu Arg Thr(fBu)-OrBu 255

Boc-Lys(eBoc) Asp Arg Ser(fBu)-OrBu 256

Boc-Lys(eBoc) Asp Arg Thr(tBu)-OrBu 257

Boc-Lys(eBoc) Arg Glu Ser(tBu)-OrBu 258

Boc-Lys(eBoc) Arg Glu Thr(zBu)-OrBu 259

Boc-Leu Glu Arg Ser(zBu)-OrBu 260

Boc-Leu Glu Arg Thr(Bu)-OrBu 261

Fmoc-Trp Arg Asp Ser(Bu)-OrBu 262

Fmoc-Trp Asp Arg Ser(fBu)-OrBu 263

Fmoc-Trp Glu Arg Ser(fBu)-OtBu 264

Fmoc-Trp Arg Glu Ser(fBu)-OzBu 265

Boc-Lys(eBoc) Glu Arg Leu-OfBu 266 _58-

Fmoc-Leu Arg Asp Ser(fBu)-OrBu 267

Fmoc-Leu Asp Arg Ser(Bu)-OrBu 268

Fmoc-Leu Glu Arg Ser(fBu)-OrBu 269

Fmoc-Leu Arg Glu Ser(zBu)-OrBu 270 ’ Fmoc-Leu Arg Asp Thr(:Bu)-OrBu 271

Boc-Glu Asp Arg Tyr(fBu)-OrBu 272

Fmoc-Lys(¢€Fmoc) Arg Asp Ser(tBu)-OrBu 273

Fmoc-Trp Arg Asp Ile-O7Bu 274

Fmoc-Trp Arg Asp Leu-OrBu 275

Fmoc-Phe Arg Asp Ile-O7Bu 276

Fmoc-Phe Arg Asp Leu-OrBu 277

Boc-Trp Arg Asp Phe-OzBu 278

Boc-Trp Arg Asp Tyr-OfBu 279

Fmoc-Trp Arg Asp Phe-OrBu 280

Fmoc-Trp Arg Asp Tyr-OtBu 281

Boc-Orn(0Boc) Arg Glu Ser(rBu)-OrBu 282

Nicotinyl Lys(¢éBoc) Arg Asp Ser(rBu)-OrBu 283

Nicotinyl Lys(¢Boc) Arg Asp Thr(Bu)-OrBu 284

Fmoc-Leu Asp Arg Thr(Bu)-OtBu 285

Fmoc-Leu Glu Arg Thr(zBu)-OtBu 286

Fmoc-Leu Arg Glu Thr(Bu)-OtBu 287

Fmoc-norLeu Arg Asp Ser(fBu)-OtBsu 288

Fmoc-norLeu Asp Arg Ser(rBu)-OtBBu 289

Fmoc-norLeu Glu Arg Ser(Bu)-OtBu 290

Fmoc-norLeu Arg Glu Ser(zBu)-OtBu 291

Fmoc-Lys(¢Boc) Arg Asp Ser(zBu)-OtBu 292

Fmoc-Lys(¢Boc) Arg Asp Thr(/Bu)-OtBu 293

Fmoc-Lys(eBoc) Glu Arg Ser(:Bu)-OtBu 294

Fmoc-Lys(gBoc) Glu Arg Thr(fBu)-OtBu 295

Fmoc-Lys(eBoc) Asp Arg Ser(rBu)-OtBu 296

Fmoc-Lys(eBoc) Asp Arg Thr(tBu)-OtBu 297

Fmoc-Lys(eBoc) Arg Glu Ser(:Bu)-OtBu 298

Fmoc-Lys(¢Boc) Arg Glu Thr@Bu)-OtBu 299

Fmoc-Lys(eBoc) Glu Arg Leu-OtBu 300

Fmoc-Lys(eBoc) Arg Glu Leu-OtBu 301

Fmoc-Lys(eFmoc) Arg Asp Thr(Bu)-OtBu 302

Fmoc- Lys(€Fmoc) Glu Arg Ser(fBu)-OtBu 303

Fmoc- Lys(€Fmoc) Glu Arg Thr(zBu)-OtBu 304

Fmoc- Lys(eFmoc) Asp Arg Ser(rBu)-OtBu 305

Fmoc- Lys(eFmoc) Asp Arg Thr(tBu)-OtBu ~~ 306

Fmoc- Lys(eFmoc) Mrg Glu Ser(rBu)-OtBu 307

Fmoc- Lys(¢Fmoc) arg Glu Thr(fBu)-OtBu ~~ 308

Fmoc- Lys(eFmoc)) Glu Arg Leu-OrBu 309 :

Boc-Lys(e¢Fmoc) Arg Asp Ser(rBu)-OtBu 310

Boc-Lys(eFmoc) Arg Asp Thr(fBu)-OtBu 311 :

Boc-Lys(¢Fmoc) Glu Arg Ser(Bu)-OtBu 312

Boc-Lys(eFmoc) Glu Arg Thr(/Bu)-OtBu 313

Boc-Lys(eFmoc) Asp Arg Ser(Bu)-OtBu 314

Boc-Lys(eFmoc) Asp Arg Thr(tBu)-OtBu 315

Boc-Lys(eFmoc) Arg Glu Ser(fBu)-OtBu 316

Boc-Lys(eFmoc) Arg Glu Thr(fBu)-OtBu 317

Boc-Lys(eFmoc) Glu Arg Leu-OtBu 318

Boc-Orn(dFmoc) Arg Glu Ser(tBu)-OtBu 319

Boc-Om(8Fmoc) Glu Arg Ser(rBu)-OtBu 320

Boc-Om(8Fmoc) Arg Asp Ser(rBu)-OtBu 321

Boc-Orn(SFmoc) Asp Arg Ser(fBu)-OtBu 322

Boc-Om(8Fmoc) ~~ Asp Arg Thr(Bu)-OtBu 323

Boc-Om(8Fmoc) Arg Asp Thr(zBu)-OtBu 324

Boc-Om(8Fmoc) Glu Arg Thr(Bu)-OtBu 325

Boc-Orn(8Fmoc) Arg Glu Thr(Bu)-OtBu 326

Fmoc-Trp Asp Arg Tle-OtBu 327

Fmoc-Trp Arg Glu Ile-OtBu 328

Fmoc-Trp Glu Arg Ile-OtBu 329

Fmoc-Trp Asp Arg Leu-OtBu 330

Fmoc-Trp Arg Glu Leu-OtBu 331

Fmoc-Trp Glu Arg Leu-OtBu 332

Fmoc-Phe Asp Arg Ile-OtBu 333

Fmoc-Phe Arg Glu Ile-OtBu 334

Fmoc-Phe Glu Arg Ile-OtBu 335

Fmoc-Phe Asp Arg Leu-OtBu 336

Fmoc-Phe Arg Glu Leu-OtBu 337

Fmoc-Phe Glu Arg Leu-OtBu 338

Fmoc-Trp Arg Asp Phe-OtBu 339

Fmoc-Trp Arg Glu Phe-OtBu 340

Fmoc-Trp Glu Arg Phe-OtBu 341

Fmoc-Trp Asp Arg Tyr-OtBu 342

Fmoc-Trp Arg Glu Tyr-OtBu 343

Fmoc-Trp Glu Arg Tyr-OtBu 344

Fmoc-Trp Arg Asp Thr(zBu)-OtIBu 345

Fmoc-Trp Asp Arg Thr(Bu)-OtBBu 346 ’ Fmoc-Trp Arg Glu Thr(zBu)-OtBBu 347

Fmoc-Trp Glu Arg Thr(zrBu)-OtIBu 348

Fmoc-Phe Arg Asp norLeu-OtBu 349

Fmoc-Phe Arg Glu norLeu-OtBu 350

Boc-Phe Lys Asp Leu-OtBu 351

Boc-Phe Asp Lys Leu-OtBuw 352

Boc-Phe Lys Glu Leu-OtBu- 353

Boc-Phe Glu Lys Leu-OtBue 354

Boc-Phe Lys Asp Jle-OtBu 355

Boc-Phe Asp Lys Ile-OtBu 356

Boc-Phe Lys Glu Ile-OtBu 357

Boc-Phe Glu Lys Ile-OtBu 358

Boc-Phe Lys Asp norLeu-OtBu 359

Boc-Phe Asp Lys norLeu-OtBu 360

Boc-Phe Lys Glu norLeu-OtBu 361

Boc-Phe Glu Lys norLeu-OtBu 362

Boc-Phe His Asp Leu-OtBwm 363

Boc-Phe Asp His Leu-OtBu 364

Boc-Phe His Glu Leu-OtButa 365

Boc-Phe Glu His Leu-OtBu 366

Boc-Phe His Asp He-OtBu 367

Boc-Phe Asp His Tle-OtBu 368

Boc-Phe His Glu Ile-OtBu 369

Boc-Phe Glu His Ile-OtBu 370

Boc-Phe His Asp norLeu-OtBu 371

Boc-Phe Asp His norLeu-OtBu 372

Boc-Phe His Glu norLeu-OtBu 373

Boc-Phe Glu His norLeu-OtBu 374

Boc-Lys(geBoc) Lys Asp Ser(rBu)-OtBu 375

Boc-Lys(eBoc) Asp Lys Ser(Bu)-OtBu 376

Boc-Lys(eBoc) Lys Glu Ser(rBu)-OtBu 377

Boc-Lys(eBoc) Glu Lys Ser(tBu)-OtBu 378

Boc-Lys(eBoc) His Asp Ser(rBu)-OtBu 379

Boc-Lys(eBoc) Asp His Ser(zBu)-OtBu 380

Boc-Lys(eBoc) His Glu Ser(tBu)-O€Bu 381

Boc-Lys(eBoc) Glu His Ser(zBu)-OtBu 382

Ne

[0184] While the p-epides of Table 4 are illustrated with particular protecting groups, it is noted that these groups may be substituted with other protecting groups as ) described herein and/or onee or more of the shown protecting group can be eliminated. 4) Small peptides having either an acidic or basic amino acid ira the center toge-ther with a central aliphatic amino acid.

[0185] In certain embodiments, the peptides of this invention range from four amino acids to about ten armino acids. The terminal amino acids are typically hydroph obic either because of a hydrophobic side chain or because the terminal amino acids bear one or more hydrophobic protecti ng groups. End amino acids (X! and X*) are hydrophobic either because of a hydrophobic side chain or because the side chain or the C and/or N termixus is blocked with one or more hydrophobic protecting group(s) (e.g., the N-terminus 1s blocked with Boc-, Fmoc-., Nicotinyl-, efc., and the C-terminus blocked with (1Bu)-OBu, etc.). Typically, the central portion of the peptide comprises a basic or acidic amino acid and an aliphatic amino acied (e.g., in a 4 mer) or a basic domain or an acidic domain amd an aliphatic domain in a longer molecule.

[0186] These four—mers can be represented by Formula I in which X' and X* are hydrophobic and/or bear hydrophobic protecting group(s) as described herein and X*1is acidic or basic while X° is aliphatic or X” is aliphatic while X° is acidic or basic. The peptide can be all L- amin-o acids or include one, or more, or all D-amino acids.

[0187] Certain preferred of this invention include, but are not limited to the peptides shown in Table 5 .

[0188] Table 5. Examples of certain preferred peptides having either an acidic or basic amino acid in the cemter together with a central aliphatic amino acid.

UE Se

SEQ ID

Fmoc-Lys(eBoc) Leu Arg Ser(tBu)-OtBu 383

Fmoc-Lys(eBoc) Arg Leu Ser(tBu)-OtBu 384

Fmoc-Lys(eBoc) Leu Arg Thr(tBu)-OtBu 385

Fmoc-Lys(eBoc) Arg Leu Thr(:Bu)-OtBu 386

Fmoc-Lys(eBoc) Gla Leu Ser(zBu)-OtBu 387

Fmoc-Lys(eBoc) Leu Glu Ser(zBu)-OtBu 388

Fmoc-Lys(eBoc) Gla Leu Thr(zBu)-OtBu 389

Fmoc-Lys(eBoc) Leu Glu Thr(:Bu)-OtBu 390

Fmoc- Lys(¢Fmoc) Leu Arg Ser(tBu)-OtBu 391

Fmoc- Lys(eFmoc) Leu Arg Thr(zBu)-OtBu 392

Fmoc- Lys(eFmoc) Gla Leu Ser(tBu)-OtBu 393

Fmoc- Lys(¢Fmoc) Gla Leu Thr(rBu)-OtBu 394

Boc-Lys(Fmoc) Gla Ile Thr(zBu)-OtBu 395

Boc-Lys(eFmoc) © Leu Arg Ser(tBu)-OtBu 396

Boc-Lys(eFmoc) Lea Arg Thr(zBu)-OtBu 397

Boc-Lys(eFmoc) Gla Leu Ser(zBu)-OtBu 398

Boc-Lys(eFmoc) Gla Leu Thr(zBu)-OtBu 399

Boc-Lys(eBoc) Lea Arg Ser(tBu)-OtBu 400

Boc-Lys(eBoc) Arg Phe Thr(zBu)-OtBu 401

Boc-Lys(eBoc) Lea Arg Thr(zBu)-OtBu 402

Boc-Lys(eBoc) Gla Ile Thr(:Bu) 403

Boc-Lys(eBoc) Glu Val Thr(tBu) 404

Boc-Lys(eBoc) Gla Ala Thr(:Bu) 405

Boc-Lys(eBoc) Gla Gly Thr(rBu) 406

Boc--Lys(gBoc) Gla Leu Ser(rBu)-OtBu 407

Boc-Lys(eBoc) Gla Leu Thr(:Bu)-OtBu 408

[0189] While the pepides of Table 5 are illustrated with particular protecting groups, it is noted that these groups may be substituted with other protecting groups as described herein and/or one or more of the shown protecting group can be eliminated.

S) Small pepticles having either an acidic or basic amino acid in the center together with a central aromatic amino acid.

[0190] In certain embodiments, the peptides of this invention range from four amino acids to about ten amino acids. The terminal amino acids are typically hydrophobsic either because of a hydrophobic side chain or because the terminal amino acids bear one or : 10 more hydrophobic protecting groups end amino acids (X! and X*) are hydrophobic either because of a hydrophobic side chaim or because the side chain or the C and/or N terminus is blocked with one or more hydrophobic protecting group(s) (e.g., the N-terminus is blocked with Boc-, Fmoc-, Nicotinyl-, ezc. , and the C-terminus blocked with (fBu)-OfBu, etc.). Typically, the central portion of the peptide comprises a basic or acidic amino acid and an aromatic amino acid (e.g., in a4 mer) or a basic domain or an acidic domain and an aromatic domain in a longer molecule. .

[0191] These four-mers can be represented by Formula I in which X! and X* are hydrophobic and/or bear hydrophobic protecting group(s) as described herein and X? is acidic or basic while X is aromatic or X* is aromatic while X3 is acidic or basic. The peptide can be all L- amino acids or include one, or more, or all D-amino acids. Five-mers can be represented by a minor modification of Formula I in which XO is inserted as shown in Table 6 and in which X is typically an aromatic amino acid.

[0192] Certain preferred of this invention include, but are not limited to the peptides shown in Table 6.

[0193] Table 6. Examples of certain preferred peptides having either an acidic or basic amino acid in the center togetEier with a central aromatic amino acid.

IE) Sr SE BE I Sa

X xX X X X SEQ I'm : NO

Fmoc-Lys(eBoc) Arg Trp Tyr(fBu)-OtBu 409 : Fmoc-Lys(eBoc) Trp Arg Tyr(rBu)-OtBu 410

Fmoc-Lys(eBoc) Arg Tyr Trp-OtBu 411

Fmoc-Lys(eBoc) Tyr Arg Trp-OtBu 412

Fmoc-Lys(eBoc) Arg Tyr Trp Thr(:Bu)-OtBu 413

Fmoc-Lys(eBoc) Arg Tyr Thr(:Bu)-OtBu 414

Fmoc-Lys(eBoc) Arg Trp Thr(tBu)-OtBu 415

Fmoc- Lys(eFmoc) Arg Trp Tyr(:Bu)-OtBu 416

Fmoc- Lys(¢Fmoc) Arg Tyr Trp-OtBu 417

Fmoc- Lys(eFmoc) Arg Tyr Trp Thr(/Bu)-OtBu 418

Fmoc- Lys(eFmoc) Arg Tyr Thr(zBu)-OtBu 419

Fmoc- Lys(¢Fmoc) Arg Trp Thr(rBu)-OtBu 420

Boc-Lys(¢Fmoc) Arg Trp Tyr(tBu)-OtBu 421

Boc-Lys(eFmoc) Arg Tyr Trp-OtBu 422

Boc-Lys(eFmoc) Arg Tyr Trp Thr(tBu)-OtBu 423

Boc-Lys(eFmoc) Arg Tyr Thr(fBu)-OtBu 424

Boc-Lys(eFmoc) Arg Trp Thr(rBu)-OtBu 425

Boc-Glu Lys(eFnaoc) Arg Tyr(tBu)-OtBu 426

Boc-Lys(eBoc) Arg Trp Tyr(tBu)-OtBu 427

Boc-Lys(eBoc) Arg Tyr Trp-OtBu 428

Boc-Lys(eBoc) Arg Tyr Trp Thr(tBu)-OtBu 429

Boc-Lys(eBoc) Arg Tyr Thr(:Bu)-OtBu 430

Boc-Lys(eBoc) Arg Phe Thr(rBu)-OtBu 431

Boc-Lys(eBoc) Arg Trp Thr{(fBu)-OtBu 432

[0194] While the pepides of Table 6 are illustrated with particular protecting groups, it is noted that these groups may be substituted with other protecting groups as described herein and/or one or mores of the shown protecting group can be eliminated. 6) Small peptides having aromatic amino acids or aromatic amine acids separated by histidine(s) at the center.

[0195] In certain embodiments, the peptides of this invention are characterized by, melectrons that are exposed in the ¢ enter of the molecule which allow hydration of the particle and that allow the peptide particles to trap pro-inflammatory oxidized lipids such as fatty acid hydroperoxides and phospholipids that contain an oxidation product of arachidonic acid at the sn-2 position.

[0196] In certain embodiments, these peptides consist of a minimum of 4 amino ) acids and a maximum of about 10 amino acids, preferentially (but not necessarily) with one or more of the amino acids being the ID-sterioisomer of the amino acid, with the end amino acids being hydrophobic either bec ause of a hydrophobic side chain or because the terminal amino acid(s) bear one or more hydrophobic blocking group(s), (e.g., an N- terminus blocked with Boc-, Fmoc-, Nicotinyl-, and the like, and a C-terminus blocked with (/Bu)-OrBu groups and the like). Instead of having an acidic or basic amino acid in the center, these peptides generally have an aromatic amino acid at the center. or have aromatic amino acids separated by histidine in the center of the peptide.

[0197] Certain preferred of this invention include, but are not limited to the peptides shown in Table 7.

[0198] Table 7. Examples of peptides having aromatic amino acids in the center or aromatic amino acids or aromatic domain s separated by one or more histidines. ee

NO

Boc-Lys(eBoc) Phe Trp Phe Ser(rBu)-OtBu 433

Boc-Lys(eBoc) Phe Trp Phe Thr(zBu)-OtBu 434

Boc-Lys(eBoc) Phe Tyr Phe Ser(zBu)-OtBu 435

Boc-Lys(eBoc) Phe Tyr Phe Thr(rBu)-OtBu 436

Boc-Lys(eBoc) Phe His Phe Ser(zBu)-OtBu 437

Boc-Lys(eBoc) Phe His Phe Thr(zBu)-OtBu 438

Boc-Lys(¢Boc) Val Phe Phe-Tyr Ser(tBu)-OtBu 439

Nicotinyl-Lys(eBoc) Phe Trp =~ Phe Ser(rBu)-OtBu 440

Nicotinyl-Lys(eBoc) Phe Trp Phe Thr(rBu)-OtBu 441

Nicotinyl-Lys(eBoc) Phe Tyr Phe Ser(:Bu)-OtBu 442

Nicotinyl-Lys(eBoc) Phe “Tyr Phe Thr(:Bu)-OtBu 443

Nicotinyl-Lys(eBoc) Phe His Phe Ser(Bu)-OtBu 444

Nicotinyl-Lys(eBoc) Phe His Phe Thr(tBu)-OtBu 445

Boc-Leu Phe Trp Phe Thr(:Bu)-OtBu 446

Boc-Leu Phe Trp Phe Ser(:Bu)-OtBu 447

[0199] While the pepides of Table 7 are illustrated with particular protecting groups, it is noted that these groups may be substituted with other protecting groups as described herein and/or one or more of the shown protecting group can be eliminated. 7) Summary of tripeptides and tetrapeptides.

[0200] For the sake of clarity, a number of tripeptides and tetrapeptides of ths invention are generally summarized below in Table 8.

[0201] Table 8. General structure of certain peptides of this invention.

X! xX xX? xX hydrophobic side chain Acidic or —— hydrophobic side or hydrophobic Basic chain or protecting group(s) hydrophobic protecting grorip(s) hydrophobic side chain Basic Acidic hydrophobic side or hydrophobic chain or protecting group(s) hydrophobic protecting growip(s) hydrophobic side chain Acidic Basic hydrophobic side or hydrophobic chain or protecting group(s) hydrophobic protecting gromip(s) hydrophobic side chain Acidic or Basic Aliphatic hydrophobic side or hydrophobic chain or protecting group(s) hydrophobic protecting growp(s) hydrophobic side chain Aliphatic Acidic or Basic hydrophobic side or hydrophobic chain or protecting group(s) hydrophobic : protecting growip(s) hydrophobic side chain Acidic or Basic Aromatic hydrophobic szde or hydrophobic chain or protecting group(s) hydrophobic protecting growp(s) hydrophobic side chain Aromatic Acidic or Basic hydrophobic s-ide or hydrophobic chain or protecting group(s) hydrophobic protecting gromp(s) hydrophobic side chain Aromatic His Aromatic hydrophobic s-ide or hydrophobic chain or protecting group(s) hydrophobic protecting gro-up(s)

[0202] Where longer peptides are desired, X* and X> can represent domains (e.g., regions of two or more amino acids of the specified type) rather than individual amino acids. Table 8. is intended to be illustrative and not li miting. Using the teaching provided ) 5S herein, other suitable peptides can readily be identified. 8) Paired amino acids and dipeptides.

[0203] In certain embodiments, this invention pertains to the discovery that certain pairs of amino acids, administered in conjunction with each other or linked to form a dipeptide have one or more of the properties described herein. Thus, without being bound to a particular theory, it is believed that when the pairs of amino acids are administered in conjunction with each other, as described herein, they are capable participating in or inducing the formation of micelles in vivo.

[0204] Similar to the other small peptides described herein, it is belived that the pairs of peptides will associate in vivo, and demonstrate physical properties including high solubility in ethyl acetate (e.g., greater than about 4 mg/mL), solubility in aqueous buffer at pH 7.0. Upon contacting phospholipids such as 1,2-Dimyristoyl-sn-glycero-3- phosphocholine (DMPC), in an aqueous environment, it is believed the pairs of amino acids induce or participate in the formation of particles with a diameter of approximately 7.5 nm (= 0.1 nm), and/or induce or participate in the formation of stacked bilayers with a bilayer dimension on the order of 3.4 to 4.1 nm with spacing between the bilayers in the stack of approximately 2 nm, and/or also induce or participate in the formation of vesicular structures of approximately 38 nm).

[0205] Moreover, it is further believed that the pairs of amino acids can display one or more of the following physiologically relevant properties:

[0206] 1. They convert pro-inflammatory HDL to anti-inflammatory HDL or make anti-inflammatory HDL imore anti-inflammatory;

[0207] 2. They decrease LDL-induced monocyte chemotactic activity generated by artery wall cells; 0208] 3. They stimulate the formation and cycling of pre-g HDL;

[0209] 4, "They raise HDL cholesterol; and/or

[0210] 5. "They increase HDL paraoxonase activity.

[0211] The pains of amino acids can be administered as separate ami no acids (administered sequenti ally or simulataneously, e.g. in a combined formulation) or they can be covalently coupled «directly or through a linker (e.g. a PEG linker, a carbon linker, a branched linker, a strai ght chain linker, a heterocyclic linker, a linker formed of derivatized lipid, ezc.). In certain embodiments, the pairs of amino acids are- covalently linked through a pepticle bond to form a dipeptide. In various embodiments while the dipeptides will typicall y comprise two amino acids each bearing an attached. protecting group, this invention also contemplates dipeptides wheren only one of the armino acids bears one or more protecting groups.

[0212] The pais of amino acids typically comprise amino acids whe-re each amino acid is attached to at least one protecting group (e.g., a hydrophobic protecting group as described herein). The- amino acids can be in the D or the LL form. In certairm embodiments, where thme amino acids comprising the pairs are not attached teo each other, cach amino acid bears &wo protecting groups (e.g., such as molecules 1 and 22 in Table 9).

[0213] Table 9. Illustrative amino acid pairs of this invention. © Amino Acid Pai ridipeptide "1. Boc-Arg-OtBu™= 2. Boc-Glu-OtBu* 3. Boc-Phe-Arg-OtBu** 4. Boc-Glu-Leu-OtBu** 5. Boc-Arg-Glu-OtBu*#** *This would typically be administered in conjunciton with a second amino a_cid. **In certain embodime nts, these dipeptides would be administered in conjuraction with each other. *#% In certain embodiments, this peptide would be administered either alones or in combination with one of the other peptides described herein..

[0214] Suitable pairs of amino acids can readily be identified by pro-viding the pair of protected amino acicls and/or a dipeptide and then screening the pair of amino

WwW -O 2005/016280 PCT/US2004/026288 - acids/dipeptide for one or more of the physical and/or physiological properties described above. In certain embodiments, this invention exclude s pairs of amino acids and/or da peptides comprising aspartic acid and phenylalanme. In certain embodiments, this imavention excludes pairs of amino acids and/or dipepticles in which one amino acid is (-)- . NE-[(trans-4-isopropylcyclohexane)carbonyl]-D-phenyl alanine (nateglinide).

[0215] In certain embodiments, the amino acid s comprising the pair are iradependently selected from the group consisting of ara acidic amino acid (e.g., aspartic acid, glutamic acid, etc.), a basic amino acid (e.g., lysime, arginine, histidine, etc.), and a neon-polar amino acid (e.g., alanine, valine, leucine, isoleucine, proline, phenylalanine, tryptophan, methionine, efc.). In certain embodiments , where the first amino acid is acidic or basic, the second amino acid is non-polar and where the second amino acid is acidic or b asic, the first amino acid is non-polar. In certain emb»odiments, where the first amino acid is acidic, the second amino acid is basic, and vice versa. (see, e.g., Table 10).

[0216] Similar combinations can be obtained b»y administering pairs of dipeptides.

Thus, for example in certain embodiments, molecules 3 and 4 in Table 9 would be administered in conjunction with each other.

T able 10. Certain generalized pepide pairs.

First Aminoacid Second Amino acid 1. Addc Basic 2. Basic Acidic 3. Acidic Non-polar 4-. Non-polar Acidic 5. Basic Non-polar 6-. Non-polar Basic - [©0217] It is noted that these amino acid pairs/dLipeptides are intended to be iMlustrative and not limiting, Using the teaching provi«ded herein other suitable amino acid peairs/dipeptides can readily be determined.

‘D) Other peptide modifications.

[0218] It was a surprising discovery that the peptides desc ribed herein, particular when they incorporated one or more D-amino acids, they retained. their activity and could ’ also be administered orally. Moreover this oral administration resulted in relatively efficient uptake and significant serum half-life thereby providing an efficacious method of mitigatang one or more symptoms of atherosclerosis or other pathologies characterized by an inflammatory process.

[0219] Using the teaching provided herein, one of skill cam routinely modify the illustrated peptides to produce other similar peptides of this invention. For example, routine conservative or semi-conservative substitutions (e.g., E fox D) can be made of the existing amino acids. The effect of various substitutions on lipid affinity of the resulting peptide can be predicted using the computational method describe=d by Palgunachari ez al. (1996) .Arteriosclerosis, Thrombosis, & Vascular Biology 16: 328-338. The peptides can be lengthened or shortened as long as the class A o-helix structure is preserved. In addition, substitutions can be made to render the resulting peptide more similar to peptide«(s) endogenously produced by the subject species.

[0220] In certain embodiments, the peptides of this invention comprise "D" forms of the p eptides described in U.S. Patent 4,643,988, more preferabl y "D" forms having one or both termini coupled to protecting groups. In certain embodiments, at least 50% of the enantiommeric amino acids are "D" form, more preferably at least 8 0% of the enantiomeric amino acids are "D" form, and most preferably at least 90% or even all of the enantiomeric amino acids are "D" form amino acids.

[0221] While, in certain embodiments, the peptides.of this invention utilize naturall y-occurring amino acids or D forms of naturally occurring amino acids, substitutions with non-naturally occurring amino acids (e.g., meth3onine sulfoxide, methiormine methylsulfonium, norleucine, episilon-aminocaproic a<id, 4-aminobutanoic acid, tetrahydroisoquinoline-3-carboxylic acid, 8-aminocaprylic acid, 4-aminobutyric acid,

Lys(N(espsilon)-trifluoroacetyl), a-aminoisobutyric acid, and the 1i ke) are also contemplated.

[0222] In addition to the peptides described herein, peptidomimetics are also contemplated herein. Peptide analogs are commonly used in the p harmaceutical industry as non-peptide drugs with properties analogous to those of the template peptide. These types of nora-peptide compound are termed "peptide mimetics” or "peptidomimetics” (Fauchere (1986) Adv. Drug Res. 15: 29; Veber and Freidinger (1985) TINS p.392; and

Evans et al. (1987) J. Med. Chem. 30: 1229) and are usually developed with the aid of . computerized molecular modeling. Peptide mimetics that are structurally similar to therapeutically useful peptides may be used to produce an equivalent therapeutic or ’ prophylactic effect.

[0223] Generally, peptidomimetics are structurally similar to &a paradigm polypeptide (e.g, 4F, SEQ ID NO: 258 described herein), but have one or more peptide linkages optionally replaced by a linkage selected from the group consisting of: -CH,NH-, -CH,S-, -CE1,-CH,-, -CH=CH- (cis and trans), -COCH;-, -CH(OH)CH],-, -CH,SO-, efc. by methods kn own in the art and further described in the following references: Spatola (1983) p. 267 in CPiemistry and Biochemistry of Amino Acids, Peptides, and Proteins, B.

Weinstein, €ds., Marcel Dekker, New York,; Spatola (1983) Vega Da ta 1(3) Peptide

Backbone Modifications. (general review); Morley (1980) Trends Pharm Sci pp. 463-468 (general review); Hudson et al. (1979) Int J Pept Prot Res 14:177-185 (-CH.NH-,

CH,CH,-); Spatola et al. (1986) Life Sci 38:1243-1249 (-CH,-S); Haran, (1982) J Chem

Soc Perkin Trans 1307-314 (-CH-CH-, cis and trans); Almquist et al. (1980) J Med Chem. 23:1392-1398 (-COCH,-); Jennings-White et al.(1982) Tetrahedron Zett. 23.2533 (-

COCH,-); Szelke, M. et al., European Appln. EP 45665 (1982) CA: 97:39405 (1982) (-

CH(OH)CEI2-); Holladay et al. (1983) Tetrahedron Lett 24:4401-4404 (-C(OH)CH>-); and

Hruby (1982) Life Sci., 31:189-199 (-CH,-S-)).

[0224] A particularly preferred non-peptide linkage is -CH,N H-. Such peptide mimetics may have significant advantages over polypeptide embodiments, including, for example: nore economical production, greater chemical stability, enthanced pharmacological properties (half-life, absorption, potency, efficacy, etc.), reduced antigenicity, and others.

[0225] In addition, circular permutations of the peptides desc ribed herein or constrained peptides (including cyclized peptides) comprising a consensus sequence or a substantial ly identical consensus sequence variation may be generated by methods known in the art (Rizo and Gierasch (1992) Ann. Rev. Biochem. 61. 387); for example, by adding intermal cysteine residues capable of forming intramolecular disulfide bridges which cyclize the peptide. . IX. Functional assays of peptides.

[0226] Certain peptides of this invention are desctritoed herein by various formulas (e.g, Formula l, above) and/or by particular sequences. In certain embodiments, however, prefexred peptides of this invention are characterized by one= or more of the following functional properties: 1. They convert pro-inflammatory HDL to anti—inflammatory HDL or make anti-inflammatory HDL more anti-inflammatory; 2. They decrease LDL-induced monocyte chem _otactic activity generated by artery wall cells; 3. They stimulate the formation and cycling of pre- HDL; 4. They raise HDL cholesterol; and/or 5. They increase HDL paraoxonase activity.

[0227] The specific peptides disclosed herein, and/ox peptides corresponding to the various formulas described herein can readily be tested for one or more of these activities as desired.

[0228] Methods of screening for each of these functi onal properties are well know to those of skill in the art. In addition, such screens are illustrated herein in the Exam_ples. In particular, it is noted that assays for monocytes chemotactic activity, HDL cholesterol, and HDL HDL paraoxonase activity are illustrated in PCT/US01/26497 (WO 02/15 923). Assays for determining HDL inflammatory andor anti-inflammatory propexties were performed as described below. :

A) Determination of HDL Inflammatory/Anti-inflammatory Properties-

D Monocyte Chemotactic Activity (M CA) Assay [0229-] Lipoproteins, human artery wall cocultures, and monocytes were prepared and monocyte chemotactic activity (MCA) was determined as previously described (Van

Lenten et al. (20022) Circulation, 106: 1127-1132). Induction of MCA by a standard control LDL. was «determined in the absence or presence of the subject's HDL. Values in the absence of HIDL were normalized to 1.0. Values greater than 1.0 after the addition of

HDL indicated preo-inflammatory HDL; values less than 1.0 indicated arati-inflammatory .

HDL. 2) Cell-free Assay-

[0230] Th e cell-free assay was a modification of a previously published method’ using PEIPC as the fluorescence-inducing agent. Briefly, HDL was isolated by dextran sulfate method. Sigma “HDL cholesterol reagent” (Catalog No. 352-3) containing dextran sulfate and magnesium ions was dissolved in distilled water (10.0 mg/m1). Fifty microliters of dex- tran sulfate solution was mixed with 500 pl of the test plasma and incubated at room temperature for 5 min and subsequently centrifuged at 8,000 g for 10 min. The supernatant containing HDL was used in the experiments afte cholesterol determination using a cholestero} assay kit (Cat. No. 2340-200, Thermo- DMA Company,

Arlington, TX). “We have previously reported (Navab et al. (2001) J Lipid Res, 1308- 1317) that HDL i solated by this method inactivates bioactive phospholipids to a similar extent as compared with HDL that has been isolated by conventional ul tracentrifuge methods. To determine the inflammatory/anti-inflammatory properties ©f HDL samples from patients andl controls, the change in fluorescence intensity as a result of the oxidation of DCFH by PEIIPC in the absence or presence of the test HDL was use-d. DCFH-DA was dissolved in freska methanol at 2.0 mg/ml and was incubated at room ternperature and protected from li ght for 30 min. resulting in the release of DCFH. The assay was adapted for analyzing a laarge number of samples with a plate reader. Flat-bottoam, black, polystyrene microtiter plates (Microfluor2,Cat. No. 14-245-176, Fisher) were utilized for this purpose. Tern pl of PEIPC solution (final concentration of 50 pg/mX), and 90 ul of

HDL-containing dextran sulfate supernatant (final concentration of 10 g/ml cholesterol), were aliquoted irato microtiter plates and mixed. The plates were then incubated at 37 °C on a rotator for 1 .0 hr. Ten pl of DCFH solution (0.2 mg/ml) was then added to each well, mixed and incub ated for an additional 2 hrs at 37 °C with rotation. The fluorescence was subsequently det ermined with a plate reader (Spectra Max, Gemini XS ; Molecular

Devices) at an excitation wavelength of 485 nm and emission wavelen &th of 530 nm and cutoff of 515 nm with the photomultiplier sensitivity set at "medium". Values for intra- and interassay variability were 5.3 + 1.7% and 7.1 #= 3.2%, respectively. Values in the absence of HDL were normalized to 1.0. Values gr eater than 1.0 after the addition of the : test HDL indicated pro-inflammatory HDL; values Jess than 1.0 indicated anti- inflammatory HDL. 3) Other Procedures

[0231] Plasma levels of interleukin-6 (IL-6) and tumor necrosis factor-o (TNF- 0) were determined by previously published methods (Scheidt-Nave et al. (2001) J Clin

Endocrinol Metab., 86:2032-2042; Piguet et al. (1987) J Experiment Med., 166, 1280- 1289). Plasma total cholesterol, triglycerides, LDL —cholesterol, HDL-cholesterol and " glucose were determined as previously described (IN avab et al. (1997) J Clin Invest, 99:2005-2019) using kits (Sigma), and hs-CRP leve-Is (Rifai et al. (1999) Clin Chem., 45:2136-2141) were determined using a sandwich enzyme immunoassay from

Immunodiagnostik (ALPCO Diagnostics, Windhamn, NH). Statistical significance was determined with model I ANOVA, and significance was defined as a value of p < 0.05.

[0232] It was a surprising finding of this inv-ention that a number of physical properties predict the ability of the small peptides (e.g., less than 10 amino acids, preferably less than 8 amino acids, more preferably from about 3 to about 5 or 6 amino acids) of this invention to render HDL more anti-inflammatory and to mitigate atherosclerosis and/or other pathologies characterized by an inflammatory response in a mammal. As explained herein, the physical properties include high solubility in ethyl acetate (e.g., greater than about 4 mg/ml), and solubility in aqueous buffer at pH 7.0.

Upon contacting phospholipids such as 1,2-Dimyris toyl-sn-glycero-3-phosphocholine (DMPQ), in an aqueous environment, the particularly effective small peptides form particles with a diameter of approximately 7.5 nm (== 0.1 nm), and/or form stacked bilayers with a bilayer dimension on the order of 3.4 to 4.1 mm with spacing between the bilayers in the stack of approximately 2 nm, and/or also form vesicular structures of approximately 38 nm). In certain preferred embodiments, the smal 1 peptides have a molecular weight of less than about 900 Da.

[0233] Virtually amy small peptide can readily be screened for one or more of these properties, e.g., as described herein in Example 3. Indeed combinatorial libraries of small peptides containing greate r than about 10°, or 10°, more preferably greater than about: 10° or 10, and most preferably greater than about 10° or 10° small peptides can readily be produced using methods well known to those of skill the art. The peptide libraries can be random libraries, or, alterraatively, in certain embodiments, the libraries will comprise ) small peptides made in accordance with one or more of the formulas provided herein -

[0234] The peptide libraries can then readily be screened, e.g., using high throughput screening methods for one more of the physical properties described above.

Peptides that test positive dn these assays are likely to have the ability to render HDL more anti-inflammatory and to rnitigate atherosclerosis and/or other pathologies characterized by an inflammatory resporise in a mammal.

[0235] It is noted that the foregoing screening methods are merely illustrative and not intended to be limiting. Using the teachings provided herein, other assays for the desired functional propertaes of the peptides can readily be provided.

X. Peptide preparation.

A General synthesis methods.

[0236] The peptides used in this invention can be chemically synthesized using standard chemical peptide= synthesis techniques or, particularly where the peptide does not comprise "D" amino acid xesidues, the peptide can readily be recombinantly expressed.

Where the "D" polypeptid_es are recombinantly expressed, a host organism (e.g., bacteria, plant, fungal cells, etc.) can be cultured in an environment where one or more of the amino acids is provided to the or ganism exclusively in a D form. Recombinantly expressed peptides in such a system then incorporate those D amino acids.

[0237] In certain embodiments, D amino acids can be incorporated in recombinantly expressed peptides using modified amino acyl-tRNA synthetases that recognize D-amino acids.

[0238] In certain preferred embodiments the peptides are chemically synthesized by any of a number of fluid or solid phase peptide synthesis techniques known to those of

R WO 2005/016280 PCT/US2004/026288 skill in the art. Solid phase synthesis in whiich the C-terminal amino acid of the sequence is attached to an insoluble support followed by sequential addition of the remaining amino acids in the sequence is a preferred method for the chemical synthesis of the polypeptides : of this invention. Techniques for solid pha se synthesis are well known to those of skill in the art and are described, for example, by Barany and Merrifield (1963) Solid-Phase

Peptide Synthesis; pp. 3-284 in The Peptides: Analysis, Synthesis, Biology. Vol. 2: Special

Methods in PeptideSynthesis, Part A.; Merxifield et al. (1963) J. Am. Chem. Soc., 85: 2149-2156, and Stewart et al. (1984) Solid Phase Peptide Synthesis, 2nd ed. Pierce Chem.

Co., Rockford, Ill.

[0239] In one embodiment, the peptides are synthesized by the solid phase peptide synthesis procedure using a benzhyderylamine resin (Beckman Bioproducts, 0.59 mmol of : NH,/g of resin) as the solid support. The COOH terminal amino acid (e.g., #- butylcarbonyl-Phe) is attached to the solid support through a 4-(oxymethyl)phenacetyl group. This is a more stable linkage than the conventional benzyl ester linkage, yet the finished peptide can still be cleaved by hydrogenation. Transfer hydrogenation using formic acid as the hydrogen donor is used for this purpose. Detailed protocols used for peptide synthesis and analysis of synthesized peptides are describe in a miniprint supplement accompanying Anantharamaiah et al. (1985) J. Biol. Chem. 260(16): 10248- 10255. :

[0240] It is noted that in the chemi <al synthesis of peptides, particularly peptides comprising D amino acids, the synthesis usually produces a number of truncated peptides in addition to the desired full-length produ ct. The purification process (e.g., HPLC) typically results in the loss of a significant amount of the full-length product.

[0241] It was a discovery of this iravention that, particularly in the synthesis of a D peptide (e.g., D-4), in order to prevent loss in purifying the longest form one can dialyze and use the mixture and thereby eliminate the last HPLC purification. Such a mixture

Joses about 50% of the potency of the highly purified product (e.g., per wt of protein : product), but the mixture contains about 6 times more peptide and thus greater total activity.

B) Incorporating D-form amino acids.

[0242] D-amino acids can be incorporated at one or more positions in the peptide simply by using a D-form derivatized amino acid residue in the chemical synthesis. D- form residues for solid phase peptide synthesis are commercially available from a number of suppliers (see, e.g., Advanced Chem Tech, Louisville; Nova Biochem, San Diego;

Sigma, St Louis; Bachem Californi a Inc., Torrance, efc.). The D-form amino acids can be completely omitted or incorporated at any position in the peptide as desired. Thus, for example, in certain embodiments, the peptide can comprise a single D-amino acid, while in other embodiments, the peptide comprises at least two, generally at least three, more generally at least four, most generally at least five, preferably at least six, more preferably at least seven and most preferably at least eight D amino acids. In particularly preferred embodiments, essentially every othier (enantiomeric) amino acid is a D-form amino acid.

In certain embodiments at least 909%, preferably at least 90%, more preferably at least 95% of the enantiomeric amino acids are D-form amino acids. In one particularly preferred embodiment, essentially every enantiomeric amino acid is a D-form amino acid. ©) Solution phase syn thesis methods.

[0243] In certain embodiments, the peptides of this inventioin can readily be synthesized using solution phase methods. One such synthesis scheme is illustrated in

Figures 1 and 2.

[0244] In this scheme, A,B, C and D represent amino acids in the desired peptide.

X- represents a permanent Q-amino protecting group. Y-represents a permanent O- carboxyl protecting group. Letters 7 and 7 represent side chain protecting groups if the

N- and C-terminal amino acids possess side chain functional groups. Side chain protecting groups o and p are protecting groups that can be removed by a treatment such as catalytic transfer hydrogenation using ammonium formate as the hydrogen donor (Anantharamaiah and Sivanandaiak (1977) Chem Soc. Perkin Trans. 490: 1-5; and

Babiker et al. (1978) J. Org. Chena. 44: 3442-3444) under the (neutral) conditions in which side chain protecting groups m and p and oi-amino and o-carboxyl protecting groups are stable. HOBT-HBTU represents condensing reagents under which minimum reacimization is observed.

[0245] To the activated amino acid X-A(m)) in presence of 1- hydroxybenzotriazole-2(H-Benzotriazole-1-y1)-1,1 ,3,3-tetramethylammonium hexafluorophosphate (HOBT-HBTU) and a small amount of tertiary amine such : diisopropylethylamine (DIEA) in DMF is added 2 equivalents of DIEA salt of HoN-B(n)-

COO and stirred overnight at room temperature. "The reaction is allowed to go to completion with respect to activated carboxylic acid using excess of amino acid in which o-amino is free and carboxyl is temporarily protec ted as DIEA salt. The reaction mixture 1s acidified using aqueous citric acid (10%) and ex tracted with ethyl acetate. In this process the free amino acid remains in citric acid. After washing ethyl acetate with water, the N-terminal protected dipeptide free acid is extracted with 5% sodium bicarbonate solution and acidified. The dipeptide free acid wass extracted with ethyl acetate, the organic layer is dried (Na,SO,) and solvent evapor-ated to obtain the dipeptide free acid.

The tripeptide is also obtained in a similar manner by reacting the dipeptide free acid with the suitably protected amino acid in which the ¢-a mino is free and the carboxyl is temporarily protected as a DIEA salt. To obtain tlae tetrapeptide, the suitably carboxyl protected amino acid was condensed using HOBT—HBTU. Since the final tetrapeptide is a protected peptide, the reaction mixture after the condensation was taken in ethyl acetate and washed extensively with both aqueous bicarbonate (5%) and citric acid(5%) and then with water. These washings will remove excess of free acid and free base and the . 20 condensing reagents. The protected peptide is them reprecipitated using ethyl acetate (or ether) and petroleum ether. The protected free pepotide is then subjected to catalytic transfer hydrogenation in presence of freshly prep ared palladium black (Pd black) using ammonium formate as the hydrogen donor. This meaction can be carried out in almost neutral condition thus not affecting the acid sensitive side chain protecting groups. This process will remove the protecting groups on amimio acids B and C. An example of this procedure is given below using the synthesis of SEEQ ID NO:256.

[0246] It is noted that this reaction schemes is intended to be illustrative and not limiting. Using the teachings provided herein, other suitable reactions schemes will be known to those of skill in the art.

D) Protecting groups.

[0247] In certain ermbodiments, the one or more R-groups on the constituent amino acids and/or the terminal armino acids are blocked with a protecting group, most preferably a hydrophobic protecting gzoup. Without being bound by a particular theory, it was a : discovery of this invention that blockage, particularly of the amino and/or carboxyl termini of the subject peptides of thais invention greatly improves oral delivery and significantly increases serum half-life.

[0248] A wide num ber of protecting groups are suitable for this purpose. Such groups include, but are not limited to acetyl, amide, and alkyl groups with acetyl and alkyl groups being particularly preferred for N-terminal protection and amide groups being preferred for carboxyl terminal protection. In certain embodiments, the blocking groups can additionally act as a detectable label (e.g., N-methyl anthranilyl).

[0249] In certain particularly preferred embodiments, the protecting groups include, but are not limited to alkyl chains as in fatty acids, propionyl, formyl, and others.

Particularly preferred carboxyl protecting groups include amides, esters, and ether-forming protecting groups. In one prreferred embodiment, an acetyl group is used to protect the amino terminus and an amide group is used to protect the carboxyl terminus. These blocking groups enhance th e helix-forming tendencies of the peptides. Certain particularly preferred blockading groups include alkyl groups of various lengths, e.g., groups having the formula: CH3-(CH,),-CO- where n ranges from about 3 to about 20, preferably from about 3 to about 16, more preferably from about 3 to about 13, and most preferably from about 3 to about 10.

[0250] Other protec ting groups include, but are not limited to N-methyl anthranilyl, Fmoc, t-butoxy«carbonyl (z-BOC), 9-fluoreneacetyl group, 1- fluorenecarboxylic group, ®-florenecarboxylic group, 9-fluorenone-1-carboxylic group, benzyloxycarbonyl, Xanthy-1 (Xan), Trityl (Trt), 4-methyltrityl (Mitt), 4-methoxytrityl (Mmt), 4-methoxy-2,3,6-trianethyl-benzenesulphonyl (Mtr), Mesitylene-2-sulphonyl (Mts), 4,4-dimethoxybenzh ydryl (Mbh),Tosyl (Tos), 2,2,5,7,8-pentamethyl chroman-6- sulphonyl (Pmc), 4-methyltoenzyl (MeBzl), 4-methoxybenzyl (MeOBzl), Benzyloxy (BzlO), Benzyl (Bzl), Benzoyl (Bz), 3-nitro-2-pyridinesulphenyl (Npys), 1-(4,4-dimentyl- 2,6-diaxocyclohexylidene)e-thyl (Dde), 2,6-dichlorobenzyl (2,6-DiCl-Bzl), 2-

chlorobenzyloxycarbonyl (2-Cl-Z), 2-bromobenzylox ycarbonyl (2-Br-Z),

Benzyloxymethy! (Bom), cyclohexyloxy (cHxO),t-bumtoxymethyl (Bum), t-butoxy (tBuO), t-Butyl (tBu), Acetyl (Ac), and Trifluoroacetyl (TFA.

[0251] Protecting/blocking groups are well kraown to those of skill as are methods of coupling such groups to the appropriate residue(s) comprising the peptides of this invention (see, e.g., Greene et al., (1991) Protective (Groups in Organic Synthesis, 2nd ed.,

John Wiley & Sons, Inc. Somerset, N.J.). In one preferred embodiment, for example, acetylation is accomplished during the synthesis whem the peptide is on the resin using acetic anhydride. Amide protection can be achieved by the selection of a proper resin for the synthesis. During the synthesis of the peptides described herein in the examples, rink amide resin was used. After the completion of the synthesis, the semipermanent protecting groups on acidic bifunctional amino acids such as Asp and Glu and basic amino acid Lys, hydroxyl of Tyr are all simultaneously removed. The peptides released from such a resin using acidic treatment comes out with the n-terminal protected as acetyl and the carboxyl protected as NH; and with the simultaneous removal of all of the other protecting groups.

X1. _ Enhancing peptide uptake/oral availability.

A) Use of D-amino acids.

[0252] It was also a surprising discovery of this invention that when an all L amino acid peptide (e.g., otherwise having the sequence of the peptides of this invention) is administered in conjunction with the D-form (i.e. a peptide of this invention) the uptake of the D-form peptide is increased. Thus, in certain embodiments, this invention contemplates the use of combinations of D-form and L-form peptides in the methods of this invention. The D-form peptide and the L-form peptide can have different amino acid sequences, however, in preferred embodiments, they both have amino acid sequences of peptides described herein, and in still more preferred embodiments, they have the same amino acid sequence.

[0253] It was also a discovery of this invention that concatamers of the class A amphipathic helix peptides of this invention are also effective in mitigating one or more symptoms of atherosclerosis. The monomers comprising the concatamers can be coupled directly together or joine=d by a linker. In certain embodiments, the linker is an amino acid linker (e.g., a proline), ox a peptide linker (e.g., GlysSers) (SEQ ID NO:448). Im certain embodiments, the conca€amer is a 2 mer, more preferably a 3 mer, still more preferably a 4 mer, and most preferably 5 mer, 8 mer, 10 mer, or 15 mer.

B) Alternati ng D- and L-amino acids. .

[0254] It was discovered that alternating the sterioisoforms of the amino» acids at the center of the peptide will allow hydration of the particle and will better allow the peptide particles to trap pro-inflammatory oxidized lipids such as fatty acid hydroperoxides and phospholipids that contain an oxidation product of arachido-nic acid at the sn-2 position.

[0255] Thus, in certain embodiments, the peptides described herein can be synthesized to comprise from 4 amino acids to 10-15 amino acids, preferentially~ (but not necessarily) with the center (non-terminal) amino acids being alternating D and L sterioisomers of the amirao acids. The terminal amino acids can be hydrophobic either because of a hydrophobic side chain or because the amino acids bear hydrophob»ic blocking groups as described herein (e.g., an N-terminus is blocked with Boc-, Fmoc-,

Nicotinyl-, and the like a nd the C-terminus blocked with (1Bu)-OrBu and the like.

[0256] Examples of such peptides are illustrated in Table 11.

[0257] Table 11. Certain examples of peptides containign alternating D— and L- residues in the central region.

Sequence SEQIDNO

Boc-Lys(eBoc)-D-Arg-L-Asp-Ser(rBu)-O7Bu 449

Boc-Lys(eBoc)-L-Arg—D-Asp-Ser(Bu)-OrBu/ 450

[0258] It is noted that while specific amino acid sequences are illustrated in Table 11, alternating D- and L- amino acids can be used in any of the peptides describe=d herein. 8) Biotin-dexivatized peptides.

[0259] In certain embodiments, any of the peptides described herein can be attached (covalently coupled directly or indirectly through a linker) to one or more biotins.

The biotin interacts with the intestinal sodium-dependent multivitamin transporter and thereby facilitates uptake and bioavailability of orally administered peptides.

[0260] The biotin can be directly coupled or coupled throu gh a linker or through a side ch ain of an amino acid by any of a number of convenient means known to those of skillin the art. In certain embodiments, the biotin is attached to thme amino groups of ’ lysine.

[0261] A number of biotin-coupled peptides are illustratecE in Table 12.

[0262] Table 12. Examples of certain preferred peptides: “Sequence 7 SEQD

NO

Ac-_Asp-Trp-Phe-Lys(e-biotin)-Ala-Phe-Tyr-Asp-Lys(e-biotin)»-Val-Ala- 451

Glu—-Lys(e-biotin)-Phe-Lys(e-biotin)-Glu-Ala-Phe-NH,

Ac-_Asp-Trp-Phe-Lys(e-biotin)-Ala-Phe-Tyr-Asp-Lys(e-biotin»-Val-Ala- 452

Glu—Lys(e-biotin)-Phe-Lys-Glu-Ala-Phe-NH,

Ac-_Asp-Trp-Phe-Lys-Ala-Phe-Tyr-Asp-Lys(e-biotin)-Val-Ala—Glu-Lys(e- 453 biotin)-Phe-Lys(e-biotin)-Glu-Ala-Phe-NH;

Ac-_Asp-Trp-Phe-Lys(¢-biotin)-Ala-Phe-Tyr-Asp-Lys-Val-Ala—Glu-Lys(e- 454 biotin)-Phe-Lys(e-biotin)-Glu-Ala-Phe-NH;

Ac-_Asp-Trp-Phe-Lys(e-biotin)-Ala-Phe-Tyr-Asp-Lys(e-biotin)-Val-Ala- 455

Glu -Lys-Phe-Lys(g-biotin)-Glu-Ala-Phe-NH,

Ac- Asp-Trp-Phe-Lys(e-biotin)-Ala-Phe-Tyr-Asp-Lys-Val-Ala—Glu-Lys- 456

Phe -Lys(e-biotin)-Glu-Ala-Phe-NH;

Ac- Asp-Trp-Phe-Lys(e-biotin)-Ala-Phe-Tyr-Asp-Lys(e-biotin)-Val-Ala- 457

Glu.-Lys-Phe-Lys-Glu-Ala-Phe-NH;

Ac- Asp-Trp-Phe-Lys-Ala-Phe-Tyr-Asp-Lys-Val-Ala-Glu-Lyse-biotin)- 458

Phe--Lys(e-biotin)-Glu-Ala-Phe-NH,

Ac~ Asp-Trp-Phe-Lys-Ala-Phe-Tyr-Asp-Lys(e-biotin)-Val-Ala -Glu-Lys- 459

Phe=-Lys(e-biotin)-Glu-Ala-Phe-NH,

Ac~—Asp-Trp-Phe-Lys-Ala-Phe-Tyr-Asp-Lys(e-biotin)-Val-Ala_-Glu-Lys(e- 460 biotin)-Phe-Lys-Glu-Ala-Phe-NH,

Ac—Asp-Trp-Phe-Lys(e-biotin)-Ala-Phe-Tyr-Asp-Lys-Val-Ala_-Glu-Lys(e- 461 biotin)-Phe-Lys-Glu-Ala-Phe-NH,

Ac—Asp-Trp-Phe-Lys(e-biotin)-Ala-Phe-Tyr-Asp-Lys-Val-Ala_-Glu-Lys- 462 : Phes-Lys-Glu-Ala-Phe-NH,

Ac—Asp-Trp-Phe-Lys-Ala-Phe-Tyr-Asp-Lys(e-biotin)-Val-Ala-Glu-Lys- 463

Phe=-Lys-Glu-Ala-Phe-NH,

Ac~Asp-Trp-Phe-Lys-Ala-Phe-Tyr-Asp-Lys-Val-Ala-Glu-Lys (e-biotin)- 464

Phes-Lys-Glu-Ala-Phe-NH;

Ac—Asp-Trp-Phe-Lys-Ala-Phe-Tyr-Asp-Lys-Val-Ala-Glu-Lys -Phe-Lys(e- 465 biotin)-Glu-Ala-Phe-NH»

XII. Pha xmaceutical formulations.

[0263] In order to carry out the methods of the invention, one Or more peptides, or pairs of ami no acids, or peptide mimetics of this invention are adminis tered, e.g., to an individual diagnosed as having one or more symptoms of atherosclerosis, or as being at risk for athezrosclerosis. The peptides, or pairs of amino acids, or pepti de mimetics can be administere«d in the "native" form or, if desired, in the form of salts, es€ers, amides, prodrugs, derivatives, and the like, provided the salt, ester, amide, prodrug or derivative is suitable pha rmacologically, i.e., effective in the present method. Salts, esters, amides, prodrugs an-d other derivatives of the active agents may be prepared using standard procedures known to those skilled in the art of synthetic organic chemistry and described, for example, by March (1992) Advanced Organic Chemistry; Reactiores, Mechanisms and

Structure, 4th Ed. N.Y. Wiley-Interscience.

[0264] For example, acid addition salts are prepared from the free base using conventional methods, that typically involve reaction with a suitable acid. Generally, the base form of the drug is dissolved in a polar organic solvent such as methanol or ethanol and the acid_ is added thereto. The resulting salt either precipitates or may be brought out of solution bby addition of a less polar solvent. Suitable acids for preparing acid addition salts includes both organic acids, e.g., acetic acid, propionic acid, glycolic acid, pyruvic acid, oxalic acid, malic acid, malonic acid, succinic acid, maleic acid, £umaric acid, tartaric acid , citric acid, benzoic acid, cinnamic acid, mandelic acid, methanesulfonic acid, ethanesulforic acid, p-toluenesulfonic acid, salicylic acid, and the like. as well as inorganic acids, e.g., hydrochloric acid, hydrobromic acid, sulfuric acid, nitric acid, phosphoric cid, and the like. An acid addition salt may be reconverte d to the free base by treatment with a suitable base. Particularly preferred acid addition salts of the active agents herei n are halide salts, such as may be prepared using hydrochloric or hydrobromic acids. Conwersely, preparation of basic salts of the peptides or mimetics are prepared in a similar manner using a pharmaceutically acceptable base such as soditwm hydroxide, potassium hydroxide, ammonium hydroxide, calcium hydroxide, trimethylamine, or the like. Particularly preferred basic salts include alkali metal salts, e.g., the sodium salt, and copper salts.

[0265] Preparation of esters typically involves functionalization o»f hydroxyl and/or carboxyl groups, tlhat can be present within the molecular structure of the drug. The esters are typically acyl-substituted derivatives of free alcohol groups, i.e., moieties that are derived from carboxylic acids of the formula RCOOH where R is alky, amd preferably is lower alkyl. Esters can be reconverted to the free acids, if desired, by usirg conventional hydrogenolysis or hydrolysis procedures.

[0266] Amides and prodrugs may also be prepared using techniques known to those skilled in thes art or described in the pertinent literature. For examp-le, amides may be prepared from esters, using suitable amine reactants, or they may be prepared from an anhydride or an acid chloride by reaction with ammonia or a lower alkyl amine. Prodrugs are typically prepaared by covalent attachment of a moiety that results in &x compound that is therapeutically &nactive until modified by an individual's metabolic system.

[0267] The peptides, or pairs of amino acids, or mimetics identifz ed herein are useful for parenteral, topical, oral, nasal (or otherwise inhaled), rectal, or local administration, su<ch as by aerosol or transdermally, for prophylactic and/or therapeutic treatment of athereosclerosis and/or symptoms thereof and/or for one or nore of the other indications identified herein. The pharmaceutical compositions can be administered in a variety of unit dosage forms depending upon the method of administration. Suitable unit dosage forms, incJude, but are not limited to powders, tablets, pills, caps ules, lozenges, suppositories, patches, nasal sprays, injectibles, implantable sustained-rezlease formulations, lipid complexes, etc.

[0268] Th e peptides, and/or pairs of amino acids, and/or peptide mimetics of this invention are typically combined with a pharmaceutically acceptable carrier (excipient) to form a pharmacol ogical composition. Pharmaceutically acceptable carriers can contain one or more physiologically acceptable compound(s) that act, for example, to stabilize the composition or to- increase or decrease the absorption of the active agen€(s). } Physiologically acceptable compounds can include, for example, carbohydrates, such as glucose, sucrose, or dextrans, antioxidants, such as ascorbic acid or glut athione, chelating agents, low molecular weight proteins, protection and uptake enhancers such as lipids,

compositions that reduce the clearance or hydrolysis of the active agents, or excipients or other stabilizers and/or buffers.

[0269] Other physiologically acceptable compound s include wetting agents, emul sifying agents, dispersing agents or preservatives that are particularly useful for preventing the growth or action of microorganisms. Various preservatives are well known and include, for example, phenol and ascorbic acid. One skilled in the art would appreciate that the choice of pharmaceutically acceptable caurier(s), including a physiologically acceptable compound depends, for example, on the route of administration of the active agent(s) and on the particular physio-chemical characteristics of the active agent(s).

[0270] The excipients are preferably sterile and gen erally free of undesirable mattesr. These compositions may be sterilized by conventiosnal, well-known sterilization techrriques.

[0271] In therapeutic applications, the compositions of this 1:ivention are admimistered to a patient suffering from one or more symptoms of atherosclerosis or at risk for atherosclerosis in an amount sufficient to cure or at least partially prevent or arrest the disease and/or its complications. An amount adequate to accomplish this is defined as a "therapeutically effective dose." Amounts effective for thais use will depend upon the severity of the disease and the general state of the patient's health. Single or multiple admimistrations of the compositions may be administered depending on the dosage and frequency as required and tolerated by the patient. Inanye vent, the composition should provi de a sufficient quantity of the active agents of the formulations of this invention to effectively treat (ameliorate one or more symptoms) the patient.

[0272] The concentration of peptide, or pair of amirio acids, or mimetic can vary widely, and will be selected primarily based on fluid volumes, viscosities, body weight and the like in accordance with the particular mode of administration selected and the patiert's needs. Concentrations, however, will typically be selected to provide dosages ranging from about 0.1 or 1 mg/kg/day to about 50 mg/kg/Aay and sometimes higher.

Typical dosages range from about 3 mg/kg/day to about 3.5 mg/kg/day, preferably from about 3.5 mg/kg/day to about 7.2 mg/kg/day, more preferat>ly from about 7.2 mg/kg/day to about: 11.0 mg/kg/day, and most preferably from about 11.00 mg/kg/day to about 15.0 mg/kg/day. In certain preferred embodiments, dosages range from about 10 mg/kg/day to about 50 mg/kg/day. It will be appreciated that such dosages may be varied to optimize a therapeutic regimen in a particular subject or group of subjects.

[0273] In certain preferred embodiments, the peptides, and/or pairs of amino acids, and/or peptide mimetics of this invention are administered orally (e.g., via a tablet) or as an injectable in accordance with standard methods well known to those of skill in the art.

In other preferred embodiments, the peptides, , or pairs of amino acids, can also be delivered through the skin using conventional transdermal drug delivery systems, i.e., transdermal "patches" wherein the active agent(s) are typically contained within a laminated structure that serves as a drug delivery device to be affixed to the skin. In such ~astructure, the drug composition is typically contained in a layer, or "reservoir," underlying an upper backing layer. It will be appreciated that the term "reservoir" in this context refers to a quantity of "active ingredient(s)" that is ultimately available for delivery to the surface of the skin. Thus, for example, the "reservoir" may include the active ingredient(s) in an adhesive on a backing layer of the patch, or in any of a variety of different matrix formulations known to those of skill in the art. ‘I'he patch may contain a single reservoir, or it may contain multiple reservoirs.

[0274] In one embodiment, the reservoir comprises a polymeric matrix of a pharmaceutically acceptable contact adhesive material that serves to affix the system to the skin during drug delivery. Examples of suitable skin contact adhesive materials include, but are not limited to, poly ethylenes, polysiloxanes, polyisobutylenes, polyacrylates, polyurethanes, and the like. Alternatively, the drug-containing reservoir and skin contact adhesive are present as separate and distinct layers, with the adhesive underlying the reservoir which, in this case, may be either a polymeric matrix as described above, or it may be a liquid or hydrogel reservoir, or may take some other form. The backing layer in these laminates, which serves as the upper surface of the device, preferably functions as a primary structural element of the "patch" and provides the device . with much of its flexibility. The material selected for the backing layer is preferably substantially impermeable to the active agent(s) and any other materials that are present.

[0275] Other preferred formulations for topical drug delivery include, but are not limited to, ointments and creams. ©Qintments are semisolid preparations, that are typically based on petrolatum or other petroleum derivatives. Creams containing the selected active agent are typically viscous liquid or semisolid emulsions, often either oil-in-water or water-in-oil. Cream bases are typically w ater-washable, and contain an oil phase, an emulsifier and an aqueous phase. The oil phase, also sometimes called the "internal" phase, is generally comprised of petrolatum and a fatty alcohol such as cetyl or stearyl alcohol; the aqueous phase usually, although not necessarily, exceeds the oil phase in volume, and generally contains a humectant. The emulsifier in a cream formulation is generally a nonionic, anionic, cationic or amphoteric surfactant. The specific ointment or cream base to be used, as will be appreciated by those skilled in the art, is one that will provide for optimum drug delivery. As with other carriers or vehicles, an ointment base should be inert, stable, nonirritating and nonsensitizing.

[0276] Unlike typical peptide formulations, the peptides, or pairs of amino acids, of this invention comprising D-form amin o acids can be administered, even orally, without protection against proteolysis by stomach acid, erc. Nevertheless, in certain embodiments, peptide delivery can be enhanced by the use of protective excipients. This is typically accomplished either by complexing the polypeptide with a composition to render it resistant to acidic and enzymatic hydrolysis or by packaging the polypeptide in an appropriately resistant carrier such as a liposome. Means of protecting polypeptides for oral delivery are well known in the art (see, e.g., U.S. Patent 5,391,377 describing lipid compositions for oral delivery of therapeutic agents).

A) __ Sustained release formulations.

[0277] Elevated serum half-life can be maintained by the use of sustained-release protein "packaging" systems. Such sustained release systems are well known to those of skill in the art. In one preferred embodiment, the ProLease biodegradable microsphere delivery system for proteins and peptides (Tracy (1998) Biotechnol. Prog. 14: 108;

Johnson et al. (1996), Nature Med. 2: 795 ; Herbert et al. (1998), Pharmaceu. Res. 15, 357) a dry powder composed of biodegradable polymeric microspheres containing the protein in a polymer matrix that can be compounded as a dry formulation with or without other agents.

[0278] The ProLease microsphere fabrication process was specifically designed to achieve a high protein encapsulation efficiency while maintaining protein integrity. The

= WO 2005/016280 PCT/US2004/026288 process consists of (i) preparation of freeze-dried protein particles from bulk protein by spray freeze-drying the drug solution with stabilizing excipients, (ii) preparation of a drug- polymer suspension followed by sonication or homogenization to reduce the drug particle size, (iii) production of frozen drug-polymer microspheres by atomization into liquid nitrogen, (iv) extraction of the polymer solvent with ethanol, and (v) filtration and vacuum drying to produce the final dry-powder product. The resulting powder contains the solid form of the protein, which is homogeneously and rigidly dispersed within porous polymer particles. The polymer most commonly used in the process, poly(lactide-co-glycolide) (PLG), is both biocompatible and biodegrad able.

[0279] Encapsulation can be achievesd at low temperatures (e.g., -40°C). During encapsulation, the protein is maintained in the solid state in the absence of water, thus minimizing water-induced conformational mobility of the protein, preventing protein degradation reactions that include water as a reactant, and avoiding organic-aqueous interfaces where proteins may undergo denaturation. A preferred process uses solvents in which most proteins are insoluble, thus yielding high encapsulation efficiencies (e.g., greater than 95%).

[0280] In another embodiment, one or more components of the solution can be provided as a "concentrate", e.g., in a storage container (e.g., in a premeasured volume) ready for dilution, or in a soluble capsule ready for addition to a volume of water.

B) Combined formulations.

[0281] In certain instances, one or more peptides, and/or pairs of amino acids, of this invention are administered in conjunction with one or more active agents (e.g., statins, beta blockers, ACE inhibitors, lipids, ezc.). "The two agents (e.g., peptide and statin) can be administered simultaneously or sequentially. When administered sequentially the two agents are administered so that both achieve a physiologically relevant concentration over a similar time period (e.g., so that both agents are active at some common time).

[0282] In certain embodiments, both agents are administered simultaneously, In such instances it can be convenient to provide both agents in a single combined formulation. This can be achieved by a variety of methods well known to those of skill in the art. For example, in a tablet formulation the tablet can comprise two layers one layer comprising, e.g., the statin(s), and the other layer comprising e.g., the peptide(s). In a time release capsule, the capsule can comprise two time release bead sets, one for the peptide(s) and one containing the statin(s).

[0283] The foregoing formulations and administration methods are intended to be ) illustrative and not limiting. It will be appreciated that, using the teaching provided herein, other suitable formulations and modes of administration can be readily devised.

XIII. Additional pharmacolegically active agents.

[0284] Additional pharmacologically active agents may be delivered along with the primary active agents, e.g., the peptides, or pairs of amino acids, of this invention. In one embodiment, such agents include, but are not limited to agents that reduce the risk of atherosclerotic events and/or complications thereof. Such agents include, but are not limited to beta blockers, beta blockers and thiazide diuretic combinations, statins, aspirin, ace inhibitors, ace receptor inhibi tors (ARBs), and the like.

A) Statins.

[0285] It was a surprising discovery that administration of one or more peptides of this invention "concurrently" with one or more statins synergistically enhances the effect of the statin(s). That is, the statiras can achieve a similar efficacy at lower dosage thereby obviating potential adverse side effects (e.g., muscle wasting) associated with these drugs and/or cause the statins to be significantly more anti-inflammatory at any given dose.

[0286] The major effect Of the statins is to lower LDL-cholesterol levels, and they lower LDL-cholesterol more than: many other types of drugs. Statins generally inhibit an enzyme, HMG-CoA reductase, which controls the rate of cholesterol production in the body. These drugs typically lower cholesterol by slowing down the production of cholesterol and by increasing thes liver's ability to remove the LDL-cholesterol already in the blood.

[0287] The large reductions in total and LDL-cholesterol produced by these drugs appears to result in large reductions in heart attacks and heart disease deaths. Thanks to their track record in these studies and their ability to lower LDL-cholesterol, statins have become the drugs most often prescribed when a person needs a cholesterol-lowering medicine. Studies using statins have reported 20 to 60 percent lower LDL-cholesterol levels in patients on these drugs. Statins also reduce elevated triglyceride levels and produce a modest increase in HDL-cholesterol. Recently it has been appreciated that . statins have anti-inflammatory properties that may not be directly related to the degree of lipid lowering achieved. For example it has been £ound that statins decrease the plasma levels of the inflammatory marker CRP relatively E ndependent of changes in plasma lipid levels. This anti-inflammatory activity of statins has been found to be as or more important in predicting the reduction in clinical events inducesd by statins than is the degree of LDL lowering.

[0288] The statins are usually given in a siragle dose at the evening meal or at bedtime. These medications are often given in the evening to take advantage of the fact that the body makes more cholesterol at night than during the day. When combined with the peptides described herein, the combined peptid.e/statin treatment regimen will also typically be given in the evening.

[0289] Suitable statins are well known to tihose of skill in the art. Such statins include, but are not limited to atorvastatin (Lipitor(®, Pfizer), simvastatin (Zocor®,

MerckO, pravastatin (Pravachol®, Bristol-Myers S«quibb®, fluvastatin (Lescol®,

Novartis), lovastatin (Mevacor®, Merck), rosuvast atin (Crestor®, Astra Zeneca), and

Pitavastatin (Sankyo), and the like.

[0290] The combined statin/peptide dosage= can be routinely optimized for each patient. Typically statins show results after several weeks, with a maximum effect in 4 to 6 weeks. Prior to combined treatment with a statin. and one of the peptides described herein, the physician would obtain routine tests for starting a statin including LDL- cholesterol and HDL-cholesterol levels. Additionally, the physician would also measure the anti-inflammatory properties of the patient’s HIDL and determine CRP levels with a high sensitivity assay. After about 4 to 6 weeks of combined treatment, the physician would typically repeat these tests and adjust the do sage of the medications to achieve maximum lipid lowering and maximum anti-inflancimatory activity.

B) Cholesterol absorption inhibitors.

[0291] In certain emabodiments, one or more peptides, and/or pairs of amino acids, of this invention are admini stered to a subject in conjunction with one or more chol esterol absorption inhibitors. The peptide(s) can be administered before, after, or simultan eously : with the cholesterol absorption inhibitor. In the latter case, the cholesterol absorption inhibitor can be provided ass a separate formulation or as a combined formulation with one or more of the peptide(s).

[0292] Cholesterol absorption inhibitors are well known to those of skill in the art.

One important cholesterol absorption inhibitor is Ezetimibe, also known as 1-(4- fluorophenyl)-3(R)-[3-(4-fluorophenyl)-3(S)-hydroxypropyll-4(S)-(4-hydrox ypherayl)-2- azetidinone (available from Merck). Ezetimibe reduces blood cholesterol by inhibiting the absorption of cholesterol by the small intestine.

C) Beta blocerss.

[0293] Suitable beta blockers include, but are not limited to cardioselectives (selective beta 1 blockers), e.g., acebutolol (Sectral™), atenolol (Tenormin™), betaxolol (Kerlone™), bisoprolol (Zebeta™), metoprolol (Lopressor ™), and the like. Suitable non- selective blockers (block beta 1 and beta 2 equally) include, but are not limited to carteolol (Cartrol™), nadolol (Corgard™), penbutolol (Levatol™), pindolol (Visken™), caxvedilol, (Coreg™), propranolol (Indderal™), timolol (Blockadren™), labetalol (Normodyne™,

Trandate™), and the like.

[0294] Suitable bet a blocker thiazide diuretic combinations include, but are not limited to Lopressor HCT, ZIAC, Tenoretic, Corzide, Timolide, Inderal LA 40/25,

Inderide, Normozide, and the like.

D) ACE inhibStors.

[0295] Suitable ace inhibitors include, but are not limited to captopril (e.g-,

Capoten™ by Squibb), berazepril (e.g., Lotensin™ by Novartis), enalapril (e.g,

Vasotec™ by Merck), fosi_nopril (e.g., Monopril™ by Bristol-Myers), lisinopril Ce.g.,

Prinivil™ by Merck or Zestril™ by Astra-Zeneca), quinapril (e.g., Accupril™ by Parke-

Davis), ramipril (e.g., Alta.ce™ by Hoechst Marion Roussel, King Pharmaceuticals),

imidapril, perindopril erbumine (e.g., Aceon™ by R hone-Polenc Rorer), trandolapril (e.&.,

Mavik™ by Knoll Pharmaceutical), and the like. Sumitable ARBS (Ace Receptor Blockers) include but are not limited to losartan (e.g., Cozaar by Merck), irbesartan (e.g.,

Avapro™ by Sanofi), candesartan (e.g., Atacand ™ by Astra Merck), valsartan (e.g., Diovan™ by Novartis), and the like.

E) Lipid-based formulations.

[0296] In certain embodiments, the peptides, and/or pairs of amino acids, of this invention are administered in conjunction with one or more lipids. The lipids can be formulated as an active agent, and/or as an excipient to protect and/or enhance transport/uptake of the peptides, or they can be admimistered separately.

[0297] Without being bound by a particular theory, it was discovered of this invention that administration (e.g., oral administration) of certain phospholipids can significantly increase HDL/LDL ratios. In addition, itis believed that certain medium- length phospholipids are transported by a process dif ferent than that involved in general lipid transport. Thus, co-administration of certain medium-length phospholipids with the peptides of this invention confer a number of advantages: They protect the phospholipids from digestion or hydrolysis, they improve peptide uptake, and they improve HDL/LDL ratios.

[0298] The lipids can be formed into liposomaes that encapsulate the polypeptides ofthis invention and/or they can be simply complexe=d/admixed with the polypeptides.

Methods of making liposomes and encapsulating reagents are well known to those of skill in the art (see, e.g., Martin and Papahadjopoulos (1982) J. Biol. Chem., 257: 286-288;

Papahadjopoulos ez al. (1991) Proc. Natl. Acad. Sci. USA, 88: 11460-11464; Huang et al. (1992) Cancer Res., 52:6774-6781; Lasic et al. (1992) FEBS Lett., 312: 255-258., and the like).

[0299] Preferred phospholipids for use in these methods have fatty acids rangin g from about 4 carbons to about 24 carbons in the sn-1 and sn-2 positions. In certain preferred embodiments, the fatty acids are saturated. In other preferred embodiments, the ’ fatty acids can be unsaturated. Various preferred fatty acids are illustrated in Table 13.

[0300] Table 13. Preferred fatty acids in the sn-1 and/or sn-2 position of the preferred phospholipids for administration of D polypeptides.

Carbon No. Common Name TUPAC Name 3:0 Propionoyl Trianoic 4:0 Butanoyl Tetranoic 5:0 Pentanoyl Pentanoic 6:0 Caproyl Hexanoic 7:0 Heptanoyl Heptanoic 8:0 Capryloyl Octanoic 9:0 Nonanoyl Nonanoic 10:0 Capry! Decanoic 11:0 Undcanoyl Undecanoic 12:0 Lauroyl Dodecanoic 13:0 Tridecanoyl Tridecanoic 14:0 Myristoyl Tetradecanoic 15:0 Pentadecanoyl Pentadecanoic 16:0 Palmitoyl Hexadecanoic 17:0 Heptadecanoyl Heptadecanoic 18:0 Stearoyl Octadecanoic 19:0 Nonadecanoyl Nonadecanoic 20:0 Arachidoyl Eicosanoic 21:0 Heniecosanoyl Heniecosanoic 22:0 Behenoyl Docosanoic 23:0 Trucisanoyl Trocosanoic 24:0 Lignoceroyl Tetracosanoic 14:1 Mpyristoleoyl (9-cis) 14:1 Myristelaidoyl (9-trans) 16:1 Palmitoleoyl (9-cis) 16:1 Palmitelaidoyl (9-trans)

The fatty acids in these positions can be the same or different. Particularly preferred phospholipids have phosphorylcholine at the sn-3 position. : [0301] In anotheT embodiment this invention provides kits for amelioration of one or more symptoms of atherosclerosis and/or for the prophylactic treatment of a subject

(human or animal) at risk for atherosclerosis and/or for stimulating the formation and cycling of pre-beta high density lipoprotein-like particles and/or for inhibiting one or more symptoms of osteop-orosis. The kits preferably comprise a container contai ning one or . more of the peptides, and/or pairs of amino acids, and/or peptide mimetics «of this invention. The peptdde, and/or pairs of amino acids, and/or peptide mimeti« can be provided in a unit dosage formulation (e.g., suppository, tablet, caplet, patc h, etc.) and/or may be optionally combined with one or more pharmaceutically acceptable excipients.

[0302] The kit can, optionally, further comprise one or more other agents used in the treatment of heaxt disease and/or atherosclerosis. Such agents include, but are not limited to, beta blockers, vasodilators, aspirin, statins, ace inhibitors or ace receptor inhibitors (ARBs) ard the like, e.g., as described above.

[0303] In cemtain preferred embodiments, the kits additionally inclu de a statin (e.g., cerivastatin, atorvas®atin, simvastatin, pravastatin, fluvastatin, lovastatin. rcssuvastatin, pitavastatin, erc.) either formulated separately or in a combined formulatior with the peptide(s). Typically the dosage of a statin in such a formulation can be lo=wer than the dosage of a statin typpically presecribed without the synergistic peptide.

[0304] In addition, the kits optionally include labeling and/or instructional materials providing «directions (i.e., protocols) for the practice of the metho«ds or use of the "therapeutics" or "pr-ophylactics” of this invention. Preferred instructional materials describe the use of omne or more polypeptides, and/or pairs of amino acids, of this invention to mitigate one or m ore symptoms of atherosclerosis and/or to prevent the onset or increase of one or m ore of such symptoms in an individual at risk for atheresclerosis and/or to stimulate the formation and cycling of pre-beta high density lipoprotein-like particles and/or to imhibit one or more symptoms of osteoporosis and/or to mitigate one or more symptoms of a pathology characterized by an inflammatory response- The instructional materials may also, optionally, teach preferred dosages/therap-eutic regiment, counter indications and the like.

[0305] While the instructional materials typically comprise written or printed materials they are not limited to such. Any medium capable of storing such instructions and communicating them to an end user is contemplated by this invention. Such media include, but are not Rimited to electronic storage media (e.g., magnetic discs, tapes,

WE 2005/016280 PCT/ USTUIAZ2E8 : cartridges, chips), optical media (e.g., CD ROM), and thes like. Such media may include addresses to internet sites that provide such instructional materials.

EXAMPLES .

[0306] The following examples are offered to illustrate, but not to limit the claimed invention. :

Example 1

Evaluation of Small Peptides to Mediate Symptoms of Atherosclerosis and other

Inflammatory Pathologi es.

[0307] The apo A-I mimetic peptides described herein (see, e.g., Table 1) exhibit antiatherogenic properties similar to apo A-I in that they remove the “seeding molecules” (e._g., oxidized phospholipids such as Ox-PAPC, POVPC , PGPC, and PEIPC, efc.) necessary for artery wall cells to oxidized LDL and are si milar to apo A-Iin that they ameliorated atherosclerosis in mouse models.

[0308] The apo A-I mimetic peptides (e.g., D-4F, SEQ ID NO:8), differ from apo A-Iin that they are also active in a co-incubation similar to apo J (see, e.g., USSN 10/120,508 and PCT/US03/09988). These peptides generally do not have substantial sequence homology to apo A-L, but have homology in their helical structure and in their ability to bind lipids.

[0309] The smaller peptides described herein (see, e.g., Tables 4-7 herein) are sirmilar to native apoA-I in that they prevent LDL oxidation and LDL-induced monocyte chemotactic activity in a pre-incubation with artery wall cells but not in a co-incubation (see, e.g., Figure 3).

[0310] The peptide described in Figure 3 was also active in vivo (Figure 4). The tetTapeptide or D-4F (SEQ ID NO:8) were added at 5 ug/ ml to the drinking water or not added to the drinking water of apoE null mice (a mouse rmodel of human atherosclerosis).

After 18 hours the mice were bled and their lipoproteins £solated by FPLC. Adding the fractions containing mature HDL or the FPLC fractions a fter these fractions where pre- beta HDL would be expected (particles that come off the FPLC column just after the main

HIDL peak; post HDL) from mice that received drinking water without peptide increased the monocyte chemotactic activity induced by a control LDL added to a human artery wall cell coculture (Figure 4). In contrast, adding HDL or the post HDL FPLC fractions from the mice that received the tetrapeptide or D-4F in their drinking water significantly . decreased the LDL -induced monocyte chemotactic activity indicating that the tetrapeptide and D-4F converted these lipoproteins from a pro-inflammatory to an anti-inflammatory ’ state (Figure 4).

[0311] As shown in Figure 5, LDL taken from the mice that received the tetrapeptide or D-4F induced significantly less monocyte chemotactic activity than did

LDL from mice that did not receive the peptides confirming the biologic activity of the orally administered D-tetrapeptide.

[0312] Figure 6 demonstrate s that HDL taken 20 min or 6 hours after SEQ ID

NO:258 from Table 4 synthesized from D-amino acids was instilled into the stomachs of apoE null mice by stomach tube, was converted from pro-inflammatory to anti- inflammatory and was similar to that from mice that received D-4F and quite different from mice that received a peptide with the same D-amino acids as in D-4F but arranged in such a way as to prevent the formation of a class A amphipathic helix and hence rendering the peptide unable to bind lipids (scrambled D-4F).

[0313] Figure 7 demonstrate s that at both 20 min and 6 hours after oral administration of D-4F or SEQ ID NO:258 synthesized from D-amino acids the mouse

LDL was significantly less able to induce monocyte chemotactic activity compared to

LDL taken from mice that received the scrambled D-4F peptide.

[0314] Figure 8 demonstrate s that adding SEQ ID NO:238 in Table 4 (synthesized from all D-amino acids) to the food of apoE null mice for 18 hours converted the pro- inflammatory HDL of apoE null mice to anti-inflammatory HDL.

[0315] Figure 9 demonstrates that in vitro SEQ ID NO:258 in Table 4 was ten times more potent than SEQ ID NO:238. + [0316] As shown in Figure 3 SEQ ID NO:238 at 125 pg/ml was only mildly effective while as shown in Figure 9, SEQ ID NO:258 was highly active at 12.5 pg/ml in a pre-incubation in vitro.

[0317] The experiments shown in Figure 10 demonstrate that SEQ ID NQ:243,

SEQ ID NO: 242, and SEQ ID NO:256 from Table 4 were also able to convert the pro- inflammatory HDL of apoE null mice to anti-inflammatory HDL.

[0318] The activity of particular peptides of this invention is dependent on ) particular amino acid substitutions as shown in Figures 11, 12, and 13. SEQ ID NO:254 is identical with SEQ ID NO:258 except that the positions of the arginine and glutamic acid amino acids are reversed in the sequence (i.e. SEQ ID NO:254 is Boc-Lys(eBoc)-Glu-

Arg-Ser(7Bu)-OrBu, while SEQ ID NO:258 is Boc-Lys(eBoc)-Arg-Glu-Ser(rBu)-OrBu).

As a result of this seemingly minor change, SEQ ID NO: 254 is substantially less effective in these assays than SEQ ID NO:258.

[0319] The experiments described in Figures 11 and 12 demonstrate that SEQ ID

NO:258 from Table 4 was more effective in converting pro-inflammatory HDL to anti- inflammatory HDL and rendering LDL less able to induce monocyte chemotactic activity than was either SEQ ID NO:254 or SEQ ID NO:282.

[0320] Serum Amyloid A (SAA) is a positive acute phase reactant in mice that is similar to C-Reactive Protein (CRP) in humans. The data in Figure 13 indicate that this acute phase reactant was significantly reduced in plasma after injection of SEQ ID

NO:258 and to a lesser, non-significant degree after injection of SEQ ID NO:254 and 282.

[0321] Figure 14 demonstrates that the peptide described in Table 4 as SEQ ID NO:258, when synthesized from all L-amino acids and given to apoE null mice orally converted pro-inflammatory HDL to anti-inflammatory and increased plasma paraoxonase activity (Figure 15).

[0322] Figures 16, 17, 18, and 19 demonstrate that the peptide described in Table 4 as SEQ ID NO:258 when synthesized fromm all D-amino acids and given orally to apoE null mice rendered HDL anti-inflammatory (Figures 16 and 17), reducing LDL-induced monocyte chemotactic activity (Figure 17) and increasing plasma HDL-cholesterol (Figure 18) and increasing HDL paraoxonase acti vity (Figure 19). These data also show that SEQ

ID NO:238, when synthesized from all L-amino acids and given orally to apoE null mice, did not significantly alter HDL inflammatory properties (Figures 16 and 17) nor did it significantly alter LDL-induced monocyte chemotactic activity (Figure 17) nor did it significantly alter plasma HDL-cholesterol concentrations (Figure 18), nor did it significantly alter HDL paraoxonase activity (Figure 1 9). Additionally these data show that when SEQ ID NO:238 from Table 4 was synthesized from all D-amino acids and was given orally to apoE null mice, HDL was rendered ant3-inflammatory (Figures 16 and 17), . and reduced LDL-induced monocyte chemotactic activity (Figure 17), but neither change was as dramatic as with SEQ ID NO:258. Moreover, unlike SEQ ID NO:258, SEQ ID

NO:238 from Table 4 when synthesized from all D-amaino acids did not raise plasma

HDL-cholesterol concentrations (Figure 18) and did not increase HDL paracxonase activity (Figure 19). We conclude that SEQ ID NO:238 from Table 4 when synthesized from L-amino acids is not effective when given orally but is effective when synthesized from D-amino acids, but is substantially less effective than SEQ ID NO:258.

[0323] The data presented herein demonstrate that SEQ ID NO:238 when synthesized from all L-amino acids and given orally is generally ineffective, and when "synthesized from all D-amino acids, while effective, is substantially less effective than the same dose of SEQ ID NO:258 synthesized from all D-zamino acids when administered orally.

Example 2

[0324] Figures 20 and 21 show the very dramatic synergy between a statin (pravastatin) and D-4F in ameliorating atherosclerosis din apoE null mice. Mice are known to be resistant to statins. The mice that received pravastatin in their drinking water at 20 ng/ml consumed a dose of pravastatin equal to 175 mg per day for a 70Kg human and the mice that received pravastatin in their drinking water a& 50 ug/ml consumed a dose of pravastatin equal to 437.5 mg per day for a 70Kg human. As shown in Figures 20 and 21, these very high doses of pravastatin were not effective in ameliorating atherosclerotic lesions in apoE null mice. As shown in Figures 20 and. 21, adding D-4F alone to the drinking water of the apoE null mice at concentrations of 2 ug/ml or 5 ug/ml did not reduce atherosclerotic lesions. These doses of D-4F waosuld be equivalent to doses of 17.5 mg per day, and 43.75 mg per day, respectively, for a 70Kg human. Remarkably, as shown in Figures 20 and 21, adding the same concentrations of pravastatin and D-4F together to the drinking water of the apoE null mice essentially abolished atherosclerosis in these mice. This indi cates a very high degree of synergy between a statin (pravastatin) and D-4F.

[0325] Figure 2-2 shows that SEQ ID NO.198 and SEQ ID NO. 203 fronn Table 4 were equally effective Or even more effective than D-4F in reducing the lipid ’ hydroperoxide content «©f both LDL and HDL in apoE null mice. These data are consistent with D-4F and the peptides described in this application acting in part by sequestering the “seeding molecules” nexcessary for LDL to induce the inflammatory atherosclerotic reaction. Taken together with the data shown in Figures 3 to 19 it is very likely that the peptides described in thris application (e.g., SEQ ID NO:250 198 and SEQ ID NO: 258 from Table 4) will be as or more effective than D-4F in ameliorating atherosclerosis.

Example 3

Physical Properties of Novel Small Organic Molecules (molecular weigkat <900 daltons) that Predict Ability to Render HDL More Anti-inflammatory andl Mitigate

[0326] It was a surprising finding of this invention that a number of physical properties predict the ability of the small peptides of this invention to render HIDL more anti-inflammatory and to mitigate atherosclerosis and/or other pathologies characterized by an inflammatory resgponse in a mammal. The physical properties include high solubility in ethyl acetate (e.g., greater than about 4mg/mlL.), and solubility in af ueous buffer at pH 7.0. Upon contacting phospholipids such as 1,2-Dimyristoyl-sn-gl sycero-3- phosphocholine MPC), in an aqueous environment, the particularly effective small peptides form particles ‘with a diameter of approximately 7.5 nm (+ 0.1 nm), ancl/or form stacked bilayers with a ‘bilayer dimension on the order of 3.4 to 4.1 nm with spacing between the bilayers in the stack of approximately 2 nm, and/or also form vesicular structures of approximately 38 nm). In certain preferred embodiments, the small peptides have a molecular weight of less than about 900 Da.

[0327] The predictive effectof these physical properties is illustrated by a comparison of two sequmences: :

SEQ ID INO 254: Boc-Lys(eBoc)-Glu-Arg-Ser(fBu)-OBu; and

SEQ ID INO 258: Boc-Lys(eBoc)-Arg-Glu-Ser(rBu)-OrBu

[03281 To evaluate solubility in ethyl acetate, each peptide was weighed and added to a centrifuge tube and ethyl acetate (HPLC grade; residue after evaporation <0.0001%) was added to give a concentration of 10 mg/mL.. The tubes were sealed, vortexed and kept at roorn temperature for 30 minutes with vortexing every 10 minutes. The tubes were then centrifuged for 5 minutes at 10, 000 rpm and the supernatant was removed to a previously weighed tube. The ethyl acetate was evaporated under argon and he tubes weighed to determine the amount of peptide that had been contained in the supernatant. The percent of the Originally added peptide that was dissolved in the supernatant is shown on the Y- axis. The data are mean + S.D. Control represents sham treated tubes; SEQ ID NO 254 and SEQ ID NO 258 were both synthesized from all D-amino acids; SEQ ID NO 250 was synthesized from all L-amino acids.

[0329] As shown in Figure 23, SEQ ID NO 258 is very soRuble in ethyl acetate while S’EQ ID NO 254 is not (both synthesized from all D-amino =cids). Additionally the data in Figure 23 demonstrate that SEQ ID NO 250 [Boc-Phe-Arg -Glu-Leu-OrBu] (synthesized from all L-amino acids) is also very soluble in ethyl acetate. - [0330] To 1mg/ml of DMPC suspension in phosphate buffered saline (PBS) was added 10% deoxycholate until the DMPC was dissolved. Peptides , SEQ ID NO 258 or

SEQ ID NO 254, were added (DMPC: peptide; 1:10; wt:wt) and thme reaction mixture dialyzed. After dialysis the solution remained clear with SEQ ID INO 258 but was turbid after the deoxycholate was removed by dialysis in the case of SEQ ID NO 254.

[0331] Figures 24-26-demonstrate that when SEQ ID NO 258 was added to DMPC in an aqueous environment particles with a diameter of approximately 7.5 nm formed, stacked lipid bilayers with a bilayer dimension on the order of 3.4 £0 4.1 nm with spacing between the bilayers in the stack of approximately 2 nm formed, arad vesicular structures of approximately 38 nm also formed.

[0332] In particular, Figure 24 shows an electron micrograph prepared with negative staining and at 147,420x magnification. The arrows indicate SEQ ID NO 258 particles measuring 7.5 nm (they appear as small white particles). . [0333] As illustrated in Figure 25 a peptide comprising SEQ ID NO 258 added to

DMPC in an aqueous environment forms particles with a diameter of approximately 7.5 nm (whit e arrows), and stacked lipid-peptide bilayers (striped arrows pointing to the white lines in the cylindrical stack of disks) with a bilayer dimension on the oxder of 3.4 to 4.1 nm with spacing between the bilayers (black lines between white lines in the stack of disks) of approximately 2 nm.

[0334] Figure 26 shows that the peptide of SEQ ID NO 258 addled to DMPC in an ’ aqueous environment forms stacked lipid-peptide bilayers (striped arrow) and vesicular } structures of approximately 38 nm white arrows).

[0335] Figure 27 shows that DMPC in an aqueous environment. without SEQ ID

NO 258 does not form particles with a diameter of approximately 7.5 nm, or stacked lipid- petide bilayers, nor vesicular structures of approximately 38 nm.

[0336] The peptide of SEQ ID NO 254 (which differs from the peptide of SEQ ID

NO 258 only in the order of arginine and glutamic acid in regard to the amino and carboxy termini of th e peptide) did not form particles with a diameter of approx imately 7.5 nm, or stacked lipid-peptide bilayers, nor vesicular structures of approximately 38 nm under the conditions ass described in Figure 24 (data not shown). Thus, the order of arginine and glutamic acid in the peptide dramatically altered its ability to interact with DMPC and this was predictesd by the solubility in ethyl acetate (i.e., the peptide of SEQ ID NO 258 was highly solubsle in ethyl acetate and formed particles with a diameter of approximately 7.5 nm, and stacked lipid-peptide bilayers, as well as vesicular structures of approximately 38 nm, while the peptide of SEQ ID NO 254 was poorly soluble in ethyl acetate and did not form these structures under the conditions described in Figure 24). In addition to the protocol described in Figure 24, similar results were also obtained if the DMPC suspension &n PBS was added to the peptide of SEQ ID NO 258 (DMP*C:peptide; 1:10; wt:wt) or to the peptide of SEQ ID NO 254 (DMPC:peptide; 1:10; wt=wt) and the mixture recycled between just above the transition temperature of DMPC (just above 50°C) and room temperature each hour for several cycles and then left at room temperature for 48 hours (data mot shown).

[0337] The physical properties of the peptide of SEQ ID NO 2 58 (but not the peptide of SEQ ID NO 254) indicate that this peptide has amphipathic properties (i.e., it is highly soluble in ethyl acetate, it is also soluble in aqueous buffer at pI 7.0 [data not . shown], ancl it interacts with DMPC as described above). It was a surprising finding of this invention that the peptides that are highly soluble in ethyl acetate, and are also soluble in aqueous buffer axt pH 7.0, interacted with DMPC to form lipid-peptide <complexes that are remarkably similar to the nascent HDL particles formed by the interaction of apoA-I with cells (Forte, e ¢ al. (1993) J. Lipid Res. 34: 317-324).

[0338] Tabrle 13 compares the interaction of lipid-free human apo_A-I with CHO- CI09 cells in vitro with the interaction of SEQ ID NO 258 with DMPC as sindicated in

Figures 4 —7 above.

[0339] Tabele 13. Comparison of the interaction of the peptide of SEQ ID NO 258 ~~ with DMPC as indicated in Figures 24-27 above with the interaction of lipid-free human apoA-I interacting with CHO-C-19 cells as described in Forteet al. (1993) J. Lipid Res. 34: 317-324.

Property ApoA-I/Cells SEQ HD NO 258/DMPC

Prominent Feature Discoidal particles Stacke=d bilayers in stacked in rouleaux cylindmrical form formation '

Bilayer dimensiom 4.6 nm 34-4-.1nm

Spacing between discoidal 1.9 nm. 2.0 nm particles/bilayers

Size “Nascent HIDL Particles” 7.3 nm 7.5 nm

Vesicular structumres 34.7 nm 38 nm —_ er oem

[0340] Thus, the small peptides described here that are highly solu ble in ethyl acetate and are also soluble in aqueous buffers at pH 7.0 interact with lipicls (DMPC) similar to apoA-I, which has a molecular weight of 28,000 Daltons.

[0341] The molecular models shown in Figures 28-32 demonstrates the spatial characteristics of SEQ ID NO 254 compared to SEQ ID NO 258.

[0342] The amolecular models shown in Figures 28-32 indicate that both the peptide of SEQ ID INO 254 and the peptide of SEQ ID NO 258 contain polar and non- ‘ 20 polar portions in each molecule but there are spatial differences in the arramgement of the polar and non-polar components of the two molecules. As a result of the differences in the spat al arrangement of the molecules there are differences in the solubility of the two molecules in ethyl acetate (Figure 23) and in their interacti«on with DMPC (Figures 24-27). [034-3] The data in Figures 33-35 demonstrate that the physical properties of the peptide of SEQ ID NO 254 versus the peptide of SEQ ID NO 258 predict the ability of these molecules to render HDL anti-inflammatory and miti gate atherosclerosis when given . orall y to a mammal. [034 4] Female apoE null mice at age 8 weeks were given no additions to their diet (Chow) or received 200 ng/gm chow of SEQ ID NO 254 (-3-254) or 200 png/gm chow of

SEQ ID NO 258 (+258), both synthesized from all D-amin« acids. After 15 weeks the mice were bled and their plasma fractionated by FPLC and their HDL, (mHDL) tested in a human artery wall cell coculture. A standard human LDL Cat 100 pg/mL of LDL- cholesterol) was added alone (LDL) or not added (no addition) or was added with 50 ug/ml of normal human HDL (hHDL) or 50 pg/mL of mowse HDL (mHDL) to human artery wall cocultures and the resulting monocyte chemotactic activity was determined and plotted on the Y-axis. Figure 33 shows that the HDL from zapoE null mice was rendered anti-Enflammatory after the mice were fed SEQ ID NO 258 but not after SEQ ID NO 254.

[0345] As shown in Figure 34 the peptide of SEQ IID NO 258 but not the peptide of SEQ ID NO 254 significantly reduced atherosclerosis in the aortic root (aortic sinus) of the agpoE null mice described above. Figure 35 demonstrates that SEQ ID NO 258 but not

SEQ ID NO 254 also significantly decreased atherosclerosis in en face preparations of the aortas. Figure 23 demonstrates that the solubility in ethyl acetate of SEQ ID NO 250 synthmesized from all L-amino acids (see Figure 23 above) accurately predicts the ability of this rmolecule to ameliorate atherosclerosis in apoE null mice.

[0346] Thus, the physical properties of these small peptides accurately predicted the ability of the peptides to ameliorate atherosclerosis in apoE null mice.

[0347] We thus teach that small peptides, typically swith molecular weights of less than about 900 Daltons that are highly soluble in ethyl acetate (greater than about 4 mg/ml), and also are soluble in aqueous buffer at pH 7.0, and that when contacted with phospholipids such as 1,2-Dimyristoyl-sn-glycero-3-phosphiocholine (DMPC), in an aqueous environment, form particles with a diameter of approximately 7.5 nm, and/or form stacked bilayers with a bilayer dimension on the order of 3.4 to 4.1 nm with spacing between the bilayers in the stack of approximately 2 nm, and/or they also form vesicular structures of approximately 38 nm, when administered to a mammal render HDL more anti-inflammatory and mitigate one ©r more symptoms of atherosclerosis and other ‘ pathologies characterized by an inflammatory response.

[0348] It is understood that the examples and embodiments described herein are for illustrative purposes only and tha t various modifications or changes in light thereof will be suggested to persons skilled in the art and are to be included within the spirit and purview of this application and scope of the appended claims. All publications, patents, and patent applications cited herein are hereby incorporated by reference in their entirety for all purposes.

What is claimed is: 1. A peptide that ameliorates one or more symptoms of an inflammatory condition, wherein said peptide: ranges in length from 3 to 5 amino acids; is soluble in ethyl acetate at a concentration greater than 4mg/mL; is soluble in aqueous buffer at pH 7.0; when contacted with a phospholipid in an aqueous environment, forms particles with a diameter of approximately 7.5 nm and forms stacked bilayers with a bilayer dimension on the order of 3.4 to 4.1 nm with spacing between the bilayexs in the stack of approximmately 2 nm; has a molecular weight less than 900 daltons; converts pro-inflammatory HDL to anti-inflammatory HDL or makes anti- inflammaatory HDL more anti-inflammatory; and does not have the amino acid sequence Lys-Arg-Assp-Ser (SEQ ID

NO:238) in which Lys-Arg-Asp and Ser are all L amino acids. 2. The peptide of claim 1, wherein said peptide protects a phospholipid against oxidation by an oxidizing agent 3. The peptide of claim 2, wherein said oxidizing agent is selected from the group consisting of hydrogen peroxide, 13(S)-HPODE, 15(S)-HPETE, HPODE, HPETE,

HODE, and HETE. 4. The peptide of claim 2, wherein said phospholipid is selected from the group consisting of 1-palmitoyl-2-arachidonoyl-sn-glycero-3 -phosphorylcholine (PAPC), 1- stearoyl—~2-arachidonoyl-sn-glycero-3-phosphorylcholine (SAPC)), and 1 -stearoyl-2-arachidonyl- sn-glycero-3-phosphorylethanolamine (SAPE).

S. A peptide that ameliorates one or more symptoms of an inflammatory conditiom, said peptide having the formula: - 106 -

AMENDED SHEET

Claims (1)

1. Xxx, X! wherein: n isOorl; XX! is a hydrophobic amino acid and/or bears a hydrophosbic protecting group; X*is a hydrophobic amino acid and/or bears a hydrophosbic protecting group; and when n is 0: X? is an amino acid selected from the group consisting of an acidic amino accid, a basic amino acid, and a histidine; whenn is I: X? and X° are independently an acidic amino acid, a basic amino acid, an aliphatic amino acid, or an aromatic ami no acid such that when X? is an acidic amino acid; X is a asic amino acid, an aliphatic amino acid, or an aromatic amino acid; when X? is a basic amino acid; X° is an acidic amino acid, an aliphatic amino acid, or an aromatic amino acid; and when X? is an aliphatic or aromatic amin o acid, X? is an acidic amino acid, or a basic amino acid; said peptide converts pro-inflammatory HDL to anti-inflammat ory HDL or makes anti- inflamm atory HDL more anti-inflammatory; and said peptide does not have the amino acid sequence Lys-Arg-A sp-Ser (SEQ ID NO:238) in which. Lys-Arg-Asp and Ser are all L amino acids.

   6. The peptide of claim 5, wherein nis 0.

   7. The peptide of claim 6, wherein wherein X! and X* are independently selected from the group consisting of alanine (A 1a), valine (Val), leucine (Leu), is-oleucine (Ile), proline (Pro) phenylalanine (Phe), tryptophan (Trp), methionine (Met), serine (Ser) bearing a hydrophobic protecting group, beta-naphthyl alanine, alpha- } naphthyl alanine, norleucine, cyclohexylalanine, threonine (Thx) bearing a hydrophobic protecting group, tyrosine (Tyr) bearing a hydrophobic protecting group, lysine (Lys) . bearing 2 hydrophobic protecting group, arginine (Arg) bearing a hydrophobic protecting group, o-rithine (Orn) bearing a hydrophobic protecting group, aspartic acid (Asp) bearing a hydrophobic protecting group, cysteine (Cys) bearing a hydrophobic protecting group, and glutamic acid (Glu) bearing a hydrophobic protecting group.

   8. The peptide of claim 7, wherein: X! is is selected from the group consisting of Glu, Leu, Lys, Orn, Phe, Trp, and morLeu; : . xX? is selected from the group consisting of Asp, Arg, and Glu; and X* is selected from the group consisting of Sex, Thr, Ile, Leu, Trp, Tyr, Phe, and norleu.

   9. The peptide of claim 7, wherein X! is is selected from the group consisting of Glu, Leu, Lys, Orn, Phe, Trp, and rorLeu; X* is selected from the group consisting of Lys, Arg, and His; and X* is selected from the group consisting of Asp, Arg, and Glu.

   10. The peptide of claim 6 wherein X! bears a hydrophobic protecting group.

   11. The peptide of claim 10, wherein said hydrophobic protecting group is selected frorm the group consisting of polyethylene glycol (PEG), t-butoxycarbonyl (Boc), Fmoc, nicotinyl, O7Bu, a benzoyl group, an acetyl (Ac), a carbbobenzoxy, methyl, ethyl, a propyl. a butyl, a pentyl a hexy! ester, an N-methyl anthranil yl, and a 3 to 20 carbon alkyl, amide, a 3 to 20 carbon alkyl group, 9-fluoreneacetyl gxoup, 1- fluorenecarboxx ylic group, 9-fluorenecarboxylic group, 9-fluorenone— 1-carboxylic group, benzyloxycarb onyl (is also called carbobenzoxy mentioned above), > anthyl (Xan), Trityl (Trt), 4-methyXtrityl (Mtt), 4-methoxytrityl (Mmt), 4-methoxy-2,3,6-trimethyl- benzenesulphosnyl (Mtr), Mesitylene-2-sulphonyl (Mts), 4,4-dimetho xybenzhydryl (Mbh), Tosyl (Tos), 2,2,5,7,8-pentamethyl chroman-6-sulphonyl (Pmc), 4-mxethylbenzyl (MeBzl), 4-methoxyben=zyl (MeOBzl), Benzyloxy (BzlO), Benzyl (Bzl), Benzoyl (Bz), 3-nitro-2- pyridinesulphesnyl (Npys), 1-(4,4-dimethyl-2,6-dioxocyclohexylidene)ethyl (Dde), 2,6- dichlorobenzyl (2,6-DiCl-Bzl), 2-chlorobenzyloxycarbonyl (2-Cl-Z), 2- bromobenzyloxycarbonyl (2-Br-Z), benzyloxymethyl (Bom), cyclohexyloxy (cHxO),t- butoxymethyl (Bum), t-butoxy (tBuO), t-Butyl (tBu), triflnoroacetyl (TFA), 4[N-{1-(4,4-

   dimethyl-2,6-dioxo<cyclohexylidene)-3-methyldibutyl)-amino } benzyl ester (€ODmab), a- allyl ester (OAIll), 2 -phenylisopropyl ester (2-PhiPr), 1-[4,4-dimethyl-2,6-dioxycyclohex- 1-yl-idene)ethyl (De).

   12. The peptide of claim 11, wherein said hydrophobic protecting group is selected from the group consisting of Boc, Fmoc, nicotinyl, and OrBu.

   13. The peptide of claim 10, wherein X* bears a hydropho bic protecting group.

   14. The peptide of claim 13, wherein said hydrophobic protecting group is selected from the group consisting of polyethylene glycol (PEG), t-butoxycarbonyl (Boc), Fmoc, nicotiryl, OzBu, a benzoyl group, an acetyl (Ac), a carbobenzo=y, methyl, ethyl, a propyl, a bu-tyl, a pentyl a hexyl ester, an N-methyl anthranilyl, and a. 3 to 20 carbon alkyl, amide. a 3 to 20 carbon alkyl group, 9-fluoreneacetyl group, 1- fluorenecarboxylic group, 9-fluorenecarboxylic group, 9-fluorenone-1-carboxylic group, benzyloxycarbonyl (is also called carbobenzoxy mentioned above), Xanthyl (Xan), Trityl (Trt), 4-methyltrityl (Mitt), 4-methoxytrityl (Mmt), 4-methoxy-2,3,6-trimethy]- benzenesulphonyl (IWItr), Mesitylene-2-sulphonyl (Mts), 4,4-dimethoxybenzh ydryl (Mbh), Tosyl (Tos), 2,2,5,7, 8-pentamethyl chroman-6-sulphonyl (Pmc), 4-methylberazyl MeBzl), 4-methoxybenzyl (M1eOBzl), Benzyloxy (BzlO), Benzyl (Bzl), Benzoyl (Bz), 3-nitro-2- pyridinesulphenyl (INpys), 1-(4,4-dimethyl-2,6-dioxocyclohexylidene)ethyl (Dde), 2,6- dichlorobenzyl (2,6-1DiCl-Bzl), 2-chlorobenzyloxycarbonyl (2-CI-Z), 2- bromobenzyloxycartbonyl (2-Br-Z), benzyloxymethyl (Bom), cyclohexyloxy {(cHxO),t- butoxymethyl (Bum), t-butoxy (tBuO), t-Butyl (tBu), trifluoroacetyl (TFA), ®[N-{ 1-(4,4- dimethyl-2,6-dioxocyclohexylidene)-3-methyldibutyl)-amino } benzyl ester (ODmab), o- allyl ester (OAL), 2-pphenylisopropyl ester (2-PhiPr), 1-[4,4-dimethyl-2,6-dioxycyclohex- l-yl-idene)ethyl (Dde).

   15. The peptide of claim 14, wherein the N-terminus of said peptide is blocked with a protecting group selected from the group consisting of Boc-, Fmoc-, and Nicotinyl-.

   16. The peptide of claim 14, wherein thae C-terminus of said peptide is blocked with a protecting group selected from the group consisting of Bu, and OzBu,

   17. The peptide of claim 6, wherein said peptide comprises the amino a cid sequence of a peptide in Table 3.

   18. The peptide of claim 6, wherein said peptide is a peptide from Table

   3.

   19. The peptide of claim 6, wherein sai d peptide comprises at least one ID-amino acid.

   20. The peptide of claim 6, wherein said peptide comprises all D- amino acids.

   21. The peptide of claim 6, wherein said peptide comprises alternating ID- and L- amino acids.

   22. The peptide of claim 6, wherein said peptide comprises all L- amino acids.

   23. The peptide of claim 6, wherein said peptide is mixed with a pharmacologically acceptable excipient.

   24. The peptide of claim 6, wherein said peptide is mixed with a pharmacologically acceptable excipient suitable for oral administration to a mammal.

   25. The peptide of claim 6, wherein said polypeptide is provided as a unit formulation in a pharmaceutically acceptable excipiesnt.

   26. The peptide of claim 6, wherein sa_id polypeptide is provided as a time release formulation.

   27. The peptide of claim 6, wherein sa id peptide protects a phospholipid against oxidation by an oxidizing agent

   28. The peptide of claim 27, wherein said oxidizing agent is selected from the group consisting of hydrogen peroxide, 13(S)-HPODE, 15(S)-HPETE, HPODE, HPETE, HODE, and HETE.

   29. The peptide of claim 27, wherein said phospholipid is selected from the group consisting of 1-palmitoyl-2-arachidonoyl-s-glycero-3-phosphorylcholine (PAPC), 1-stearoyl-2-arachidonoyl-sn-glycero-3-pho sphorylcholine (SAPC)), 1-stearoyl- 2-arachidonyl-sn-glycero-3-phosphorylethanolamine (SAPE).

   30. The peptide of claim 6, wherein said peptide is coupled to a biotin.

   31. The peptide of claim 5, wherein: nis 1; and X? and X° are independently an acidic amino acid or a basic amino acid such that when X° is an acidic amino acid, X> is a basic amino acid and when X is a basic amino acid, X® is an acidic amino acid.

   32. The peptide of claim 31, wheresin wherein X' and X* are independently selected from the group consisting of alanine (Ala), valine (Val), leucine (Leu), isoleucine (lle), proline (Pro), phenylalanine (Phe), tryptophan (Trp), methionine (Met), serine (Ser) bearing a hydrophobic protecting group, beta-naphthyl alanine, alpha- naphthyl alanine, norleucine, cyclohexylalanine, threonine (Thr) bearing a hydrophobic protecting group, tyrosine (Tyr) bearing a hydrophobic protecting group, lysine (Lys) bearing a hydrophobic protecting group, arginine (Arg) bearing a hydrophobic protecting group, ornithine (Orn) bearing a hydrophobic protecting group, aspartic acid (Asp) bearing a hydrophobic protecting group, cysteine (Cys) bearing a hydrophobic protecting group, - and glutamic acid (Glu) bearing a hydrophobic protecting group.

   33. The peptide of claim 32, wherein X* and X> are independently selected from the group consisting of : Asp, Glu, Lys, Arg, and His.

   34. The peptide of claim 32, wherein X? and X° are independently selected from the group consisting of Asp, Arg, and Glu.

   35. The peptide of claim 33 wherein X' bears a hydrophobic protecting group.

   36. The peptide of claim 35, wherein said hydrophobic protecting group ) is selected from the group consisting of polyethylene glycol (PEG), t-butox ycarbonyl (Boc), Fmoc, nicotinyl, O7Bu, a benzoyl group, an acetyl (Ac), a carbobenzoxy, methyl, . ethyl, a propyl, a butyl, a pentyl a hexyl ester, an N-methyl anthranilyl, and a 3 to 20 carbon alkyl, amide, a 3 to 20 carbon alkyl group, 9-fluoreneacetyl group, 1- fluorenecarboxylic group, 9-fluorenecarboxylic group, 9-fluorenone-1-carboxylic group, benzyloxycarbonyl (is also called carbobenzoxy mentioned above), Xanthyl (Xan), Trityl (Trt), 4-methyltrityl (Mtt), 4-methoxytrityl (Mmt), 4-methoxy-2,3,6-trimethyl- benzenesulphonyl (Mtr), Mesitylene-2-sulphonyl (Mts), 4,4-dimethoxybenzhydryl (Mbh), Tosyl (Tos), 2,2,5,7,8-pentamethyl chroman-6-sulphonyl (Pmc), 4-methylbenzyl (MeBzl), 4-methoxybenzyl (MeOBzl), Benzyloxy (BzlO), Benzyl (Bzl), Benzoyl (Bz), 3-nitro-2- pyridinesulphenyl (Npys), 1-(4,4-dimethyl-2,6-dioxocyclohexylidene)ethyl (Dde), 2,6- dichlorobenzyl (2,6-DiCl -Bzl), 2-chlorobenzyloxycarbonyl (2-Cl1-Z), 2- bromobenzyloxycarbonyl (2-Br-Z), benzyloxymethyl (Bom), cyclohexyloxy (cHxO),t- butoxymethyl (Bum), t-butoxy (tBuO), t-Butyl (tBu), trifluoroacetyl (TFA), 4[N-{1-(4,4- dimethyl-2,6-dioxocyclohiexylidene)-3-methyldibutyl)-amino }benzyl ester (ODmab), a- allyl ester (OAD), 2-phen ylisopropyl ester (2-PhiPr), 1-[4,4-dimethyl-2,6-dioxycyclohex- 1-yl-idene)ethyl (Dde).

   37. The peptide of claim 35, wherein said said hydrophobic protecting group is selected from the group consisting of Boc, Fmoc, nicotinyl, and OzBu.

   38. The peptide of claim 35, wherein X* bears a hydrophobic protecting group.

   39. The peptide of claim 38, wherein said hydrophobic protecting group is selected from the group consisting of polyethylene glycol (PEG), t-butoxycarbonyl (Boc), Fmoc, nicotinyl, OfBu, a benzoyl group, an acetyl (Ac), a carbobenzoxy, methyl, ethyl, a propyl, a butyl, a pentyl a hexyl ester, an N-methyl anthranilyl, and a 3 to 20 carbon alkyl, amide, a 3 to 20 carbon alkyl group, 9-fluoreneacetyl group, 1- fluorenecarboxylic group, 9-fluorenecarboxylic group, 9-fluorenone-1-carboxylic group,

   benzyloxycarbonyl (is also called carbobenzoxy mentiomed above), Xanthyl (Xan), Trityl (Trt), 4-methylirityl (Mit), 4-methox ytrityl (Mmt), 4-me- thoxy-2,3,6-trimethyl- benzenesulphonyl (Mtr), Mesitylene-2-sulphonyl (Mts), 4,4-dimethoxybenzhydryl (Mbh), : Tosyl (Tos), 2,2,5,7,8-pentamethyl chroman-6-sulphony-1 (Pmc), 4-methylbenzyl (MeBzl), 4-methoxybenzyl (MeOBzl), Benzyloxy (BzlO), Benzyl (Bzl), Benzoyl (Bz), 3-nitro-2- pyridinesulphenyl (Npys), 1-(4,4-dimethyl-2,6-dioxocyc=lohexylidene)ethyl (Dde), 2,6- dichlorobenzyl (2,6-DiCl-Bzl), 2-chlorobenzyloxycarbomyl (2-Cl-Z), 2- bromobenzyloxycarbonyl (2-Br-Z), benzyloxymethyl (Bom), cyclohexyloxy (cHxO),t- butoxymethyl (Bum), t-butoxy (tBuO), t-Butyl (tBu), trifluoroacetyl (TFA), 4[N-{1-(4 4- dimethyl-2,6-dioxocyclohexylidene)-3-methyldibutyl)-a-mino} benzyl ester (ODmab), o- allyl ester (OAll), 2-phenylisopropyl ester (2-PhiPr), 1-[=4,4-dimethyl-2,6-dioxycyclohex- 1-yl-idene)ethyl (Dde).

   40. The peptide of claim 35, wherein the N-terminus of said peptide is blocked with a protecting group selected from the group consisting of Boc-, Fmoc-, and Nicotinyl-.

   41. The peptide of claim 35, wherein ®he C-terminus of said peptide is blocked with a protecting group selected from the group consisting of tBu, and OtBu.

   42. The peptide of claim 31, wherein said peptide comprises the amino acid sequence of a peptide in Table 4.

   43. The peptide of claim 31, wherein said peptide is a peptide from Table 4.

   44. The peptide of claim 31, wherein said peptide comprises at least one D- amino acid.

   45. The peptide of claim 31, wherein said peptide comprises all D- amino acids.

   46. The peptide of claim 31, wherein said peptide comprises alternating D- and L- amino acids.

   47. The peptide of claim 31, wherein said peptide comprises all L- amino acids.

   438. The peptide of claim 31, wherein said peptide is mixed with a pharmacologically acceptable excipient.

   49. The peptide of claim 31, wherein said peptide is mixed with a pharmacologically acceptable excipient suitable for oral administration to a ma¥nmal.

   50. The peptide of claim 31, wherein said polypeptide is prowided as a unit formulation in a pharmaceutically acceptable excipient.

   51. The peptide of claim 31, wherein said polypeptide is provided as a time release formulati on.

   52. The peptide of claim 31, wherein said peptide protects a phospholipid against Oxidation by an oxidizing agent

   53. The peptide of claim 31, wherein said peptide is coupled to a biotin.

   54. The peptide of claim 5, wherein: nis 1; and x2, X3 are independently an acidic, a basic, or a aliphatic amino acid with one of X? or- X> being an acidic or a basic amino acid such that: when X? is an acidic or a basic amino acid, X® is an aliphatic amino acid; an.d when X° is an acid or a basic amino acid, X*is an aliphatic amino acid.

   S55. The peptide of claim 54, wherein wherein X! and X* are independently selected from the group consisting of alanine (Ala), valine (Val), leucine (Leu), isoleucine (Ile). proline (Pro), phenylalanine (Phe), tryptophan (Trp), methionine : (Met), serine (Ser) bearing a hydrophobic protecting group, beta-naphthyl alanine, alpha- naphthyl alanine, norleucine, cyclohexylalanine, threonine (Thr) bearing a hydrophobic protecting group, tyrosine (Tyr) bearing a hydrophobic protecting group, lysine (Lys) bearing a hydrophobic. protecting group, arginine (Arg) bearing a hydrophobic protecting i WO 2005/016280 PCT/US2004/026288 group, omithine (Orn) bearing a hydrophobic protecting group, aspartic acid (Asp) bearing a hydrophobic protecting group, cysteine (Cys) bearing a hydrophobic protecting group, and glutamic acid (Glu) bearing a hydrophobic protecting group.

   56. The peptide of claim 55, wherein ) 5 X? and X3 are dependently selected from the group consisting of Asp, Arg, Lys, Leu, Ile, and Glu.

   57. The peptide of claim 55, wherein X' bears a hydrophobic protecting group.

   58. The peptide of claim 57, wherein said hydrophobic protecting group is selected from the group consisting of polyethylene glycol (PEG), t-butoxycarbonyl (Boc), Fmoc, nicotinyl, OrBu, a benzoyl group, an acetyl (Ac), a carbobenzoxy, methyl, ethyl, a propyl, a butyl, a pentyl a hexyl ester, an N-methyl anthranilyl, and a 3 to 20 carbon alkyl, amide, a 3 to 20 carbon alkyl group, 9-fluoreneacetyl group, 1- fluorenecarboxylic group, 9-fluorenecarbox ylic group, 9-fluorenone-1-carboxylic group, benzyloxycarbonyl (is also called carbobenzoxy mentioned above), Xanthyl (Xan), Trityl (Trt), 4-methyltrityl (Mit), 4-methox ytrityl CMmt), 4-methoxy-2,3,6-trimethyl- benzenesulphonyl (Mtr), Mesitylene-2-sulphonyl (Mts), 4,4-dimethoxybenzhydryl (Mbh), ~ Tosyl (Tos), 2,2,5,7,8-pentamethyl chromam-6-sulphonyl (Pmc), 4-methylbenzyl (MeBzl), 4-methoxybenzyl (MeOBzl), Benzyloxy (BzIO), Benzyl (Bzl), Benzoyl (Bz), 3-nitro-2- pyridinesulphenyl (Npys), 1-(4,4-dimethyl-2,6-dioxocyclohexylidene)ethyl (Dde), 2,6- dichlorobenzyl (2,6-DiCl-Bzl), 2-chloroben=zyloxycarbonyl (2-Cl-Z), 2- bromobenzyloxycarbonyl (2-Br-Z), benzylo xymethyl (Bom), cyclohexyloxy (cHxO),t- butoxymethyl (Bum), t-butoxy (tBuO), t-Bu tyl (tBu), trifluoroacetyl (TFA), 4[N-{1-(4 4- dimethyl-2,6-dioxocyclohexylidene)-3-methayldibutyl)-amino } benzyl ester (ODmab), a- allyl ester (OAll), 2-phenylisopropyl ester (2-PhiPr), 1-[4,4-dimethyl-2,6-dioxycyclohex- 1-yl-idene)ethyl (Dde).

   59. The peptide of claim 57, wherein said said hydrophobic protecting group is selected from the group consisting of Boc, Fmoc, nicotinyl, and OzBu.

   60. The peptide of claim 57, wherein X* bears a vdrophobic protecting group.

   61. The peptide of claim 60, wherein said hydrophobic protecting grouap is selected from the group consisting of polyethylene glycol (PEG), t-butoxycarbonyl (Boc), Fmoc, nicotinyl, OrBu, a benzoyl group, an acetyl (Ac), a carbobenzoxy, methyl, . ethyl, a propyl, a butyl, a pentyl a hexyl ester, an N-methyl anthranilyl, and a 3 to 20 carbon alkyl, amide, a 3 to 20 carb on alkyl group, 9-fluoreneacety! group, 1- fluorenecarboxylic group, 9-fluore necarboxylic group, 9-fluorenone-1-carboxylic group, benzyloxycarbonyl (is also called carbobenzoxy mentioned above), Xanthyl (Xan), Trityd (Trt), 4-methyltrityl (Mtt), 4-methoxytrityl (Mmt), 4-methoxy-2,3,6-trimethyl- benzenesulphonyl (Mtr), Mesitylerne-2-sulphonyl (Mts), 4,4-dimethoxybenzhydryl (Mbh)), Tosyl (Tos), 2,2,5,7,8-pentamethyl chroman-6-sulphonyl (Pmc), 4-methylbenzyl (MeBz1 ), 4-methoxybenzyl (MeOBzl), Benz yloxy (BzlO), Benzyl (Bzl), Benzoyl (Bz), 3-nitro-2- pyridinesulphenyl (Npys), 1-(4,4-dimethyl-2,6-dioxocyclohexylidene)ethyl (Dde), 2,6- dichlorobenzyl (2,6-DiCl-Bzl), 2-c hlorobenzyloxycarbonyl (2-Cl-Z), 2- bromobenzyloxycarbonyl (2-Br-Z», benzyloxymethyl (Bom), cyclohexyloxy (cHxO),t- butoxymethyl (Bum), t-butoxy (tBuO), t-Butyl (tBu), trifluoroacetyl (TFA), 4[N-{1-(4,4— dimethyl-2,6-dioxocyclohexylidene)-3-methyldibutyl)-amino }benzyl ester (ODmab), a- allyl ester (OALll), 2-phenylisoprop yl ester (2-PhiPr), 1-[4,4-dimethyl-2,6-dioxycyclohex— 1-yl-idene)ethyl (Dde).

   62. The peptide of claim 57, wherein the N-terminus of said peptide is blocked with a protecting group selected from the group consisting of Boc-, Fmoc-, and Nicotinyl-.

   63. The peptide of claim 57, wherein the C-terminus of said peptide is blocked with a protecting group selected from the group consisting of Bu, and O7Bu.

   64. The peptide of claim 54, wherein said peptide comprises the amino acid sequence of a peptide in Table 5.

   65. The peptide of claim 54, wherein said peptide is a peptide from Table 5.

   66. The peptide of claim 54, wherein said peptide comprises at least one D- amino acid.

   67. The peptide of claim 54, wherein said peptide comprises all D- amino acids.

   68. The peptide of cl aim 54, wherein said peptide comprises alternating D- and L- amino acids.

   69. The peptide of cl aim 54, wherein said peptide comprises all L- amino acids.

   70. The peptide of claim 54, wherein said peptide is mixed with a pharmacologically acceptable excipient.

   71. The peptide of claim 54, wherein said peptide is mixed with a pharmacologically acceptable excipient suitable for oral administration to a mammal.

   72. The peptide of claim 54, wherein said polypeptide is provided as a unit formulation in a pharmaceutically acceptable excipient.

   73. The peptide of claim 54, wherein said polypeptide is provided as a time release formulation.

   74. The peptide of claim 54, wherein said peptide protects a phospholipid against oxidation by an oxidizing agent

   75. The peptide of claim 54, wherein said peptide is coupled to a biotin.

   76. The peptide of claim 5, wherein: nis 1; and x2, X3 are indeperadently an acidic, a basic, or an aromatic amino . acid with one of X”* or X> being an acidic or a basic amino acid such that: when X? is an acidic or a basic amino acid, X* is an aromatic amino acid; and when 3° is an acid or a basic amino acid, X* is an aromatic amino acid.

   77. The peptide of ¢ laim 76, wherein wherein X' and X* are independently selected from the group consisting of alanine (Ala), valine (Val), leucine (Leu), isoleucine (Ile), proline (Pro), phenylalanine (Phe), tryptophan (Trp), methionine . (Met), serine (Ser) bearing a hydrophobic protecting group, beta-naphthyl alanine, alpha- naphthyl alanine, norleucine, cyclohex ylalanine, threonine (Thr) bearing a hydrophobic protecting group, tyrosine (Tyr) bearing a hydrophobic protecting group, lysine (Lys) bearing a hydrophobic protecting group, arginine (Arg) bearing a hydrophobic protecting group, ornithine (Orn) bearing a hydrophobic protecting group, aspartic acid (Asp) bearing a hydrophobic protecting group, cysteine (Cys) bearing a hydrophobic protecting group, and glutamic acid (Glu) bearing a hydrophobic protecting group.

   78. The peptide of claim 77, wherein X? and X are independently is selected from the group consisting of Asp, Arg, Glu, Trp, Tyr, Phe, and Lys.

   79. The peptide of claim 76, wherein X! bears a hydrophobic protecting group.

   80. The peptide of claim 79, wherein said hydrophobic protecting group is selected from the group consisting ©f polyethylene glycol (PEG), t-butoxycarbonyl (Boc), fmoc, nicotinyl, OfBu, a benzoyl group, an acetyl (Ac), a carbobenzoxy, methyl, ethyl, a propyl, a butyl, a pentyl a hexxyl ester, an N-methyl anthranilyl, and a 3 to 20 carbon alkyl, amide, a 3 to 20 carbon alkyl group, 9-fluoreneacetyl group, 1- fluorenecarboxylic group, 9-fluorenecarboxylic group, 9-fluorenone-1-carboxylic group, benzyloxycarbonyl (is also called carbobenzoxy mentioned above), Xanthyl (Xan), Trityl (Trt), 4-methyltrityl (Mtt), 4-methoxytrityl (Mmt), 4-methoxy-2,3,6-trimethyl- benzenesulphonyl (Mtr), mesitylene- 2-sulphonyl (Mts), 4 4-dimethoxybenzhydryl (Mbh), Tosyl (Tos), 2,2,5,7,8-pentamethyl chroman-6-sulphonyl (Pmc), 4-methylbenzyl (MeBzl), 4-methoxybenzyl (MeOBzl), Benzyl oxy (Bz1O), Benzyl (Bz), Benzoyl (Bz), 3-nitro-2- pyridinesulphenyl (Npys), 1-(4,4-dimnethyl-2,6-dioxocyclohexylidene)ethyl (Dde), 2,6- dichlorobenzyl (2,6-DiCl-Bzl), 2-chL orobenzyloxycarbonyl (2-Cl-Z), 2-

   bromobenzylox ycarbonyl (2-Br-Z), benzyloxymethyl (Bom), cyclohexyloxy (cHxO),t- butoxymethyl (Bum), t-butoxy (tBuQ), t-Butyl (tBu), trifluoroacetyl (TFA), 4[IN-{1-(4,4- dimethyl-2,6-dioxocyclohexylidene)-3-methyldibutyl)-amino } benzyl ester (OIDmab), o- : allyl ester (OAll), 2-phenylisopropyl ester (2-PhiPr), 1-[4,4-dimethyl-2,6-dioxy/cyclohex- 1-yl-idene)ethyl (Ddle).

   81. The peptide of claim 79, wherein said said hydrophobic protecting group is selected from the group consisting of Boc, Fmoc, nicotinyl, and OtBu.

   82. The peptide of claim 79, wherein X* bears a hydrophobic protecting group.

   83. The peptide of claim 82, wherein said hydrophobic protecting group is selected from the group consisting of polyethylene glycol (PEG), t-butoxycamrbonyl (Boc), Fmoc, nicotimyl, OrBu, a benzoyl group, an acetyl (Ac), a carbobenzoxy~, methyl, ethyl, a propyl, a bu tyl, a pentyl a hexyl ester, an N-methyl anthranilyl, and a 3 to 20 carbon alkyl, amide. a 3 to 20 carbon alkyl group, 9-fluoreneacetyl group, 1- fluorenecarboxylic group, 9-fluorenecarboxylic group, 9-fluorenone-1-carboxy lic group, benzyloxycarbonyl (is also called carbobenzoxy mentioned above), Xanthyl (Xan), Trityl (Trt), 4-methyltrityl (Mitt), 4-methoxytrityl (Mmt), 4-methoxy-2,3,6-trimethyl- benzenesulphonyl (BMtr), Mesitylene-2-sulphonyl (Mts), 4,4-dimethoxybenzhydryl (Mbh), Tosyl (Tos), 2,2,5,7 .8-pentamethyl chroman-6-sulphonyl (Pmc), 4-methylbenzy1 (MeBzl), 4-methoxybenzyl (MeOBzl), Benzyloxy (BzlO), Benzyl (Bzl), Benzoyl (Bz), 3 -nitro-2- pyridinesulphenyl (INpys), 1-(4,4-dimethyl-2,6-dioxocyclohexylidene)ethyl (Dde), 2,6- dichlorobenzyl (2,6-DiCl-Bzl), 2-chlorobenzyloxycarbonyl (2-Cl-Z), 2- bromobenzyloxycar bony! (2-Br-Z), benzyloxymethyl (Bom), cyclohexyloxy (cHxO),t- butoxymethyl (Bum), t-butoxy (tBuO), t-Butyl (tBu), trifluoroacetyl (TFA), 4[IN-{1-(4,4- dimethyl-2,6-dioxocyclohexylidene)-3-methyldibutyl)-amino }benzyl ester (OIDmab), o- allyl ester (OAll), 2—phenylisopropyl ester (2-PhiPr), 1-[4,4-dimethyl-2,6-diox y-cyclohex- 1-yl-idene)ethyl (DdAe).

   84. The peptide of claim 79, wherein the N-terminus of said peptide is blocked with a protecting group selected from the group consisting of Boc-, Fimoc-, and Nicotinyl-.

   85. The peptide of claim 79, wherein the C-terminus of said peptide is blocked with a protecting group selected from the group consisting of Bu, and OrBu.

   86. The peptide of claim 76, wherein said peptide comprises the amino acid sequence of a peptide in Table 6.

   87. The peptide of claim 76, wherein said peptide is a peptide from Table 6.

   88. The peptide of claim 76, wherein said peptide comprises at least one D- amino acid.

   89. The peptide of claim 76, wherein said peptide comprises all D- amino acids.

   90. The peptide of claim 76, wherein said peptide comprises alternating D- and L- amino acids.

   91. The peptide of claim 76, wherein said peptide comprises all L- amino acids.

   92. The peptide of claim 76, wherein said peptide is mixed with a pharmacologically acceptable excipient.

   93. The peptide of claim 76, wherein said peptide is mixed with a pharmacologically acceptable excipient suitable for oral administration to a mammal.

   94. The peptide of claim 76, wherein said polypeptide is provided as a unit formulation in a pharmaceutically acceptable excipient.

   95. The peptide of claim 76, wherein s aid polypeptide is provided as a time release formulation.

   96. The peptide of claim 76, wherein s aid peptide protects a phospholipid against oxidation by an oxidizing agent

   97. The peptide of claim 76, wherein s aid peptide is coupled to a biotin.

   98. A peptide that ameliorates one or more sympt-oms of an inflammatory condition, said peptide having the formula: XLx2x3- xX wherein: X' is & hydrophobic amino acid and/or bears a hydrophobic perotecting group: X’ is & hydrophobic amino acid and/or bears a hydrophobic perotecting group; and x2, x3, and X* are independently selected aromatic amino ac&ds or histidine; and said pesptide converts pro-inflammatory HDL to anti-inflammmatory HDL. or makes anti-inflammatory HDL more anti-inflammatory.

   99. The peptide of claim 98, wherein wherein X' and X° are independently selected from the group consisting of alanine (Ala), valine (Val), leucine (Leu), isoleucine (lle), proline (Pro), phenylalanine (Phe), tryptopham (Trp), methionine (Met), phenylalanine (Phe), tryptophan (Trp), methionine (Met), serike (Ser) bearing a hydrophobic protecting group, beta-naphthyl alanine, alpha-naphthyl alanine, norleucine, cyclohexylalamine, threonine (Thr) bearing a hydrophobic protecting group, tyrosine (Tyr) bearing a hydrophobic protecting group, lysine (Lys) bearing a hydro-phobic protecting group, arginine (Arg) bearing a hydrophobic protecting group, omithane (Om) bearing a hydrophobic protecting group, aspartic acid (Asp) bearing a hydrophobic protecting group, cysteine (Cys) bearing a hydrophobic protecting group, and glutamic acid (Glu) bearing a hydrophobic p-rotecting group.

   100. The peptide of claim 99, wherein X?, X2, and X* are independently is selected from the group consisting of P*he, Val, Trp, Tyr, and His.

   101. The peptide of claim 98, wherein X' bears a hydrophobic protecting group.

   102. The peptide of claim 101, wherein said hydropkobic protecting group is selected from the group consisting of polyethylene glycol (PEG), t- butoxycarbony-1 (Boc), Fmoc, nicotinyl, OrBu, a benzoyl group, an acetyl (Ac), a carbobenzoxy, methyl, ethyl, a propyl, a butyl, a pentyl a hexyl ester, an N-methyl anthranilyl, ancl a 3 to 20 carbon alkyl, amide, a 3 to 20 carbon alkyl ggroup, 9-

   fluoreneaccetyl group, 1-fluorenecarboxylic group, 9-fluorenecartoboxylic group, 9- fluorenon e-1-carboxylic group, benzyloxycarbonyl (is also called carbobenzoxy mentioned above), Xanthyl (Xan), Trityl (Trt), 4-methyltrityl (MCtt), 4-methoxytrityl (Mmt), 4-methoxy-2,3,6-trimethyl-benzenesulphonyl (Mtr), Messitylene-2-sulphonyl : (Mts), 4,4-dimethoxybenzhydryl (Mbh), Tosyl (Tos), 2,2,5,7,8-prentamethyl chroman-6- sulphonyl (Pmc), 4-methylbenzyl (MeBzl), 4-methoxybenzyl (VEeOBzl), Benzyloxy (Bz10), Benzyl (Bzl), Benzoyl (Bz), 3-nitro-2-pyridinesulphenyl. (Npys), 1-(4,4-dimethyl- 2,6-dioxocyclohexylidene)ethyl (Dde), 2,6-dichlorobenzyl (2,6-IDiCl-Bzl), 2- chloroberzyloxycarbonyl (2-Cl-Z), 2-bromobenzyloxycarbonyl «2-Br-Z), benzylox ymethyl (Bom), cyclohexyloxy (cHxO),t-butoxymethyl (Bum), t-butoxy (tBuO), t-Butyl (t Bu), trifluoroacetyl (TFA), 4[N-{1-(4,4-dimethyl-2,6-d ioxocyclohexylidene)-3- methyldibutyl)-amino } benzyl ester (ODmab), a-allyl ester (OAl1), 2-phenylisopropyl ester (2-PhiPr), 1-[4,4-dimethyl-2,6-dioxycyclohex-1-yl-idene)ethyl (IDde).

   103. The peptide of claim 101, wherein said said hydrophobic protecting group is selected from the group consisting of Boc, Fmoc, nicotinyl, and OrBu.

   104. The peptide of claim 101, wherein X° bears a hydrophobic protectin g group.

   105. The peptide of claim 104, wherein said hydrophobic protecting group is selected from the group consisting of polyethylene glycol (PEG), t- butoxycarbonyl (Boc), Fmoc, nicotinyl, OrBu, a benzoyl group, an acetyl (Ac), a carbobermzoxy, methyl, ethyl, a propyl, a butyl, a pentyl a hexyl ester, an N-methyl anthranil yl, and a 3 to 20 carbon alkyl, amide, a 3 to 20 carbon axlkyl group, 9- fluoreneacetyl group, 1-fluorenecarboxylic group, 9-fluorenecar-boxylic group, 9- fluorenome-1-carboxylic group, benzyloxycarbonyl (is also called carbobenzoxy mentioned above), Xanthyl (Xan), Trityl (Trt), 4-methyltrityl (NAtt), 4-methoxytrityl (Mmt), 4-methoxy-2,3,6-trimethyl-benzenesulphonyl (Mtr), Messitylene-2-sulphonyl (Mts), 4 .4-dimethoxybenzhydryl (Mbh), Tosyl (Tos), 2,2,5,7,8-pentamethyl chroman-6- sulphonsyl (Pmc), 4-methylbenzyl (MeBzl), 4-methoxybenzyl (WeOBzl), Benzyloxy (BzlO), Benzyl (Bzl), Benzoyl (Bz), 3-nitro-2-pyridinesulpheny/1 (Npys), 1-(4,4-dimethyl- 2,6-diox ocyclohexylidene)ethyl (Dde), 2,6-dichlorobenzyl (2,6~DiCl-Bzl), 2- chlorobesnzyloxycarbonyl (2-Cl-Z), 2-bromobenzyloxycarbonyk. (2-Br-Z),

   ben zyloxymethyl (Bom), cyclohexyloxy (cHxO),t-butoxymethyl (Bum), t-butoxy (tBuO), t-Butyl (tBu), trifluoroacetyl (TFA), 4[N-{1-(4,4-dimethyl-2,6-di oxocyclohexylidene)-3- methyldibutyl)-amino }benzyl ester (ODmab), o-allyl ester (OAL, 2-phenylisopropyl ester : (2-PhiPr), 1-[4,4-dimethyl-2,6-dioxycyclohex-1-yl-idene)ethyl (IDde).

   106. The peptide of claim 98, wherein the N-terminus of said peptide is blocked with a protecting group selected from the group consisting of Boc-, Fmoc-, and Nic otinyl-.

   107. The peptide of claim 98, wherein the C-terminus of said peptide is blocked with a protecting group selected from the group consisting of tBu, and OfBu.

   108. The peptide of claim 98, wherein said peptide comprises the amino acid sequence of a peptide in Table 7.

   109. The peptide of claim 98, wherein said peptide is a peptide from Table 7.

   110. The peptide of claim 98, wherein said peptide comprises at least one D- amino acid.

   111. The peptide of claim 98, wherein said pep&ide comprises all D- amino acids. :

   112. The peptide of claim 98, wherein said peptide comprises alternating D- and L- amino acids.

   113. The peptide of claim 98, wherein said peptide comprises all L- amEgno acids.

   114. The peptide of claim 98, wherein said peptide is mixed with a pharmacologically acceptable excipient.

   115. The peptide of claim 98, wherein said peptide is coupled to a biotin.

   116. A peptide that ameliorates one or more symnptoms of an infl. ammatory condition, wherein said peptide:

   ranges in length from 5 to 11 amino acids; the terminal amino acids are hydrophobic amino acids and/or bear hydrophobic protecting groups; the non-terminal amino acids form at least one acidic domain and at least one basic domain; and said peptide converts pro-inflammatory HDL to anti-inflammatory ) HDL or makes anti-inflammatory HDL more anti-inflammatory.

   117. A peptide that ameliorates one or more symptoms of an inflammatory’ condition, wherein said peptide: ranges in length from 5 to 11 amino acids; the terminal amino acids are hydrophobic amino acids and/or bear hydrophobic protecting groups; the non-terminal amino acids form at least one acidic domain or one basic domain and at least one aliphatic domain; and said peptide converts pro-inflammatory HDL to anti-inflammatory HDL or makes anti-inflammatory HDL more anti-inflammatory.

   118. A peptide that ameliorates one or more symptoms of an inflammatory” condition, wherein said peptide: ranges in length from S to 11 amino acids; the terminal amino acids are hydrophobic amino aci ds and/or bear hydrophobic protecting groups; the non-terminal amino acids form at least one acidic domain or one basic domain and at least one aromatic domain; and said peptide converts pro-inflammatory HDL to anti-inflammatory HDL or makess anti-inflammatory HDL more anti-inflammatory.

   119. A peptide that ameliorates one or more symptoms of an inflammatory condition, wherein said peptide: ranges in length from 6 to 11 amino acids; the terminal amino acids are hydrophobic amino aci ds and/or bear hydrophobic gprotecting groups;

   the non-terminal amino acids form at least one mromatic domain or two or more aromatic domains separated by one or more histidines; ard said peptide converts pro-inflammatory HDL to anti-inflammatory : HDL or makes anti-inflammatory HDL more anti-inflammatory.

   120. A pair of amino acids that ameliorates one or more symptoms of an inflammatory condition, wherein said pair of amino aicds comprise: a first amino acid bearing at least one protecting group; and a second amino acid bearing at least one protec ting group; wherein said first amino acid and said second amino acid are different species of amino acid, and wherein said pair of amino acids «converts pro- inflammato ry HDL to anti-inflammatory HDL or makes anti-inflammnmatory HDL more anti-inflammmatory

   121. The pair of amino acids of claim 120, wherein said pair of amino acids, wherm contacted with a phospholipid in an aqueous environment, forms particles with a dianaeter of approximately 7.5 nm and forms stacked bilayers with a bilayer dimension on the order of 3.4 to 4.1 nm with spacing between the bilayers in the stack of approximately 2 nm.

   122. The pair of amino acids of claim 120, wherein said first and second amino acids are independently selected from the group consisting of an acidic amino acid, abasic amino acid, and a non-polar amino acid.

   123. The pair of amino acids of claim 122, wherein said first amino acid is acidic or basic and said second amino acid is non-polar, or said firsst amino acid is non- polar and said second amino acid is acidic or basic.

   124. The pair of amino acids of claim 122, wherein both amino acids are acidic.

   125. The pair of amino acids of claim 122, wherein both amino acids are basic.

   126. The pair of amino acids of claim 120, wherein said pair of amino acids ares covalently coupled together directly or through a linker.

   127. The pair of amino acids of claim 126, wherein the amino acids are joined tharough a peptide linkage thereby forming a dipeptide.

   128. The pair of amino acids of claim 120, wherezin said pair of amino acids ares mixed together, but not covalently linked.

   129. The pair of amino acids of claim 120, wheresin said protecting group is selecteed from the group consisting of polyethylene glycol (PEG), t-butoxycarbonyl (Boc), Famoc, nicotinyl, OrBu, a benzoyl group, an acetyl (Ac), a carbobenzoxy, methyl, ethyl, a propyl, a butyl, a pentyl a hexyl ester, an N-methyl anthrarailyl, and a 3 to 20 carbon a 1kyl, amide, a 3 to 20 carbon alkyl group, 9-fluoreneacetyl group, 1- fluorenecarboxylic group, 9-fluorenecarboxylic group, 9-fluorenorae-1-carboxylic group, benzylox ycarbonyl (is also called carbobenzoxy mentioned above), Xanthyl (Xan), Trityl (Trt), 4-rnethyltrityl (Mitt), 4-methoxytrityl (Mmt), 4-methoxy-2,3, 6-trimethyl- benzenesulphonyl (Mtr), Mesitylene-2-sulphonyl (Mts), 4,4-dimethoxybenzhydryl (Mbh), Tosyl (Tos), 2,2,5,7,8-pentamethyl chroman-6-sulphonyl (Pmc), 4—methylbenzyl (MeBzl), 4-methoxybenzyl (MeOBzl), Benzyloxy (Bzl0), Benzyl (Bzl), Bemzoyl (Bz), 3-nitro-2- pyridinesulphenyl (Npys), 1-(4,4-dimethyl-2,6-dioxocyclohexylidene)ethyl (Dde), 2,6- dichloro benzyl (2,6-DiCl-Bzl), 2-chlorobenzyloxycarbonyl (2-Cl-Z), 2- bromobesnzyloxycarbonyl (2-Br-Z), benzyloxymethyl (Bom), cyclohexyloxy (cHxO),t- butoxymaethyl (Bum), t-butoxy (tBuO), t-Butyl (tBu), trifluoroacet yl (TFA), 4[N-{1-(4,4- dimethyX-2,6-dioxocyclohexylidene)-3-methyldibutyl)-amino}benz=zyl ester (ODmab), o- allyl ester (OAL), 2-phenylisopropyl ester (2-PhiPr), 1-[4,4-dimetlayl-2,6-dioxycyclohex- 1-yl-idere)ethyl (Dde).

   130. The pair of amino acids of claim 120, wherezin the first amino acid is blockesd with a protecting group selected from the group consisting of Boc-, Fmoc-, and nicotinyXl-, and the second amino acid is blocked with a protecting group selected from the group consisting of Bu, and OrBu.

   131. The pair of amino acids of claim 128, wherein each am&no acid bears at least two protecting groups.

   132. The pair of amino acids where each amino acid is blocked with a with a first protecting group selected from the group consisting of Bac-, Fmoc-, and : 5 nicotinyl-, and a second protecting group selected from the group consisting o f fBu, and OrBu.

   133. The pair of amino acids where each amino acid is blockzed with a Boc and an OtBu.

   134. The pair of amino acids of claim 120, wherein the pair ©f amino acids form a dipeptide selected from the group consisting of Phe-Arg, Glu-Lew, and Arg-

   Glu.

   135. The pair of amino acids of claim 120, wherein the pair «of amino acids form a dipeptide selected from the group consisting of Boc-Arg-OtBu, Boc-Glu- OtBu, Boc-Phe-A rg-OtBu, Boc-Glu-Leu-OtBu, and Boc-Arg-Glu-OtBu. :

   136. A pharmaceutical formulation comprising; one or more peptides according to claims 1, 5, 6, 31, 54,76, 98, 116, 117, and 119, or a pair of amino acids according to claim 120; and . a pharmaceutically acceptable excipient. 1377. The pharmaceutical formulation of claim 136, wherein the peptide is present in an effective dose. : 13 8. The pharmaceutical formulation of claim 136, wherein the peptide is in a time releas e formulation.

   139. The pharmaceutical formulation of claim 136, wherein the formulation is formulated as a unit dosage formulation. 14-0. The pharmaceutical formulation of claim 136, wherein the formulation is formulated for oral administration.

   141. The pharmaceutical formulation of claim 136, wherein the formul ation is formulated for administration by a route selected from the group consisting of oral administration, inhalation, rectal administration, intraperitoneal injection, intravascular imjection, subcutaneous injection, transcutaneous administration, inhalation administration, and intramuscular injection. ‘

   142. AKit comprising: a container containing one or more of the peptides according to claims 1, 5,6,31,54,76,98, 116,117, and 119, or a pair of amino acids according to claim 120; and instructional materials teaching the use of the peptide(s) or pairs of amino acids in the treatment of a pathology characterized by inflammation.

   143. The kit of claim 142, wherein said pathology is a pathology select ed from the group consisting of atherosclerosis, rheumatoid arthritis, lupus erythematous, polyarteritis nodosa, osteoporosis, Altzheimer’s disease, chronic obstructive pulmonary disease, asthima, multiple sclerosis, diabetes, and a viral illnesses.

   144. The use of an effective amount of a peptide as claimed in any one of claims 1, 5, 6, 31, 54, 76, 98, 116, 117, and 119, or a pair of amino acids as claimed in claims 120 in the manufacture of a pharmaceutical formulation for use in a method of mitigating one or more symptoms of atherosclerosis in a mammal comprising administering an effective arnount of said pharmaceutical formulation to said mammal.

   145. The use of a peptide in the manufacture of a pharmaceutical formulation as claimed in claim 144, wherein said peptide is in a pharmaceutically acceptable excipient.

   146. The use of a peptide in the manufacture of a pharmaceutical formulation as claimed in claim 144, wherein said peptide is administered in conjunction with a lipid.

   147. The use of a peptide in the manufacture of a pharmaceutical formulation as claimed in claim 144, wherein said peptide is in a pharmaceutically acceptable excipient suitable for oral administration.

   148. The use of a peptide in the manufacture of a pharmaceutical formulation as claimed in claim 144, wh erein said pharmaceutical formulation is administered as a umit dosage formulation. - 128 - AMENDED SHEET

   149. The use of a peptide in the manufactu-re of a pharmaceutical formulation as cL aimed in claim 144, wherein the pharmaceutical formulation is administered by a route seleccted from the group consisting of oral administration, inhalation, rectal administration, intraperitoneal injection, intravascular injection, subcutaneows injection, transcutaneous adm inistration, and intramuscular injection.

   150. The use of a peptide in the manufacture of a pharmaceutical formulation as cl aimed in claim 144, wherein said mammal is a mammal. diagnosed as having one or more symptoms of atherosclerosis.

   151. The use of a peptide in the manufacture of a pharmaceutical formulation as cLaimed in claim 144, wherein said mammal is a mammal diagnosed as at risk for stroke or athexosclerosis.

   152. The use of a peptide in the manufacture of a pharmaceutical formulation as cl aimed in claim 144, wherein said mammal is a human.

   153. The use of a peptide in the manufacture of a pharmaceutical formulation as cl aimed in claim 144, wherein said mammal is non-human mammal.

   154. The use of an effective amount of a peptide as claimed in any one of claims 1, 5, 6, 31, 54, 76, 98, 116, 117, and 119, or a pair of amino acids as claimed in claims 120 in the manufacture of a pharmaceutical formulation for -use in a method of mitigating one or mores symptoms of an inflammatory pathology in a mammal comprising administering an effective amount of said pharmaceutical formulation to said mammal.

   155. The use of a peptide in the manufacture of a pharmaceutical formulation as cl aimed in claim 154, wherein said inflammatory patholo gy is a pathology selected from the growp consisting of atherosclerosis, rheumatoid arthritis, lup-us erythematous, polyarteritis nodosa, osteoporosis, Altzheimer’s disease, multiple sclerosis, chronic obstructive pulmonary disease, asthma, diabetes, and a viral illnesses.

   156. The use of a peptide in the manufacture of a pharmaceutical formulation as claimed in claim 154, wherein said peptide is in a pharmanceutically acceptable excipient. - 129 - AMENDED SHEET

   159. The use of a peptide in the manufacture of a pharmaceutical formulation as claimed in claim 154, wherein said pharmaceutical formulation is administered as a unit dosage formulation.

   160. The use of a peptide in the manufacture of a pharmaceutical formulation as claimed in claim 154, wherein said pharmaceutical formulation is administered by a route selected from the group consisting of oral administration, inhalation, rectal administration, intraperitoneal injection, intravascular injection, subcutaneous injection, transcutaneous administration, and intramuscular injection.

   161. The use of a peptide in the manufacture of a pharmaceutical formulation as claimed in claim 154, wherein said mammal is a manmmal diagnosed as at risk for stroke.

   162. The use of a peptide in the manufacture of a pharmaceutical formulation as claimed in claim 154, wherein said mammal is a human.

   163. The use of a peptide in the manufacture of a pharmaceutical formulation as claimed in claim 154, wherein said mammal is non-h-uman mammal.

   164. The use of an effective amount of a peptide as claimed in any one of claims 1, 5, 6, 31, 54, 76, 98, 116, 117, and 119, or a par of amino acids as claimed in claims 120 in the manufacture of a pharmaceutical formulation for use in a method of enhancing the activity of a statin in a mammal, said method comprising coadministering with said statin an effective amount of said pharmaceutical formulation.

   165. The use of a peptide in the manufacture of a pharmaceutical formulation as claimed in claim 164, wherein said statin is selected £rom the group consisting of cerivastatin, atorvastatin, simvastatin, pravastatin, fluvastatin, lovastatin. rosuvastatin, and pitavastatin.

   166. The use of a peptide in the manufacture of a pharmaceutical formulation as claimed in claim 164, wherein said pharmaceutical fosrmulation is administered simultaneously with said statin.

   167. The use of a peptide in the manufacture of a pharmaceutical formulation as claimed in claim 164, wherein said pharmaceutical formulation is administered before said statin. -130- AMENDED SHEET

   169. The use of a peptide in the manufacture of a pharmaceutical formulation as claimed in claim 164, wherein said pharmaceutical formulation and/or said statin are administered as a unit dosage formulation.

   170. The use of a peptide in the manufacture of a pharm aceutical formulation as claimed in claim 164, wherein said pharmaceutical formulation and/or said statin are administered by a route selected from the group consisting of oral administration, inhalation, rectal admimistration, intraperitoneal injection, intravascular injection, subcutaneous injection, transcutaneous administration, and intramuscular injection.

   171. The use of a peptide in the manufacture of a pharmaceutical formulation as claimed in claim 164, wherein said mammal is a mammal diagnosed ass having one or more symptoms of atherosclerosis.

   172. The use of a peptide in the manufacture of a pharmaceutical formulation as claimed in claim 164, wherein said mammal is a mammal diagnosed as at risk for stroke or atherosclerosis.

   173. The use of a peptide in the manufacture of a pharmaceutical formulation as claimed in claim 164, wherein said mammal is a human.

   174. The use of a peptide in the manufacture of a pharrmaceutical formulation as claimed in claim 164, wherein said mammal is non-human mammal.

   175. The use of an effective amount of a peptide as claimed in any one of claims 1, S, 6, 31, 54, 76, 98, 116, 117, and 119, or a pair of amino acids as claimed in claims 120 in the manufacture of a pharmaceutical formulation for use in a method of mitigating one or more symptoms associated with atherosclerosis in a mammal, said meth od comprising: -131- AMENDED SHEET

   178. The use of a peptide in the manufacture of a pharmaceutical formulation as claimed in,claim 175 wherein said pharma ceutical formulation is administered simultaneously with said statin.

   179. The use of a peptide in the manufacture of a pharmaceutical formulation as claimed in claim 175, wherein said pharmaceutical formulation is administered before said statin.

   180. The use of a peptide in the manufacture of a pharmaceutical formulation as claimed in claim 175, wherein said pharmaceutical formulation is administered after said statin.

   181. The use of a peptide in the manufacture of a pharmaceutical formulation as claimed in claim 175, wherein said pharmaceutical formulation , and/or said statin are administered as a unit dosage formulation.

   182. The use of a peptide in the manufacture of a pharmaceutical formulation as claimed in claim 175, wherein said pharmaceutical formulation is administered orally.

   183. The use of a peptide in the manufacture of a pharmaceutical formulation as claimed in claim 175,, wherein said pharmaceutical formulation is administered by a route selected from the group consisting of oral admainistration, inhalation, rectal administration, intraperitoneal injection, intravascular injection, subcutaneous injection, transcutaneous administration, inhalation administration, and intramuscular injection.

   184. The use of a peptide in the manufacture of a pharmaceutical formulation as claimed in claim 175, wherein said mammal is a mammal diagnosed as having one or more symptoms of atherosclerosis.

   185. The use of a peptide in the manufacture of a pharmaceutical formulation as claimed in claim 175, wherein said mammal is a mammal diagnosed as at risk for stroke or atherosclerosis. -132- AMENDED SHEET

   189. The pharmaceutical formulatiom of claim 188, wherein the peptide and/or the statin are present in an effective dose.

   190. The pharmaceutical formulatiom of claim 189, wherein the effective amount of the statin is lower than the effective amour t of the statin administered without the peptide.

   191. The pharmaceutical formulatiom of claim 189, wherein the effective amount of the peptide is lower than the effective amount of the peptide administered without the statin,

   192. The pharmaceutical formulatiom of claim 189, wherein the effective amount of the Ezetimibe is lower than the effective arnount of the Ezetimibe administered without the peptide. :

   193. The pharmaceutical formulation of claim 189, wherein the effective amount of the peptide is lower than the effective amount of the peptide administered without the Ezetimibe.

   194. The pharmaceutical formulation of claim 188, wherein the statin is selected from the group consisting of cerivastatin, atorvastatin, simvastatin, pravastatin, fluvastatin, lovastatin. rosuvastatin, and pitavastatin.

   195. The pharmaceutical formulation of claim 188, wherein the Ezetimibe, the statin, and/or the peptide are in a time release formulation.

   196. The pharmaceutical formulation of claim 188, wherein the formulation is formulated as a unit dosage formulation.

   197. The pharmaceutical formulation of claim 188, wherein the formulation is formulated for oral administration. : 198. The pharmaceutical formulatior of claim 188, wherein the formulation is formulated for administration by a route selected from the group consistin g of oral administration, inhalation, rectal administration, intraperitoneal injection,

   intravascular injection, subcutaneous injection, transcutaneous administration, inhalation administration, and intramuscular injection.

   199. The pharmaceutical formulation of claim 188, wherein the formulation further comprises one or more phospholipids.

   200. The use of an effective amount of a peptide as claimed in any one of claims 1, 5, 6, 31, 54, 76, 98, 116, 117, and 1 19, or a pair of amino acids as claimed in claims 120 in the manufacture of a pharmaceutical formulation for use in a method of reducing or inhibiting one or more symptoms of osteoporosis in a mammal, the method comprising administering said pharmaceutical formulation to the mammal in a concentration sufficient to reduce or eliminate one or more symptoms of osteoporosis.

   201. The use of a peptide im the manufacture of a pharmaceutical formulation as claimed in claim 200, wherein the pharmaceutical formulation is administered in a concentration sufficient to reduce or eliminate decalcification of a bone.

   202. The use of a peptide in the manufacture of a pharmaceutical formulation as claimed in claim 200, wherein the pharma ceutical formulation is administered in a concentration sufficient to induce recalcification of a bone.

   203. The use of a peptide in the manufacture of a pharmaceutical formulation as claimed in claim 200, wherein the pharma ceutical formulation includes a pharmacologically acceptable excipient.

   204. The use of a peptide in the manufacture of a pharmaceutical formulation as claimed in claim 200, wherein the pharmaceutical formulation includes a pharmacologically acceptable excipient suitable for oral administration to a mammal. -134 - AMENDED SHEET