US20020168340A1 - Novel HIV-specific synthetic oligonucleotides and methods of their use - Google Patents

Novel HIV-specific synthetic oligonucleotides and methods of their use Download PDF

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US20020168340A1
US20020168340A1 US09/837,806 US83780601A US2002168340A1 US 20020168340 A1 US20020168340 A1 US 20020168340A1 US 83780601 A US83780601 A US 83780601A US 2002168340 A1 US2002168340 A1 US 2002168340A1
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oligonucleotide
hiv
ribonucleotides
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Sudhir Agrawal
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Aceragen Inc
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    • C12NMICROORGANISMS OR ENZYMES; COMPOSITIONS THEREOF; PROPAGATING, PRESERVING, OR MAINTAINING MICROORGANISMS; MUTATION OR GENETIC ENGINEERING; CULTURE MEDIA
    • C12N15/00Mutation or genetic engineering; DNA or RNA concerning genetic engineering, vectors, e.g. plasmids, or their isolation, preparation or purification; Use of hosts therefor
    • C12N15/09Recombinant DNA-technology
    • C12N15/11DNA or RNA fragments; Modified forms thereof; Non-coding nucleic acids having a biological activity
    • C12N15/113Non-coding nucleic acids modulating the expression of genes, e.g. antisense oligonucleotides; Antisense DNA or RNA; Triplex- forming oligonucleotides; Catalytic nucleic acids, e.g. ribozymes; Nucleic acids used in co-suppression or gene silencing
    • C12N15/1131Non-coding nucleic acids modulating the expression of genes, e.g. antisense oligonucleotides; Antisense DNA or RNA; Triplex- forming oligonucleotides; Catalytic nucleic acids, e.g. ribozymes; Nucleic acids used in co-suppression or gene silencing against viruses
    • C12N15/1132Non-coding nucleic acids modulating the expression of genes, e.g. antisense oligonucleotides; Antisense DNA or RNA; Triplex- forming oligonucleotides; Catalytic nucleic acids, e.g. ribozymes; Nucleic acids used in co-suppression or gene silencing against viruses against retroviridae, e.g. HIV
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P31/00Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
    • A61P31/12Antivirals
    • A61P31/14Antivirals for RNA viruses
    • A61P31/18Antivirals for RNA viruses for HIV
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K38/00Medicinal preparations containing peptides
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    • C12N2310/00Structure or type of the nucleic acid
    • C12N2310/30Chemical structure
    • C12N2310/31Chemical structure of the backbone
    • C12N2310/315Phosphorothioates
    • CCHEMISTRY; METALLURGY
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    • C12N2310/00Structure or type of the nucleic acid
    • C12N2310/30Chemical structure
    • C12N2310/32Chemical structure of the sugar
    • C12N2310/3212'-O-R Modification
    • CCHEMISTRY; METALLURGY
    • C12BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
    • C12NMICROORGANISMS OR ENZYMES; COMPOSITIONS THEREOF; PROPAGATING, PRESERVING, OR MAINTAINING MICROORGANISMS; MUTATION OR GENETIC ENGINEERING; CULTURE MEDIA
    • C12N2310/00Structure or type of the nucleic acid
    • C12N2310/30Chemical structure
    • C12N2310/34Spatial arrangement of the modifications
    • C12N2310/346Spatial arrangement of the modifications having a combination of backbone and sugar modifications

Definitions

  • This invention relates to the treatment of HIV infection. More particularly, this invention relates to synthetic modified antisense oligonucleotides and pharmaceutical compositions containing such oligonucleotides and to methods of inhibiting HIV replication and treating HIV infection using such oligonucleotides.
  • HIV-1, HIV-2 formerly called human T-cell leukemia lymphotropic virus-type III (HTLV-III)
  • HIV is part of the Retroviridaie family, the members of which contain an RNA genome and reverse transcriptase activity.
  • retroviruses copy their RNA into proviral DNA.
  • the proviral DNA is able to integrate into the chromosomal DNA of the host cell where it uses the transcriptional and translational machinery of the host to express viral RNA and proteins.
  • Viruses are released from the cell by budding from the cytoplasmic membrane.
  • helper T-cell host cells In the case of HIV-1 and HIV-2, viral replication results in the death of helper T-cell host cells, which leads to a state of severe immunodeficiency, to the development of various malignancies and opportunistic infections, and ultimately to the death of the infected organism.
  • antisense oligonucleotides bind to a target singe-stranded nucleic acid molecules according to the Watson-Crick or the Hoogstein rule of base pairing, and in doing so, disrupt the function of the target by one of several mechanisms: by preventing the binding of factors required for normal translation or transcription; in the case of an mRNA target, by triggering the enzymatic destruction of the message by RNase H; or by destroying the target via reactive groups attached directly to the antisense oligonucleotide.
  • Antisense oligodeoxynucleotides have been designed to specifically inhibit the expression of HIV-1 and other viruses (see, e.g., Agrawal (1992) Trends in Biotechnology 10:152-158; Agrawal et al. in Gene Regulation: Biology of Antisense RNA and DNA (Erickson and Izant, eds.) Raven Press Ltd., New York (1992) pp. 273-283); Matsukura et al. in Prospects for Antisense Nucleic Acid Therapy of Cancer and AIDS , Wiley-Liss, Inc. (1992) pp.
  • Kniep et al. discloses that oligonucleotides containing the CG dinucleotide flanked by certain other sequences have a mitogenic and other side effects.
  • the phosphorothioate linkages may be mixed R p and S p enantiomers, or they may be stereoregular or substantially stereoregular in either R p or S p form (see Iyer et al. (1995) Tetrahedron Asymmetry 6:1051-1054).
  • synthetic oligonucleotide includes chemically synthesized polymers of 12 to 50, preferably from about 15 to about 30, and most preferably, 21 ribonucleotide and/or deoxyribonucleotide monomers connected together or linked by at least one, and preferably more than one, 5′ to 3′ internucleotide linkage.
  • nucleotide sequence specifically complementary to nucleotides 324 to 345 of a conserved gag region of the HIV genome is intended to mean a sequence of nucleotides that binds to the gag genomic RNA, proviral DNA, or mRNA sequence under physiological conditions, e.g., by Watson-Crick base pairing (interaction between oligonucleotide and single-stranded nucleic acid) or by Hoogsteen base pairing (interaction between oligonucleotide and double-stranded nucleic acid) or by any other means including in the case of a oligonucleotide binding to RNA, causing pseudoknot formation.
  • a conserved gag region refers to a sequence of nucleotides within the gag gene which is found in related HIV strains.
  • the oligonucleotides of the invention comprise at least two 3′-terminal ribonucleotides, at least two 5′-terminal ribonucleotides, or at least two 3′-terminal and at least two 5′ terminal ribonucleotides.
  • the oligonucleotide is a core region hybrid oligonucleotide comprising a region of at least two deoxyribonucleotides, flanked by 5′ and 3′ ribonucleotide regions, each having at least two ribonucleotides.
  • the oligonucleotides of the invention have four contiguous 3′-terminal ribonucleotides and four contiguous 3′-terminal ribonucleotides, flanking 13 deoxynucleotides.
  • the ribonucleotides in the hybrid oligonucleotide are 2′-substituted ribonucleotides.
  • the term “2′-substituted” means substitution of the 2′ position of the pentose moiety with an -O-lower alkyl group containing one to six saturated or unsaturated carbon atoms, or with an -O-aryl or allyl group having two to six carbon atoms, wherein such alkyl, aryl or allyl group may be unsubstituted or may be substituted, e.g., with halo, hydroxy, trifluoromethyl, cyano, nitro, acyl, acyloxy, alkoxy, carboxyl, carbalkoxyl, or amino groups; or with a hydroxy, an amino or a halo group, but not with a 2′-H group.
  • the ribonucleotides are 2′-substituted ribonucleo
  • the oligonucleotides of the invention have SEQ ID NO:1, NO:2, NO:3, or NO:4. In some embodiments, these oligonucleotides inhibit HIV-1 or HIV-2 infection in a cell and/or exhibit antiviral activity against HIV-1 and HIV-2.
  • the invention provides pharmaceutical formulations suitable for inhibiting and treating HIV-1 or HIV-2 infection and having reduced side effects such as immunogenicity. These formulations and for inhibiting comprising at least one oligonucleotide in accordance with the invention in a pharmaceutically acceptable carrier.
  • a “pharmaceutically or physiologically acceptable carrier” includes any and all solvents (including but limited to lactose), dispersion media, coatings, antibacterial and antifungal agents, isotonic and absorption delaying agents and the like.
  • solvents including but limited to lactose
  • dispersion media including but limited to lactose
  • coatings including but limited to lactose
  • antibacterial and antifungal agents include antibacterial and antifungal agents, isotonic and absorption delaying agents and the like.
  • isotonic and absorption delaying agents and the like The use of such media and agents for pharmaceutically active substances is well known in the art. Except insofar as any conventional media or agent is incompatible with the active ingredient, its use in the therapeutic compositions of the invention is contemplated. Supplementary active ingredients can also be incorporated into the compositions.
  • the invention provides a method of treating HIV-1 or HIV-2 infection in a mammal.
  • an oligonucleotide according to the invention is administered to the mammal in an amount effective to inhibit the proliferation of the virus.
  • the term “mammal” is meant to encompass primates and_humans.
  • the oligonucleotide is orally administered to the mammal.
  • the term “orally administered” refers to the provision of the formulation via the mouth through ingestion, or via some other part of the gastrointestinal system including the esophagus.
  • the oligonucleotide is administered via intravenous injection.
  • the oligonucleotide is administered colorectally.
  • colorectal administration or “rectal administration” or “colorectally administered” refers to the provision of the pharmaceutical formulation of the invention to any part of the large intestine via surgical implantation, anal administration, or any other mode of placement therein.
  • the invention also provides in another aspect a method of inhibiting HIV-1 or HIV-2 infection in a cell.
  • the cell is contacted with a synthetic oligonucleotide according to the invention.
  • the invention provides a method for introducing an intact oligonucleotide into a mammal.
  • This method comprises administering to the mammal an oligonucleotide according to the invention which is present in intact form in the systemic plasma of the mammal following oral administration.
  • the oligonucleotide is orally or enterally administered.
  • the oligonucleotide is intravenously administered.
  • FIG. 1 is a graphic representation of the inhibition of HIV-1 infection in cells treated during initial infection with a 4 ⁇ 4 hybrid oligonucleotide of the invention having SEQ ID NO:1;
  • FIG. 2 is a graphic representation of the inhibition of HIV-1 infection in cells treated following initial infection with a 4 ⁇ 4 hybrid oligonucleotide of the invention having SEQ ID NO:1;
  • FIG. 3 is a graphic representation of the results of an XTT assay demonstrating the ability of a 4 ⁇ 4 oligonucleotide of the invention having SEQ ID NO:1 to inhibit HIV-2-induced cell killing.
  • antisense oligonucleotides can bind to a target single-stranded nucleic acid molecule according to the Watson-Crick or the Hoogsteen rule of base pairing, and in doing so, disrupt the function of the target by one of several mechanisms: by preventing the binding of factors required for normal transcription, splicing, or translation; by triggering the enzymatic destruction of MRNA by RNase H if a contiguous region of deoxyribonucleotides exists in the oligonucleotide, and/or by destroying the target via reactive groups attached directly to the antisense oligonucleotide.
  • Novel antisense oligonucleotides have been designed which inhibit HIV-1 and HIV-2 replication. These oligonucleotides are synthetic oligonucleotides having phosphorothioate internucleotide linkages and a nucleotide sequence that is complementary to a portion of the gag region of the genome of HIV-1 and HIV-2. Sequences situated in this region have been demonstrated to be essential for viral packaging. These sequences form a stable secondary structure (Harrison et al. (1991) in RNA Tumor Viruses (Coffin et al., eds.) Cold Spring Harbor Laboratory, Cold Spring Harbor, N.Y., pp. 235).
  • the oligonucleotides of the invention have been designed to bind to this region of RNA and DNA, thereby disrupting its natural stability and resulting ultimately in the inhibition of viral packaging and translation of gag mRNA.
  • the specific sequence to which the oligonucleotides of the invention are complementary is nucleotides 324-345 of the gag region of HIV-1. This sequence is very conserved among strains of HIV-1, as shown below in TABLE 1. TABLE 1 Sequence of: 324-345 ⁇ TCTTCCTCTCTCTACCCACGCT CONSENSUS CGGAGGCTAGAAGGAGAGAGATGGGTGCGAGAGCGTCAGTA . . Strains . . of HIV-1 . .
  • HIV/LLAV G A HIVLAI G A HIVNL43 G G HIVMN G G HIVJH3 G A HIVOYI G A HIVCDC4 G A HIVRF G A HIVMAL G A (African) HIVU455 A A CCTCAG (Ugandan) HIVSF2 (GA) 4G G HIVNDK G A
  • Targeting an antisense oligonucleotide to such a conserved region including an active gene allows for efficient inhibition of HIV proliferation without the generation of “escape mutants.” Escape mutants arise when a mutation occurs in a region of the genome targeted by the antisense oligonucleotide. They occur at a higher frequency in non-coding regions (like the SA region of HIV-1) than in regions encoding a protein.
  • Oligonucleotides of the invention are more specific, less toxic, and have greater nuclease resistance than many other chemotherapeutic agents designed to inhibit HIV replication.
  • these oligonucleotide are less immunostimulatory than other oligonucleotides directed to the HIV-1 gag sequence because their nucleotide sequences are not GC-rich.
  • these hybrid oligonucleotides having phosphorthioate linkages are more resistant to nucleolytic degradation than are DNA compounds having solely phosphodiester linkages.
  • the oligonucleotides useful in the method of the invention are at least 12 nucleotides in length, but are preferably 15 to 21 nucleotides long, with 21mers being most common. They are composed of deoxyribonucleotides, ribonucleotides, or a combination of both (i.e., are “hybrids”), with the 5′ end of one nucleotide and the 3′ end of another nucleotide being covalently linked by phosphorodithioates or phosphorothioates, non-phosphodiester internucleotide linkages.
  • Oligonucleotides with these linkages can be prepared according to known methods such as phosphoramidate or H-phosphonate chemistry which can be carried out manually or by an automated synthesizer as described by Brown ( A Brief History of Oligonucleotide Synthesis. Protocols for Oligonucleotides and Analogs, Methods in Molecular Biology (1994) 20:1-8). (See also, e.g., Sonveaux “Protecting Groups in Oligonucleotides Synthesis” in Agrawal (1994) Methods in Molecular Biology 26:1-72; Uhlmann et al. (1990) Chem. Rev. 90:543-583).
  • the oligonucleotides of the composition may also be additionally modified in a number of ways without compromising their ability to hybridize to the target nucleic acid.
  • modifications include, for example, those which are internal or at the end(s) of the oligonucleotide molecule and include additions to the molecule of the internucleoside phosphate linkages, such as cholesteryl or diamine compounds with varying numbers of carbon residues between the amino groups and terminal ribose, deoxyribose and phosphate modifications which cleave, or crosslink to the opposite chains or to associated enzymes or other proteins which bind to the viral genome.
  • modified oligonucleotides include oligonucleotides with a modified base and/or sugar such as arabinose instead of ribose, or a 3′, 5′-substituted oligonucleotide having a sugar which, at both its 3′ and 5′ positions is attached to a chemical group other than a hydroxyl group (at its 3′ position) and other than a phosphate group (at its 5′ position).
  • Other modified oligonucleotides are capped with a nuclease resistance-conferring bulky substituent at their 3′ and/or 5′ end(s), or have a substitution in one nonbridging oxygen per nucleotide.
  • Such modifications can be at some or all of the internucleoside linkages, as well as at either or both ends of the oligonucleotide and/or in the interior of the molecule.
  • Oligonucleotides which are self-stabilized are also considered to be modified oligonucleotides useful in the methods of the invention (Tang et al. (1993) Nucleic Acids Res. 20:2729-2735).
  • oligonucleotides comprise two regions: a target hybridizing region; and a self-complementary region having an oligonucleotide sequence complementary to a nucleic acid sequence that is within the self-stabilized oligonucleotide.
  • Preferred oligonucleotides according to the invention are hybrid oligonucleotides in that they contain both deoxyribonucleotides and at least two 2′ substituted ribonucleotides at their termin(i/us).
  • the term “2′-substituted” means substitution at the 2′ position of the ribose with, e.g., a -O-lower alkyl containing 1-6 carbon atoms, aryl or substituted aryl or allyl having 2-6 carbon atoms e.g., 2′-O-allyl, 2′-O-aryl, 2′-O-alkyl, 2′-halo, or 2′-amino, but not with 2′-H, wherein allyl, aryl, or alkyl groups may be unsubstituted or substituted, e.g., with halo, hydroxy, trifluoromethyl, cyano, nitro, acyl, acyloxy, alkoxy, carboxyl, carbalkoxyl or amino groups.
  • Useful substituted ribonucleotides are 2′-O-alkyls such as 2′-O-methyl, 2′-O-ethyl, and
  • the hybrid oligonucleotides useful in the method of the invention resist nucleolytic degradation, form stable duplexes with RNA or DNA, and preferably activate RNase H when hybridized with RNA. They may additionally include at least one unsubstituted ribonucleotide.
  • an oligonucleotide useful in the method of the invention may contain all deoxyribonucleotides with the exception of two 2′ substituted ribonucleotides at the 3′ terminus of the oligonucleotide, or the 5′ terminus of the oligonucleotide.
  • the oligonucleotide may have at least two, and preferably 4, substituted ribonucleotides at both its 3′ and 5′ termini.
  • Preferred oligonucleotides have at least two and preferably four 2′-O-methyl ribonucleotides at both the 3′ and 5′ termini, with the remaining nucleotides being deoxyribonucleotides.
  • One preferred oligonucleotide is a 21mer phosphorothiote linked oligonucleotide containing therein deoxyribonucleotides flanked on each side by four 2′-O-methyl ribonucleotides. This preferred oligonucleotide is referred to as a “4 ⁇ 4”.
  • oligonucleotides useful in the method of the invention contains four or more deoxyribonucleotides in a contiguous block, so as to provide an activating segment for RNase H. In certain cases, more than one such activating segment will be present at any location within the interior of the oligonucleotide. There may be a majority of deoxyribonucleotides in oligonucleotides according to the invention. In fact, such oligonucleotides may have as many as all but two nucleotide being deoxyribonucleotides.
  • TABLE 2 lists some representative species of oligonucleotides which are useful in the method of the invention. 2′-substituted nucleotides are underscored.
  • Oligonucleotides as described above are useful in a method of inhibiting HIV-1 or HIV-2 infection in a cell.
  • a cell is contacted with an oligonucleotide of the invention such that virus present in the cell at the time of contact, or after such contact is unable to replicate.
  • CPE- cytopathic effect-
  • oligonucleotides of the invention will be used in a method of treating the fetuses and human mothers harboring HIV.
  • oligonucleotides described herein are administered to the mammal in the form of therapeutic pharmaceutical formulations that are effective for treating virus infection. These pharmaceutical formulation may be administered in conjunction with other therapeutic agents, e.g., AZT and/or various protease inhibitors, to treat AIDS.
  • therapeutic agents e.g., AZT and/or various protease inhibitors
  • the therapeutic pharmaceutical formulation containing at least one oligonucleotide according to the invention includes a physiologically acceptable carrier which is congruent with the mode of administration.
  • a physiologically acceptable carrier which is congruent with the mode of administration.
  • examples include an inert diluent or an assimilable edible carrier.
  • suitable formulations that include pharmaceutically acceptable excipients for introducing compounds to the bloodstream by intravenous injection and other than injection routes can be found in Remington's Pharmaceutical Sciences (18th ed.) (Genarro, ed. (1990) Mack Publishing Co., Easton, Pa.).
  • the pharmaceutical forms suitable for injectable use include sterile aqueous solutions or dispersions and sterile powders for the extemporaneous preparation of sterile injectable solutions or dispersions.
  • the form must be sterile. It must be stable under the conditions of manufacture and storage and may be preserved against the contaminating action of microorganisms, such as bacterial and fungi.
  • the carrier can be a solvent or dispersion medium.
  • the prevention of the action of microorganisms can be brought about by various antibacterial and antifungal agents. Prolonged absorption of the injectable therapeutic agents can be brought about by the use of the compositions of agents delaying absorption.
  • Sterile injectable solutions are prepared by incorporating the oligonucleotide in the required amount in the appropriate solvent, followed by filtered sterilization.
  • the oligonucleotide of the invention and other ingredients may be enclosed in a hard or soft shell gelatin capsule, compressed into tablets, or incorporated directly into the individual's diet.
  • the oligonucleotide may be incorporated with excipients and used in the form of ingestible tablets, buccal tablets, troches, capsules, elixirs, suspensions, syrups, wafers, and the like.
  • the oligonucleotide When the oligonucleotide is administered orally, it may be mixed with other food forms and pharmaceutically acceptable flavor enhancers.
  • oligonucleotide When the oligonucleotide is administered enterally, they may be introduced in a solid, semi-solid, suspension, or emulsion form and may be compounded with any number of well-known, pharmaceutically acceptable additives. Sustained release oral delivery systems and/or enteric coatings for orally administered dosage forms are also contemplated such as those described in U.S. Pat. Nos. 4,704,295, 4,556,552, 4,309,404, and 4,309,406.
  • the term “therapeutically effective amount” means the total amount of each active component of the pharmaceutical formulation or method that is sufficient to show a meaningful subject or patient benefit, i.e., a reduction in tumor growth or in the expression of proteins which cause or characterize the cancer.
  • a meaningful subject or patient benefit i.e., a reduction in tumor growth or in the expression of proteins which cause or characterize the cancer.
  • the term refers to that ingredient alone.
  • the term refers to combined amounts of the active ingredients that result in the therapeutic effect, whether administered in combination, serially or simultaneously.
  • a “therapeutically effective manner” refers to a route, duration, and frequency of administration of the pharmaceutical formulation which ultimately results in meaningful patient benefit, as described above.
  • the pharmaceutical formulation is administered via injection, sublingually, colorectally, intradermally, orally, enterally or in bolus, continuous, intermittent, or continuous, followed by intermittent regimens.
  • the therapeutically effective amount of synthetic oligonucleotide administered in the method of the invention will depend upon the nature and severity of the condition being treated, and on the nature of prior treatments which the patent has undergone. Ultimately, the attending physician will decide the amount of synthetic oligonucleotide with which to treat each individual patient. Initially, the attending physician may administer low doses of the synthetic oligonucleotide and observe the patient's response. Larger doses of synthetic oligonucleotide may be administered until the optimal therapeutic effect is obtained for the patient, and at that point the dosage is not increased further.
  • the dosages of the pharmaceutical compositions administered in the method of the present invention should contain about 0.1 to 100.0 mg/kg body weight per day, preferably 0.1 to 75.0 mg/kg body weight per day, more preferably, 1.0 to 50.0 mg/kg body weight per day, even more preferably, 1 to 25 mg/kg body weight per day, and even more preferably, 1 to 10 or 1 to 5.0 mg/kg body weight per day.
  • the oligonucleotide is preferably administered at a sufficient dosage to attain a blood level of oligonucleotide from about 0.01 ⁇ M to about 100 ⁇ M.
  • the concentration of oligonucleotide at the site of aberrant gene expression should be from about 0.01 ⁇ M to about 50 ⁇ M, more preferably, from about 0.01 ⁇ M to about 10 ⁇ M, and most preferably from about 0.05 ⁇ M to about 5 ⁇ M.
  • concentrations of the invention may be administered simultaneously or sequentially a therapeutically effective amount of one or more of the therapeutic compositions of the invention when individual as a single treatment episode.
  • the unit content of active ingredient or ingredients contained in an individual dose of each dosage form need not in itself constitute an effective amount since the necessary effective amount can be reached by administration of a plurality of dosage units (such as suppositories, gels, or creams, or combinations thereof).
  • a plurality of dosage units such as suppositories, gels, or creams, or combinations thereof.
  • multi-dosing once a day has been shown to significantly increase the plasma and tissue concentrations of MBO's (data not shown).
  • Administration of pharmaceutical compositions in accordance with invention or to practice the method of the present invention can be carried out in a variety of conventional ways, such as by oral ingestion, enteral, colorectal, or transdermal administration, inhalation, sublingual administration, or cutaneous, subcutaneous, intramuscular, intraocular, intraperitoneal, or intravenous injection, or any other route of administration known in the art for administrating therapeutic agents.
  • the therapeutic formulation will preferably include a physiologically acceptable carrier, such as an inert diluent or an assimilable edible carrier with which the composition is administered.
  • a physiologically acceptable carrier such as an inert diluent or an assimilable edible carrier with which the composition is administered.
  • suitable formulations that include pharmaceutically acceptable excipients for introducing compounds to the bloodstream by other than injection routes can be found in Remington's Pharmaceutical Sciences (18th ed.) (Genarro, ed. (1990) Mack Publishing Co., Easton, Pa.).
  • the oligonucleotide and other ingredients may be enclosed in a hard or soft shell gelatin capsule, compressed into tablets, or incorporated directly into the individual's diet.
  • the therapeutic compositions may be incorporated with excipients and used in the form of ingestible tablets, buccal tablets, troches, capsules, elixirs, suspensions, syrups, wafers, and the like.
  • the therapeutic composition When the therapeutic composition is administered orally, it may be mixed with other food forms and pharmaceutically acceptable flavor enhancers.
  • Sustained release oral delivery systems and/or enteric coatings for orally administered dosage forms are also contemplated such as those described in U.S. Pat. Nos. 4,704,295, 4,556,552, 4,309,404, and 4,309,406.
  • the synthetic oligonucleotide When a therapeutically effective amount of composition of the invention is administered by injection, the synthetic oligonucleotide will preferably be in the form of a pyrogen-free, parenterally-acceptable, aqueous solution.
  • a preferred pharmaceutical composition for injection should contain, in addition to the synthetic oligonucleotide, an isotonic vehicle such as Sodium Chloride Injection, Ringer's Injection, Dextrose Injection, Dextrose and Sodium Chloride Injection, Lactated Ringer's Injection, or other vehicle as known in the art.
  • the pharmaceutical composition of the present invention may also contain stabilizers, preservatives, buffers, antioxidants, or other additives known to those of skill in the art.
  • the pharmaceutical formulation can be administered in bolus, continuous, or intermittent dosages, or in a combination of continuous and intermittent dosages, as determined by the physician and the degree and/or stage of illness of the patient.
  • the duration of therapy using the pharmaceutical composition of the present invention will vary, depending on the unique characteristics of the oligonucleotide and the particular therapeutic effect to be achieved, the limitations inherent in the art of preparing such a therapeutic formulation for the treatment of humans, the severity of the disease being treated and the condition and potential idiosyncratic response of each individual patient. Ultimately the attending physician will decide on the appropriate duration of intravenous therapy using the pharmaceutical composition of the present invention.
  • the initial experiment performed involved evaluation of Oligos 12, 32, and 41 against three laboratory strains of HIV-1 (IIIB, RF and SK1) and one strain of HIV-2 (ROD) in parallel with the positive control compound ddC in the XTT-based anti-HIV assay. All these oligonucleotides are active against both HIV-1 and HIV-2. An enhanced level of activity was detected with these compounds when evaluated against the HIV-2 strain ROD. Representative results are shown in FIG. 3.
  • the activity of the compounds was also evaluated against the monocyte-macrophage strains BaL and ADA.
  • Oligos 12 and 32 according to the invention, as well as Oligo 41 are active against low passage clinical T-tropic strains of HIV-1. The activity of the compounds varies from strain to strain. The compounds were not active against the monocyte-macrophage-tropic strains BaL and ADA.
  • Oligo 41 was evaluated in uninfected and HIV-1 infected fresh human peripheral blood mononuclear cells, using a variety of quantitative endpoints. Toxicity was evaluated using the tetrazolium dyes XTT or MTT, trypan blue cell and cell viability counting and the incorporation of tritiated thymidine. Two replicate assays were performed. In the first assay, Oligo 41 was used at a high test concentration of 50 ⁇ g/ml and toxicity was evaluated on day 7. No toxicity was detected by any of the quantitative endpoints employed. A second assay was performed to further evaluate toxicity at higher compound concentration and with longer exposure to the compound. In this assay, employing a high test concentration of 150 ⁇ g/ml and extending the time of drug exposure from 7 days until 14 days, once again no toxicity was detected.
  • oligonucleotides systemically administered to pregnant murine females were found to cross the placenta and be available in the blood of embryos in utero.
  • oligonucleotides of the invention be used in methods of treating human fetuses and mothers harboring HIV.
  • oligonucleotide may also be detected in liver various hours after administration. Further evidence to support the absorption of the oligonucleotide may come from urine sample analysis after radioactively labelled gag-specific oligonucleotide was orally administered. That the oligonucleotide continues to be excreted in the urine over time following the administration of radiolabelled oligonucleotide implies that other tissues had absorbed it, and that the body was capable of absorption for an extended period of time.
  • Oligonucleotide phosphorothioates were synthesized using an automated DNA synthesizer (model 8700, Biosearch, Bedford, Mass.) using a beta-cyanoethyl phosphoramidate approach on a 10 micromole scale. To generate the phosphorothioate linkages, the intermediate phosphite linkage obtained after each coupling was oxidized using 3H, 1,2-benzodithiole-3H-one-1,1-dioxide (see Beaucage, in Protocols for Oligonucleotides and Analogs: Synthesis and Properties , Agrawal (ed.), (1993) Humana Press, Totowa, N.J., pp. 33-62).
  • Hybrid oligonucleotides were synthesized similarly, except that segments containing 2′-O-methylribonucleotides were assembled using 2′-O-methylribonucleoside phosphoramidite, followed by oxidation to a phosphorothioate or phosphodiester linkage as described above. Deprotection and purification of oligonucleotides was carried out according to standard procedures, (see Padmapriya et al. (1994) Antisense Res. & Dev. 4:185-199).
  • the CEM-SS cell line (Southern Research Institute-Frederick Research Center, Frederick, MD) is highly susceptible to infection with HIV, rapidly form multinucleated syncytia, and are eventually killed by HIV.
  • the cells were maintained (2-7 ⁇ 10 5 cells per ml) in RPMI 1640 tissue culture medium supplemented with 10% fetal bovine serum, glutamine, and antibiotics, and were passaged twice weekly at 1:20 dilution. Passage number was logged each week. Cells were discarded after twenty weeks of passage and fresh CEM-SS cells thawed and utilized in the assay.
  • CEM-SS cells Stocks of CEM-SS cells were frozen in liquid nitrogen in 1 ml NUNC vials in 90% fetal calf serum and 10% dimethyl sulfoxide (DMSO). Following thawing, CEM-SS cells were routinely ready to be utilized in the primary screen assay after two weeks in culture. Prior to replacing a late passage cell line, the new CEM-SS cells were tested in the screening assay protocol utilizing the current stock of infectious virus and AZT. If the infectivity of the virus was significantly different on the new cells or if AZT appeared less active than expected the new cells were not entered into the screening program. Mycoplasma testing was routinely performed on all cell lines.
  • the N119 isolate was derived in vitro by culture of the clinical strain A018 in the presence of the nonnucleoside reverse transcriptase inhibitor nevirapine. This isolate was obtained from the NIAID AIDS research and Reference Reagent Program (catalog #1392). The isolate possesses one mutation in the reverse transcriptase (Y181C) and we have found the isolate to be extremely cytopathic to T cells such as CEM-SS and MT2 (Richman et al. (1991) Proc. Natl. Acad Sci. USA 88:11241).
  • the 3TC/M1841 isolate was selected in vitro using the wild type IIIB strain of virus and sequential passage of the virus in the presence of increasing drug concentration in CEM-SS cells (Buckheit Jr. et al. (1996) Antimicrob. Chem Chemother. 7:243-252).
  • the JE 105/R isolate was derived from sequential passage of IIIB in the presence of a protease inhibitor.
  • This isolate possesses the 184V and S37N amino acid changes in the protease.
  • the KNI272/R isolate was derived from sequential passage bf IIIB in the presence of the protease inhibitor KNI272.
  • the isolate possesses three amino acid changes in the protease, F53L, A71V and T80I.
  • the 4xAZT-Ri isolate was obtained by site-directed mutagenesis through introduction of four amino acid changes in the reverse transcriptase of the NL4-3 wild type virus.
  • the four amino acid changes are D67N, K70R, T215Y, and K219Q.
  • Virus pools (Southern Research Institute-Frederick Research Center, Frederick M) were prepared and titrated in CEM-SS cells, placed in 5 ml aliquots, and frozen at ⁇ 135° C. After thawing, unused virus is discarded to avoid changes in infectious titer.
  • Virus pools were prepared by the acute infection of 5 ⁇ 10 5 CEM-SS cells with HIV in a volume of 200 ⁇ l at a multiplicity of infection determined to give complete cell killing at day 7 post-infection (approximately 0.05 for the III B isolate of HIV-1 and 0.01 for the RF isolate of HIV-1).
  • Infection was allowed to proceed for one hour at 37° C., after which the cells were transferred to a T25 flask and the volume increased to 2 ml. On day 1 post-infection the volume was brought to 5 ml and on day 2 the volume was increased to 10 ml. Beginning on day 4, the cells were pelleted, the supernatant saved, and the cells resuspended in a fresh 10 ml aliquot of -tissue culture medium. Complete medium changes on a daily basis, rather than allowing growth of the cells in the medium for longer periods of time, allowed the virus inoculum utilized in the primary screen to remain relatively undepleted of nutrients when it is used to infect cells. The staining reaction utilized (XTT, see method below) required that the glucose concentration remain high (161). Wells depleted of glucose by cell growth will not permit metabolic conversion of the tetrazolium dye to the formazan product.
  • the XTT staining method was utilized to determine the exact amount of virus required to kill all of the CEM-SS cells in each well and this minimum amount of virus was utilized for performance of all primary testing. Identical methods were utilized to prepare all virus isolates utilized, including laboratory-derived strains of HIV-1, HIV-2 and SIV. Clinical isolates utilized were passaged in fresh human cells. The methods for the growth of these cells and the production of virus pools is described below.
  • CEM-SS cells (AIDS Research and Reference Reagent Program, NIH) or other established human T cell lines used in these experiments were passaged in T-150 flasks for use in the assay. On the day preceding the assay, the cells were split 1:2 to assure they would be in an exponential growth phase at time of infection. On the day of assay the cells were washed twice with tissue culture medium and resuspended in fresh tissue culture medium. Total cell and viability counting was performed using a hemacytometer and trypan blue dye exclusion. Cell viability was greater than 95% for the cells to be utilized in the assay. The cells were pelleted and resuspended at 2.5 ⁇ 10 4 cells per ml in tissue culture medium. Cells were added to the drug-containing plates in a volume of 50 ⁇ l.
  • a pretitered aliquot of virus was removed from the freezer ⁇ 80° C.) and allowed to thaw slowly to room temperature in a biological safety cabinet.
  • the virus was resuspended and diluted into tissue culture medium such that the amount of virus added to each well in a volume of 50 ⁇ l will be the amount determined to give complete cell killing at 6 days post-infection.
  • the virus pools produced with the IIIB isolate of HIV required the addition of 5 ⁇ l of virus per well. Pools of RF virus were five to ten-fold more potent, requiring 0.5 to 1 ⁇ l per well.
  • TCID 50 calculation by endpoint titration in CEM-SS cells indicated that the multiplicity of infection of these assays ranged from 0.005 to 2.5.
  • Each plate contained cell control wells (cells only), virus control wells (cells plus virus), drug toxicity control wells (cells plus drug only), drug colorimetric control wells (drug only) as well as experimental wells (drug plus cells plus virus).
  • test plates were analyzed by staining with the tetrazolium dye XTT.
  • XTT-tetrazolium is metabolized by the mitochondrial enzymes of metabolically active cells to a soluble formazan product, allowing the rapid quantitative analysis of the inhibition of HIV-induced cell killing by anti-HIV test substances.
  • post-infection plates were removed from the incubator and observed. The use of round bottom microtiter plates allows rapid macroscopic analysis of the activity of a given test compound by the evaluation of pellet size. The results of the macroscopic observations were confirmed and enhanced by further microscopic analysis.
  • XTT solution was prepared daily as a stock of 1 mg/ml in PBS.
  • Phenazine methosulfate (PMS) solution was prepared at 15 mg/ml in PBS and stored in the dark at ⁇ 20° C.
  • XTT/PMS stock was prepared immediately before use by diluting the PMS 1:100 into PBS and adding 40 ⁇ l per ml of XTT solution. Fifty microliters of XTT/PMS was added to each well of the plate and the plate was incubated for an additional 4 hours at 37° C.
  • Adhesive plate sealers were used in place of the lids, the sealed plate was inverted several times to mix the soluble formazan product and the plate was read spectrophotometrically at A450 nm with a Molecular Devices Vmax plate reader. Using an in-house computer program % CPE (cytopathic effect) reduction, % cell viability, IC 25, 50 & 95 , TC 25,50 & 95 and other indices were calculated and the graphic results summary was displayed.
  • CPE cytopathic effect
  • RT reverse transcriptase
  • NNN Tritiated thymidine triphosphate
  • Poly rA and oligo dT were prepared as a stock solution which was kept at ⁇ 20° C.
  • the RT reaction buffer was prepared fresh on a daily basis and consists of 125 ⁇ l 1 M EGTA, 125 ⁇ l dH 2 O, 125 ⁇ l Triton X-100, 50 ⁇ l 1 M Tris (pH 7.4), 50 ⁇ l 1 M DTT, and 40 ⁇ l 1 M MgCl 2 . These three solutions were mixed together in a ratio of one part distilled water. Ten microliters of this reaction mixture was placed in a round bottom microtiter plate and 15 ⁇ l of virus containing supernatant was added and mixed. The plate was incubated at 37° C. and incubated for 60 minutes.
  • reaction volume was spotted onto filter mats, washed 6 times for 5 minutes each in a 5% sodium phosphate buffer, two times for 1 minute each in distilled water, two times for 1 minute each in 70% ethanol, and then dried.
  • the dried filter mat was placed in a plastic sample bag, Betaplate scintillation fluid was added and the bag was heat-sealed. Incorporated radioactivity was quantified utilizing a Wallac Microbeta, scintillation counter (Gaithersburg, Md.).
  • ELISA kits were purchased from Coulter (Miami, Fla.). The assay is performed according to the manufacturer's recommendations. Prior to ELISA analysis the reverse transcriptase activity assays (described above) were routinely performed and used the values for incorporated radioactivity in the RT activity assay to determine the dilution of our samples requires for the ELISA. Standard curves were constructed so that the dilutions of virus to be used in the p24 ELISA could be accurately determined from the RT activity assay. Control curves were generated in each assay to accurately quantify the amount of capsid protein in each sample. Data was obtained by spectrophotometric analysis at 450 nm using a plate reader. Molecular Devices Vmax P24 (Sunnydale, Calif.) concentrations were calculated from the optical density values by use of the Molecular Devices (San Hose, Calif.) software package Soft Max.
  • Infectious virus particles were qualified utilizing the CEM-SS plaque assay as described by Nara et al. ( Nature (1988) 332:469-470).
  • Flat bottom 96-well microtiter plates were coated with 50 ⁇ l of poly-L-lysine (Sigma. St. Louis, Mo.) at 50 ⁇ g/ml for 2 hours at 37° C.
  • the wells were then washed with PBS and 2.5 ⁇ 10 5 CEM-SS cells were placed in the microtiter well where they became fixed to the bottom of the plate. Enough cells were added to form a monolayer of CEM-SS cells in each well.
  • Virus containing supernatant was added from each well of the XTT plate, including virus and cell controls and each serial dilution of the test substance.
  • the number of syncytia were qualified in the flat-bottom 96-well microtiter plate with an Olympus CK2 inverted microscope at 4 days following infection. Each syncytium resulted from a single infectious HIV virion.
  • Fresh human peripheral blood lymphocytes were isolated from voluntary Red Cross donors, seronegative for HIV and HBV. Leukophoresed blood was diluted 1:1 with Dulbecco's phosphate buffered saline (PBS), layered over 14 ml of Ficoll-Hypaque density gradient in a 50 ml centrifuge tube. Tubes were then centrifuged for 30 minutes at 600 X g. Banded PBLs were gently aspirated from the resulting interface and subsequently washed 2X with PBS by low speed centrifugation.
  • PBS Dulbecco's phosphate buffered saline
  • PHA-P stimulated cells from at least two normal donors were pooled, set in fresh medium at 2 ⁇ 10 6 /ml, and plated in the interior wells of a 96 well round bottom microplate at 50 ⁇ L/well.
  • Test drug dilutions were prepared at a 2X concentration in microtiter tubes, and 100 ⁇ l of each concentration was placed in appropriate wells in a standard format. Fifty microliters of a predetermined dilution of virus stock was placed in each test well. Wells with cells and virus alone were used for virus control. Separate plates were identically set without virus for drug cytotoxicity studies using an XTT assay system.
  • the RT reaction buffer was prepared fresh on a daily basis and consists of 125 ⁇ l 1 M DTT, and 40 ⁇ l 1 M MgCl 2 . These three solutions were mixed together in a ratio of 2 parts TTP, 1 part poly rA:oligo dT, and 1 part reaction buffer. Ten microliters of this reaction mixture was placed in a round bottom microtiter plate and 15 ⁇ l of virus containing supernatant was added and mixed. The plate was incubated at 37° C. in a water bath with a solid support to prevent submersion of the plate and incubated for 60 minutes.
  • reaction volume was spotted onto pieces of DE81 paper, washed 5 times for 5 minutes each in a 5% sodium phosphate buffer, 2 times for 1 minute each in distilled water, 2 times for 1 minute each in 70% ethanol, and then dried.
  • Opti-Fluor 0 was added to each sample and incorporated radioactivity was quantified utilizing a liquid scintillation counter, (Wallac 1450 Microbetaplus, Gaithersburg, Md.).
  • Tritiated thymidine incorporation was measured in parallel cultures at day 7. Each well was pulsed with 1 ⁇ Ci of tritiated thymidine and the cells were harvested 18 hours later with a Skatron cell harvester onto glass fiber filter papers. The filters were dried, placed in a scintillation vial with 1 ml of scintillation cocktail and incorporated radioactivity was quantified on a liquid scintillation counter (e.g., Packard Tri-Carb 1900 TR450).
  • a liquid scintillation counter e.g., Packard Tri-Carb 1900 TR450.
  • Each of these virus isolates was obtained from the NIAID AIDS Research and Reference Reagent Program. High titer pools of each of these viruses have been harvested from infected cultures of peripheral blood adherent cells and frozen in 1.0 ml aliquots at ⁇ 80° C. Monocyte-macrophage monolayers were infected at an MOI of 0.1. Compounds to be evaluated in the monocyte-macrophage assay are added to the monolayers shortly before infection in order to maximize the potential for identifying active compounds.
  • MT-4 cells were obtained from the AIDS Research and Reference Reagent Bank, Division of AIDS, NIAID, NIH contributed Dr. Richman (Pauwels et al. (1988) J. Virol. Meth. 20:309).
  • T-lymphoid H9 (HUT-78) cells were obtained from Dr. Robert Gallo, National Cancer Institute, Bethesda, Md. (Popovic et al. (1984) Science 224:497; Gazdar et al.
  • oligonucleotide of the invention inhibits HIV-1 infection when added to cells during viral infection (FIG. 1) or post-viral adsorption (FIG. 2).
  • mice Male Sprague-Dawley rats (100-120 g, Harlan Laboratories, Indianapolis, Ind.) and male CD-/F2 mice (25 ⁇ 3 g, Charles River Laboratory, Wilmington, Mass.) are used in the study. The animals are fed with commercial diet and water ad libitum for 1 week prior to the study.
  • Unlabelled and 35 S-labelled oligonucleotides are dissolved in physiological saline (0.9% NaCl) in a concentration of 25 mg/ml, and are administered to the fasted animals via gavage at the designated dose (30-50 mg/kg for rats and 10 mg/kg for mice). Doses are based on the pretreatment body weight and rounded to the nearest 0.01 ml. After dosing, each animal is placed in a metabolism cage and fed with commercial diet and water ad libitum. Total voided urine is collected and each metabolism cage is then washed following the collection intervals. Total excreted feces is collected from each animal at various timepoints, and feces samples are homogenized prior to quantitation of radioactivity.
  • Plasma samples are collected in heparinized tubes from animals at the various timepoints. Plasma is separated by centrifugation. Animals are euthanized by exsanguination under sodium pentobarbital anesthesia at various times (i.e., 1, 3, 6, 12, 24, and 48 hr; 3 animals/time point). Following euthanasia, the tissues are collected from each animal. All tissues/organs are trimmed of extraneous fat or connective tissue, emptied and cleaned of all contents, individually weighed, and the weights recorded.
  • oligonucleotide To obtain 35 S-labelled oligonucleotide, synthesis is carried out in two steps. The first nucleotides of the oligonucleotide sequence from its 3′-end are assembled using the ⁇ -cyanoethyl-phosphoramidite approach (see, Beaucage in Protocols for Oligonucleotides and Analogs (Agrawal, ed.), Humana Press, (1993), pp. 33-61). The last nucleotides are assembled using the H-phosphonate approach (see, Froehler in Protocols for Oligonucleotides and Analogs (Agrawal, ed.) Humana Press, 1993, pp. 63-80).
  • CPG Controlled pore glass
  • the solution is removed and the CPG support is washed with carbon disulfide/pyridine/triethylamine (10:10:1) (3 ⁇ 500 ⁇ l) and with acetonitrile (3 ⁇ 700 ⁇ l).
  • the product is deprotected in concentrated ammonium hydroxide (55° C., 14 hr) and evaporated.
  • the resultant product is purified by polyacrylamide gel electrophoresis (20% polyacrylamide containing 7 M urea).
  • the desired band is excised under UV shadowing and the PS-oligonucleotide was extracted from the gel and desalted with a Sep-Pak C18 cartridge (Waters) and Sephadex G-15 column.
  • the total radioactivities in tissues and body fluids is determined by liquid scintillation spectrometry (LS 6000TA, Beckman, Irvine, Calif.).
  • biological fluids plasma, 50-100 ⁇ l; urine, 50-100 ⁇ l
  • 6 ml scintillation solvent Budget-Solve, RPI, Mt. Prospect, Ill.
  • Feces are ground and weighed prior to being homogenized in a 9-fold volume of 0.9% NaCl saline.
  • An aliquot of the homogenate (100 ⁇ l) is mixed with solubilizer (TS-2, RPI, Mt. Prospect, Ill.) and then with scintillation solvent (6 ml) to permit quantitation of total radioactivity.
  • solubilizer TS-2, RPI, Mt. Prospect, Ill.
  • tissues are immediately blotted on Whatman No. 1 filter paper and weighed prior to being homogenized in 0.9% NaCl saline (3-5 ml per gram of wet weight).
  • the resulting homogenate (100 ⁇ l) is mixed with solubilizer (TS-2, RPI, Mt. Prospect, Ill.) and then with scintillation solvent (6 ml) to determine total radioactivity.
  • solubilizer TS-2, RPI, Mt. Prospect, Ill.
  • scintillation solvent 6 ml
  • Mobile phase includes two buffers; Buffer A was 5 mM-A reagent (Waters Co., Bedford, Mass.) in water and Buffer B is 4:1 (v/v) Acetonitrile (Fisher)/water.
  • Buffer A was 5 mM-A reagent (Waters Co., Bedford, Mass.) in water and Buffer B is 4:1 (v/v) Acetonitrile (Fisher)/water.
  • the column is eluted at a flow rate of 1.5 ml/min, using the following gradient: (1) 0-4 min, 0% buffer B; (2) 4-15 min 0-35% Buffer B; and (3) 15-70 min 35%-80% Buffer B.
  • the column is equilibrated with Buffer A for at least 30 min prior to the next run.
  • Polyacrylamide gel electrophoresis (PAGE) of oligonucleotides and its metabolites is carried out by known and established methods. Plasma and tissue homogenates are incubated with proteinase K (2 mg/ml) in extraction buffer (0.5% SDS/10 mM NaCl/20 mM Tris-HCl, pH 7.6/10 mM EDTA) for 1 hr at 60° C. The samples are then extracted twice with phenol/chloroform (1:1, v/v) and once with chloroform. After ethanol precipitation, the extracts are analyzed by electrophoresis in 20% polyacrylamide gels containing 7 M urea. Urine samples are filtered, desalted and then analyzed by PAGE. The gels are fixed in 10% acetic acid/10% methanol solution and then dried before autoradiography.

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AU8771398A (en) 1999-03-08
WO1999009154A2 (en) 1999-02-25
US20030100521A1 (en) 2003-05-29
EP1007657A2 (de) 2000-06-14
DE69833438D1 (de) 2006-04-20
ATE317432T1 (de) 2006-02-15
EP1007657B1 (de) 2006-02-08
ES2255732T3 (es) 2006-07-01
WO1999009154A3 (en) 1999-05-06
DE69833438T2 (de) 2006-10-26
US7173014B2 (en) 2007-02-06

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