US20040127408A1 - Synthetic human peptides and pharmaceutical compositions comprising them for the treatment of systemic lupus erythematosus - Google Patents

Synthetic human peptides and pharmaceutical compositions comprising them for the treatment of systemic lupus erythematosus Download PDF

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US20040127408A1
US20040127408A1 US10/468,924 US46892404A US2004127408A1 US 20040127408 A1 US20040127408 A1 US 20040127408A1 US 46892404 A US46892404 A US 46892404A US 2004127408 A1 US2004127408 A1 US 2004127408A1
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peptide
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mmp
amino acid
acid residues
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Edna Mozes
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Yeda Research and Development Co Ltd
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    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K16/00—Immunoglobulins [IG], e.g. monoclonal or polyclonal antibodies
    • C07K16/46—Hybrid immunoglobulins
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K16/00—Immunoglobulins [IG], e.g. monoclonal or polyclonal antibodies
    • C07K16/18—Immunoglobulins [IG], e.g. monoclonal or polyclonal antibodies against material from animals or humans
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P17/00—Drugs for dermatological disorders
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P29/00—Non-central analgesic, antipyretic or antiinflammatory agents, e.g. antirheumatic agents; Non-steroidal antiinflammatory drugs [NSAID]
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P37/00—Drugs for immunological or allergic disorders
    • A61P37/02—Immunomodulators
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P37/00—Drugs for immunological or allergic disorders
    • A61P37/02—Immunomodulators
    • A61P37/06—Immunosuppressants, e.g. drugs for graft rejection
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P43/00—Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K39/00—Medicinal preparations containing antigens or antibodies
    • A61K2039/505—Medicinal preparations containing antigens or antibodies comprising antibodies
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K39/00—Medicinal preparations containing antigens or antibodies
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K2317/00—Immunoglobulins specific features
    • C07K2317/20—Immunoglobulins specific features characterized by taxonomic origin
    • C07K2317/21—Immunoglobulins specific features characterized by taxonomic origin from primates, e.g. man
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K2317/00—Immunoglobulins specific features
    • C07K2317/50—Immunoglobulins specific features characterized by immunoglobulin fragments
    • C07K2317/56—Immunoglobulins specific features characterized by immunoglobulin fragments variable (Fv) region, i.e. VH and/or VL
    • C07K2317/565—Complementarity determining region [CDR]
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K2317/00—Immunoglobulins specific features
    • C07K2317/70—Immunoglobulins specific features characterized by effect upon binding to a cell or to an antigen
    • C07K2317/73—Inducing cell death, e.g. apoptosis, necrosis or inhibition of cell proliferation

Definitions

  • the present invention relates to synthetic peptides and, more particularly, to synthetic peptides based on the complementarity-determining region (CDR) of a human monoclonal anti-DNA antibody, to pharmaceutical compositions comprising them, and to their use in the immunomodulation of systemic lupus erythematosus (SLE)-associated responses.
  • CDR complementarity-determining region
  • 16/6Id human 16/6Id mAb
  • CDR complementarity-determining region
  • CFA complete Freund's adjuvant
  • hCDR peptide a peptide based on a CDR region of the human 16/6Id mAb
  • hCDR1 the human peptide of the SEQ ID NO:6
  • hCDR3 the human peptide of the SEQ ID NO:7
  • human 16/6Id mAb human pathogenic anti-DNA mAb that bears the 16/6Id
  • ICD immune complex deposits
  • Id idiotype
  • LNC lymph node cells
  • mAb monoclonal antibody
  • MMP matrix metalloproteinase
  • mCDR1 the murine peptide of the SEQ ID NO: 1
  • mCDR3 the murine peptide of the SEQ ID NO3
  • PBL peripheral blood lymphocytes
  • PBS phosphate-buffered saline
  • rev reverse
  • SLE Systemic lupus erythematosus
  • autoantibodies including antibodies to DNA, antibodies to nuclear antigens and antibodies to ribonucleoproteins.
  • the progression of the disease is associated with general clinical manifestations and damage to tissues and organs caused by deposition of immune complexes. Similar to other autoimmune conditions, the etiology of SLE is multifactorial entailing genetic, environmental, hormonal and immunological factors. No specific treatment aimed towards the prevention or cure of SLE is available.
  • the human monoclonal anti-DNA antibody termed 16/6Id bears a common idiotype (Shoenfeld et al., 1983). The idiotype was found to have clinical relevance in SLE patients. Thus, the 16/6Id was found to be expressed on anti-DNA antibodies of 54% of SLE patients with active disease (Isenberg et al., 1984) and in affected organs of patients with SLE (Isenberg and Collins, 1985). Mice of inbred strains that do not develop any spontaneous autoimmune diseases were immunized with this human anti-DNA 16/6Id mAb and developed the major hallmarks of SLE in humans and in the spontaneous murine models for this disease (Mendlovic et al., 1988).
  • mice produced antibodies specific to the 16/6Id, antibodies that bear the 16/6Id and antibodies directed against different nuclear antigens (dsDNA, ssDNA, Sm, ribonucleoprotein, Ro, La and others).
  • the serological findings were associated with leukopenia, elevated erythrocyte sedimentation rate, proteinuria, abundance of immune complexes in the kidneys and sclerosis of the glomeruli (Mendlovic et al., 1988), which are typical manifestations of SLE.
  • a murine anti-16/6Id mAb (Ab2) derived from mice with experimental SLE was also capable of inducing the experimental disease in mice (Mendlovic et al., 1989) similar to the 16/6Id (Ab1).
  • a murine anti-DNA mAb that expresses the 16/6Id was prepared from mice afflicted with experimental SLE.
  • the antibody Ab3 termed 5G12 reacted with antibodies specific to the 16/6Id. Immunization with the latter antibody resulted in the induction of experimental SLE with similar manifestations as observed following immunization with the human 16/6Id (Ab1) and with the murine anti-16/6Id (Ab2) mAbs (Waisman et al., 1993).
  • V variable (V) regions of nine autoantibodies that bind either DNA or HeLa nuclear extract (NE), isolated from the C3H.SW mice with experimental SLE, were sequenced (Waisman and Mozes, 1993). Monoclonal antibodies with different specificity were analyzed in an attempt to determine the connections between the different autoantibodies. Three mAb were found to bind DNA, and were shown to exhibit sequence characteristics of pathogenic anti-DNA antibodies. One of these mAb, designated 2C4C2, was shown to use a heavy (H) chain V region gene (V H ) identical to the V H of anti-DNA mAb isolated from other lupus-prone mice, namely (NZB x NZW)F l .
  • V H heavy chain V region gene
  • the light (L) chain V region gene (V L ) of mAb 2C4C2 is 98% homologous to the V L of another anti-DNA mAb, also isolated from (NZB x NZW)F l mice.
  • the other two anti-DNA mAb, designated 5G12-4 and 5G12-6 share 93% of their V H sequences with that of mAb 2C4C2. Based on the analysis of these mAbs, it appeared that autoantibodies found in mice with experimental SLE use genetic elements similar to those used by mAb that were isolated from mouse strains which develop lupus spontaneously.
  • T cells play an important role in the induction and development of experimental SLE.
  • T cell lines and clones specific to the 16/6Id were shown to induce experimental SLE in syngeneic recipients similarly to the 16/6Id antibody. Therefore, following the inoculation of the activated cells of the lines, the mice developed both the serology and the renal damage which is typical to SLE (Fricke et al., 1991).
  • the mAb 5G12 that was isolated from mice with experimental SLE and was shown to bind DNA and bear the 16/6Id, is capable of inducing experimental SLE in mice (Waisman et al., 1993).
  • mCDR1 SEQ ID NO:1
  • mCDR3 SEQ ID NO:3
  • the peptides mCDR1 and mCDR3 were further shown by the inventor to either prevent or treat an already established SLE that is either induced by the human anti-DNA 16/6Id mAb or that develops spontaneously in the SLE prone mice (NZB x NZW) Fl or MRL/lpr/lpr (Eilat et al., 2000 and 2001).
  • peptides based on the CDR of the human monoclonal anti-DNA 16/6Id antibody are capable of immunomodulating SLE-associated responses.
  • peptides based on the CDR1 and CDR3 of the human 16/6Id were tested and shown to inhibit lymph node cell proliferation of mice immunized with the murine peptides mCDR1 (SEQ ID NO:1) and mCDR3 (SEQ ID NO:3) or with the whole human anti-DNA 16/6Id mAb, to inhibit the proliferative response of peripheral blood lymphocytes (PBL) of SLE patients to the human anti-DNA 16/6Id mAb, and to ameliorate disease manifestations of mice afflicted with spontaneous or experimental SLE.
  • PBL peripheral blood lymphocytes
  • the present invention thus relates, in one aspect, to a synthetic peptide selected from the group consisting of:
  • a peptide of at least 12 and at most 30 amino acid residues comprising a sequence consisting of, or found within, a complementarity-determining region (CDR) found in the heavy or light chain of the human monoclonal anti-DNA 16/6Id antibody (hereinafter “hCDR sequence”), or a sequence obtained by: (i) replacement of one or more of the amino acid residues of the hCDR sequence by different amino acid residues; (ii) deletion of one or more amino acid residues from the hCDR sequence; and/or (iii) addition of one or more amino acid residues to the hCDR sequence , or a salt or a chemical derivative of said peptide;
  • CDR sequence complementarity-determining region
  • human 16/6Id mAb is a pathogenic human monoclonal anti-DNA antibody capable of inducing a SLE-like disease in mice.
  • hCDR peptide A peptide according to the invention comprising a hCDR sequence as defined above is herein referred to as “hCDR peptide”.
  • the hCDR peptide includes a sequence of a CDR, more preferably of the CDR1 or CDR3, of the heavy chain of the human 16/6Id mAb, such as, but not being limited to, the peptides herein designated hCDR1 and hCDR3, having the sequences substantially as denoted by SEQ ID NO:6 and SEQ ID NO:7, respectively, as follows: G Y Y W S W I R Q P P G K G E E W I G [SEQ ID NO:6] Y Y C A R G L L R G G W N D V D Y Y G M D V [SEQ ID NO:7]
  • the invention provides a pharmaceutical composition
  • a pharmaceutical composition comprising at least one synthetic peptide or peptide polymer of the invention, and a pharmaceutically acceptable carrier.
  • the pharmaceutical composition is particularly useful for the treatment of SLE and amelioration of the clinical manifestations of the disease, particularly by modulating SLE-associated responses, e.g. down-regulating the levels of P-3 and/or MMP-9, and/or IL-2 and/or IFN- ⁇ activities, or up-regulating the level of TGF- ⁇ activity in a patient with SLE.
  • the invention relates to a method for the treatment of SLE comprising administering to an SLE patient an effective amount of a peptide or peptide polymer of the invention.
  • the invention further relates to a method of immunomodulating SLE-associated responses, e.g. down-regulating the levels of MMP-3 and/or MNP-9, and/or IL-2 and/or IFN- ⁇ activities, or up-regulating the level of TGF- ⁇ activity in a patient with SLE, comprising administering to an SLE patient an effective amount of a peptide or peptide polymer of the invention.
  • the invention relates to a method for assessing the effectiveness of a drug in the treatment of a SLE patient which comprises measuring at different intervals of time the levels of MMP-3 and/or MMP-9 in a blood sample obtained from said patient being treated with said drug, whereby a decreased level of MMP-3 and/or MMP-9 correlates with the effectiveness of the drug.
  • the invention relates to a method for assessing the effectiveness of a drug in the treatment of a SLE patient which comprises measuring at different intervals of time the level of IL-2 and/or IFN- ⁇ in a blood sample obtained from said patient being treated with said drug, whereby a decreased level of IL-2 and/or IFN- ⁇ correlates with the effectiveness of the drug.
  • the invention relates to a method for assessing the effectiveness of a drug in the treatment of a SLE patient which comprises measuring at different intervals of time the level of TGF- ⁇ in a blood sample obtained from said patient being treated with said drug, whereby an increased level of TGF- ⁇ correlates with the effectiveness of the drug.
  • the drug which effectiveness is to be assessed according to any of the above methods may be, for example, without being limited to, a peptide according to the invention or a murine peptide as described in the above-mentioned WO 96/30057.
  • FIG. 1 shows inhibition of the proliferative responses of lymph node cells of mice immunized with human 16/6Id mAb to various concentrations of the 16/6Id mAb (0.1-10 ⁇ g/well), by treatment with 300 ⁇ g hCDR1.
  • FIG. 2 shows inhibition of the proliferative responses of lymph node cells of mice immunized with human 16/6Id mAb to various concentrations of the 16/6Id mAb (0.1-10 ⁇ g/well), by treatment with 50 ⁇ g hCDR1.
  • FIGS. 3 A-C show the cytokine pattern in BALB/c mice immunized with human 16/6Id nab and treated with hCDR1 or with an irrelevant peptide p259-271.
  • FIG. 3A IFN- ⁇ pattern
  • FIG. 3B TGF- ⁇ pattern
  • FIG. 3C IL-10 pattern.
  • FIG. 4 shows the concentrations of the human anti-DNA 16/6Id mAb required for optimal stimulation of PBL of SLE patients and of healthy controls. PBL were stimulated with various concentrations (0.1-40 ⁇ g/well) of the 16/6Id mAb. The concentration yielding the highest stimulation index was defined as optimal for triggering a proliferative response.
  • FIG. 5 shows proliferation of PBL from one SLE patient stimulated with the mitogen phytohemagglutinin (PHA) in the absence or presence of hCDR1 or hCDR3.
  • PHA mitogen phytohemagglutinin
  • FIG. 6 shows proliferation of PBL from one SLE patient stimulated with human 16/6Id mAb in the absence or presence of the human peptides hCDR1 or hCDR3 or the murine peptide mCDR3.
  • FIG. 7 shows proliferation of PBL from one SLE patient stimulated with human 16/6Id mAb in the absence or presence of the human peptides hCDR1 or hCDR3 or the murine reversed peptides revmCDR1 and revmCDR3.
  • FIG. 8 shows inhibition of IL-2 secretion in PBL of SLE patients triggered by the human 16/6Id mAb in the absence or presence of hCDR1 or hCDR3.
  • FIG. 9 shows up-regulation of TGF- ⁇ secretion in the PBL of one representative SLE patient stimulated with the human 16/6Id mAb in the absence or presence of hCDR1 or hCDR3.
  • FIG. 10 shows anti-DNA autoantibody levels in (NZB x NZW)Fl mice untreated or treated with 300 ⁇ g hCDR1 or with the reversed peptide revhCDR1 (used as control).
  • FIGS. 11 A- 11 D are photos showing representative kidney sections of SLE-prone (NZB x NZW)Fl mice that were treated starting at the age of 5 and half months with PBS ( 11 A, 11 B) or with 100 ⁇ g hCDR1 ( 11 C, 11 D). The sections are of mice sacrificed at the age of 9 months. For the detection of Ig deposits, sections were incubated with FITC-conjugated goat anti-mouse IgG ( ⁇ chain specific) ( 11 A, 11 C x 100; 11 B, 11 D x 400).
  • FIGS. 12 A- 12 F are photos showing representative kidney sections of SLE-prone (NZB x NZW)Fl mice that were treated with PBS ( 12 A, 12 B) or with 300 ⁇ g hCDR1 ( 12 C, 12 D), or with the reversed peptide revhCDR1 ( 12 E, 12 F).
  • the sections are of mice sacrificed at the age of 9 months.
  • sections were incubated with FITC-conjugated goat anti-mouse IgG ( ⁇ chain specific) ( 12 A, 12 C, 12 E x 100; 12 B, 12 D, 12 F x 400).
  • FIGS. 13 A- 13 C show the cytokine pattern as measured by ELISA in supernatants of Con A-stimulated cultures of splenocytes of SLE-prone (NZB x NZW)Fl mice that were untreated or treated with hCDR1 or with the reversed peptide revhCDR1.
  • FIG. 13A IFN- ⁇ pattern
  • FIG. 13B IL-10 pattern
  • FIG. 13C TGF- ⁇ pattern.
  • FIGS. 14 A- 14 F are photos showing representative kidney sections of BALB/c mice with 16/6Id-induced experimental SLE treated with PBS ( 14 A, 14 B) or with 200 ⁇ g hCDR1 ( 14 C, 14 D), or with the reversed peptide revhCDR1 ( 14 E, 14 F).
  • the sections are of mice sacrificed at the age of 9 months.
  • sections were incubated with FITC-conjugated goat anti-mouse IgG ( ⁇ chain specific) ( 14 A, 14 C, 14 E x 100; 14 B, 14 D, 14 F x 400).
  • FIGS. 15 A- 15 E show the cytokine pattern as measured by ELISA in supernatants of 16/6Id-stimulated lymph node cultures of BALB/c mice with 16/6Id induced experimental SLE that were untreated or treated with hCDR1 (200 or 300 ⁇ g ) or with the reversed peptide revhCDR1.
  • FIG. 15A IFN- ⁇ pattern
  • FIG. 15B TNF- ⁇
  • FIG. 15C IL-10 pattern
  • FIG. 15D TGF- ⁇ pattern
  • FIG. 15E TGF- ⁇ pattern, measured in supernatants of 16/6Id-triggered spleen cells.
  • FIGS. 16 A- 16 F are photos showing representative kidney sections of SLE-prone (NZB x NZW)Fl mice untreated ( 16 A, 16 B) or mice recipients of splenocytes of mice treated either with 300 ⁇ g hCDR1 ( 16 C, 16 D) or with the reverse peptide revhCDR1 ( 16 E, 16 F).
  • sections were incubated with FITC-conjugated goat anti-mouse IgG ( ⁇ chain specific) ( 16 A, 16 C, 16 E x 400; 16 B, 16 D, 16 F x 100).
  • FIGS. 17 A- 17 B depict kinetics of appearance of MMP-3, MMP-2, and MMP-9 in the sera of (NZB x NZW)Fl mice.
  • (NZB x NZW)Fl mice (10 mice/group) were bled at the indicated time points. Pooled sera (4 ⁇ L) of mice from each group were tested for MMP-3 expression levels using Western blot (FIG. 17A) or for MMP-9 and MMP-2 activities using gel zymography (FIG. 17B). The results represent 4 similar experiments.
  • FIGS. 18 A- 18 B depict kinetics of appearance of MMP-3, MMP-2, and MMP-9 in the sera of BALB/c mice.
  • Non-immunized BALB/c mice (10 mice/group) or mice that were immunized with PBS/CFA (10 mice/group) or with the 16/6Id (in CFA; 10 mice/group), were bled at the indicated time points.
  • Pooled sera of mice (4 ⁇ l) from each group were tested for MMP-3 expression levels using Western blot (FIG. 18A) or for MMP-9 and MMP-2 activities using gel zymography (FIG. 18B). The results are representative of 3 similar experiments.
  • FIGS. 19 A- 19 C depict immunostaining of kidney sections of immunized BALB/c mice for MMP-3 and MMP-9.
  • Kidneys were removed, and their 5 ⁇ m cryostat sections were immunostained for P-3 ( 19 A) and P-9 ( 19 B).
  • FIGS. 20 A- 20 B depict levels of MMP-3 and MMP-9 in sera of (NZB x NZW)Fl mice treated with mCDR1.
  • mice (10/group) were given weekly s.c. injections with mCDR1 starting at the age of 2 months during 10 weeks. The results represent sera taken 4 months after the end of the treatment.
  • mice (10/group) were injected s.c. with either PBS or 250 ⁇ g/mouse of mCDR1 starting at the age of 5 months. The results represent sera taken 3 weeks after the end of the treatment. Pooled sera of each experimental group were tested for MMP-3 levels by Western blot analysis ( 20 A) and for MMP-9 activity using gel zymography ( 20 B). UT—untreated. The results are representative of 2 similar experiments.
  • FIGS. 21 A- 22 B depict levels of MMP-3 and MMP-9 in 16/6Id-immunized BALB/c mice treated with mCDR1.
  • mice (8/group) were treated i.v. with mCDR1 (100 ⁇ g/mouse). The results shown are of sera taken 4.5 months after the end of the treatment.
  • mice (8/group) were treated s.c. with 100 ⁇ g/mouse mCDR1. The results are of sera obtained at the end of treatment. Pools of sera of each experimental group were tested for MMP-3 by Western blot analysis ( 21 A) and for MMP-9 activity by gel zymography ( 21 B). UT —untreated. The results are representative of 2 similar experiments.
  • FIGS. 22 A- 22 B depict immunostaining for MMP-3 and MMP-9 of kidney sections of 16/6Id immunized BALB/c mice that were treated with mCDR1 for prevention ( 22 A) or treatment ( 22 B) of experimental SLE. Mice were sacrificed 8 months following disease induction, and their kidneys were removed. Cryostat sections (5 ⁇ m) were prepared and immunostained for MMP-3, MMP-9 and for the presence of immune complex deposits (x200). (W/O)—control staining to the efficiency of blocking, without the first antibody. The results are representative of 2 similar experiments.
  • FIGS. 23 A- 23 B depict levels of MMP-3 and P-9 in sera of (NZB x NZW)Fl mice treated with hCDR1.
  • mice (10/group) were injected s.c. with either PBS or 100 ⁇ g or 30 ⁇ g/mouse of hCDR1 once a week for ten weeks starting at the age of 7 months.
  • the results represent sera collected at the middle of the treatment. Pooled sera of each experimental group were tested for MMP-3 levels by Western blot analysis ( 23 A) and for MMP-9 activity using gel zymography ( 23 B). The results are representative of 2 similar experiments.
  • FIG. 24 depicts a representative gel showing activity of MMP-2 and MMP-9 in sera of SLE patients and healthy controls. Sera (5 ⁇ l) of 40 individual SLE patients and 25 healthy controls were analysed for their MMP-2 or MMP-9 activities by gel zymography. The figure shows representative results with serum samples of the two groups.
  • FIGS. 26 A- 26 B are graphs showing MMP-9 activity levels and disease activity indices (SLEDAI) in patients with SLE. Thirty-five serum samples from 8 males (FIG. 26A) and 27 females (FIG. 26B) SLE patients were tested for MMP-9 activity by a specific activity assay kit. The distribution of MMP-9 activity according to the SLEDAI of the patients is presented. The dashed line represents the activity of MMP-9 in healthy controls.
  • FIGS. 27 A- 27 B are graphs showing pattern of MMP-2 (white circles) and MMP-9 (black circles) activities in sera of two SLE patients sampled during 4-6 years of disease. The sera were tested for MMP-2 or MMP-9 activities by specific activity assay kits. The assays were performed in duplicate.
  • the present invention relates, in one aspect, to synthetic peptides comprising a sequence consisting of, or found within, a CDR found in the heavy or light chain of the pathogenic human monoclonal anti-DNA 16/6Id antibody (herein identified as “human anti-DNA 16/6Id mAb” or “human 16/6Id mAb”), which antibody induces a SLE-like disease in mice.
  • human anti-DNA 16/6Id mAb or “human 16/6Id mAb”
  • human 16/6Id mAb human monoclonal anti-DNA 16/6Id antibody
  • the synthetic peptides of the invention derived from a CDR of the human 16/6Id mAb, herein identified as hCDR peptides, are preferably based on a CDR found in the heavy chain of the human 16/6Id mAb.
  • the CDR regions of the V H sequences of the human 16/6Id mAb are boxed in FIG. 4A of Waisman et al., 1995.
  • the CDR regions of the heavy chains of the human 16/6Id mAb have the sequences substantially as denoted by SEQ ID NO: 8 to SEQ ID NO: 10, as follows: CDR1: FSGYYWS [SEQ ID NO: 8] CDR2: EINHSGSTNYKTSLKS [SEQ ID NO: 9] CDR3: GLLRGGWNDVDYYYGMDV [SEQ ID NO: 10]
  • the hCDR peptides of the invention contain at least 12 and at most 30 amino acid residues and comprise, preferably, a sequence identical to a sequence selected from the group consisting of SEQ ID NO: 8, 9 and 10, or more preferably are sequence found within said SEQ ID NO: 8, 9 or 10, or a sequence obtained by: (i) replacement of one or more of the amino acid residues of the SEQ ID NO: 8, 9 and 10 sequences by different amino acid residues; (ii) deletion of one or more amino acid residues from the SEQ ID NO: 8, 9 and 10 sequences; or (iii) addition of one or more amino acid residues to the SEQ ID NO: 8, 9 and 10 sequences.
  • the hCDR peptides of the invention besides the hCDR sequence, contain further amino acid residues, preferably amino acid residues of the sequences of the human 16/6Id mAb flanking the hCDR sequences or sequences obtained by replacement of one or more of the amino acid residues of the hCDR flanking sequences by different amino acid residues, by deletion of one or more amino acid residues from the hCDR flanking sequences or by addition of one or more amino acid residues to the hCDR flanking sequences.
  • further amino acid residues preferably amino acid residues of the sequences of the human 16/6Id mAb flanking the hCDR sequences or sequences obtained by replacement of one or more of the amino acid residues of the hCDR flanking sequences by different amino acid residues, by deletion of one or more amino acid residues from the hCDR flanking sequences or by addition of one or more amino acid residues to the hCDR flanking sequences.
  • the present invention provides a synthetic peptide based on the CDR1 of the heavy chain of the human 16/6Id mAb, said CDR1 region being of the sequence substantially as denoted by SEQ ID NO:8, said peptide being selected from the group consisting of:
  • a peptide comprising a sequence consisting of, or found within, the sequence of SEQ ID NO: 8, or a sequence obtained by: (i) replacement of one or more of the amino acid residues of said SEQ ID NO:8 by different amino acid residues; (ii) deletion of one or more amino acid residues from said SEQ ID NO:8; and/or (iii) addition of one or more amino acid residues to said SEQ ID NO:8, or a salt or a chemical derivative of said peptide;
  • a peptide based on the CDR1 of the heavy chain of the human 16/6Id mAb is a peptide of the sequence substantially as denoted by SEQ ID NO: 11:
  • X 1 is G or TG;
  • X 2 is R or K;
  • X 3 is P or S;
  • X 4 is G or E;
  • X 5 is K or D; and
  • X 6 is E, L or S.
  • the peptide of SEQ ID NO:11 is the 19-mer peptide herein designated “hCDR1 peptide” or simply “hCDR1”, of the sequence substantially as denoted by SEQ ID NO:6:
  • hCDR1 the sequence GYYWS comprised within SEQ ID NO:8, is followed by the natural sequence of the CDR1 of the heavy chain of the human 16/6Id mAb, with the exception that the natural leucine (L) residue of the mAb sequence was replaced by a glutamic acid residue (E) (bold) at position 15 of the peptide hCDR1.
  • the peptide of SEQ ID NO:11 is an analog of the hCDR1 peptide obtained by replacement and/or addition of amino acid residues to the sequence of the hCDR1 peptide, examples thereof being the peptides of the sequences substantially as denoted by SEQ ID NO:12 to SEQ ID NO:18 (wherein the amino acids replaced or added are represented in bold): G Y Y W S W I R Q P P P G K G L E W I G [SEQ ID NO:12] G Y Y W S W I R Q P P P G K G S E W I G [SEQ ID NO:13] G Y Y W S W I R Q P P P G D G E E W I G [SEQ ID NO:14] G Y Y W S W I K Q P P P G K G E E W I G [SEQ ID NO:15] G Y Y W S W I R Q S P G K G E E W I G [SEQ ID NO:16] G Y Y W
  • the invention provides a synthetic peptide based on the CDR3 of the heavy chain of the human 16/6Id mAb, said CDR3 region being of the sequence substantially as denoted by SEQ ID NO:10, said peptide being selected from the group consisting of:
  • a peptide comprising a sequence consisting of, or found within, the sequence of SEQ ID NO:10, or a sequence obtained by: (i) replacement of one or more of the amino acid residues of said SEQ ID NO:10 by different amino acid residues; (ii) deletion of one or more amino acid residues from said SEQ ID NO: 10; and/or (iii) addition of one or more amino acid residues to said SEQ ID NO:10, or a salt or a chemical derivative of said peptide;
  • the peptide based on the CDR3 of the heavy chain of the human 16/6Id mAb is a peptide of the sequence substantially as denoted by SEQ ID NO:19:
  • X 1 is G or F
  • X 2 is R or A
  • X 3 is G or A
  • X 4 is G or A
  • X 5 is W or A
  • X 6 is N or A
  • X 7 is Y or W
  • X 8 is M or Q.
  • the peptide of SEQ ID NO: 19 is the peptide herein designated “hCDR3 peptide” or simply “hCDR3”, of the SEQ ID NO:7:
  • the sequence GLLRGGWNDVDYYYGMDV [SEQ ID NO:10]of the CDR3 region of the heavy chain of the human 16/6Id mAb is modified by deletion of one of the tyrosine (Y) residues and is preceded by the natural sequence of the mAb.
  • the peptide of SEQ ID NO:19 is an analog of the hCDR3 peptide obtained by replacement and/or addition of amino acid residues to the sequence of the hCDR3 peptide, examples thereof being the peptides of the sequences SEQ ID NO:20 to SEQ ID NO:27 (wherein the amino acids replaced or added are represented in bold): Y Y C A R G L L R G G W A D V D Y Y G M D V [SEQ ID NO:20] Y Y C A R G L L R G G A N D V D Y Y G M D V [SEQ ID NO:21] Y Y C A R G L L R G A W N D V D Y Y G M D V [SEQ ID NO:22] Y Y C A R G L L R A G W N D V D Y Y G M D V [SEQ ID NO:23] Y Y C A R G L L A G W N D V D Y Y G M D V [SEQ
  • the invention provides a synthetic peptide based on the CDR2 of the heavy chain of the human 16/6Id mAb, said CDR2 region being of the sequence substantially as denoted by SEQ ID NO:9, said peptide being selected from the group consisting of:
  • a peptide comprising a sequence consisting of, or found within, the sequence of SEQ ID NO:9, or a sequence obtained by: (i) replacement of one or more of the amino acid residues of said SEQ ID NO:9 by different amino acid residues; (ii) deletion of one or more amino acid residues from said SEQ ID NO:9; and/or (iii) addition of one or more amino acid residues to said SEQ ID NO:9, or a salt or a chemical derivative of said peptide;
  • the synthetic peptides of the present invention have 12-30, preferably 17-23, most preferably 19-22, amino acid residues, and may be manufactured by chemical synthesis or by recombinant technology by methods well known in the art.
  • substitutions be selected from those which cumulatively do not substantially change the volume, hydrophobic-hydrophilic pattern and charge of the corresponding portion of the unsubstituted parent peptide.
  • a hydrophobic residue may be substituted with a hydrophilic residue, or vice-versa, as long as the total effect does not substantially change the volume, hydrophobic-hydrophilic pattern and charge of the corresponding unsubstituted parent peptide.
  • the present invention also includes chemical derivatives of a peptide of the invention.
  • the “chemical derivative” contains additional chemical moieties not normally a part of the peptide and is encompassed by the invention as long as it retains at least a portion of the function of the peptide which permits its utility in preventing or inhibiting T cell proliferative responses and autoimmune disease.
  • a chemical derivative may result from the reaction of an organic derivatizing agent capable of reacting with selected side chains or terminal residues of said peptide, and will preferably retain at least a portion of the function of the peptide to inhibit specifically the proliferative response and cytokine secretion of T lymphocytes of mice that are high responders to SLE-inducing autoantibodies.
  • the amides are of particular interest, both amnides of carboxyl groups at the C-terminus and amides of free carboxyl groups of aspartic or glutamic acid residues. Many such chemical derivatives and methods for making them are well known in the art.
  • salts of the peptides and analogs of the invention are also included in the scope of the invention.
  • the term “salts” refers to both salts of carboxyl groups and to acid addition salts of amino groups of the peptide molecule.
  • Salts of a carboxyl group may be formed by means known in the art and include inorganic salts, for example, sodium, calcium, ammonium, ferric or zinc salts, and the like, and salts with organic bases such as those formed for example, with amines, such as triethanolamine, arginine, or lysine, piperidine, procaine, and the like.
  • Acid addition salts include, for example, salts with mineral acids such as, for example, hydrochloric acid or sulfuric acid, and salts with organic acids, such as, for example, acetic acid or oxalic acid.
  • mineral acids such as, for example, hydrochloric acid or sulfuric acid
  • organic acids such as, for example, acetic acid or oxalic acid.
  • Such chemical derivatives and salts are preferably used to modify the pharmaceutical properties of the peptide insofar as stability, solubility, etc., are concerned.
  • the hCDR peptides according to the invention may be selected by testing for their potential in inhibiting the proliferative response of T lymphocytes of mice that are high responders to SLE-inducing autoantibodies. Once a peptide in accordance with the present invention is produced, its ability to inhibit the proliferative response of T lymphocytes of mice that are high responders to SLE-inducing autoantibodies may be readily determined by those of ordinary skill in the art without undue experimentation using tests such as those described herein. One test which may be readily conducted is for the ability of the peptides to inhibit in vitro the proliferative responses of certain T cell lines and clones specific to SLE-inducing autoantibodies.
  • the T cell lines and clones may be, for example, the T cell lines and clones specific to the 16/6Id mAb (Fricke et al., 1991) established from immunized lymph node cells of mice by previously described methodology (Axelrod, O. and Mozes, E. Immunobiology, 172, 99 (1986)). Cells are exposed to the stimulating antibody presented on irradiated syngeneic spleen cells in the presence of enriched medium every two weeks. The T cell lines are cloned by the standard limiting dilution technique. The proliferative responses of these T cell lines and clones are tested, for example, by the method described in WO 96/30057, in Materials and Methods, section (g).
  • Another test which can be conducted in order to select analogs having the desired activity is to test for the ability of the synthetic peptides to inhibit the ability of the T. cell lines and clones to provide help to peptide-specific B cells in the presence of the parent peptide.
  • the synthetic peptides may also be tested for their ability to bind directly, following biotinylation, to MHC Class II products on antigen-presenting cells of the relevant strains. For this purpose, N-terminal biotinylation of the relevant peptides is performed at 0° C. with an excess of biotin-N-hydroxysuccinimide in aqueous solution (Mozes et al., 1989).
  • Mouse splenic adherent cells or PBL-adherent cells (1 ⁇ 10 6 /sample) are incubated with biotinylated peptides in PBS containing 0.1% bovine serum albumin (PBS/BSA) at 37° C. for 20 hr, followed by incubation with phycoerythrin-streptavidin for 30 min at 4° C. After each incubation, the cells are washed twice with the above solution. Thereafter, the cells are analyzed by flow cytometry using FACScan. In each analysis, a minimum of 5000 cells are examined (for above procedures, see, for example, Mozes et al., 1989).
  • a further test which can be conducted is to test for the ability of the peptides to inhibit cytokine secretion by the T cell line or by T lymphocytes or lymph node cells of mice that are high responders to SLE-inducing autoantibodies.
  • the cytokines are detected as follows: IL-1 activity is assessed by ELISA using a pair of capture and detecting antibodies (as described below for IL-4, IL-6, IL-10). IL-2 is directly detected using the IL-2 dependent CTLL line or by ELISA.
  • IL-4, IL-6, IL-10, INF- ⁇ and TNF- ⁇ in the supernatants are determined by ELISA using antibodies to the various cytokines (Pharmingen, San Diego, Calif., USA) according to the manufacturer's instructions.
  • the ability of the peptides to elevate the level of secretion of the immunosuppressive cytokine TGF- ⁇ can be assessed by ELISA as described herein in the Examples.
  • mice which test positive in one or more of these in vitro tests will provide a reasonable expectation of in vivo activity.
  • in vitro tests can also be conducted without undue experimentation.
  • adult mice may be injected with the candidate peptide at either day ⁇ 3 or day 0.
  • the mice are then immunized with the disease-inducing autoantibody or with the peptide.
  • lymph node cells of the mice are tested for their ability to proliferate to the immunogen in order to find out the inhibitory capacity of the candidate peptide.
  • Another such in vivo animal test consists of measuring the therapeutic activity directly in the murine model in vivo for the production of SLE as described above.
  • the peptides can be injected into the mice in which experimental SLE is induced by different routes at different dosages and at different time schedules. Furthermore, the treated mice can be tested periodically in order to determine the effect of the peptides on the autoantibody responses and on disease manifestations elicited in the mice by the SLE-inducing autoantibody.
  • Another in vivo procedure consists of assessing the candidate peptide ability to treat mice that spontaneously develop SLE e.g. (NZB x NZW)Fl mice, as described herein in the Examples.
  • the present invention provides a multi-epitope single peptide such as a dual peptide.
  • the dual peptide consists of two different peptides based on the same CDR such as two different peptides including the sequence of the CDR1 (SEQ ID NO:8) or of the CDR3 (SEQ ID NO:10) of the heavy chain of the human 16/6Id nab.
  • the dual peptide consists of two different peptides each based on a different CDR such as one peptide including the sequence of CDR1 (SEQ ID NO:8) and another including the sequence of the CDR3 (SEQ ID NO:10) of the heavy chain of the human 16/6Id mAb.
  • the dual peptide according to the invention preferably consists of two different peptides, one being a peptide of SEQ ID NO:11 and the other being a peptide of SEQ ID NO:19, more preferably one peptide selected from the group consisting of SEQ ID NO:6 and NO:12-18 and another peptide selected from the group consisting of SEQ ID NO:7 and NO:20-27, most preferably one peptide being the peptide of SEQ ID NO:6 and the other being the peptide of SEQ ID NO:7, the two different peptides being covalently linked to one another either directly or by a short linking chain such as a stretch of alanine residues or by a putative site for proteolysis by cathepsin. See, for example, U.S. Pat, No. 5,126,249 and European Patent 495049 with respect to such sites.
  • the present invention provides a multi-epitope single peptide comprising a number of the same or different peptides of the present invention in the form of a peptide polymer, obtained, for example, by polymerization of the peptides with a suitable polymerization agent, such as 0.1% glutaraldehyde (Audibert et al., 1981, Nature 289:593).
  • the polymer will preferably contain from 5 to 20 peptide residues, preferably a peptide of SEQ ID NO: 6, 7 and 11-27.
  • Such peptide polymers may also be formed by crosslinking the peptides or attaching multiple peptides to macromolecular carriers.
  • Suitable macromolecular carriers are, for example, proteins, such as tetanus toxoid, and linear or branched copolymers of amino acids, such as a linear copolymer of L-alamine, L-glutamic acid and L-lysine and a branched copolymer of L-tyrosine, L-glutamic acid, L-alanine and L-lysine (T,G)-A-L-, or multichain poly-DL-alanine (M. Sela et al., 1955, J. Am. Chem. Soc. 77:6175).
  • proteins such as tetanus toxoid
  • linear or branched copolymers of amino acids such as a linear copolymer of L-alamine, L-glutamic acid and L-lysine and a branched copolymer of L-tyrosine, L-glutamic acid, L-alanine and L-lysine (T,G)-
  • the conjugates are obtained, for example, by first coupling the peptide with a water-soluble carbodiimide, such as 1-ethyl-3-(3′-dimethylamnino-propyl)carbodiimide hydro-chloride, and then performing the conjugation with the macromolecular carrier as described by Muller, G. M. et al. (1982) Proc. Natl. Acad. Sci. USA 79:569.
  • the contents of the coupled peptide in each conjugate are determined by amino acid analysis, in comparison to the composition of the carrier alone.
  • one or more active peptides may be attached to a suitable macromolecular carrier or may be polymerized in the presence of glutaraldehyde.
  • the peptides, polymers thereof or their conjugates with suitable macromolecular carriers are administered to patients in a form that insures their bioavailability, making them suitable for treatment. If more than one peptide of the invention is found to have significant inhibitory activity, these peptides may be given to patients in a formulation containing a mixture thereof.
  • the invention thus further relates to pharmaceutical compositions comprising at least one synthetic peptide or peptide polymer according to the invention, optionally with a pharmaceutically acceptable carrier.
  • the pharmaceutical compositions comprises at least one synthetic peptide of the invention, more preferably a peptide selected from the group consisting of peptides hCDR1 [SEQ ID NO:6] and hCDR3 [SEQ ID NO:7] and peptides obtained by substitution and/or addition of amino acid residues in the hCDR1 and hCDR3 sequences, in particular a peptide selected from the group consisting of peptides of SEQ ID NO:12 to SEQ ID NO:18 and of SEQ ID NO:20 to SEQ ID NO:27.
  • any suitable route of administration is encompassed by the invention, including oral, intravenous, subcutaneous, intraarticular, intramuscular, inhalation, intranasal, intrathecal, intraperitoneal, intradermral, transdermal or other known routes, including the enteral route.
  • the peptides of the invention are administered by oral, intranasal or subcutaneous routes.
  • the dose ranges for the administration of the compositions of the present invention should be large enough to produce the desired effect, whereby, for example, an immune response to the SLE-inducing autoantibody, as measured by T cell proliferation in vitro, is substantially prevented or inhibited, and further, where the disease is significantly treated.
  • the doses should not be so large as to cause adverse side effects, such as unwanted cross reactions, generalized immunosuppression, anaphylactic reactions and the like.
  • Effective doses of the peptides of this invention for use in treating SLE are in the range of about 1 ⁇ g to 1 mg and up to 100 mg/kg body weight.
  • the synthetic human peptides of the invention are aimed at inhibiting or suppressing specific antigen responses of SLE patients, without affecting all other immune responses. This approach is of the utmost importance since most diagnosed patients are young women that have to be treated for many years and the currently accepted treatment for SLE involves administration of immunosuppressive agents, such as corticosteroids and/or cytotoxic drugs, that are both non-specific and have multiple adverse side effects.
  • immunosuppressive agents such as corticosteroids and/or cytotoxic drugs
  • the invention further relates to a method for the treatment of systemic lupus erythematosus (SLE) comprising administering to a SLE patient an effective amount of a peptide or peptide polymer of the invention.
  • the method comprises administering the peptide of the SEQ ID NO:6.
  • the method comprises administering the peptide of the SEQ ID NO:7.
  • the invention still further relates to method of immunomodulation of SLE-associated responses in a SLE patient which comprises administering to said SLE patient an effective amount of an effective amount of a peptide or peptide polymer of the invention.
  • the method comprises down-regulating the levels of matrix metalloproteinase (MMP)-3 and/or MMP-9 activities in a SLE patient.
  • the method comprises immunomodulating the level of a cytokine activity in a SLE patient, particularly down-regulating the level of IL-2 and/or IFN- ⁇ activity and/or up-regulating the level of TGF- ⁇ activity, in a SLE patient.
  • the method comprises administering the peptide of the SEQ ID NO: 6.
  • the method comprises administering the peptide of the SEQ ID NO: 7.
  • the invention also provides methods for assessing the effectiveness of a drug in the treatment of a SLE-patient which comprises measuring at different intervals of time the levels of MMP-3, MMP-9, IL-2 , IFN- ⁇ and/or TGF- ⁇ in a blood sample obtained from said patient being treated with said drug, whereby a decreased level of MMP-3, MMP-9, IL-2 and/or IFN- ⁇ or an increased level of TGF- ⁇ ,correlates with the effectiveness of the drug.
  • the invention still further relates to the use of a peptide of or peptide polymer of the invention for the preparation of a pharmaceutical composition, in particular for treatment of SLE, more particularly for immunomodulation of SLE-associated responses in a SLE patient such as down-regulation of MMP-3 and/or MMP-9 and/or IL-2 and/or IFN- ⁇ or up-regulation of TGF- ⁇ levels in a SLE-patient.
  • mice Female (NZB x NZW)Fl mice were obtained from the Jackson Laboratory (Bar Harbor, Me.). Female mice of the BALB/c inbred strain at the age of 6-8 weeks were obtained from the Experimental Animal Unit, The Weizmann Institute of Science, Rehovot, Israel.
  • Anti-DNA monooclonal antibody The human anti-DNA mAb that bears the 16/6Id (IgGl/k) was previously characterized (Shoenfeld et al., 1982; Waisman et al., 1995). The mAb was secreted by hybridoma cells that were grown in culture and were purified by using a protein G-Sepharose column (Pharmacia, Fine Chemicals, Uppsala, Sweden).
  • the reversed peptides have the sequences: G I W E L S K E P S Q K V W Q M Y Y G T revmCDR1 [SEQ ID NO:28] S G Q G W Y D M A Y P E W L F R A C Y Y revmCDR3 [SEQ ID NO:29] G I W E E G K G P P Q R I W S W Y Y G revhCDR1 [SEQ ID NO:30]
  • mice were immunized with 1-2 ⁇ g of the human mAb 16/6Id and boosted 3 weeks later.
  • mice were given hCDR1 or hCDR3 (mCDR1 or revmCDR1 as control peptide in Example 12) intravenously (i.v.) or s.c. concomitant with the immunization, and were injected weekly thereafter for 5 weeks.
  • hCDR1 or hCDR3 mCDR1 or revmCDR1 as control peptide in Example 12
  • intravenously i.v.
  • s.c. concomitant s.c. concomitant with the immunization
  • mice were injected weekly thereafter for 5 weeks.
  • Treatment of an established disease started three and a half months following disease induction with the 16/6Id, when clinical manifestations were already observed.
  • mice received 10 weekly injections (i.v. or s.c.) of mCDR1 or revmCDR1 at a dose of 100 ⁇
  • mice at the age of 2 months, before disease manifestations are observed were injected s.c. with hCDR1 (or mCDR1 in Example 12, 250 ⁇ g/mouse) once a week for 10 weeks.
  • mice at the age of 5-7 months were injected with hCDR1 (in Example 12, mCDRl s.c., 250 ⁇ g/mouse) once a week for 10 weeks.
  • PBL were isolated from heparinized venous blood by Ficoll-Hypaque (Pharmacia) density-gradient centrifugation. All assays were performed, in triplicate, in flat-bottomed microtiter plates (Falcon, Becton Dickinson, Oxmard, Calif., USA) in which 2 ⁇ 10 5 PBL were cultured in enriched RPMI-1640 as described (Dayan et al., 2000). The PBL were exposed to various concentrations (0.1-40 ⁇ g/well) of the human anti-DNA 16/6 Id mAb with and without the addition of the various CDR-based peptides at a concentration of at least 10-fold excess over that of the 16/6Id.
  • Phytohemagglutinin (PH-A; 2 ⁇ g/well) was used as a control for culture conditions at each experiment. The cultures were incubated in 7.5% CO 2 at 37° C. for 6 days. Eighteen hours before the cells were harvested, [ 3 H]-thymidine (0.5 ⁇ Ci of 5 Ci/mmol)(Nuclear Research Center, Negev, Israel) was added to all cultures. Results are expressed as the mean thymidine incorporation in counts per minute (CPM) of triplicate culture ⁇ SD, or as stimulation index (S.I.; the ratio of mean CPM at the optimal concentration of the human 16/6Id to the mean CPM in the presence of medium alone). A S.I.
  • Proteinuria was measured semiquantitatively by using Combistix kit (Ames Division, Bayer Diagnostics, Newbury, U.K.). White blood cells (WBC, for leukopenia) were counted after a 10-fold dilution of heparinized blood in distilled water containing 1% acetic acid (vol/vol). For immunohistology analysis, frozen kidney sections (6 ⁇ m) were fixed and stained with FITC-conjugated goat Abs to mouse IgG ( ⁇ -chain specific; Sigma). ELISA.
  • 96-well Maxisorb microtiter plates (Nunc) were coated with either methylated BSA or polyL-lysine (Sigma). The plates were then washed and coated with either 10 ⁇ g/ml of denatured calf thymus DNA (Sigma) or ⁇ -phage double-stranded DNA (Boehringer Mannheim, 5 ⁇ g/ml).
  • MMP-2 and MMP-9 Measurement of activities of MMP-2 and MMP-9.
  • MMP activity was tested by gelatin zymography. Pooled sera of individual mice of the different experimental groups were separated by an 8% SDS-PAGE polymerized with 1 mg/ml gelatin. Following electrophoresis, gels were washed once for 30 min in 2.5% Triton X-100 to remove the SDS, and once for 30 min in the reaction buffer containing 50 mM Tris-HCI, 200 mM NaCl, 10 mM CaCl2 and 0.02% (w/v) Brij 35 (pH 7.5). The reaction buffer was changed to a fresh one, and the gels were incubated at 37° C. for 24 h. Gelatinolytic activity was visualized by staining the gels with 0.5% Coomassie brilliant blue.
  • kidney sections for A MMP-3 or MMP-9 were fixed with cold acetone (5 min at room temperature), washed twice in PBS, permeabilized (1 min at room temperature) in 0.05% Triton X-100 (diluted in PBS), and washed twice in PBS.
  • kidney sections were blocked (1 hr at room temperature) with unlabeled goat anti-mouse IgG+IgM (diluted 1:1 in 1% BSA/PBS; (Jackson ImmunoResearch Laboratories) and washed 3 times with PBS containing 0.05% Tween.
  • Monoclonal anti-MMP-9 (1:100; Chemicon International, Inc.) or anti-MMP-3 (1:50; Oncogene Research Products) antibody diluted in 1% BSA/PBS were added for 30 min, at room temperature.
  • FITC-labeled goat anti-mouse IgG+IgM Jackson ImmunoResearch Laboratories
  • diluted 1:30 in 1% BSA/PBS 30 min at room temperature
  • hCDR1 SEQ ID NO:1
  • hCDR3 SEQ ID NO:3
  • peptides were prepared by methods well-known in the art, for example, by chemical solid phase or solution phase synthesis using an automated synthesizer by using the manufacturer's protocols for t-butyloxycarbonyl (t-Boc), fluorenylmethoxycarbonyl (Fmoc) or other alpha-amino acid protecting group procedure essentially as described (see, for example, Peptides: Synthesis, Structure and Applications, ed. by B. Gutte, Academic Press, 1995; Peptide Synthesis Protocols, ed. by M. Pennington and B. Dunn, Humana Press, 1994; Schnolzer M. et al., In situ neutralization in Boc-chemistry solid phase peptide synthesis. Rapid, high yield assembly of difficult sequences. Int. J. Pept. Protein Res. 40: 180-193, 1992).
  • mice were immunized with mCDR1 and mCDR3, respectively.
  • the immunizing murine peptides were injected (10 ⁇ g/mouse) in CFA intradermally in the hind footpads.
  • groups of BALB/c mice were injected subcutaneously (s.c.) with 200 ⁇ g in PBS of hCDR1 and groups of SJL mice were similarly injected with hCDk3.
  • mice were sacrificed and their lymph nodes were harvested and the cells were tested for their ability to proliferate following triggering with the immunizing peptides.
  • LNCs of immunized mice were cultured (in triplicates) in the presence of different concentrations (1-20 ⁇ g /well) of the murine immunizing peptides in enriched RPMI-1640 medium supplemented with 1% normal mouse serum. Following four days of incubation, 3 H-thymidine was added for additional 16 hours. Cells were then harvested and radioactivity was counted using a ⁇ -counter.
  • Tables 1A and 1B represent the maximum % inhibition of proliferation of LNCs of mice immunized with mCDR1 and mCDR3 and treated with hCDR1 and hCDR3, respectively. The inhibition was calculated based on the proliferation of LNCs of mice that were not treated with the inhibitory peptides hCDR1 and hCDR3. It can be seen that hCDR1 and hCDR3 were capable of inhibiting the proliferative responses to the immunizing murine CDR peptides. TABLE 1A Inhibition by hCDR1 of the proliferation of BALB/c-derived LNCs to mCDR1 Inhibitor % Inhibition hCDR1 55%
  • mice were immunized with 1 ⁇ g human 16/6Id in CFA, intradermally in the hind footpads, and either were injected with hCDR1 s.c., 300 ⁇ g/mouse in PBS, or were not further treated.
  • hCDR1 s.c. 300 ⁇ g/mouse in PBS
  • PBS PBS
  • LNC LNC
  • popliteal LNCs 0.5 ⁇ 10 6
  • 3 H-thymidine was added to the cultures for the last 18 hours of incubation. Cells were then harvested and radioactivity counted.
  • FIG. 1 shows the results of such experiments and demonstrates that hCDR1 inhibited efficiently the proliferative responses of lymph node cells of the treated mice.
  • the % inhibition of proliferation at the various concentrations of 16/6Id mAb was as follows: 0.1 ⁇ g/well—47%; 1 ⁇ g/well—66%; 5 ⁇ g/well—76%; and 10 ⁇ g/well—62%.
  • FIG. 2 shows that hCDR1 is very effective in inhibiting the in vivo priming of mice with the whole anti-DNA 16/6Id macromolecule and even a s.c. injection with as little as 50 ⁇ g of hCDR1 inhibited significantly the ability of lymph node cells to proliferate to the 16/6Id autoantibody.
  • the % inhibition of proliferation at the various concentrations of 16/6Id mAb was as follows: 0.1 ⁇ g/well—98%; 1 ⁇ g/well—76%; 5 ⁇ g/well—73%; and 10 ⁇ g/well—64%.
  • lymph node cells of the BALB/c mice treated with 50 ⁇ g of hCDR1 of Example 3 were also stimulated with the human 16/6Id mAb for cytokine production and the supernatants were tested for cytokine (INF- ⁇ TGF- ⁇ and IL-10) secretion, by ELISA.
  • FIG. 3 shows results of a representative experiment. It can be seen that hCDR1 down-regulated the production of INF- ⁇ (FIG. 3A) and up-regulated the secretion of TGF- ⁇ (FIG. 3B) and IL-10 (FIG. 3C). It should be noted that a peptide used as control (p259-271, that was shown to be a myasthenogenic peptide) did not affect significantly INF- ⁇ and IL-10 production and was less effective in up-regulating TGF- ⁇ .
  • Peptides hCDR1 and hCDR3 inhibit the proliferative response of PBL of SLE patients to the human 16/6Id mAb.
  • Table 4 shows the results of these experiments. Inhibition of above 50% of the proliferative capacity was considered positive.
  • the Table represents the highest positive inhibition capacity for each peptide. It can be seen that the human hCDR1. and hCDR3 inhibited the proliferation of PBL of 16/19 (84.2%) and 15/19 (78.9%), respectively, of the 1.9 responders tested. Both peptides inhibited the proliferation of PBL of 18/19 (95%) of responders tested. It can also be seen in the Table that the magnitudes of inhibitions were similar for both peptides.
  • hCDR1 or hCDR3 were added to cultures of PBL of SLE patients that were stimulated with the mitogen phytohemagglutinin (PHA, 2 ⁇ g/ml). The results of such an experiment performed with PBL of one SLE patient is shown in FIG. 5.
  • the peptides hCDR1 and hCDR3 could not inhibit the proliferative responses (expressed in cpm) of the PBL to the mitogen PHA and the proliferative responses were similarly high in the absence (black column) or presence of either hCDR1 or hCDR3.
  • hCDR peptides are capable of inhibiting IL-2 secretion by PBL of SLE patients following stimulation with the human 16/6Id mAb. Such inhibition might also suggest that the human CDR-based peptides inhibit the proliferative responses to the 16/6Id mAb at least partially by down-regulating IL-2 secretion.
  • PBL of SLE patients were incubated with the human 16/6Id mAb in the absence or presence of the peptides hCDR1 or hCDR3.
  • Supernatants of the cultures were collected following 48 hours of incubation. Assays to determine levels of IL-2 in the supernatants were performed using the CTLL IL-2 dependent line.
  • TGF- ⁇ was determined by ELISA according to the manufacturer's instructions. Briefly, Maxisorb plates (Nunc) were coated with recombinant human TGF ⁇ sRII/Fc chimera (R&D Systems) diluted in PBS (100 ng/ml). After blocking, cell supernatants were added. After 18 hours incubation the detecting biotinylated anti-human TGF- ⁇ antibody (R&D Systems) was added. The substrate solution used was the TMB Colour Reagent (Helix Diagnostics) and enzyme activity was evaluated by the MRX ELISA reader using the 570 nm and 630 nm filters. The results are summarized in Table 6.
  • the peptides based on the CDR of the human anti-DNA 16/6Id mAb were capable of inhibiting the priming of lymph node cells to the 16/6Id mAb and the proliferative responses of PBL of SLE patients to the 16/6Id mAb with similar efficiency. It was thus of interest to find out if these peptides can immunomodulate an SLE-like disease in animal models.
  • mice were treated with 300 ⁇ g of hCDR1 at the age of 7 months and used a control peptide, namely, the reversed hCDR1.
  • the aim of the experiment was to fund out if, in addition to the amelioration in the clinical manifestations, treatment with hCDR1 immunomodulates cytokine production.
  • FIG. 10 demonstrates the mild reduction in anti-DNA autoantibody levels. Table 9 shows the proteinuria measured at different time points.
  • Kidney damage is one of the main manifestations of the SLE-like disease in the (NZB x NZW)Fl mice.
  • Ten-week treatment with the hCDR1 peptide reduced significantly the kidney disease.
  • the 50 ⁇ g dose was less efficient than the 100 and 200 ⁇ g doses in treating the kidney disease.
  • the latter two doses were similarly efficient.
  • FIGS. 11 A- 11 D are photos showing representative kidney sections of mice treated with the 100 ⁇ g dose of hCDR1.
  • mice at the age of 9 months were sacrificed and their kidneys were removed and frozen immediately in liquid nitrogen. Frozen cryostat sections of 5 ⁇ m were air dried and fixed in acetone. For the detection of Ig deposits, sections were incubated with FITC-conjugated goat anti-mouse IgG ( ⁇ -chain specific).
  • FIGS. 11A and 11B show kidney sections of a mouse of the PBS-treated group (control) whereas FIGS. 11C and 11D show kidney sections of a mouse treated with 100 ⁇ g of hCDR1. It can be seen in the figures that the treatment reduced the number of immune complexes as well as their intensity ( 11 A, 11 C x 100; 11 B, 11 D x 400).
  • mice were treated with hCDR1 at the age of 7 months when their full blown disease is already observed.
  • the mice were treated for 10 weeks with either 100 ⁇ g/mouse or 300 ⁇ g/mouse.
  • Treatment with both doses led to a moderate reduction in the anti-DNA autoantibody titers, similar to the above described results.
  • a reduction in proteinuria in comparison to the PBS-treated group was measured as well.
  • the kidney disease was ameliorated following treatment with both doses; nevertheless, a more significant effect was determined in the group of mice treated with the 300 ⁇ g dose.
  • A- 12 F are representative mouse kidney sections of each group where A, B represent an untreated mouse; C, D represent a kidney of a hCDR1-treated mouse and E, F represent a kidney section of a mouse treated with the reversed hCDR1.
  • FIGS. 13 A- 13 C show the cytokine (INF- ⁇ , IL-10 and TGF- ⁇ ) pattern as measured by ELISA in supernatants of Con A-stimulated cultures of splenocytes of mice of the 3 groups taken at the end of treatment (10 weekly s.c. injections). It can be seen that INF- ⁇ (FIG. 13A) and IL-10 (FIG. 13B, to a lesser extent) were down-regulated in the treated mice. An increased secretion of TGF- ⁇ could be seen in the supernatants of non-stimulated cells (FIG. 13C, left). Con A did not trigger the cells to secrete more TGF- ⁇ (FIG. 13C, right).
  • mice were immunized and boosted with the 16/6Id pathogenic autoantibody. Three and a half months following the booster injection, when the mice developed already disease manifestations, they were divided into three groups. One group was not treated, the second group was treated with 100 ⁇ g/mouse of the hCDR1 and the third group was treated for 10 weeks with 300 ⁇ g/mouse of the hCDR1 peptide. The mice were followed for disease manifestations.
  • Table 10 presents the results obtained in testing individual mice at the end of treatment. An amelioration was observed for all measured clinical manifestations with both doses used for the treatment [anti-dsDNA antoantibodies, white blood cells counts (WBC) and urine protein]. Analysis of kidneys of mice sacrificed at the end of the experiment (7 months after booster injections) demonstrated immune complex deposits in kidneys of 9/10 mice that were immunized with the 16/6Id mAb and were not treated. In contrast, immune complex deposits were observed in kidneys of only 3/10 and 2/9 mice that were immunized with the 16/61d mAb and treated with 100 ⁇ g/mouse and 300 ⁇ g/mouse hCDR1, respectively.
  • the human peptide hCDR1 is capable of treating an established experimental SLE. TABLE 10 The effect of treatment of BALB/c mice afflicted with experimental SLE with 100 ⁇ g or 300 ⁇ g hCDR1 peptide.
  • mice were immunized and boosted with the human 16/6Id for induction of experimental SLE. Two months after the boost, mice were divided into groups (8 mice per group). The mice were treated with 200, 300 or 400 ⁇ g/mouse for 10 weeks. The mice were followed for antibody production, leukopenia, proteinuria and, when sacrificed, two months after the end of treatment, their kidneys were analyzed for immune complex deposits. The results, summarized in Table 11, show no effect of treatment on the 16/6Id specific antibody response. TABLE 11 Effect of treatment of BALB/c mice afflicted with experimental SLE with 200 ⁇ g, 300 ⁇ g or 400 ⁇ g hCDR1 peptide.
  • treatment affected anti-DNA antibody titers, leukopenia, levels of proteinuria and, more importantly, immune complex deposits in the kidneys.
  • the control group of the experiment is of BALB/c mice of the same age that were not immunized or treated at all. This experiment suggested that hCDR1 is effective in treating experimental SLE and no advantage of the 400 ⁇ g dose could be seen.
  • mice were treated with 200 and 300 ⁇ g /mouse.
  • a control peptide was used in this experiment, the reversed hCDR1.
  • the aim of this experiment has been, in addition to the comparison between the 200 and 300 ⁇ g treatment doses, to study the effect of treatment on the cytokine production in the treated mice.
  • Sixty BALB/c mice were immunized and boosted with the 16/6Id. Three months after the boost, the mice were divided into groups (15 mice per group) that either were not further treated or were weekly treated with 200 or 300 ⁇ g of hCDR1.
  • An additional group was treated with 300 ⁇ g of reversed hCDR1.
  • a fifth group (control) was not immunized and was not further treated.
  • mice were followed for antibody production and disease manifestations.
  • the anti-16/6Id antibody levels at a dilution of 1:10000
  • Treatment with both 200 and 300 ⁇ g reduced the anti-DNA antibody levels as can be seen in the Table (the sera were diluted 1:1250).
  • Table 12 also summarizes the clinical manifestations in the different groups of mice. It can be seen that, although both doses were effective in reducing leukopenia and proteinuria, the effect of the 200 ⁇ g dose in this experiment did not reach significance (mice were sacrificed a month after the end of treatment).
  • FIGS. 14 A-F represent one kidney of each group where A,B represent an untreated mouse; C,D represent a kidney of a hCDR1-treated mouse and E,F represent a kidney section of a mouse treated with the reversed hCDR1. Pictures A,C,E x 100 and B,D,F x 400.
  • FIGS. 15 A-E shows levels of the different cytokines in supernatants of 16/6Id stimulated lymph node cultures of the treated mice. The latter tests were performed at the end of treatment (after 10 treatment injections). It can be seen that treatment with hCDR1 (both doses) down regulated INF- ⁇ (FIG. 15A), IL-10 (FIG. 15C) and TNF- ⁇ (FIG. 15B). On the other hand, hCDR1 up-regulated the levels of TGF- ⁇ . Because splenocytes usually secrete more TGF- ⁇ (FIG. 15D) than lymph node cells, TGF- ⁇ was also measured in supernatants of 16/6Id triggered spleen cells of mice of the different groups (FIG. 15E).
  • hCDR1 ameliorates disease manifestations and immunomodulates cytokine production in mice afflicted with an induced experimental SLE.
  • mice 8-month old (NZB x NZW)Fl mice, that suffer already from the full-blown lupus-like disease, were divided into 2 groups.
  • Group 1 was not treated and mice of group 2 were transferred with 20 ⁇ 10 6 spleen cells of 3-month old (NZB x NZW)Fl mice that were injected 3 times ( s.c., every other day) with 300 ⁇ g/mouse of hCDR1. All splenocytes were injected intraperitoneally. Mice were tested for anti-dsDNA autoantibody production, disease manifestations, and were sacrificed 4 weeks after cell transfer. Transfer of cells of hCDR1-treated mice caused a mild reduction in the levels of anti-DNA antibodies.
  • Table 13 demonstrates that transfer of splenocytes of hCDR1-treated mice resulted in a significantly lower proteinuria and in a reduction in immune complexes in the kidneys.
  • FIGS. 16 A-F represent kidney sections of mice of group 1 (A, B—untreated mice), group 2 (C, D—recipients of splenocytes of 2-month old mice treated with hCDR1) and group 3 (E, F—recipients of splenocytes of 2-month old mice treated with revhCDR1).
  • MMPs Matrix metalloproteinases
  • MMPs are synthesized as zymogen-like latent precursors and are converted subsequently to an active form.
  • P-2 and MMP-9 which are both gelatinases, can degrade type IV collagen, denatured collagens, types V, VII, X and XII collagens, vitronectin, aggrecan, galectin-3 and elastin.
  • MMP-2 is the most widely expressed UP. It is produced by a variety of cells and is frequently elevated in malignant tumor metastasis.
  • MMP-9 is the largest and most complex member identified so far. MMP-9 expression is characterized by a complex regulation with tight control at the levels of gene transcription and protein secretion (such as cytokines, chemokines, eicosanoids) inflammatory mediators, and action of tissue inhibitors of metalloproteinases (TIMPs). In addition, MMP-9 activity is modulated by the activation of pro-MMP-9, by components of the plasminogen activation system or other MMPs (Guedez et al., 1996).
  • MMPs The involvement of MMPs in autoimmune diseases was demonstrated in various autoimmune diseases such as multiple sclerosis (Ozenci et al., 1999) and its animal model experimental autoimmune encephalomyelitis (EAE) (Gijbels et al., 1994), rheumatoid arthritis (Keyszer et al., 1999), Guillain-Barre syndrome (Creange et al., 1999), experimental bullous pemphigoid (Liu et al., 1998) and experimental autoimmune neuritis (Hughes et al., 1998). Serum levels of MMP-3 and TIMP-2 in patients with lupus nephritis were reported to be significantly higher than those of healthy controls, but no correlation with disease activity was noted (Zucker, 1999; Keyszer et al., 1999).
  • MMP inhibitors [0199] The potential importance of the many activities of MMPs in inflammatory responses has been suggested by the inhibitory effects of MMP inhibitors in several animal models of autoimmune diseases. Specific inhibition of MMPs in vivo suppresses edema, pathologic tissue proliferation, and damage to specialized tissue structures in several inflammatory and autoimmune diseases (Gijbels et al., 1994; Wallace et al., 1999; Conway et al., 1995).
  • FIG. 19 represents immunohistology of kidneys taken 5 months after the boost.
  • immunization of mice with CFA up-regulated the expression of both MMP-3 ( 19 A) and MMP-9 ( 19 B) in the kidneys, in the glomeruli and in the surrounding tissue.
  • immunization with 16/6Id in CFA further elevated significantly the expression levels of these two MMPs. This elevation was observed already two months after the boost with the 16/6Id (data not shown). The nonspecific background levels of the staining are also demonstrated ( 19 C).
  • the murine mCDR1 peptide down regulates levels of MMP-3 and activity of MMP-9 in sera of (NZB x NZW)Fl mice.
  • the mCDR1 peptide down-regulates levels of MMP-3 and activity of MMP-9 in sera of 16/6Id immunized mice.
  • FIG. 21 represents results of a prevention and a treatment experiments. The figure shows that mCDR1 could down regulate MMP-3 and MMP-9 in this experimental model as well.
  • FIG. 22 demonstrates that in both prevention (FIG. 22A) and treatment (FIG. 22B) experiments, mCDR1 down-regulated the expression levels of both MMP-3 and MMP-9 in the kidneys of the treated mice.
  • the reduction in the levels of MMP was observed in both the glomeruli and interstitium.
  • the observed reduction in MMP expression correlated with the reduction in staining for immune complex deposits using anti-Ig (FIG. 22B).
  • FIG. 23 represents results of an experiment in which mice were treated starting at the age of 7 months when all clinical manifestations were observed. The results are of sera collected at the middle of treatment, after 5 injections of hCDR1. The results of FIG. 23 indicate that treatment of mice with 300 ⁇ g hCDR1 down regulated the levels of MMP-3 and the activity of MMP-9. These results are in agreement with the significant amelioration of disease manifestations following treatment with hCDR1.
  • the mCDR1 peptide that specifically and directly affects SLE-associated T-cell responses, could down regulate levels of MMP-3 and MMP-9 that are already up regulated (treatment protocol) as well as to prevent their elevation (prevention protocol).
  • MMP-9 activity in sera was neither reported in SLE patients nor in animal models of SLE. This is the first time that a correlation between SLE and MP-9 is shown and that MMP-9 is demonstrated to be elevated in sera and kidneys of SLE-afflicted mice. Although the elevation in sera appears relatively late (around 4 months after the boost), the elevation of P-9 in the kidneys is observed at early stages after disease induction (2 months) (data not shown). It is further shown herein for the first time that peptides that ameliorate SLE manifestations in mice (mCDR1 and hCDR1 as shown above), also down regulate MMP-9 both in sera and in kidneys.
  • MMP-3 and MMP-9 differ in the kinetics of their induction in experimental models of autoimmune diseases as shown here specifically for SLE. This may indicate the different roles of the above MMPs in the pathogenesis of the disease.
  • Our results demonstrate that peptides that immunomodulate SLE-associated T-cell responses and down regulate disease manifestations can control the secretion (although not necessarily by the T cells themselves) of those MMPs in sera and kidneys.
  • MMP-3 and MMP-9 play a role in the pathogenesis of SLE and may serve as surrogate markers of disease progression on one hand, and of disease amelioration by a given treatment, on the other hand.
  • MMP-9 and MMP-2 we determined the levels of MMP-9 and MMP-2 in sera of 40 patients with SLE and we demonstrate that MMP-9 but not MMP-2 activity is significantly elevated in sera of SLE patients compared to healthy controls.
  • High MMP-9 activity correlated with the presence of discoid rash, Raynaud phenomenon, pneumonitis, mucosal ulcers and the presence of anti-phospholipid antibodies (APLA).
  • APLA anti-phospholipid antibodies
  • elevated levels of MMP-9 correlated with SLE activity in the group of male patients.
  • MMP-2 and MMP-9 Measurement of MMP-2 and MMP-9 by activity assay, kits. Activities of MMP-2 and MMP-9 were measured by specific Biotrak MMP-2 or MMP-9 activity assay kits (Amersham Phalmacia Biotech UK Limited, UK) according to the manufacturer's instructions. Sera were diluted 1:100 and 1:32 for the determination of MMP-2 and MMP-9 activities, respectively. The appropriate standards were added in each assay. In order to measure the total content of the MMPs, activation of the pro form of the MMPs was performed using p-aminophenylmercuric acetate (APMA).
  • APMA p-aminophenylmercuric acetate
  • MMP-2 and MMP-9 activities were tested by gelatin zymography.
  • a 5 ⁇ l sample of serum was separated by an 8% SDS-PAGE gel polymerized with 1 mg/ml gelatin. Gels were washed once for 30 min in 2.5% Triton X-100 to remove the SDS, and once for 30 min in the reaction buffer containing 50 mM Tris-HCl, 200 mM NaCl, 10 mM CaCl 2 and 0.02% (w/v) Brij 35 (pH 7.5).
  • the reaction buffer was changed to a fresh one, and the gels were incubated at 37° C. for 24 h.
  • Gelatinolytic activity was visualized by staining the gels with 0.5% Coomassie brilliant blue and was quantified by densitometry.
  • MMP-9 was shown to be involved in several autoimmune diseases as well as in animal models of SLE. Thus, we were interested in studying whether MMP-9 is also elevated in sera of SLE patients. For this purpose, we examined sera of 40 SLE patients and of 25 healthy controls by gel zymography, in which both MMP-9 and MMP-2 activities can be visualized. A representative gel is shown in FIG. 24. As can be seen in this figure, levels of MMP-9 are elevated in the sera of SLE patients when compared to healthy controls.
  • Anti-nuclear antibodies ANA
  • anti-ds DNA antibodies were determined by using Hep2 cells and Crithidia luciliae, respectively.
  • Anti-phospholipid antibodies were defined as reactivity with one or more of the following assays: false positive VDR, lupus anti-coagulant (LAC) or ELISA for anticardiolipin antibodies.
  • the anti-malarial agent hydroxychloroquine was used at dose of 200-400 mg/day. Steroid treatment was defined as a daily dose >5 mg of prednisone. Cytotoxic agents used were cyclophosphaniide (0.5-1 g/m 2 monthly) or azathioprine (100-150 mg/day).
  • MMP-9 The present study demonstrates for the first time the involvement of MMP-9 in human SLE.
  • MMP-9 the activity of MMP-9, but not MMP-2, is significantly elevated in sera of 68% of SLE patients compared with healthy controls.
  • High MMP-9 levels correlated with Raynaud phenomenon, pneumonitis, neurological disorders, discoid rash and the presence of APLA. Changes in MMP-9 activity were observed in serum of the same patient at different periods of the disease.
  • MMP-9 activity levels did not correlate with disease activity index (SLEDAI, BILAG) in female patients, but correlated with SLE activity in the group of male patients.
  • SLEDAI disease activity index
  • MMP-2 activity levels of MMP-2 are not elevated significantly in sera of SLE patients. These results are compatible with those reported previously (Zucker, 1999) that MMP-2 levels were not increased in SLE. Levels of MMP-2 were also constitutive and unchanged in other pathological conditions (like optic neuritis and multiple sclerosis) in which levels of MMP-9 were elevated relatively to the healthy controls (Gijbels et al., 1992; Paemen et al., 1994).
  • MMP-3 Involvement of an additional MMP, namely, MMP-3 was suggested in the pathogenesis of SLE, since it was significantly increased in sera of patients with SLE (Kotajima et al., 1998).
  • the MMP-3 transcript was shown to increase significantly with the progression of nephritis in (NZB x NZW)Fl mice (Nakamura et al., 1993).
  • MMP-9 has been shown to be secreted by peripheral blood cells such as T cells, neutrophils, and macrophages (for review, see Goetzl et al., 1996).
  • peripheral blood cells such as T cells, neutrophils, and macrophages
  • MMP-9 activity levels may suggest that MMP-9 was not secreted by peripheral blood immune cells but rather, by SLE-affected organs like kidneys or lungs/pleura.
  • SLE-affected organs like kidneys or lungs/pleura.
  • All SLE patients with pneumonitis exhibited high MMP-9 activity levels may suggest the diseased lung as a source of high MMP-9 levels.
  • cytotoxic treatment which represents the severity of SLE-related organ impairment
  • high levels of MMP-9 in the sera may also support the notion that the diseased organs are the source of MMP-9 activity in SLE patients. Nevertheless, the possibility still exists that less peripheral blood lymphocytes secreted higher activity levels of MMP-9.
  • TNF- ⁇ and IL-1 were shown to play an important role in the pathogenesis of SLE both in the human disease (Dean et al., 2000) and in murine models (Segal et al., 1997; Theofilopoulos et al., 1999; Eilat et al., 2001). It has been shown in several systems that these cytokines induce MMP-9 production (Guedez et al., 1996), and thus, it is possible that the induction of the latter MMPs is part of the pathogenic effect of these cytokines in SLE.
  • MMP-9 that are secreted spontaneously by peripheral blood monocytes of healthy individuals, were upregulated upon exposure to TNF- ⁇ and IL-1 ⁇ (Saren et al., 1996).
  • MMPs of both T cells and macrophages facilitate secretion of TNF- ⁇ by cleavage of the membrane-bound form (Gearing et al., 1994).
  • these examples demonstrate the mutual regulatory effects of MMP on the proinflammatory cytokines and vice versa.
  • MMP-9 might play a role in the pathogenesis of SLE, and that measurement of plasma/serum activity levels of this metalloproteinase may provide important information when monitoring patients treated with drugs that interfere with MMP-9 activity.
  • Ebihara I Nakamura T, Shimada N et al. Increased plasma metalloproteinase-9 concentrations precede development of microalbuminuria in non-insulin-dependent diabetes mellitus. Am J Kidney Dis 32:544-50 (1998).
  • Ebihara I Nakamura T, Ushiyama C et al. Effect of oral adsorbent AST-120 on plasma metalloproteinase-9 and serum tissue inhibitor of metalloproteinase-1 concentrations in chronic renal failure. Nephron 83:169 (1999).
  • Hay EM Bacon PA, Gordon C et al.
  • the BILAG index a reliable and valid instrument for measuring clinical disease activity in systemic lupus erythematosus.
  • the matrix metalloproteinase inhibitor BB-1101 prevents experimental autoimmune. uveoretinitis (EAU). Chli. Exp. Immunol. 118, 364 1999).

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US20050008634A1 (en) * 2003-01-14 2005-01-13 Sharon Cohen-Vered Parenteral formulations of peptides for the treatment of systemic lupus erythematosus
WO2004064788A3 (fr) * 2003-01-14 2005-03-24 Teva Pharma Formulations parenterales contenant un peptide utilisees dans le traitement du lupus erythemateux systemique
EA008438B1 (ru) * 2003-01-14 2007-06-29 Тева Фармасьютикал Индастриз, Лтд. Парентеральные композиции пептида для лечения системной красной волчанки
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