NZ612615B2 - Use of toll-like receptor agonist for treating cancer - Google Patents
Use of toll-like receptor agonist for treating cancer Download PDFInfo
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- NZ612615B2 NZ612615B2 NZ612615A NZ61261512A NZ612615B2 NZ 612615 B2 NZ612615 B2 NZ 612615B2 NZ 612615 A NZ612615 A NZ 612615A NZ 61261512 A NZ61261512 A NZ 61261512A NZ 612615 B2 NZ612615 B2 NZ 612615B2
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Abstract
Disclosed is the use of a Toll-Like Receptor (TLR) agonist for the manufacture of a medicament for the treatment of cancer in a mammal, wherein the cancer is present in a tissue that expresses TLR5, the TLR agonist comprising the amino acid sequence of SEQ ID NO: 8, wherein the sequence is as defined in the specification. d in the specification.
Description
USE OF TOLL-LIKE RECEPTOR AGONIST FOR TREATING CANCER
FIELD OF THE INVENTION
This invention relates to methods of treating cancer in Toll—Like Receptor—expressing
tissues, and to methods of protecting the liver from the effects of a liver toxicity, using a TLR
agonist.
BACKGROUND OF THE INVENTION
Interaction between members of the death receptor family and their cognate ligands
s apoptosis controlling the homeostasis of cell populations in tissues, particularly in the
immune system. Although many tumor cell types are sensitive to death ligands, activation of Fas
signaling also induces massive apoptosis in the liver leading to organ e and death
precluding its use for systemic anticancer therapy. Fas ligand is a 40 kDa physiological agonist
of Fas signaling expressed on activated lymphocytes and many tumor cells which can also be
secreted through metalloproteinase—mediated cleavage and kill the sensitive cells in autocrine
and paracrine manner. Fas is a transmembrane receptor expressed on activated lymphocytes,
variety of tissues and tumor cells. Fas signaling plays crucial role in regulation of the immune
system by triggering autocrine suicide or paracrine death (apoptosis), suppressing immune
reaction by eliminating activated lymphocytes. Upon g, it induces p53 ndent cell
death h extrinsic pathway of apoptosis engaging DISC ion, caspase—8 and 10, and
intrinsic (mitochondrial) apoptosis activating caspase—8 and Bid cleavage, and rome
release. Both apoptotic pathways lead to activation of caspase—3 and 7. Mitochondrial apoptosis
is ted by pro— and anti—apoptotic Bc12 family s. In tumor cells, Fas ing is
often found deregulated either by absence of Fas receptor, or by constitutive activation of NF—kB
resulting in the expression of anti—apoptotic genes, such as c—Flip, Bcl—2, Bcl—xL. C—Flip, an NF—
kB responsive gene, has been trated to inhibit e—8 and Fas mediated apoptosis in
tumors (REFs, Kataoka et a12000).
Upon discovery of p53 independent apoptotic mechanism h Fas, TRAIL and TNFOL
death receptor signaling, they seemed to be promising targets for anti—cancer therapy since tumor
cells usually have impaired p53 function. A severe hepatotoxicity, however, is induced by death
receptor ligands. This has hampered development of these anti—cancer therapies. While Fas
ts cause liver damage and TNF—a induces strong inflammation in liver, lungs and other
organs, TRAIL is the least toxic in humans. TRAIL has therefore received more attention than
other agonists for the al application for an anticancer treatment. Many tumors, however, are
not sensitive to TRAIL therapy. Several ches to e death receptor ty issue are
currently undertaken, most of which are aimed to increase tumor sensitivity by blockage of NF—
kB activity and increasing receptor expression thus reducing the amount of drug necessary for
the effective therapy. Another direction is to ze the drug delivery to the tumors to minimize
toxic effects on distant organs. To date, there is no reliable approach to the tion of
toxicity (including liver ) that would allow the systemic application of death receptor
agonists in clinical trials. Accordingly, there is a need in the art for methods of preventing the
undesirable effects of death receptors when they are used to treat cancer. In particular, there is a
need to protect the liver from these undesirable effects. There is also a need for protecting the
liver from liver toxicities in general.
TLRs are found to be expressed on both epithelial and endothelial cells as well as
immunocytes. At present, thirteen TLRs have been identified in mammals. Upon receptor
stimulation, several common signaling pathways get activated such as NF—kB, AP—l, PI3K/AKT
and mitogen—activated protein kinases (MAPK) leading to increased survival, stimulation of cell
proliferation and the secretion of many cytokines with chemotactic and pro—inflammatory
functions. Induction of TLR in cancer cells can be used to treat cancer, however, the distribution
of different TLRs varies significantly among the various organs and cell types. This affects the
cytokine e and extent of the inflammatory se of cells. Accordingly, there is a need in
the art for cancer immunotherapeutic methods that do not depend on the presence of TLR5
expression.
SUMMARY OF THE INVENTION
Provided herein is a method of treating cancer in a mammal, which may se
administering to a mammal in need thereof of Toll—Like Receptor (TLR) agonist. Also provided
is a method of reducing cancer recurrence in a mammal, which may comprise administering to a
mammal in need thereof a TLR agonist. The cancer may be t in a tissue that expresses
TLR. The cancer may be a metastasis or tumor regrowth.
[0005a] In a first aspect there is ed Use of a Toll-Like Receptor (TLR) agonist for
the manufacture of a ment for the treatment of cancer in a mammal, wherein the cancer is
present in a tissue that expresses TLR5, the TLR agonist comprising an amino acid sequence of
at least 95% identity with SEQ ID NO: 8.
] In a second aspect there is provided use of a Toll-Like Receptor (TLR) agonist for
the manufacture of a medicament for the treatment of cancer in a , wherein the cancer is
present in a tissue that expresses TLR5, the TLR agonist comprising the amino acid sequence of
SEQ ID NO: 8.
[0005c] It is to be noted that, throughout the description and claims of this specification,
the word 'comprise' and ions of the word, such as 'comprising' and 'comprises', is not
intended to exclude other variants or additional components, integers or steps. cations
and improvements to the invention will be readily apparent to those skilled in the art. Such
modifications and improvements are intended to be within the scope of this invention.
[0005d] Any reference to or discussion of any document, act or item of knowledge in this
ication is included solely for the purpose of providing a context for the present invention.
It is not suggested or represented that any of these matters or any combination thereof formed at
the priority date part of the common general knowledge, or was known to be relevant to an
attempt to solve any problem with which this ication is concerned.
The TLR agonist may be flagellin. The cancer may not express TLR, which may be
TLRS. The tissue may be liver, lung, bladder, or intestinal. The cancer may be metastatic. The
cancer may be melanoma, colon, breast, prostate, or a logical malignancy, which may be
lymphoma. The cancer may be tumor.
The agent may be administered as a monotherapy. The mammal may not be receiving a
combination y. The mammal may also not be receiving chemotherapy or radiation therapy,
but may be treated surgically. The mammal may have sufficient innate immunity, which may be
at a level that is equivalent to the level required for ility for a first or subsequent round of
herapy. The mammal may have a white blood cell count within the range of normal, or
may have a white blood cell count indicative of mild—immunosuppression. The TLR agonist may
be administered to the mammal before, after or rent with removal of a tumor. The TLR
agonist may be administered during tumor removal.
r provided herein is a method of treating cancer in a mammal, which may comprise
administering to a mammal in need thereof a FAS agonist and a TLR agonist, which may be
flagellin. The FAS agonist may be a FAS agonist antibody. The cancer may be metastatic, and
may be a tumor. The cancer may not express a TLR. The cancer may have metastasized to an
invaded tissue that expresses TLR. The invaded tissue may be liver, bladder, lung, or intestinal.
Also provided herein is a method of protecting liver tissue in a mammal from the effects
of a liver toxicity, which may comprise administering to a mammal in need thereof a TLR
t. The toxicity may be a FAS ligand, a FAS agonistic antibody, TNFOL, acetaminophen,
alcohol, a viral infection of the liver, or a chemotherapeutic agent. The toxicity may also be a
Salmonella infection, which may be from Salmonella typhimurium. The TLR agonist may be
BRIEF DESCRIPTION OF THE DRAWINGS
Figure 1 shows the domain structure of bacterial flagellin. The Ca backbone trace,
hydrophobic core distribution and structural information of F41. Four distinct hydrophobic cores
that define domains Dl, D2a, D2b and D3. All the hydrophobic side—chain atoms are displayed
with the Ca backbone. Side—chain atoms are color coded: Ala, yellow; Leu, lle or Val, orange;
Phe and Tyr, purple (carbon atoms) and red (oxygen . c, on and region of various
structural features in the amino—acid sequence of flagellin. Shown are, from top to bottom: the
F41 fragment in blue; three b—folium folds in brown; the secondary structure distribution with a—
heliX in yellow, b—structure in green, and b—turn in ; tic mark at every 50th residue in blue;
domains D0, D1, D2 and D3; the aXial subunit contact region within the proto—element in cyan;
the well—conserved amino—acid sequence in red and variable region in violet; point mutations in
F4l that produce the elements of different supercoils. Letters at the bottom indicate the
morphology of mutant elements: L (DlO7E, Rl24A, Rl24S, G426A), L—type straight; R
(A449V), R-type straight; C (D3l3Y, A4l4V, A427V, N433D), curly33.
Figure 2 shows a schematic of Salmonella flagellin domains, its fragments, and its
interaction with TLRS. Dark bars denote regions of the flagellin gene used to construct
fragments comprising A, B, C, A’ and B’.
Figure 3 depicts flagellin tives. The domain structure and imate ries
(amino acid coordinates) of selected flagellin derivatives (listed on the . FliC flagellin of
Salmonella dublin is encoded within 505 amino acids (aa).
Figure 4 shows the nucleotide and amino acid sequence for the following flagellin
variants: AA’ (SEQ ID NO: 7-8), AB’ (SEQ ID NO: 9-10), BA’ (SEQ ID NO: 11-12), BB’
(SEQ ID NO: 13-14), CA’ (SEQ ID NO: , CB’ (SEQ ID NO: 17—18), A (SEQ ID NO: 19—
), B (SEQ ID NO: 21-22), C (SEQ ID NO: 23-24), GST-A’ (SEQ ID NO: 25—26), GST—B’
(SEQ ID NO: 27-28), AA’nl-l70 (SEQ ID NO: 29-30), AA’nl—l63 (SEQ ID NO: 33—34),
-l70 (SEQ ID NO: , AA’n54-l63 (SEQ ID NO: ), AB’nl-l70 (SEQ ID
NO: 37—38), l63 (SEQ ID NO: , AA’nl-l29 (SEQ ID NO: 41-42), AA’n54-l29
(SEQ ID NO: 43-44), AB’nl-l29 (SEQ ID NO: 45-46), AB’n54-l29 (SEQ ID NO: 47-48),
100 (SEQ ID NO: 49-50), AB’nl-100 (SEQ ID NO: 51—52), AA’nl—70 (SEQ ID NO: 53—
54) and AB’nl—70 (SEQ ID NO: 55—56). The pRSETb leader sequence is shown in Italic (leader
includes Met, which is also amino acid 1 of FliC). The N al constant domain is underlined.
The amino acid linker sequence is in Bold. The C terminal constant domain is underlined. GST,
if present, is highlighted.
Figure 5 shows a comparison of amino acid sequences of the conserved amino (Fig. 5A)
and carboxy (Fig. 5B) terminus from 21 species of bacteria. The 13 conserved amino acids
important for TLRS activity are shown with shading. The amino acid sequences are identified by
their accession numbers from TrEMBL (first letter 2 Q) or Swiss—Prot (first letter 2 P).
Figure 6 shows the sequence of human TLRS.
Figure 7 NF—kB activation in vivo in se to CBLB502 and LPS injections. A.
Background and NF—kB dependent luciferase expression in BALB/c—Tg(IKBOt—luc)Xen reporter
mice was detected by noninvasive imaging 2 hs after the treatment with CBLB502 (0.2 mg/kg).
B. NF—kB dependent luciferase expression in liver, small intestine (ileum part), colon, spleen,
kidneys, lungs and heart was assessed in the reporter mice 2 hs after s.c. injections of 100 ul of
either PBS, CBLB502 (0.2 mg/kg) or LPS (1 mg/kg). Luciferase activity normalized per ug of
the protein t was detected in 3 mice in each group. Bars represent e +/— s.d. C. The
dynamics of NF—kB nuclear translocation (p65) indicative of the bioactivity of agonists LPS and
CBLB502 in liver from NIH—Swiss mice injected s.c either with CBLB502 or LPS. Control
mice were injected with PBS. Tissue samples were obtained 20, 40 and 60 min after the
treatments, processed into paraffin blocks. Nuclear translocation of p65 in primary mouse
hepatocytes isolated from NIH—Swiss mice (D) and human hepatocytes purchased from (BD
Biosciences) (E) was detected after in vitro treatment with CBLB502 (100 ng/ml) or LPS (1
ug/ml) for indicated period of time. Control cytes remained intact. P65 was stained with
green fluorescence, cytokeratin—8 with red fluorescence and nuclei with non—specific Dapi blue
ng. Pictures are taken at x20 ication. Arrows indicate Kupffer and endothelial cells
ined based on morphological criteria.
Figure 8 shows 2 protection from Fas mediated hepatotoxicity. A. Survival of
NIH—Swiss mice after i.p. injection of 4 ug of as antibodies alone or in combination with
CBLB502 (1 ug/ mouse) injected 30 min, 2 hours and 6 hours prior antibodies. In parenthesis are
the numbers of mice per each treatment. B. tion of livers from anti—Fas antibody toxicity.
Apoptosis in livers 5 hours after injections of anti—Fas dies was detected using TUNEL
que. C. Tissue morphology with H&E staining revealed necrotic damge to livers by anti—
Fas antibody injections and protection by 2. D. Hemorrhage in liver was detected using
erythrocyte autofluorescence (rhodamine channel, red), mouse IgG control (Cy5—conjugated anti—
mouse IgG dy, pceudocolored in purple) and DAPI nuclei (blue). E. Caspase—3/7 activity
in liver samples of NIH—Swiss mice was determined in tissue protein lysates 5 hours after
injection of 3 ug anti—Fas antibody with or without CBLB502 thirty minute pre—treatment. N=3.
Bars represent average +/— s.d. F. Alanine aminotransferase (ALT) accumulation in blood serum
of NIH—Swiss mice was detected 5 hours after as antibody ions with or without
CBLB502. N=3. Bars represent average +/— s.d. G. Caspase—8 activity in liver samples of NIH—
Swiss mice was ined in tissue protein lysates 5 hours after injection of 3 ug as
antibody with or without CBLB502 thirty minute pre—treatment. N23. Bars represent average +/—
s.d. .
Figure 9 shows regulation of apoptosis—related factors by CBLB502 in liver and its effect
on diated antitumor activity in CT—26 tumor model. Inhibition of caspase—8 (A) and Bid
(B) cleavage by CBLB502 detected in liver isolated from C57BL/6 mice 2 hours after anti—Fas
dy injections (5 ug) alone or in ation with CBLB502 by western blot. C. RNA
expression of Bcl2AlB, Bcl2AlD, IER—3, Fos, Jun and JunB genes in livers of intact mice and
treated with 2 for 30 min and 2 hours was detected by . GAPDH was used as a
control to monitor the induction of gene expression. D. Mice with s.c. growing CT—26 tumors
were injected either with single anti—Fas antibodies (4 ug/mouse) and CLB502 or their
combination. Control mice (“intact”) received PBS in replace of CBLB502 and antibodies. In
hesis are the numbers of tumors in each group. The results represent the average tumor
volumes (m +/— standard error). (*) — The difference between intact and combination treatment
groups is significant (p<0.05). E. Mice were treated with anti—Fas antibodies alone or in
combination with 2 on day 5 after plenic injection of luciferase expressing CT—26
tumor cells. Tumor growth in livers was determined using Xenogen IVIS Imaging System on the
days 10, 15, 17, 22, 28 and 40 after tumor cell inoculation. Images of 3 mice from each group
taken on day 15 are presented. The difference between proportions of mice with tumor—free
livers in CBLB502—treated and control groups reaches statistical significance (p<0.05) on days
indicated by asterisks. F. Migration and infiltration of immunocytes (arrows) into tumor nodules
grown in liver of mice 5 hrs post treatment with CBLB502.
Figure 10. Dynamics of NF—kB activation in different organs after injections with
CBLB502 (5 ug, s.c.) or LPS (20 ug, s.c.). Mice were euthanized 2, 6, 24 and 48 hours later by
C02 inhalation. Luciferase activity in protein extracts from liver, large intestine, kidneys and
lungs was normalized per ug of the protein extract and average values were calculated per organ.
Luciferase fold induction was calculated as ratio between average luciferase activity in protein
t from organs of the TLR agonist treated mice and that obtained in the extracts from the
corresponding organs of the PBS injected control mice (3 mice/ group). Bars represent fold
induction as average i s.e.
Figure 11. NF—kB dependent luciferase expression in primary culture of mouse
hepatocytes isolated from luciferase reporter mice and treated in vitro for 3 hours with CBLB502
(100 ng/ml), LPS (5 ug/ml) or PBS control. Then hepatocytes were rinsed with PBS and
collected in cell lysis buffer ga). Luciferase activity in the protein supernatants was
determined by Promega reporter system and normalized per ug of the protein extract. Bars
represent luciferase units (mean i s.d.).
Figure 12. H&E staining of liver samples from NIH—Swiss mice treated with CBLB502,
anti—Fas antibodies (3 ug) or their combination obtained at different time—points after the
treatment. s of livers were obtained 5, 12 and 26 hours after injections of anti—Fas
antibodies, fixed in 10% formalin, embedded in paraffin and stained for tissue morphology with
hematoxilin and eo sin.
Figure 13. TLRS expression on B16 and CT—26 cells. A. sion of mRNA encoding
TLR5 and GAPDH (as a control) genes in B16 and CT—26 cells were determined by RT—PCR. A
region of mouse TLRS mRNA was ied using primers specific for the mouse TLRS gene:
forward (5’-AGTCCCCCAGCTCCAGTTTC—3’) and reverse (5’—GGAGCCCCCTAGCAGTG
AGT—3’). B. NF—kB activation in B16 and CT—26 tumor cells in response to CBLB502, mouse
TNFOL and LPS was tested using luciferase er assay. Data represent rase units (mean
i s.d).
Figure 14. Shows TLRS expresion in CT—26 tumor cells and A20 lymphoma cells. For
Figs. 14A and C, total RNA was extracted from CT—26 and B16 tumor cells (Fig. 14A) and CT—
26 and A20 cells (Fig. 14C) using TRIzol reagent as bed in the main text of the
manuscript. The primers for TLRS were designed using LaserGene software (DNASTAR, Inc.,
Madison, W1). A region of mouse TLRS mRNA (GenBank Accession No. NM_016928.2) was
amplified using primers specific for the mouse TLRS gene: forward (5’—
CCAGCTCCAGTTTC—3’) and reverse (5’—GGAGCCCCCTAGCAGTGAGT—3’).
GAPDH was used as a control to monitor the induction of gene expression. cDNAs were
synthesized using SuperscriptTM II e Transcriptase and oligo(dT)12—18 primer
(Invitrogen, Carlsbad, CA). B. An in vitro luciferase assay for NF—kB activation in B16 (TLRS
positive) and CT—26 TLRS negative) tumor cells was performed.
Figure 15 shows the cs of TLR5 positive HCT116 tumor growth in athymic nude
mice after CBLB502 or PBS (no treatment) treatments (0.2 mg/kg, s.c., days 1, 2, 3), n=6—10.
Figure 16 shows 293—TLR5 tumor growth in athymic nude mice after CBLB502 or PBS
(no treatment) treatments (0.2 mg/kg, s.c., days 1, 2, 3), n=6—10.
Figure 17 shows the dynamics of xenogenic A549 tumor growth in athymic nude mice
during 2 courses of CBLB502 vs. PBS (control) treatments (days 1, 2, 3, 14, 15 and 16), n=6—10.
Antitumor activity of colon HCT116 adenocarcinoma s.c. Grown as a xenograft in athymic mice.
HCT116 were ed s.c. into 2 flanks of 8 athymic nude mice (0.5x106 /100 n11 of PBS) to
induce tumors. When tumors became of about 3—5 mm in diameter (by day 6 after injections)
mice were randomly distributed into 2 groups, 5 mice for CBLB502 treated group and 3 mice in
PBS control group.
Figure 18 shows the rate of SCCVII orthotopic tumor growth in syngenic C3H mice after
CBLB502 or PBS (no treatment) ents (0.1 mg/kg, s.c.days l, 2, 3) to reach 400 mm3 tumor
size, n=6—10. Right figure represents the amount of days needed for tumors to reach 400 m3
volume with and without treatment with CBLB502.
Figure 19. Fischer rats with s.c. growing syngeneic Ward colon tumors were treated with
CBLB502 (0.2 mg/kg) was stered by i.p. once a day for three days.
Figure 20 shows the dynamics of xenogenic A549—shV and hTLR5 tumor growth
in athymic nude mice after CBLB502 or PBS ol) treatments (days 1, 2, 3). Statistical
difference between tumor volumes on days 2, 4, 6 and 8 observed in A549—shV tumors (p<0.05),
n=9—14. Right figure demonstrates NF—kB dependent induction of luciferase reporter expression
in A549—shV and A549—shTLR5 in response to CBLB502 treatment.
Figure 21 shows the dynamics of H1299 (control) and H1299—TLR5 tumor growth in
athymic nude mice after CBLB502 or PBS (control) treatments (days 1, 2, 3), n=6. Right figure
demonstrates IL—8 production in response to CBLB502 treatment as indicative of TLR5 on
in H1299—TLR5 cells.
Figure 22 shows that the bladder strongly responds to 2.
Figure 23 shows that CBLB502 treatment delays tumor appearance and growth in ,
even in tumors that do not express TLR5.
Figure 24 shows CBLB502 protection from Fas mediated hepatotoxicity.
Figure 25 shows that the liver is protected from TNFOL and LPS toxicity by 2.
Figure 26 shows that 2 protects the lungs from TNF and LPS toxicity.
Figure 27 shows that CBLB502 protects mice from legal oral administration of
Salmonella.
Figure 28 shows that irinotecan tes the mor effect of flagellin (CBLBSOZ).
DETAILED DESCRIPTION
The inventors have made the surprising discovery that the provision of a Toll—Like
Receptor (TLR) agonist, such an agonist of TLR5 like flagellin, can effectively t the
growth of and reduce cancer cells, even when the cells do not express TLRS. The TLR agonist
may be particularly useful in treating liver, bladder, lung, and intestinal cancers, whether primary
or metastatic, as well as cancer affecting other TLRS—positive tissues. The TLR agonist can also
be used to treat cancers that originate in s other than the liver, bladder, lung, intestinal, and
other TLRS—positive tissues, but metastasize to these tissues. Even though the metastatic cancer
cells do not express TLRS, the cancer may nonetheless be treatable with the TLR agonist when
the cancer has asized to xpressing tissues such as the liver. While not being bound
by theory, the idea implemented in this invention is that TLR agonists effectively reduce or kill
cancer cells affecting a tissue that has a strong innate immunity , thereby ing the
need for any pre—existing expression of TLR5 in the cancer cells. Unexpectedly, by providing a
TLR agonist, the innate immune system is sufficiently triggered so as to treat cancers that are
devoid of TLR5 expression. Thus, TLRS does not need to be provided to the cancer cells in
order for the TLR agonist to ively reduce or kill cancer cells.
The inventors have also made the surprising discovery that a TLR agonist can protect the
liver from a liver toxicity. For example, death ligands and activators of FAS—mediated apoptosis,
such as FAS ligand and anti—FAS agonistic antibodies, can induce does—dependent
hepatotoxicity. stering the TLR agonist can protect the liver t such toxicities. This
unexpected property of TLR agonists allows it be combined with FAS agonists or TNF for
cancer treatment, such that the adverse of effects of the FAS agonist or TNF are reduced or
prevented.
1. Definitions.
The terminology used herein is for the purpose of describing particular embodiments only
and is not intended to be limiting. As used in the specification and the appended claims, the
singular forms 4‘ 77 4‘
a, an” and “the” include plural referents unless the context clearly dictates
otherwise.
For recitation of c ranges herein, each intervening number there between with the
same degree of precision is explicitly plated. For e, for the range of 6—9, the
numbers 7 and 8 are contemplated in addition to 6 and 9, and for the range 60—70, the numbers
6.0, 6.1, 6.2, 6.3, 6.4, 6.5, 6.6, 6.7, 6.8, 6,9, and 7.0 are explicitly contemplated.
“Administer” may mean a single dose or multiple doses of an agent or agent.
“Analog” may mean, in the context of a peptide or polypeptide, a peptide or polypeptide
comprising one or more non—standard amino acids or other structural variations from the
conventional set of amino acids.
“Antibody” may mean an antibody of classes IgG, IgM, IgA, IgD or IgE, or fragments, or
derivatives thereof, including Fab, F(ab’)2, Pd, and single chain dies, diabodies, bispecific
antibodies, bifunctional antibodies and derivatives thereof. The antibody may be a monoclonal
antibody, polyclonal antibody, affinity purified antibody, or es thereof which exhibits
sufficient binding specificity to a desired epitope or a sequence derived therefrom. The antibody
may also be a chimeric dy. The antibody may be derivatized by the attachment of one or
more chemical, peptide, or polypeptide moieties known in the art. The antibody may be
conjugated with a chemical moiety.
A “derivative” may mean a peptide or ptide different other than in primary
structure (amino acids and amino acid analogs). Derivatives may differ by being glycosylated,
one form of post—translational modification. For example, peptides or polypeptides may exhibit
glycosylation patterns due to expression in heterologous s. If at least one biological
ty is retained, then these peptides or polypeptides are derivatives according to the
invention. Other derivatives may include fusion peptides or fusion polypeptides having a
covalently modified N— or inus, PEGylated peptides or polypeptides, peptides or
polypeptides associated with lipid moieties, ted peptides or polypeptides, es or
ptides linked via an amino acid side—chain functional group to other peptides, polypeptides
or chemicals, and additional cations as would be understood in the art.
A “fragment” may mean a portion of a reference peptide or polypeptide.
A “homolog” may mean a peptide or polypeptide sharing a common evolutionary
ancestor.
A “leader sequence” may be a nucleic acid encoding any peptide sequence that is linked
and translated with a peptide or polypeptide of interest to allow the peptide or polypeptide of
interest be ly routed through a eukaryotic cell’ s endoplasmic reticulum and Golgi
complexes for the purposed of extracellular secretion from the cell’s membrane. The leader
peptide sequence may be derived from alkaline phosphatase. The leader sequence may have a
DNA sequence comprising atgctgctgctgctgctgctgctgggcctgaggctacagctct ccctgggc.
A “liposome” may mean a tiny bubble (vesicle) made out of the same material as a cell
membrane. A liposome be filled with drugs and used to deliver drugs for cancer and other
diseases. A liposome may be filled with a vector. A liposome membrane may be made of
olipids, which are molecules that have a head group and a tail group. The head of the
me may be ted to water, and the tail, which is made of a long hydrocarbon chain, is
repelled by water. The tails may be ed by water, and line up to form a surface away from
the water. The lipids in the plasma membrane may be chiefly phospholipids like
phosphatidylethanolamine and phosphatidylcholine. Liposomes may be composed of naturally—
derived phospholipids with mixed lipid chains (like egg phosphatidylethanolamine), or of pure
surfactant components like DOPE (dioleoylphosphatidylethanolamine).
A “peptide” or “polypeptide” may mean a linked ce of amino acids and may be
natural, synthetic, or a modification or ation of natural and synthetic.
“Substantially identical” may mean that a first and second amino acid sequence are at
least 60%, 65%, 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%,or 99% over a region of 10,
, 20, 25, 30, 35, 40, 45, 50, 55, 60, 65, 70, 75, 80, 85, 90, 95, 100, 200, 300, 400, 500, 600,
700, 800, 900, 1000, 1100 amino acids .
“Treating,” “treatment,” or “to treat” each may mean to alleviate, suppress, repress,
eliminate, prevent or slow the appearance of symptoms, clinical signs, or ying pathology
of a condition or disorder on a temporary or ent basis. Preventing a condition or disorder
involves administering a agent of the present invention to a subject prior to onset of the e.
Suppressing a condition or disorder involves administering a agent of the present invention to a
t after induction of the condition or disorder but before its clinical appearance. Repressing
the condition or disorder involves administering a agent of the present invention to a subject after
al appearance of the disease.
A “variant” may mean means a peptide or polypeptide that s in amino acid sequence
by the insertion, deletion, or conservative tution of amino acids, but retain at least one
biological activity. Representative examples of “biological activity” include the ability to bind to
a toll—like receptor and to be bound by a specific antibody. Variant may also mean a n with
an amino acid sequence that is substantially identical to a referenced protein with an amino acid
sequence that retains at least one biological activity. A conservative substitution of an amino
acid, i.e., replacing an amino acid with a different amino acid of similar ties (e.g.,
hydrophilicity, degree and distribution of charged regions) is recognized in the art as typically
involving a minor change. These minor changes can be identified, in part, by considering the
hydropathic index of amino acids, as understood in the art. Kyte et al., J. M01. Biol. 157:105—132
(1982). The hydropathic index of an amino acid is based on a consideration of its
hydrophobicity and charge. It is known in the art that amino acids of similar athic
indexes can be substituted and still retain protein function. In one aspect, amino acids having
athic indexes of i2 are substituted. The hilicity of amino acids can also be used to
reveal substitutions that would result in proteins retaining biological on. A consideration
of the hydrophilicity of amino acids in the context of a peptide permits calculation of the st
local average hydrophilicity of that peptide, a useful measure that has been reported to correlate
well with antigenicity and immunogenicity. US. Patent No. 4,554,101, orated fully herein
by reference. Substitution of amino acids having similar hydrophilicity values can result in
peptides retaining biological activity, for example immunogenicity, as is understood in the art.
Substitutions may be performed with amino acids having hydrophilicity values within i2 of each
other. Both the hyrophobicity index and the hydrophilicity value of amino acids are influenced
by the particular side chain of that amino acid. Consistent with that observation, amino acid
substitutions that are compatible with ical on are understood to depend on the
relative similarity of the amino acids, and particularly the side chains of those amino acids, as
revealed by the hydrophobicity, hydrophilicity, charge, size, and other ties.
A “vector” may mean a nucleic acid sequence containing an origin of replication. A
vector may be a plasmid, a yeast or a mammalian artificial chromosome. A vector may be a
RNA or DNA vector. A vector may be either a self—replicating extrachromosomal vector or a
vector which integrates into a host genome.
2. Toll-like Receptor Agonist
Provided herein is a TLR agonist. The TLR agonist may be a PAMP, which may be
conserved lar product derived from a pathogen. The pathogen may be a Gram—positive
ium, Gram—negative bacterium,, fungus, or virus. The TLR agonist may be a damage—
associated lar pattern (DAMP) ligand, which may be an endogenous molecule released
from injured or dying cells. A DAMP or PAMP may initiate an immune se through TLR
signals and t adapter molecules within the cytoplasm of cells in order to propagate a signal.
The TLR agonist may be an agonist for the TLR, which may be a ligand from the following in
Table 1:
Table l TLRs and Ligands
TLR Ligand DAMP Ligand PAMP
TLRl Triacyl lipoproteins
TLR2 Heat Shock proteins Peptidoglycan
HMGBl (high mobility group Lipoprotein
box oterin)
ichoic acid
Zymosan
TLR3 Self dsRNA Viral dsRNA
TLR4 Heat shock proteins Heat shock ns
Fibrinogen Lipopolysaccharides
Heparan sulfate RSV fusion protein
Fibronectin MMTV (Mouse mammary
tumor virus) envelope proteins
Hyaluronic acid Paclitaxel
HMGB l
TLRS flagellin
TLR6 Lipoteichoic acid
Triacyl lipoproteins
zymosan
TLR7/TLR8 Self ssRNA Viral ssRNA
TLR9 Self DNA Bacterial and viral DNA
TLRlO
TLRl l Profilin
The TLR agonist may be a fragment, variant, analog, homology or derivative of a PAMP
or DAMP that binds a TLR and induces TLR—mediated activity, such as activation of NF—KB
activity. The TLR agonsist fragment, variant, analog, homolog, or derivative may be at least 30—
99% identical to amino acids of a TLR—agonist and induce TLR—mediated activity.
The TLR t may target a TLR such as TLR—5. The TLR agonist may be an agonist
of TLR—5 and stimulate TLR—5 activity. The TLR agonist may be an anti—TLR5 antibody or
other small molecule. The TLR t may be flagellin.
The flagellin may also be a flagellin or flagellin—related polypeptide. The flagellin may
be from any source, including a variety of Gram—positive and Gram—negative bacterial species.
The flagellin may be a flagellin polypeptide from any Gram—positive or Gram—negative ial
s including, but not limited to, a flagellin polypeptide disclosed in US. Pat. Pub. No.
2003/000044429, the contents of which are fully incorporated herein by reference. For example,
the flagellin may have an amino acid sequence from a bacterial species depicted in Figure 7 of
US. Patent Publication No. 2003/0044429. The nucleotide sequences ng the flagellin
polypeptides listed in Figure 7 of US. 2003/0044429 are ly available at sources including
the NCBI Genbank database. The flagellin may also be a flagellin peptide corresponding to an
Accession number listed in the BLAST results shown in Fig. 25 of US. Patent Pub.
2003/000044429, or a variant thereof. The flagellin may also be a flagellin polypeptide as
sed in US. Patent Appl. Publication No. 2009/0011982, the contents of which are fully
incorporated herein. The flagellin maybe any one of a flagellin polypeptide as disclosed in
s 3 and 4 herein.
The flagellin may be a fragment, variant, analog, homology or derivative of a flagellin
that binds TLR5 and induces TLR5—mediated activity, such as activation of NF—KB activity. A
fragment, variant, analog, homolog, or derivative of flagellin may be at least 30—99% identical to
amino acids of a flagellin that binds TLR5 and induces TLR5—mediated activity.
The flagellin may be from a species of ella, a representative example of which is
S.dublin (encoded by GenBank Accession Number ). The in related—polypeptide
may be a fragment, variant, analog, homolog, or tive of M84972, or combination thereof,
that binds to TLR5 and s TLR5—mediated activity, such as activation of NF—kB activity. A
fragment, variant, , homolog, or derivative of flagellin may be obtained by rational—based
design based on the domain structure of Flagellin and the conserved structure recognized by
TLR5.
The flagellin may comprise at least 10, 11, 12, or 13 of the 13 conserved amino acids
shown in Fig. 2 ions 89, 90, 91, 95, 98, 101, 115, 422, 423, 426, 431, 436 and 452). The
flagellin may be at least 30—99% identical to amino acids 1 174 and 418 505 of M84972. Fig. 26
of US. Patent Appl Publication No. 2009/0011982, the contents of which are fully incorporated
herein, lists the percentage identity of the amino— and carboxy—terminus of flagellin with known
TLR—5 stimulating activity, as compared to M84972.
The flagellin may be the major component of bacterial flagellum. The flagellin may be
ed of three domains (Fig. 1). Domain 1 (D1) and domain 2 (D2) may be discontinuous
and may be formed when residues in the amino terminus and carboxy terminus are juxtaposed by
the formation of a hairpin structure. The amino and carboxy terminus comprising the D1 and D2
domains may be most conserved, whereas the middle hypervariable domain (D3) may be highly
le. Studies with a recombinant protein containing the amino D1 and D2 and yl D1
and D2 separated by an Escherichia coli hinge /ECH/CD2) indicate that D1 and D2 may
be bioactive when d to an ECH element. This a, but not the hinge alone, may
induce IkBa ation, NF—kB activation, and NO and IL—8 production in two intestinal
epithelial cell lines. The non—conserved D3 domain may be on the surface of the flagellar
filament and may contain the major antigenic epitopes. The potent proinflammatory activity of
flagellin may reside in the highly ved N and C D1 and D2 regions (See Figure l).
The flagellin may induce NF—kB activity by binding to Toll—like receptor 5 (TLRS). The
TLR may recognize a ved structure that is particular to the flagellin. The conserved
structure may be composed of a large group of residues that are somewhat permissive to
variation in amino acid content. Smith et al., Nat Immunol. 4: 3 (2003), the contents of
which are incorporated herein by reference, have identified 13 conserved amino acids in flagellin
that are part of the conserved structure ized by TLRS. The 13 conserved amino acids of
flagellin that may be important for TLRS activity are shown in Fig. 2.
Numerous deletional mutants of flagellin have been made that retain at least some TLRS
stimulating activity. The flagellin may be such a deletional mutant, and may be a deletional
mutant disclosed in the Examples herein. The flagellin may comprise a sequence translated from
GenBank Accession number Dl3689 missing amino acids 185—306 or 444—492, or from
k Accession number M84973 missing amino acids 179—415, or a variant thereof.
The flagellin may comprise transposon insertions and changes to the variable D3 domain.
The D3 domain may be substituted in part, or in whole, with a hinge or linker ptide that
allows the D1 and D2 domains to properly fold such that the variant stimulates TLRS activity.
The variant hinge elements may be found in the E. coli MukB protein and may have a sequence
as set forth in International Application No. PCT/USlO/Sl646, filed on October 6, 2010, the
contents of which are orated herein by reference.
The flagellin as described above may further comprise a leader sequence. The flagellin
further sing a leader sequence may be CBLBSOZS.
3. Agent
This invention also relates to an agent comprising a therapeutically effective amount of a
TLR agonist. The agent may be a ptide. The agent may also be a . The vector may
comprise a nucleic acid encoding the TLR agonist. The vector may be capable of transducing
ian cells. The vector may be delivered into a ian cell by a virus or liposome
d vector system. The virus vector system may be an adenovirus or a cytomegalovirus.
The agent may be a liposome harboring the vector. The liposome maybe capable of
transducing mammalian cells and delivering the vector for expression.
The agent may be a drug formulation that activates a TLR, thereby exposing tumor or
infected cells to the host immune system imitating the situation of a massive penetration through
the intestinal wall. The agent may be delivered atically in solution for administration such
as intramuscularly. The agent may be a drug formulation that expresses the TLR agonist in the
form of a nano—particle, which may carry a functional agonist to the cell surface of a mammalian
cell.
The agent may be a pharmaceutical agent comprising the drug formulation described
above, which may be produced using s well known in the art. The agent may also
comprise a coagent.
The vector may comprise a nucleic acid encoding flagellin. The vector may be capable
of expressing flagellin using a strong promoter. The expression vector may further comprise a
leader sequence cloned upstream of the gene encoding the TLR agonist. The drug formulation
may be an adenovirus sing:
the TLR agonist, delivered systematically in solution for stration, such as
intramuscularly; or
the TLR agonist, expressed in the form of nano—particles carrying functional TLR
agonist, such as flagellin, which may be d from CBLB502, on their surface. The nano—
particle may be on the basis of a bacteriophage T7, or fully formed to retain its biological
activity. The nano—formulation may provide for dose—dependent, NF—KB—responsive reporter
activation, and may result in cell alization by endocytosis for effective zation
ch (Mobian AP—A).
3. Administration
Administration of the agents using the method described herein may be systemically,
orally, parenterally, sublingually, ermally, rectally, transmucosally, topically, via
inhalation, via buccal administration, or combinations thereof. Parenteral administration
includes, but is not limited to, intravenous, intraarterial, intraperitoneal, subcutaneous,
intramuscular, intrathecal, and intraarticular. Administration may also be subcutaneous,
intravenous, via intra—air duct, or intra—tumoral. For veterinary use, the agent may be
administered as a suitably acceptable formulation in accordance with normal veterinary practice.
The veterinarian can readily determine the do sing regimen and route of administration that is
most riate for a particular . The agents may be administered to a human patient,
cat, dog, large animal, or an avian.
The agent may be administered as a monotherapy or simultaneously or metronomically
with other treatments, which may be a surgery or removal of a tumor. The term taneous”
or taneously” as used herein, means that the agent and other treatment be administered
Within 48 hours, preferably 24 hours, more preferably 12 hours, yet more preferably 6 hours, and
most preferably 3 hours or less, of each other. The term “metronomically” as used herein means
the administration of the agent at times different from the other treatment and at a certain
frequency relative to repeat administration.
The agent may be administered at any point prior to another treatment including about
120 hr, 118 hr, 116 hr, 114 hr, 112 hr, 110 hr, 108 hr, 106 hr, 104 hr, 102 hr, 100 hr, 98 hr, 96 hr,
94 hr, 92 hr, 90 hr, 88 hr, 86 hr, 84 hr, 82 hr, 80 hr, 78 hr, 76 hr, 74 hr, 72 hr, 70 hr, 68 hr, 66 hr,
64 hr, 62 hr, 60 hr, 58 hr, 56 hr, 54 hr, 52 hr, 50hr, 48 hr, 46 hr, 44 hr, 42 hr, 40 hr, 38 hr, 36 hr,
34hr, 32hr, 30hr, 28 hr, 26hr, 24hr, 22hr, 20hr, 18 hr, 16hr, 14hr, 12hr, 10hr, 8hr, 6hr,4
hr, 3 hr, 2 hr, 1 hr, 55 mins., 50 mins., 45 mins., 40 mins., 35 mins., 30 mins., 25 mins., 20 mins.,
mins, 10 mins, 9 mins, 8 mins, 7 mins., 6 mins., 5 mins., 4 mins., 3 mins, 2 mins, and 1 mins.
The agent may be administered at any point prior to a second treatment of the agent including
about 120 hr, 118 hr, 116 hr, 114 hr, 112 hr, 110 hr, 108 hr, 106 hr, 104 hr, 102 hr, 100 hr, 98 hr,
96 hr, 94 hr, 92 hr, 90 hr, 88 hr, 86 hr, 84 hr, 82 hr, 80 hr, 78 hr, 76 hr, 74 hr, 72 hr, 70 hr, 68 hr,
66 hr, 64 hr, 62 hr, 60 hr, 58 hr, 56 hr, 54 hr, 52 hr, 50hr, 48 hr, 46 hr, 44 hr, 42 hr, 40 hr, 38 hr,
36hr, 34hr, 32hr, 30hr, 28hr, 26hr, 24hr, 22hr, 20hr, 18hr, 16hr, 14hr, 12hr, 10hr, 8hr, 6
hr, 4 hr, 3 hr, 2 hr, 1 hr, 55 mins., 50 mins., 45 mins., 40 mins., 35 mins., 30 mins., 25 mins., 20
mins., 15 mins., 10 mins., 9 mins., 8 mins., 7 mins., 6 mins., 5 mins., 4 mins., 3 mins, 2 mins,
and 1 mins.
The agent may be administered at any point after another treatment including about
1min, 2 mins., 3 mins., 4 mins., 5 mins., 6 mins., 7 mins., 8 mins., 9 mins., 10 mins., 15 mins.,
mins., 25 mins., 30 mins., 35 mins., 40 mins., 45 mins., 50 mins., 55 mins., 1 hr, 2 hr, 3 hr, 4
hr, 6hr, 8hr, 10hr, 12hr, 14hr, 16hr, 18 hr, 20hr, 22hr, 24hr, 26hr, 28 hr, 30hr, 32hr, 34hr,
36 hr, 38 hr, 40 hr, 42 hr, 44 hr, 46 hr, 48 hr, 50 hr, 52 hr, 54 hr, 56 hr, 58 hr, 60 hr, 62 hr, 64 hr,
66 hr, 68 hr, 70 hr, 72 hr, 74 hr, 76 hr, 78 hr, 80 hr, 82 hr, 84 hr, 86 hr, 88 hr, 90 hr, 92 hr, 94 hr,
96 hr, 98 hr, 100 hr, 102 hr, 104 hr, 106 hr, 108 hr, 110 hr, 112 hr, 114 hr, 116 hr, 118 hr, and
120 hr. The agent may be administered at any point prior after a second treatment of the agent
including about 120 hr, 118 hr, 116 hr, 114 hr, 112 hr, 110 hr, 108 hr, 106 hr, 104 hr, 102 hr, 100
hr, 98 hr, 96 hr, 94 hr, 92 hr, 90 hr, 88 hr, 86 hr, 84 hr, 82 hr, 80 hr, 78 hr, 76 hr, 74 hr, 72 hr, 70
hr, 68 hr, 66 hr, 64 hr, 62 hr, 60 hr, 58 hr, 56 hr, 54 hr, 52 hr, 50hr, 48 hr, 46 hr, 44 hr, 42 hr, 40
hr, 38 hr, 36 hr, 34 hr, 32 hr, 30 hr, 28 hr, 26 hr, 24 hr, 22 hr, 20 hr, 18 hr, 16 hr, 14 hr, 12 hr, 10
hr, 8 hr, 6 hr, 4 hr, 3 hr, 2 hr, 1 hr, 55 mins., 50 mins., 45 mins., 40 mins., 35 mins., 30 mins., 25
mins., 20 mins., 15 mins., 10 mins., 9 mins., 8 mins., 7 mins., 6 mins., 5 mins., 4 mins., 3 mins, 2
mins, and 1 mins.
b. Formulation
The method may comprise administering the agent. Agents provided herein may be in the
form of tablets or lozenges formulated in a conventional manner. For example, tablets and
capsules for oral stration may contain conventional excipients may be binding agents,
fillers, lubricants, disintegrants and g agents. Binding agents include, but are not limited to,
syrup, accacia, gelatin, sorbitol, tragacanth, mucilage of starch and polyvinylpyrrolidone. Fillers
may be e, sugar, microcrystalline cellulose, maizestarch, calcium phosphate, and sorbitol.
ants include, but are not limited to, magnesium stearate, stearic acid, talc, polyethylene
glycol, and silica. Disintegrants may be potato starch and sodium starch glycollate. Wetting
agents may be sodium lauryl sulfate. s may be coated ing to methods well known in
the art.
Agents provided herein may also be liquid formulations such as aqueous or oily
suspensions, solutions, emulsions, syrups, and elixirs. The agents may also be formulated as a
dry product for constitution with water or other suitable vehicle before use. Such liquid
preparations may contain additives such as suspending agents, emulsifying agents, nonaqueous
vehicles and preservatives. Suspending agent may be sorbitol syrup, methyl cellulose,
glucose/sugar syrup, n, hydroxyethylcellulo se, carboxymethyl cellulose, um stearate
gel, and hydrogenated edible fats. Emulsifying agents may be lecithin, sorbitan monooleate, and
acacia. Nonaqueous es may be edible oils, almond oil, fractionated coconut oil, oily esters,
propylene , and ethyl alcohol. Preservatives may be methyl or propyl p—hydroxybenzoate
and sorbic acid.
Agents provided herein may also be formulated as itories, which may contain
suppository bases such as cocoa butter or glycerides. Agents provided herein may also be
formulated for inhalation, which may be in a form such as a solution, suspension, or emulsion
that may be administered as a dry powder or in the form of an aerosol using a propellant, such as
dichlorodifluoromethane or trichlorofluoromethane. Agents provided herein may also be
formulated as transdermal formulations comprising aqueous or nonaqueous vehicles such as
creams, ointments, lotions, pastes, medicated plaster, patch, or membrane.
Agents provided herein may also be ated for parenteral administration such as by
injection, intratumor injection or continuous on. ations for injection may be in the
form of sions, solutions, or emulsions in oily or aqueous vehicles, and may contain
formulation agents including, but not limited to, suspending, stabilizing, and sing agents.
The agent may also be provided in a powder form for reconstitution with a le vehicle
including, but not limited to, sterile, pyrogen—free water.
Agents provided herein may also be formulated as a depot preparation, which may be
stered by implantation or by intramuscular injection. The agents may be formulated with
suitable polymeric or hydrophobic materials (as an emulsion in an acceptable oil, for example),
ion exchange resins, or as gly soluble derivatives (as a sparingly soluble salt, for example).
c. Dosage
The method may comprise administering a therapeutically effective amount of the agent
to a patient in need thereof. The therapeutically effective amount ed for use in therapy
varies with the nature of the ion being treated, the length of time desired to activate TLR
activity, and the ndition of the patient. In general, however, doses employed for adult
human treatment typically are in the range of 0.001 mg/kg to about 200 mg/kg per day. The dose
may be about 1 mg/kg to about 100 mg/kg per day. The desired dose may be conveniently
stered in a single dose, or as multiple doses administered at riate intervals, for
example as two, three, four or more ses per day. Multiple doses may be desired, or
required.
The dosage may be at any dosage such as about 0.1 mg/kg, 0.2 mg/kg, 0.3 mg/kg, 0.4
mg/kg, 0.5 mg/kg, 0.6 mg/kg, 0.7 mg/kg, 0.8 mg/kg, 0.9 mg/kg, 1 mg/kg, 25 mg/kg, 50 mg/kg,
75 mg/kg, 100 mg/kg, 125 mg/kg, 150 mg/kg, 175 mg/kg, 200 mg/kg, 225 mg/kg, 250 mg/kg,
275 mg/kg, 300 mg/kg, 325 mg/kg, 350 mg/kg, 375 mg/kg, 400 mg/kg, 425 mg/kg, 450 mg/kg,
475 mg/kg, 500 mg/kg, 525 mg/kg, 550 mg/kg, 575 mg/kg, 600 mg/kg, 625 mg/kg, 650 mg/kg,
675 mg/kg, 700 mg/kg, 725 mg/kg, 750 mg/kg, 775 mg/kg, 800 mg/kg, 825 mg/kg, 850 mg/kg,
875 mg/kg, 900 mg/kg, 925 mg/kg, 950 mg/kg, 975 mg/kg or 1 mg/kg.
d. Monotherapy
The agent may be administered as a monotherapy, under which the agent is not
administered together with any other type of cancer treatment, such as chemotherapy, ion
therapy, another biological therapy, or other combination therapies; provided that “monotherapy”
may include administration of the agent together with surgical treatment. The agent may be
administered in combination with a y, which may be tumor removal. The agent may be
administered prior to, together with, or after the surgery. The agent may be administered during
the surgery.
4. Method for Treating Cancer
Provided herein is a method for treating cancer, which may be present in a tissue that
expresses a TLR such as TLR5, by administering to a mammal in need thereof the agent. The
cancer may be a tumor or a metastatic cancer. The cancer may also be present in liver, bladder,
lung, or intestinal tissue, and also may have originated in another type of tissue such as colon,
breast, or prostate. The cancer may also be melanoma or a hematological malignancy such as
ma. The cancer may also be any cancer that has metastasized to a TLR—expressing tissue,
such as liver, lung, bladder, intestine, or other TLR—expressing tissue. The cancer may be a
TLR—negative cancer, and thus lack expression of a Toll—Like Receptor. The cancer may lack
both endogenous and ous expression of the Toll—Like Receptor. The method may
comprise a step of not providing the Toll—Like Receptor to the cancer, which may include not
providing the Toll—Like Receptor either exogenously or endogenously. The cancer may lack any
and all Toll—Like Receptor expression.
a. Toll-Like Receptor
The Toll—Like Receptor (TLR) may recognize molecules that are ved lar
products derived from pathogens that include Gram—positive, egative bacteria, fungi, and
viruses, but are distinguishable from host molecules, collectively referred to as pathogen—
ated lar patterns (PAMPs). The TLR may also recognize endogenous molecules
released from injured or dying cells, collectively referred to as damage—associated lar
n (DAMPs). A PAMP or DAMP may be a TLR agonist as further described below. The
TLR may be a fragment, variant, analog, homolog or derivative that recruits adapter molecules
within the cytoplasm of cells in order to propagate a signal. The TLR may be from a human or
other mammalian s such as rhesus monkey, mouse, or rat. The TLR may be at least 30—
99% identical to a TLR that recruits adapter molecules within the cytoplasm of cells in order to
propagate a signal.
The TLR may be one of the between ten and fifteen types of TLR that are estimated to
exist in most mammalian species. The TLR may be one of the 13 TLR (named simply TLRl to
TLRl3) that have been identified in humans and mice together, or may be an equivalent form
that has been found in other mammalian species. The TLR may be one of the ll members
(TLRl—TLRl 1) that have been identified in humans.
The TLR may ordinarily be expressed by different types of immune cells, and may be
located on the cell surface or in the cell cytoplasm. The TLR may ordinarily be expressed on
cancer cells. The TLR may rily be expressed by normal epithelial cells in the digestive
system, normal keratinocytes in the skin, alveolar and bronchial epithelial cells, and epithelial
cells of the female uctive tract. These cells lining an organ may be the first line of defense
against invasion of microorganisms, and TLRs ordinarily expressed in epithelial cells may have a
crucial role in the regulation of proliferation and apopto sis.
The TLR may not be sed by the cancer cells. The TLR—negative cancer cells may
not express any TLR mRNA, may not express any TLR protein, or may not express any
functional TLR protein. The TLR protein may not function due to reduced ability to bind a TLR
ligand or reduced ability to transmit ream signals triggered by ligand binding. The TLR—
negative cancer cells may also have reduced levels of TLR mRNA, protein, or TLR function.
The reduction may be 100%, or by more than 99.9%, 99%, 95%, 90%, 85%, 80%, 75%, 70%,
65%, 60%, 55%, or 50%, as ed to a normal cell from the tissue from which the cancer
cell originated, or as compared to another, known TLR—expressing cell type. The TLR—
expressing cell may be a normal cell or a tumor cell, such as a tumor cell line or tumor xenograft.
The TLR ordinarily expressed on cancer cells may upregulate the NF-KB cascade and
produce anti—apoptotic proteins that bute to ogenesis and cancer cell proliferation.
Four adapter molecules of TLRs are known to be involved in signaling. These proteins
are known as myeloid differentiation factor 88 (MyD88), Tirap (also called Mal), Trif, and Tram.
The adapters activate other molecules within the cell, ing n protein kinases (IRAKl,
IRAK4, TBKl, and IKKi) that amplify the signal, and ultimately lead to the induction or
ssion of genes that orchestrate the inflammatory response. TLR signaling pathways
during pathogen recognition may induce immune reactions via extracellular and intracellular
pathways mediated by MyD88, nuclear factor light—chain—enhancer of activated B cells
(NF-KB), and mitogen—associated protein kinase (MAPK). In all, thousands of genes are
activated by TLR signaling, and collectively, the TLR constitute one of the mo st pleiotropic, yet
tightly regulated gateways for gene tion.
TLRs together with the Interleukin—l receptors form a receptor amily, known as the
“Interleukin—l Receptor/Toll—Like Receptor Superfamily.” All members of this family have in
common a so—called TIR (Toll—IL—l receptor) domain. Three subgroups of TIR domains may
exist. Proteins with subgroup I TIR domains are receptors for interleukins that are produced by
macrophages, monocytes and dendritic cells and all have extracellular globulin (Ig)
domains. ns with subgroup II TIR domains are classical TLRs, and bind directly or
indirectly to molecules of microbial origin. A third subgroup of proteins containing TIR domains
(III) consists of adaptor proteins that are exclusively cytosolic and mediate signaling from
proteins of subgroups l and 2. The TLR may be a fragment, variant, analog, homolog or
derivative that retains either a subgroup I TIR domain, subgroup II TIR domain, or subgroup III
TIR domain.
The TLR may function as a dimer. For example, gh most TLRs appear to function
as homodimers, TLR2 forms heterodimers with TLRl or TLR6, each dimer having a different
ligand specificity. The TLR may also depend on other co—receptors for full ligand sensitivity,
such as in the case of TLR4’s recognition of LPS, which requires MD—2. CD14 and LPS Binding
Protein (LBP) are known to facilitate the presentation of LPS to MD—2.
(1) TLRl
The TLR may be TLRl, which izes PAMPs with a specificity for gram—positive
bacteria. TLRl has also been ated as CD281.
(2) TLRS
The TLR may be Toll—Like Receptor 5. The protein encoded by the TLRS may play a
fundamental role in pathogen recognition and activation of innate immunity. TLRS may
recognize PAMPs that are sed on infectious agents, and mediate the production of
cytokines necessary for the development of effective immunity. TLRS may recognize bacterial
flagellin, a principal component of bacterial flagella and a nce factor. The activation of the
TLRS may mobilize the nuclear factor NF-KB and stimulate tumor necrosis —alpha
production.
(3) Cancer type
The cancer may be a y cancer or a metastatic cancer. The primary cancer may be
an area of cancer cells at an originating site that becomes clinically detectable, and may be a
primary tumor. In contrast, the metastatic cancer may be the spread of a disease from one organ
or part to another non—adjacent organ or part. The metastatic cancer may be caused by a cancer
cell that acquires the ability to penetrate and infiltrate surrounding normal tissues in a local area,
forming a new tumor, which may be a local metastasis.
The metastatic cancer may also be caused by a cancer cell that acquires the y to
penetrate the walls of lymphatic and/or blood vessels, after which the cancer cell is able to
circulate through the bloodstream (thereby being a circulating tumor cell) to other sites and
tissues in the body. The metastatic cancer may be due to a process such as lymphatic or
hematogeneous spread. The metastatic cancer may also be caused by a tumor cell that comes to
rest at another site, re—penetrates through the vessel or walls, continues to multiply, and
ally forms another clinically able tumor. The metastatic cancer may be this new
tumor, which may be a metastatic (or secondary) tumor.
The metastatic cancer may be caused by tumor cells that have asized, which may
be a secondary or metastatic tumor. The cells of the metastatic tumor may be like those in the
original tumor. As an example, if a breast cancer or colon cancer metastasizes to the liver, the
secondary tumor, while present in the liver, is made up of abnormal breast or colon cells, not of
abnormal liver cells. The tumor in the liver may thus be a atic breast cancer or a metastatic
colon cancer, not liver cancer.
The metastatic cancer may have an origin from any tissue. The metastatic cancer may
originate from melanoma, colon, breast, or prostate, and thus may be made up of cells that were
originally skin, colon, breast, or prostate, respectively. The metastatic cancer may also be a
logical malignancy, which may be lymphoma. The metastatic cancer may invade a tissue
such as liver, lung, bladder, or intestinal. The invaded tissue may express a TLR, while the
metastatic cancer may or may not s a TLR.
b. Combination
The method may also se co—administration of the TLR agonist with an anti—cancer
therapy. The anti—cancer therapy may be FAS ligand, a FAS agonistic dy, TNFOL, a TNFOL
agonistic antibody, TRAIL, or a TRAIL agonistic antibody. The TLRS agonist may be used to
sensitize the cancer to the anti—cancer therapy. The method may also be ed with other
methods for treating cancer, including use of an immunostimulant, cytokine, or
herapeutic. The immunostimulant may be a growth hormone, prolactin or vitamin D.
. Method of reducing cancer recurrence
Also provided herein is a method of reducing cancer recurrence, comprising
administering to a mammal in need thereof a TLR agonist. The cancer may be or may have been
present in a tissue that either does or does not s TLR, such as TLRS. The cancer, tissue,
TLR, mammal, and agent may be as described above. The method may also prevent cancer
recurrence. The cancer may be an oncological disease.
The cancer may be a dormant tumor, which may result from the metastasis of a cancer.
The dormant tumor may also be left over from surgical removal of a tumor. The cancer
recurrence may be tumor th, a lung metastasis, or a liver metastasis.
6. Mammal
The mammal may have a fully—functional immune system, and may not be
immunocompromised. The mammal may also have a level of immunity that is equivalent to the
level sufficient to make the mammal eligible for a first or second round a chemotherapy. The
mammal may not have a low white blood cell count, which may be chemotherapy—induced. The
low white blood cell count may be caused by the loss of healthy cells during chemotherapy. The
loss may be an expected side effect of a herapy drug. The low white blood cell count
may be a severe immunosuppression caused by chemotherapy. The low white blood cell count
may compromise the antitumor effect of the agent. The low white blood cell count may be
ed 7— 14 days after a chemotherapy treatment.
The mammal may have a white blood cell count that is within a normal range. The
mammal may also have a white blood cell count that is indicative of mild immunosuppression.
The mammal may have not received chemotherapy treatment for 7— 14 days, or at least 14 days.
The mammal may also have total white blood cell count of at least 3000 or 3500 cells/ml of
whole blood; a ocyte count of at least 1800 or 2100 cells/ml of whole blood; or an albumin
level of at least 3.0 or 3.5 g/ 100 ml of whole blood. The white blood cell count, granulocyte
count, or albumin level may also fall within +/— 5%, 10%, 20%, 30%, 40%, or 50% of these
levels.
7. Method of protecting liver
As sed above, anti—cancer ents that trigger apoptosis through FAS, TRAIL,
and TNFOL death receptor signaling, such as death ligands, can cause severe liver toxicity. Thus,
the use of molecules such as FAS, TRAIL, and TNFOL as anti—cancer treatments has been limited,
despite the efficacy of these molecules in targeting cancer cells. Accordingly, also provided
herein is a method of protecting liver tissue in a mammal from the effects of a liver toxicity. The
liver may be protected by administering the agent to the mammal. The death receptor signaling
agonist may be FAS, TRAIL, or TNFOL. The death ligand may be a liver toxicity. The FAS,
TRAIL, or TNFOL may be used as an anti—cancer agent.
The liver toxicity may also be a Salmonella infection, which may be from Salmonella
typhimurium. The agent may also be used to protect against liver toxicity that may be FAS—
mediated. The toxicity may also be FAS ligand, a FAS tic dy, TNFOL,
acetaminophen, alcohol, a viral infection of the liver, or a chemotherapeutic agent. The agent
may be administered to the mammal.
Example 1
An agonist of TLR5 protects liver from hepatotoxicity
CBLB502, which is a pharmacologically optimized TLR5 agonist, is a powerful
radioprotectant due to, at least in part, inhibition of apoptosis in radiosensitive s. CBLB502
was tested for liver protection from Fas—mediated apoptosis. The following examples
demonstrate that upon stimulation with CBLB502 the TLRS pathway is active in liver
hepatocytes of mice and humans g to NF—kB—dependent induction of genes encoding anti—
apoptotic ns. Pretreatment of mice with CBLB502 protected them from lethal doses of Fas
agonistic antibodies, reduced Fas—induced elevation of liver enzymes in the blood, caspase
activity in liver extracts and preserved liver tissue integrity. 2 did not protect tumors in
eic melanoma and colon carcinoma mouse models. These observations support the use of
Fas agonists for cancer treatment under the protection of a TLRS agonist, such as CBLB502.
NF—kB response was compared in different organs after administration of TLR5 agonist
CBLB502 and TLR4 agonist LPS, another known activator of NF—kB. CBLB502 was found to
induce fast direct activation of NF—kB in hepatocytes, while LPS activation of NF—kB in
hepatocytes was mediated through different types of cells. The following data thus also
demonstrate that pre—treatment with CBLB502 can reduce Fas—mediated hepatotoxicity during
anti—cancer therapy in mice. The approaches described below are based on the increasing the
resistance of normal tissues to damaging side effects through activation of NF—kB ing by
toll—like receptor—5 (TLRS) agonist CBLB502 derived from flagellin of Salmonella urium.
1. Determination of NF-k activation in vivo in response to TLR4 and TLR5 agonists.
NF—kB response was investigated in different organs of mice to TLRS agonist CBLB502
in comparison with bacterial LPS acting through TLR4. NF—kB dependent luciferase reporter
Xenogen mouse model in which luciferase transgene is expressed under the control of NFkB—
dependent natural promoter of lkBot gene (Zhang N, et al, 2005). Upon stration of NFkB—
ting agents, luciferase activity was sed in cells and tissues that d to a given
agent. Using noninvasive Xenogen imaging system and ex vivo luciferase reporter assay,
detected strong activation of NF—kB in liver of mice was detected 2 hours after so injection of
CBLB502 (Figure 7A). The quantitative analysis of NF—kB activation in different organs
revealed that in comparison with LPS, CBLB502 induced much er activation of NF—kB in
liver, r high NF—kB activation level in the ine, while less NF—kB activity was found in
spleen, bone marrow, kidney and lungs (Figure 7B). The dynamics of NF—kB induced luciferase
reporter ty was similar for both TLR agonists with the activation profile g
approximately two hours after injection, reduced at the six hour time point and effectively
undetectable 24 hours post—injection (Figure 10).
Immunohistochemical staining of mouse liver samples for p65 ocation to the nuclei
revealed that CBLB502 directly activated NF—kB in hepatocytes as early as 20 min after injection
with no response of Kupffer and elial cells yet (Figure 7C). By 1 h after CBLB502
injection, all liver cells including Kupffer cells and endothelium cells demonstrated nuclear
accumulation of p65 suggesting overlap of y and ary effects with subsequent
tion of NF—kB by paracrine mechanisms. In st, LPS—activated NF—kB nuclear
translocation in hepatocytes occurred significantly later. The activation of NF—kB was observed
first in Kupffer and endothelial cells followed by the engagement of hepatocytes about 1 h after
LPS administration.
Primary hepatocyte es (murine and human) treated with CBLB502, but not with
LPS, demonstrated NF—kB translocation to the nuclei (Figure 7D, E). CBLB502 mediated NF—kB
tion was confirmed by NF—kB dependent luciferase expression with murine hepatocyte cell
culture, while LPS did not induce NF—kB activation in this cells (Figure 11). Small level of NF—
kB activation found in LPS—treated hepatocytes was more likely due to contamination of y
hepatocyte culture with other stromal liver cells.
These results show that hepatocytes express TLRS but not TLR4 ng 2 to
directly activate NF—kB in hepatocytes while LPS initially activates other cell types (immune
and/or stromal) and only later indirectly activates hepatocytes as a secondary event.
2. CBLB502 protection from Fas mediated hepatotoxicity
As it has been demonstrated, the anti—Fas antibodies can induce dose—dependent
hepatotoxicity and rapidly kill mice by ng apopto sis, liver tissue necrosis and hemorrhage
(Ogasawara J et al, Nature 1993, Nishimura et al 1997). Thus, NF—kB activation in hepatocytes
d by TLRS agonist CBLB502 may protect liver from Fas mediated apoptosis. In NIH—
Swiss mice, 4 ug of anti—Fas antibodies (clone J02) injected i.p. induced massive apoptosis,
necrosis and hemorrhage in liver (Figure SE, C and D) killing mice within first 1—2 days after
dy injections (Figure 8A). Pathomorphological examination of CBLB502—treated mice in
dynamics compared to intact control mice showed that their livers had slight vacuolization of the
cytes (Figure 12). The examination of mice injected with sub—lethal dose of anti—Fas
antibodies (3 ug/ mouse) in dynamics revealed pronounced apoptosis of the hepatocytes around
the portal tracts with better preserved cells adjacent to the terminal (central) venues, mo st
pronounced at 5 hrs and diminishing with time (12 and 24 hours post—injection). In the livers of
mice treated with CBLB502 and anti—Fas antibodies the changes were minimal and the
hepatocytes looked close to normal — only slight vacuolization and single apoptotic cells were
visible.
CBLB502 injected mice had much less damage to the liver that ed in better overall
survival after injections of about than 80% of NIH—Swiss mice when injected 30 min before anti—
Fas dies (Figure SA). All mice survived when CBLB502 was ed 2 hours before
antibodies. The protection level then declined by 6 hours time—point of pre—treatment.
Two and three ug of anti—Fas antibodies induced only transient liver toxicity in NIH—
Swiss mice, caspase 3/7 activation in the liver and alanine aminotransferase (ALT) secretion in
the blood (Figure 8E, F). Both tests showed significant reduction of liver damage induced by
anti—Fas dies if mice were pre—treated with CBLB502. Interestingly, Balb/c and C57Bl/6
mice appeared to be less sensitive to anti—Fas dies than NIH—Swiss mice. Four ug of anti—
Fas antibodies, the lethal dose for NIH—Swiss mice, induced only ent caspase 3/7 activation
in BALB/c and C57Bl/6 mice which was successfully prevented by 2 injection 30 min
before antibodies e 13).
These data support the esis that TLRS mediated NF—kB activation in hepatocytes
can be an indicator and a measure of increased resistance to Fas—mediated toxicity.
3. Suppression of pro-apoptotic and induction of anti-apoptotic factors by CBLB502 in
liver.
Caspases 3 and 7 are downstream targets of both intrinsic (mitochondrial) and extrinsic
(caspase) Fas—mediated apoptosis signaling. Upon activation of the receptor, first caspase—8
becomes phosphorylated and cleaved leading to activation of mitochondrial apoptotic
mechanism acting through cleavage of pro—apoptotic Bid n and cytochrome release (Lou et
al 1998). Therefore we examined whether CBLB502 suppresses this mechanism.
Western blot analysis of liver protein extracts for both caspases—8 and Bid demonstrated
much less cleavage of these proteins in mice injected with combination of CBLB502 and anti—
Fas antibodies in comparison with a single injection of as antibodies (Figure 9A, B).
Consistently, e 8 activation was reduced to a background level, as indicated by using
fluorigenic substrate assay (Fig. SF).
The fact that the protection of mice from Fas—mediated hepatotoxicity by 2 is
increased with time with maximum g at 30 min—2 hours suggests the existing of pre—
conditioning events in hepatocytes. Among the numerous of cytokines and anti—apoptotic factors,
the up—regulation of two anti—apoptotic bcl2 family members B and bcl2AlD (Chao and
Korsmeyer, 1998, Arikawa et al 2006) was found in livers by RNA array ization 30 min
and 2 hours after CBLB502 administration that was confirmed by RT—PCR (Figure 9C).
CBLB502 also quickly induced RNA expression of r anti—apoptotic protein immediate
early response protein IER—3 (Figure 9C, IEX—l is an ative name) that was shown
suppressing the production of reactive oxygen species and mitochondrial apoptotic pathway
(Shen et al 2009). RT—PCR analysis of liver samples revealed the induction of IER—3 RNA
expression by CBLB502 already 30 min after administration with significant increase by 2 hours.
Several proteins of MAPK pathway were found up—regulated in livers of CBLB502 treated mice.
It was demonstrated that activation of MAPK pathway in tumors es the resistance of these
cells to Fas receptor apoptosis (REF). The up—regulation of Jun, Jun—B and Fos gene expressions
directly correlated with mouse survival after anti—Fas antibody injections followed the pre—
treatment with 2 suggesting their possible role in CBLB502 mediated protection from
Fas hepatotoxicity.
4. Effect of CBLB502 on diated antitumor activity
LPS is not a good candidate for al application, since it induces strong inflammation
in many organs and can be ly xic through FADD/caspase—8 apoptotic y
(REFs). CBLB502 in its turn has been tested in mice, non—human primates and human healthy
volunteers and found to be a rather mild inducer of short—lasting inflammation. When evaluating
a tissue protecting compounds, there is always possibility that by reducing toxic side effects it
can also make tumor cells more resistant and jeopardize the efficacy of antitumor therapy. The in
vivo antitumor effect of combination treatment with CBLB502 and anti—Fas antibodies was
tested in CT—26 colon carcinoma mouse model of so growing tumors and experimental liver
metastases. This tumor model was used in a ly published study applying FasL—expressing
S. typhimurium, total attenuated bacteria, to deliver FasL to the tropic tumors and to induce Fas
mediated antitumor effect (Loeffler et al 2008). CT—26 tumor cells and A20 ma cells do
not express TLR5, as ined by RT—PCR and a NF—kB dependent luciferase reporter assay
(Figure 14). Here, tumor—bearing mice were treated with anti—Fas antibodies alone or
combination of recombinant CBLB502 given twice 24 hs and l h before a single injection of
anti—Fas antibodies (4 ug/ mouse, Figure 9D). The volumes of so growing tumors in treated
mice were compared with tumors growing in the intact mice. CT—26 tumors were found to be
rather resistant to the toxic but not lethal dose of anti—Fas antibodies (Figure 9D). Pre—treatment
with CBLB502 slightly sensitized tumors to anti—Fas antibodies reflecting in —inhibitory
tumor response. Fas mediated antitumor effect was tested in the mental model of liver
ases induced by intrasplenic injection of luciferase expressing CT—26 tumor cells followed
by splenectomy. Hepatic tumor growth was assessed using Xenogen luciferase imaging every 4—
6 days after the treatment. Mice ed free from liver tumor growth were counted at each
imaging procedure (Figure 9E). The results demonstrate significant delay of tumor appearance
(Figure 9G) and growth in livers by both treatments, anti—Fas antibody alone or given after pre—
treatment with CBLB502. The increased sensitivity of TLR5 negative CT—26 tumors to
combination treatment with anti—Fas and CBLB502 suggests the activation of antitumor immune
response against CT—26 tumors. Indeed, the histochemical analysis of liver sample with
CT—26 tumors taken 24 hours after anti—Fas/CBLB502 treatment revealed the accumulation of
neutrophils in inside and around of tumor nodules (Figure 9F). Thus, CBLB502 does not protect
tumors from anti—Fas antibodies ty and can even ly enhance Fas mediated antitumor
effect against CT—26 . The simultaneous protection of normal liver tissue from Fas
mediated toxicity may allow increasing the amount of the Fas agonist reaching complete
prevention of liver ases and the therapeutic effect against s.c. growing tumors.
Materials and s
Mice
NIH—Swiss female mice were sed from NCI (Frederick, MD), BALB/c and
C57Bl/6 female mice were sed from Jackson Laboratory (Bar , ME). All mice were
used in the experiments at the age of 10—14 weeks old. Balb/C—Tg(IKBOt—luc)Xen mice with NF—
kB inducible luciferase reporter gene were originally purchased from Xenogen (Alameda, CA)
and bred in our domestic colony.
Reagents
CBLB502, a bacterial flagellin derivative, was obtained from Cleveland BioLabs, Inc.
Bacterial lipopolysacharide (LPS) from Escherichia coli 055:B5 was purchased from Sigma.
Purified agonistic hamster anti—mouse Fas antibodies, clone J02, were purchased from BD
Biosciences.
Analysis of NF-KB activation in vivo using NF—kB reporter mouse model
BALB/c—Tg(IKBOt—luc)Xen reporter mice were injected s.c. with CBLB502 (0.2 mg/kg).
The induction of NF—kB by CBLB502 was detected by noninvasive in vivo imaging 2 hours after
the treatment (Fig. 1A). Mice were injected with D—luciferin (3 mg/ 100 ul, i.p., a),
ately anesthetized with isofluorane and images were taken using Xenogen IVIS Imaging
System 100 series. To quantify the results, samples of liver, lungs, kidney, spleen, heart and
intestine from NF—kB er mice injected s.c. with 100 ul of either PBS, 2 (0.2
mg/kg) or LPS (1 mg/kg) were obtained 2, 6 and 24 h after injections (Fig. 7B, 10). Tissue
samples were covered with lysis buffer containing proteinase inhibitor cocktail (according to
manufacture’s recommendation, Calbiochem) to get 100 mg tissue per 1 ml lysis buffer. This
was ed by nization and centrifugation at 14,000 rpm for 10 min at 4C. Luciferase
activity was measured in 20 ul of samples immediately after adding 30 ul of luciferin reagent
(Bright—Glo Luciferase Assay System, Promega). Luciferase activity was normalized per g of
the protein extract. Luciferase fold induction was calculated as ratio between average luciferase
units in livers of the TLR ligand d mice and that obtained from PBS injected control mice.
histochemical staining for p65 translocation.
P65 localization was detected in livers isolated from NIH—Swiss mice injected s.c either
with 2 (0.04 mg/kg) or LPS (1 . Control mice were injected with PBS. Tissue
samples were obtained 20, 40 and 60 min after the treatments, processed into paraffin blocks. All
liver tissues were stained with rabbit polyclonal antibody against NF—kB p65 and rat monoclonal
antibody t cytokeratin 8 followed by appropriate secondary fluorochrome—conjugated
antibodies (p65 — green, cytokeratin—8 — red). The same staining was performed on the plates
with primary mouse hepatocytes isolated from EGTA (0.5mM in PBS) perfused liver tissues of
NIH—Swiss mice followed by collagenase digestion and with human hepatocyte culture
purchased from (BD Biosciences). Both types of cytes were treated in vitro with
CBLB502 (100 ng/ml) or LPS (1 ug/ml) for indicated period of time. Control hepatocytes
remained intact. Pictures were taken at X20 magnification (Fig. 7C, D, E).
al assay
NIH—Swiss mice were injected i.p. with 2, 3, 4, and 5 ug of anti—Fas antibodies in 200 ul
of PBS to determine a 100% lethal dose that was found to be 4 ug/ mouse for this mouse strain.
Then CBLB502 (0.04 mg/kg, s.c.) was injected s.c. 30 min, 2 hours and 6 hours before 4 ug of
anti—Fas antibodies (i.p.) (Fig. 8A). Usually death from anti—Fas hepatotoxicity occurs during first
1—2 days after antibody injections. Mouse survival was observed and recorded during 30 days.
TUNEL staining of apoptotic cells in liver
Apoptosis in the liver of NIH—Swiss mice five hours after injections with 2 (s.c.,
0.04 mg/kg) or PBS 30 min before anti—Fas antibodies was detected in paraffin—embedded
specimens. tic cells were d by the indirect terminal deoxynucleotidyl transferase
mediated deoxyuridine osphate nick end labeling (TUNEL) method with TUNEL POD kit
(Roche Applied Science) (Fig. 8B).
Histological assessment of liver morphology
Liver specimens were collected from NIH—Swiss mice five hours (Fig. 2C) or in
dynamics of 5, 12 and 26 hours (Fig. S3) after anti—Fas antibody injections with or without pre—
treatment with CBLB502 (0.04 mg/kg) 30 minutes before antibodies. Mice that were not treated
(“intact”) were used as controls. Tissue specimens were fixed in 10% buffered formalin,
embedded in paraffin, sectioned and processed with H&E staining.
Histological staining of liver for hemorrhage
Paraffin sections were d with antibody t mouse IgG ated with Cy5
[Jackson Immunoresearch, pseudo—colored in purple] and mounted with ProLong Gold anti—fade
reagent with DAPI[Invitrogen, blue nuclear stain]. Erythrocytes were fisualized in red channel
by red autofluorescence. (Figure 2D). Images were captured under AXioImager Zl fluorescent
microscope ) equipped with AXioCam HRc 13 megapixel digital camera using AXio Vision
software (rel. 4.6.3)
Caspase activation
Livers were cut to small pieces and homogenized with a tissue grinder (Bullet Blender,
NextAdvance) in the buffer (10mM Hepes, 0.4mM EDTA, 0.2% CHAPS, 2% glycerol),
supplemented with 2mM DTT. All steps were med on ice. Liver homogenates were
centrifuged for 20 min at 13,000 xg, and supernatant was stored at —20°C. Caspase activities were
determined by incubation of liver homogenate ining 50 ug of total protein) with 50 uM of
the fluorogenic substrate acetyl—Asp(OMe)—Glu(OMe)—Val—Asp(OMe)—aminomethylcoumarin
(Ac—DEVD—amc) (ENZO, iences) in 200 pl cell—free system buffer containing 10 mM
HEPES, 0.4mM EDTA, 0.2% CHAPS, 2% glycerol and 2 mM DTT. The e of fluorescent
amc was measured after at time 0 and 2 hours of incubation at 37°C by fluorometry (Ex: 355,
Em: 485) (Victor3, PerkinElmer). Data are shown as the difference between twp and zero hours
(Figure SE).
Detection of alanine—aminotransferase (ALT) in the serum of anti—Fas antibody —treated
mice with and without CBLB502 injections
iss mice (3 per group) were ed s.c. with 1 ug CBLB502 30 min before anti—
Fas antibodies. The alanine aminotransferase (ALT) presence in mouse serum was ined
using commercial enzyme assays according to the manufacturer’s instructions (Stanbio
Laboratory, Boerne, TX, USA). Absorbance at 340nm was ed at 60 second interval
(AA/minute). (Figure SF)
n blot analysis
Total protein was ed from treated and untreated mouse liver using RIPA buffer
—Aldrich St. Louis, MO) supplemented with protease inhibitor cocktail (Sigma—Aldrich St.
Louis, MO). The protein extracts were separated by electrophoresis in denaturing 4 to 20%
polyacrylamide Novex gels (Invitrogen, Carlsbad, CA) and transferred to nylon polyvinylidene
difluoride (PVDF) membranes (Immobilon—P, Millipore Billerica MA). The following antibodies
were used: Caspase—8 antibody (Calbiochem, Darmstadt, Germany), ID (AbCam,
Cambridge MA). Horseradish peroxidase (HRP)—conjugated secondary anti—rabbit and anti—
mouse antibodies were purchased from Santa Cruz Biotechnology, Inc. (Santa Cruz, CA).
(Figure 9A and 9B)
RNA analysis
Total RNA was extracted from treated and untreated mouse livers using TRIzol reagent
according to manufacturer instructions (Invitrogen, Carlsbad, CA). To eliminate any eventual
contamination with genomic DNA, isolated RNAs were treated with DNaseI (Invitrogen,
Carlsbad, CA). cDNAs were synthesized by using SuperScriptTM II Reverse Transcriptase and
oligo(dT)12—18 primer (Invitrogen, Carlsbad, CA), according to manufacturer instructions. RNA
expression of BchAlB, BchAlD, IER—3, Fos, Jun and JunB genes in livers of intact mice and
treated with 2 and LPS for 30 min and 2 hours was detected by RT—PCR. GAPDH was
used as a control to monitor the induction of gene expression. The primers were designed using
ene software AR, Inc., Madison, WI) and then UCSC Genome Browser In—
Silico PCR website was used to check for locating primers. Primers ic for the IER3 gene
(GenBank Accession No. NM_l33662.2) (sense 5’—ACTCGCGCAACCATCTCCACAC—3’ and
antisense 5’—CTCGCACCAGGTACCCATCCAT—3’), Bcl2AlB gene nk Accession No.
NM_007534.3) (sense 5’—TAGGTGGGCAGCAGCAGTCA-3’ and antisense 5’-
CTCCATTCCGCCGTATCCAT—3’), Bcl2AlD gene (GenBank Accession No. NM_007536.2)
(sense 5’—TCTAGGTGGGCAGCAGCAGTC—3’ and antisense 5’—
CCGTATCCATTCTCC—3’), Jun (GenBank Accession No. NM_01059l.2) (sense 5’—
TGAAGCCAAGGGTACACAAGAT—3’ and antisense 5’—
CCAAACAAACAAACAT—3’), Fos (GenBank Accession No. NM_010234.2) (sense
’—GAGCGCAGAGCATCGGCAGAAG—3’ and antisense 5’—
TTGAGAAGGGGCAGGGTGAAGG—3’), JunB (GenBank Accession No. NM_0084l6.2)
(sense 5’—AGCCCTGGCAGCCTGTCTCTAC—3’ and antisense 5’—
GTGATCACGCCGTTGCTGTTGG—3’) and GAPDH gene (sense 5’—
ACCACAGTCCATGCCATCAC—3’ and antisense 5’-TCCACCACCATGTTGCTGTA-3’) were
used. ication of cDNA was done for 20—30 cycles using specific primer pairs for each
gene (Figure 3C).
Experimental therapy of CT—26 tumor—bearing mice
The effect of CBLB502 on the sensitivity of tumors to anti—Fas antibodies was analyzed
using two models of ic colon adenocarcinoma CT—26 tumor: 1) CT—26 s.c. g
tumors, and 2) Experimental liver metastatic model of CT—26 tumors. CT—26 cells were
transduced with lentiviral vector carrying luciferase gene under CMV promoter for constitutive
expression of luciferase. Tumors were d by s.c. injections of CT—26 tumor cells (2.5x105/
100 ul) in both flanks of BALB/c mice. When the tumors reached about 4—5 mm in diameter, the
mice were randomly divided into three groups and treatment was initiated. One group of mice
was ed i.p. with anti—Fas antibodies (4 ug/mouse), another was treated with CBLB502 (l
ug/mouse) 24 h and l h before anti—Fas dy injection (4 ug/mouse). Control mice (‘intact’)
received PBS injections s.c. and i.p. in replace of CBLB502 and antibodies. Tumor volumes
were measured every second day using calipers and calculated by formula: V=H/6*a2*b, where
a<b. Survival was followed for 2 weeks when ment was terminated due to large tumors in
the control group (Fig. 9D). Statistical difference n tumor volumes was estimated using
ANOVA one—way analysis of ces (p<0.05). For the development of liver tumor growth,
CT—26 tumor cells (2x105 /50 ul) were injected directly into spleen followed by splenectomy 5
min later. Mice were treated with anti—Fas antibodies and combination of CBLB502 with
antibodies the same way as described for s.c. tumors starting on day 5 after tumor cell
inoculation. Noninvasive bioluminescent imaging of mice anesthetized with isoflurane and
injected with D—luciferin (3 mg/ 100 ul, i.p.) was performed using Xenogen IVIS Imaging
System 100 series on the days 14, 17, 22 and 28 after tumor cell injection. Mice were sacrificed
when tumor growth in liver was ined. Statistical comparison of liver tumor—free curves
was done using log—rank l—Cox) test (p<0.05) (Fig. 9G).
Example 2
Antitumor activity of CBLB502 on colon HCT116 adenocarcinoma s.c. growth in
xenogenic model of athymic mice. HCT116 were injected s.c. into 2 flanks of 8 athymic nude
mice (0.5x106 /100 ul of PBS) to induce tumors. When tumors became of about 3—5 mm in
diameter (by day 6 after injections) mice were randomly distributed into 2 groups, 5 mice for
CBLB502 treated group and 3 mice in PBS control group. Suppression of tumor growth was
determined in CBLB502 treated mice. Data are shown in Figure 15.
Example 3
Antitumor activity of CBLB502 on 293—TLR5 s.c. tumor growth in xenogenic model of
athymic mice. Tumor cells were ed s.c. into 2 flanks of 10 athymic nude mice (2x106 /100
ul of PBS) to induce . When tumors became of about 3—5 mm in diameter (by day 7 after
ions) mice were randomly distributed into 2 groups, 5 mice for CBLB502 treated group and
mice in PBS control group. Suppression of tumor growth was found in CBLB502 treated mice.
Data are shown in Figure 16.
Example 4
Antitumor activity of CBLB502 on A549 adenocarcinoma s.c. growth in xenogenic
model of athymic mice. The original A549 cells (ATCC, CLL—185) were injected s.c. into 2
flanks of 8 athymic nude mice (0.5x106 /100 ul of PBS) to induce tumors. When tumors became
of about 3—5 mm in diameter (by day 6 after injections) mice were randomly distributed into 2
groups, 5 mice for 2 treated group and 3 mice in PBS control group. A549 tumor—
bearing mice were ed with either CBLB502 (1 ug/ mouse) or PBS three times with a 24—hr
time interval. In the PBS injected control group of mice, tumor s gradually and rly
increased. On the other hand, the CBLB502 injected mice expressed inhibited tumor growth
during the first l days after injections and then tumor growth restored. The second round of
CBLB502 injections 2 weeks after the first treatment (days 14, 15 and 16) induced analogous
tumor growth inhibition for approximately 1—2 weeks before the restart of tumor growth. As a
result, by the end of the experiment the sizes of the A549 tumors differed significantly in the two
groups of mice, being much smaller in CBLB502 treated vs. PBS treated mice. Data are shown
in Figure 17.
Example 5
Antitumor effect of CBLB502 on syngenic orthotopically (s.c.) growing squamous cell
carcinoma SCCVII tumors. The rate of SCCVII orthotopic tumor growth in ic C3H mice
after CBLB502 or PBS (no treatment) ents (0.1 mg/kg, s.c.days l, 2, 3) to reach 400 mm3
tumor size, n=6—10. The x—axis in Figure 18 represents the amount of days needed for tumors to
reach 400 mm3 volume with and t treatment with 2. Data are shown in Figure
Example 6
Antitumor activity of CBLB502 in Fischer rats bearing so advanced Ward colorectal
carcinoma. CBLB—502 was administered by i.p. once a day for 5 days (0.2 mg/kg x 5 doses)
initiated 5 days after tumor transplantation into 4 rats. Control 4 rats received PBS injection as a
vehicle control. Tumor weight was measured daily. Complete response (tumor complete
disappearance) was observed in 3 rats treated with CBLB502 (Figure 19). The fourth rat in this
group had tumor growth similar to rats in the control group.
Example 7
The effect of CBLB502 injections on A549 tumors differing in TLR5 expression (A549—
shTLR5 vs. hV). In order to suppress TLR5 expression, A549 cells expressing Firefly
luciferase gene under the control of NF— kB er (Cellecta, Mountain View, CA) were
transduced with lentiviral pLKOl—puro vector expressing shRNA specific to human TLR5 gene
[CCG—GCC—TTG—CCT—ACA—ACA-AGA-TAA-ACT-CGA-GTT-TAT-CTT-GTT-GTA-GGC-
AAG—GTT—TTT—G] or control empty vector (shV, Sigma—Aldrich, St. Louis, MO). After
puromycin selection, hV and hTLR5 cells were tested for NF—kB activation in
se to CBLB502 treatment using luciferase reporter assay according to manufacture
protocol (Promega, Cat#E4530, Madison, WI). Then A549—shV and A549—shTLR5 cells (1x106
/ 100 ul of PBS) were injected s.c. into 2 flanks of 20 athymic nude mice to induce . Mice
bearing s.c. growing A549—shV and A549—shTLR5 tumor xenografts (5 mice per group) were
treated with either CBLB502 or PBS acting as control The results demonstrate that the repeated
administration of 2 alone led to a reduction in tumor growth rates in the A549—shV
(TLR5—expressing) tumor xenografts demonstrating a direct tumor ssive effect of the drug.
As shown for A549 d tumors, this effect was TLR5 dependent since TLR5 own
elicited by lentiviral transduction of shRNA against human TLR5 rendered the A549 tumors no
longer ive to the direct antitumor effect of CBLB502. Data are shown in Figure 20.
Example 8
The effect of CBLB502 injections on Hl299 tumors ing in TLR5 expression
(Hl299—control vs. Hl299—TLR5). In order to induce TLR5 sion, Hl299 cells (originally
TLR5 negative) were transduced with lentriviral construct sing human TLR5 gene. The
functional activity of TLR5 was checked by IL—8 production in response to CBLB502 treatment.
Then both tumor cell types (lxlO6 /100 ul of PBS) were injected s.c. into 2 flanks of athymic
nude mice to induce tumors. Similar to A549 model described above, mice bearing were treated
with either CBLB502 or PBS acting as control. The results demonstrate that the repeated
administration of CBLB502 alone led to a reduction in tumor growth rates only in Hl299—TLR5
(TLR5—expressing) tumor xenografts demonstrating a direct tumor suppressive effect of the drug.
As shown for the control Hl299 (TLR5—negative) tumor growth was not affected CBLB502
treatment. Data are shown in Figure 21.
Example 9
This example demonstrates that bladder tissue is a strong responder to 2. The
experiment was conducted as described as described above for liver tissues. NF—kB dependent
luciferase expression in liver, small intestine (ileum part), colon, spleen, kidneys, lungs and heart
was assessed in the reporter mice 2 hs after s.c. injections of 100 ul of either PBS, CBLB502 (0.2
mg/kg) or LPS (1 . Luciferase activity normalized per ug of the protein extract was
detected in 3 mice in each group. The data are shown in Figure 22.
Example 10
Table 2 shows the spectrum of genes transcriptionally activated by CBLB502 in target
organs of mice (bladder results are shown). Genes that are strongly upregulated in rs of
mice treated with CBLB502, l and 3 hrs post—injection, are clustered according to their function.
The largest group consists of chemokines, cytokines and their receptors tive of activation
of innate immunity mobilizing mechanisms.
Example 11
CT—26 tumor cells, which do not express TLRS, were injected s.c. into syngenic BALB/c
mice to induce tumors. Tumor bearing mice were treated with CBLB502 (0.04 mg/kg, s.c.) given
twice 24 hour apart. The volumes of s.c. g tumors in treated mice were ed with
tumors growing in the intact mice. Pre—treatment with CBLB502 did not have any effect on
tumor growth. Then CT26 tumor growth was tested in the experimental model of liver
metastases induced by intrasplenic injection of rase expressing CT—26 tumor cells (Figures
23B and C) and A20 lymphoma cells (Figure 23D) followed by splenectomy. Hepatic tumor
growth was assessed using n luciferase imaging every 4—6 days after the treatment. Mice
remained free from liver tumor growth were counted at each imaging procedure. The results
demonstrate prevention of tumor growth and significant delay of tumor appearance in livers by
CBLB502 treatment in both tumor models. The difference between CBLB502 treated and
control groups in liver tumor models (B, C, D) is significant (log rank p<0.05). The data are
shown in Figure 23.
Example 12
2 protection from Fas mediated hepatotoxicity. A. Survival of NIH—Swiss mice
after i.p. injection of 4 ug of anti—Fas antibodies alone or in ation with CBLB502 (1 ug/
mouse) injected 30 min, 2 hours and 6 hours prior antibodies. In parenthesis are the numbers of
mice per each treatment. B. Protection of livers from as antibody toxicity. Apoptosis in
livers 5 hours after injections of anti—Fas antibodies was ed using TUNEL technique.
Tissue morphology with H&E staining revealed necrotic damage to livers by as antibody
injections and protection by CBLB502. hage in liver was detected by erythrocyte
infiltration in tissue, mouse IgG control (purple) and DAPI nuclei (blue). Data are shown in
Figure 24.
Example 13
Liver protection from TNF—alpha and LPS toxicity. A. Caspases 3/7 were detected 5
hours after injections of TNF—a or LPS and lipis oxidation (indicative of inflammation damage)
was detected 24 hours post ion in mice with and t CBLB502 treatment 30 min
before TPS/ TNF—a. e activation and lipid oxidation in lungs induced by TNF (l
mg/mouse) was prevented by CBLB502 injection. LPS (10 mg/kg) induced damaging effect was
completely abolished by CBLB502 injection 30 min before LPS. Data normalized by protein
concentration, 24 hours after the treatment, n=3. It was no e activation (5 hours after TNF
injections) and much less lipid oxidation (24 hours post—TNF ions as indicative of
atory damage) in livers of mice if CBLB502 was injected 30 min before h—TNF. B.
lmmunohistochemical analysis (H&E staining) confirmed the preservation of liver integrity by
CBLB502 injection before TNF—a. Compared to the intact control, the liver of the TNF—treated
mice showed vacuolization of the hepatocytes that is slightly more pronounced periportally and
is dose—dependent (more severe in TNF 0.4 mg/mouse). In the livers of mice treated with
CBLB502 and TNF 0.2 mg or 0.4 se, the changes were minimal and the hepatocytes
were close to normal though slight ization was still visible. Data are shown in Figure 25.
Example 14
Lung protection from TNF—a and LPS ty. Compared to intact control, the lungs of
the TNF—treated mice showed reactive proliferation of ar cells, hyperemia titial
edema and exudates in alveoli leading to reduction of the air spaces and the alteration was dose—
dependent (more severe in TNF 400). In the lungs of mice treated with CBLB502 and TNF 200
ng or 400 ng, the changes were minimal. The morphology was close to normal though slight
thickening of alveolar walls was still visible (Figure 26B). It was almost normal level of lipid
oxidation (indicative of inflammatory damage) in lungs of mice if CBLB502 was injected 30 min
before LPS (10 mg/kg) or h—TNF (0.05 mg/kg) (Figure 26A). Data are shown in Figure 26.
Example 15
Protection of mice from lethal oral Salmonella typhimurium administration by CBLB502
injections. Conditions of the experiments are shown in Figure 27.
e 16
This examples trates that irinotecan abrogates the antitumor effect of flagellin.
The data are shown in Figure 28. Fischer rats with s.c. growing syngeneic Ward colon tumors
were treated with 2 (0.2 mg/kg), which was administered by i.p. once a day for three
days. Irinotecan (200 mg/kg) was injected iv. 30 min after each CBLB502 injection. PBS was
used as a vehicle control (Fig. 28A). CBLB502 rescued rats from Irinotecan toxicity with no
interference with irinotecan antitumor activity (Fig. 28B). The mor effect of CBLB502,
however, was not observed in irinotecan—treated rats (Fig. 28C). This demonstrates that the
antitumor effect of CBLB502 requires sufficient innate immunity levels.
TableZ
‘EEEEEEEEEEEEE E‘EEEEEEEEEEEE EEEEEE EEEEEEE EEEEEEEEEEE
control flic 1 LPS 1 1 qac prrepnfi 3 lEaca
CXCL2 1 4175.5 466.8 4175.5 -1.6 92.4 113.7
cxc110 1 3477.1 751.9 3477.1 5.1 304 18.9
CCL2 1 1460.8 523.5 1450.8 —0.5 247.5 —0.4
cxc11 21.5 21314.9 13985.8 985.8 73.3 18247.5 5458.7
CCL20 1 521.4 15.1 521.4
CXCL2 1 240.2 8.9 240.2
cc17 25.2 3738.3 2575.3 148.3 1.1 554.1 218.3
CCL4 14.6 613.2 3296.7 42.0 28.2 1002 3630.4\
cc13 1.8 74.2 350.5 41.2
CXCL9 11.5 185.5 94.5 15.0 2.8 389.7 481.3
CCL4 11.1 99.3 445.7 8.9 28.2 1002 3530.4
CXCL16 253.2 2048.1 545.5.-. .78. 35.8 524.2 385.1k
CXCL15 1 34.5 14.1; E.
CCLS 19 480 558.7 25.3
CCL19 1.9 44.5 35.2 23.5
CXCL12 —5.3 14.9 14.4 14.9
CCL25 25.5 224.5 280.1 8.5
CCL1 1 4.2
CCL11 192.8 616.4
CCL11 149.7 452.1
CCL17 13.7 125.5 3.5 540.1 \\
CCL19 7.5 18.4
CCL2 1 1450.8 523.5 1450.8
CCL20 1 521.4
CCL22 1 3.9
CCL26 1 4.2
CCL28 1 3.7
CCL3 1.8 74.2
CCL4 14.5 513.2
CCL4 11.1 99.3
CCL7 25.2 3738.3
CCL7 12.3 1453.5
CCR3 1 2.3
CCRS 5.9 12.1
CCRS 11.5 22.7
CORE 1 3.8 -4.7 17.5 5.8;\\\
CCRL2 52.7 510.5
CLCF1 4.5 23.2
CNTFR 1 9.1 -1.1 9.1
Table 2
CNTFR 14.5 29.8 21
CX3CL1 216.7 1081.9 328.9; 183.2 1471.3 440.5
CXADR (CAR) 22.2 59.4 52.72
CXCL1 21.6 21314.9 13985.8
cxcuo 1 3477.1 751.9
CXCL15 1 34.5 14.1
CXCL16 30.4 371.9 61.3
CXCL16 263.2 2048.1 546.6
CXCL17 1 7.7 4.5
CXCL2 1 4175.5 466.8;
CXCL2 1 240.2 8.93
CXCL9 11.6 185.6 94.53
CXCRS 1.3 4.7 143
FAS 138.7 967.8 288
FAS 396.2 1802.5 730 6g
FASL 3.6 10.2 1
FPR2 14.2 96.4 187 0.1 954.1 1765.8§x
|ER3 1494.5 12012.4 8339.1
L|F 1 213.4 13.8
LIFR 1 6
DARC 131.2 360.4 277 2.7 87.9 1102.6 2605.8 12.5
CMKLR1 -7.3 8.9 10.4 8.9
0.1 954.1 1765.8“
EBB 21.5 297.3 208.511111
0 .3330: @6933 68.2.8103
|L7R 1.6 24.9 43.8 15.6
|L8RA -2 10.7 3.4 10.7
|L9R 0.5 9.5 3.1 9.5
|L17C 1 887.3 31.8 887.3
LIF 1 213.4 13.8 213.4
|L1RN 1 52.8 45.2 52.8 51.3 729.5 538.5 14.2
Table2
|L1F5 —4.2 8 3.8 8.0
|L1R1 0.1 10 22.1 10.0
|L1R2 51.8 397.6 281.7 7.7
|L10 1 19.5 263
|L1ORA 15.5 34.3 29.55
|L10RB 1.5 14 15.2
11124 -1.2 32.2 10.3 32.2
|L12RB1 14.7 -0.5 13.7 10.9
|L12RB1 7.1 21.7
1113 11.4 111.9 258.5 9.8
|L13RA2 -4.2 12.4 121.7 12.4
|L15 4.8 10.6 8.6%
|L15RA 7.4 38.1 195
|L15RA 5.1 24.8 14.35
|L15RA 19.2 47.1 323
1116 1 2 4E
|L17A 1 5.4
|L17B -2.5 30.8 -4.5 30.8
mm 1 887.3 -0.2 8.6 1.7
|L17RA 26.1 72.2
|L17RB 0.2 38.1 10 38.1
|L18BP 20 143.7 283 7.2
|L18Rl 57.4 857.8 892.9 14.9
P 1.3 24.3 0.1 18.7
|L18RAP 7.6 18.4 19.15
1119 -0.7 26.7 95.4 26.7
|L1A 1 14.9 43.7 14.9
|L1A 2.8 35.5 72.3 12.7
|L1B 20.7 437.9 1023.3 21.2
|L1RAP 6.1 11.9 5i
111 RL1 1 22.3 13.1
|L1RN 1 52.8 45.2 -2.7 34.4 0.9
|L1RN 1.9 6 2.93 51.3 729.5 538.5
|L1RN 51.5 158.5 118.85 -2.9 10.3 1%
|L2RA -5.8 8.7 18.1 8.7
ILZRB 4.8 49 -2.2 10.2
ILZRG 1.2 12.9 3 10.8
ILZORA 4.8 34.2 21 7.1
120103 1.6 6 —1.1 11.9 —3.4 11.9
ILZORB 2.5 8.5
|L21R 1 7.5 5.8 65 65.4§\\\\
|L21R 6.5 13
|L22RA1 1.2 8
|L23A 2.2 10.5
1127 1 5.2
|L28RA 1.6 15.3
|L28RA 134.8 279.3
|L2RG 1 7
|L31RA 1 4.5
IL33 150.4 352.9 \
|L4l1 28.9 1891 46.8 4000 741.7
115 1 2.5 -0.7 9.2 3.4
|L6 1.1 11.8 0.4 12 59.6k
|L6RA 37.1 387.1 798.5 10.4
|LF2 0.9 17.4 8 17.4
ILTIFB 0.8 20.5 10.4 20.5
55 55 .5555
AIF1 -5.2 8.3 11 8.3
ARIDSA 25.1 259.4 302.6 10.3
EGR4 1 231.2
CSFZ 1 202.5 0 10.4 4
CD70 1 54.7 0.6 520.2 67.5
AREG 8 1299.1 11.5 692.1 255.8
CSF3-(GCSF) 1 35.4
CSF1 49.7 486 33.1 509.2 397.4 15.4
CSF2 1 202.5
CSF2RB 1.2 6.6
CSF3 1.3 6
CSF3-(GCSF) 1 35.4
CSF3R 1 2.3
EGR1 1824.5 6578.8
EGR2 31.1 224.1 157.4 7.2
EGR3 58.6 1126.3 1120.8 19.2
EGR4 1 231.2
FGF10 3.5 8.8
FGF12 1 5.3
FGF12 4.8 11.7
FGF13 4.9 15.2
FGF15 6.6 18.4
FGF17 1.1 3
FGF22 1.7 13.6
FGF3 1 2.3
FGFBP3 1 6.4
FGFH1OP 11.8 31.7
FGFHZ 11.1 24.6
GDF15 8.5 173.4
HBEGF 72.3 1118.3
|GFBP3 120.1 301.3
NELLZ -4.9 24.9 10.3 24.9
BDNF 0.4 19.2 18.6 19.2
TGFBRl 6.6 73.4 137.8 11.1
NGFR 20.3 177.1 52.3 8.7
888288 88888
13sz 68.6 4.4_
CLEC1A
CLEC2D
CLEC2E
CLEC4D
CLEC4E
CLEC7A
CLECSF9
PGLYRP
PGLYRP1 21.7 429.5 28 19.8
PTX3 1 309.8 525.7 \8
PVR 13.8 99.3 31.1 7.2
PVR 52.1 262.7 144
PVR 30.7 95.4 52
PVRL1 40.7 107.6 52
PVRL2 70.7 207.8 96
S100A8 34.5 288.9 32.6:
S100A9 23.6 139.9 20
8AA1 2.9 5.7 16
SAA3 125.6 500 1208
ICOSL 25.3 106.7 3
KLRG2 273.2 695.9
KLR|1 2.1 14.5
2888-82 88888 2282888888 8 888888 88 8 8888 8828888888
SFTPD -7.5 23.4 84.8 23.4
SAA3 69.9 3183.4 2571.7 45.5
PGLYRP1 40.8 2012.5 255 49.3
KLRD1 5.8 107.8 171.1 18.6
HCST 26.4 198.3 202.3 7.5
FCGR4 37.6 1168.4 2200.4 31.1
MYD88 75.8 312.2 174
NOD2 5.3 37.6 17.2 2 30.3 7.8
TLFl1 5.1
TLR2 372.6 7545.6 2270.3 20.3 4.5
TLR3 9.1
TLR5 2.0
TLR6 2.804973
0.353293
Table 2
TLFI7 2.5
LY96 332.8 2474.1 1466.9 7.4
|RAK3 109.4 314.9 231 101.8 941.3 1132.4§\\\\\\
|RAK4 1 10.5
3188856883589 338828
ZBPl 27.5 210.1 419.6 7.6
WFDC12 3.8 1134.8 3.3 298.6
SlOOA8 0 897.8 661.5 897.8
510049 -0.7 1021.2 1620.9 1021.2
RSAD2 154 5347.3 3471.3 34.7
REG3G -3.3 857.6 471.2 857.6
MX2 21.9 959.8 671.8 43.8
LYZL4 24.8 215.1 -8.4 8.7
LTF -0.5 272 184 272.0
DMBTl -4.3 69.9 1 69.9
CRP 0.6 210.5 1721 210.5
CH|3L1 6.8 843.8 257.1 124.1
HAMP 1 117.6 -7.2 27.2 8.9
LCN2 7.7 492.4 9.2 1256.1 511.3
CHI3L1 11.8 128.2 6.8 843.8 257.1&
DEFB18 -5.7 11.7 -5.4 11.7
DEFBZO -0.5 22.1 22 22.1
DEFB26 2.4 30.1 29.5 12.5
DEFB34 -2.2 7.1 -5.3 7.1
DEFB36 -0.7 8.3 —1.3 8.3
DEFB38 -6.9 7.6 -2.9 7.6
DEFB50 -5.4 8.6 6 8.6
DEFCRS -2.6 10.9 -4.7 10.9
RSl -1.2 8 3.9 8.0
DEFCR-RSlZ —0.7 11.9 16.9 11.9
DEFCR-RSlZ -6 11.6 5.4 11.6
DEFCR—RSZ -2.8 9.4 —3.1 9.4
DEFB23 1 3.5
DEFBBO 1 2.4
DEFBS 7.4 16.4
DEFCR6 3.7 7.6
07 27.4 57.7
CFB 24.2 396 682.4 16.4
ClQL2 -4.5 18.3 12.1 18.3
C9 1 4.2 2.2% -8 15.4 17.8 15.4
CAMP 1.2 7.5 12.45
|RGM1 1 3.6 3.4% 1.2 32.2 -4.3
MX2 20 42.6 91.4; 21.9 959.8 671.8
REGBG 1 81.2 3.9 -3.3 857.6 471.2
WFDC12 1 238.5 —2 3.8 1134.8 3.3:\\
LCN10 -0.7 49.8 50.7 49.8
LCN3 —1.3 36.5 0 36.5
Table 2
CAMP 2.4 56.3 43 23.5
APOM 1 21.7 2.5 21.7
APOOL -8 8.9 -8.2 8.9
ClQL2 -4.5 18.3 12.1 18.3
CD14 570.3 12181.7 2137.5 21.4
CD160 -1.1 70.5 96.2 70.5
CD177 1 5.7 0.3 23.2 3.9§\\\\\
CD177 9.9 110.9 3.6 11.2
CD19 2.1 6.9
CD2OOR1 4.1
2 —4.5 7.6 12.1 7.6
CD207 1.2 5.8
CD207 1 3.1
CD247 2.9
CD27 -2.9 11.3 4.4 11.3
CD274 108 1070.2 398.3 9.9
CD28 | 1.2 2.7
CD209C 2 24.2 93.6 12.1
CD209D -3.6 35.5 54.7 35.5
CD209E -8.5 7.1 11.5 7.1
CD300LB 1 2.7
CD33 13.5 27.4
CD3E 17.2 122.3 21.2 7.1
CD4 1.2 9.3
CD40 52.6 460.8 54.8 1419.4 775.7
CD40 15.2 108.4 15.9 193.1 101.3
CD44 31.3 106.2 -2.6 27.8 19
CD44 13.5 32.8 -1.7 22.8 0.2
CD44 305.7 725.2 171.5 1251.9 596.8§
CD44 66.4 133.3
CD52 1 2.1
CD53 10 20.6
CD6 1 5.5 -2 7.4 17.5&\\
CD6 1 3.3
CD6 3.2 7.2
CD6 6.7 13.1
CD69 4 100.3 9.7 97.2 269.3
CD7 1.3 10.5 8.9
CD70 1 54.7 0.6 520.2 67.5%
CD79B 1 3.9
CD80 8.5 31.5
CD80 3.1 7.1 . g
CD83 45.7 771.8 486 16.9
CD86 3.2 5.8 -4.3 3.5 59.4 30.3 17.0
CD8B1 -1 30.2 -5.1 30.2
CD96 1 5.3
Table2
3333333333933 33% 3333 “38833033
NEOl 9.8 69.3 .
NFIC 12.3 136.2 297.6
POU2F2 11 161.3 164.9
POU3F1 6.5 140.6 83.1
SBNOZ 54 765.1 860.1
SIRT6 17.7 182.1 195.4 10.3
GTF3C6 4.2 84.2 106.1 20.0
GEMINS 11.3 93.2 157.1 8.2
F|P1L1 —2.1 57.9 10.3 57.9
FAP 5 51.7 2.4 10.3
CHDl 27.5 295.2 529.8 10.7
BACHl 21.7 159 299.5 7.3
BARX2 15.6 234.6 144.6 15.0
ATF3 31.6 690.5
ATF4 43.8 115
BATF 17.2 150.8 21.9 185.7 460.4
BAZ1A 27.6 93.8
CCND2 1.6 7.9
CCNL 30.3 67.6
CCNYL1 30.5 103.3
CDK2 29.1 67.9
CDKS 4 8.8
CDK5R1 24.2 110.2
CDK6 4.1 27.3
CDK7 1.5 3.8
CDKN1A 147.1 374.4
CDKN1A 370.5 730.6
CDKN2B 1231.3 2751.7
EGLNS 406 2015 -1.3 19.3 -4.6§\\\\\\
EGLNB 3.2 11.4
E|F4E1B -2.4 18.9 4.9 18.9
ELF3 #REF! 3525.2
ETS1 1 22.7
FKHL18 63.6 336.2 52.6 431.6 \\\\
FOSB 92.3 738.1
FOSL2 4.6 32.2 0.4 11.7 -0.1
FOSL2 4.7 20.4 6.7 70.5 61
FOXA3 1 13.2 3.2 100.6 0.9%
FOXB1 1 3.8
FOXDQ 1 5.6 . §\\\\\\
FOXE1 -0.4 8.8 -2.9 8.8
FOXF2 -1.2 10.3 20.6 10.3
FOXF1A 400.7 960.3
FOX/2 1 2.6
FOXJ3 9.2 20.3
FOXJ3 5.7 12.2
Table 2
' \N‘x‘g
.5
\wxsg
14.1
GADD45A
GADD453 ' \“W-
GADD45B
GADD45G
HF1A
HWlAN
JDP2
JUNB
JUND1
MAFF
NFATC1
NFATC1
NFATC1
NFATC1
NFATC2
NFATC2
NFE2L2
KLF6
MYCT1
SOX7
SOX9
soxe
$§§3$§§§3§i§R 1- \ ‘4 '\
. _
ANKHD1
APBA1
Table 2
APBBMP
APHlA
NRCZ
MRC3
NRC6
BBC3
BCLAF1
BCL1o
BCL10
BCL2A1 B
BCL2A1C
BCL2A1D
BCL2A1D
BCL2LT
BCL2L11
BCL2Lr
BCL3
BCLGB
BCL9
BCLQL
NUPR1
DNASE1L3 1396
125373
DUSP13
DUSP2
DUSP2
DUSP3
DUSP3
DUSPe
DUSPs
DUSPe
DUSP8
MMP2K3
MAP3K2
A4AP3K7
MAP3K8
NMFMK5 §§§§§k34
MAPK11
MAPK15
MAPK1IP1L
MAPK6
MAPK8
MAPK8
MAPK8IP3
MAPK8IP3
MAP2K1
MAP3K12
MAP3K4
MAP3K5
MAP3K6
MAPKlO
MAPK7
CKMT1
CSNK1G1
DAPP1
DYRK1A
P|M1
P|M1
P|M2
P|M2
PLK2
PLKS
ITPKC
RIPK2
' {Rx
16.4 531.5 170.4
796 1974.1 1706 i
8.6 53.9 40.6;
28.9 67.5 76
580.4 1978.1
548.9 1582.2
90.4 672
|F|202B 14.6 51.4
Table 2
|F|47 38.6 90.7
IFITMl 3562.3 8026.1 8.1 474 58mm
IFITM1 1023 7728.1 4581.7 7.6
|F|TM5 1.3 20.3 -2.5 14.6 -1.9
IFITM6 -1.9 12.1 62.7 12.1
|FNE1 8.5 28
IFNG 1 2.6
|FNGR2 107.1 425.9
|RF5 23.5 52.3
|RF6 23.5 52.3 —5.1 15.4 —4.7m
|RF6 23.5 52.3
|RF7 15.4 230.7 207.4 15.0
|RF9 23.5 52.3
PLSCR1 114.6 893.3
PLSCR1 66.9 305.6
SLFN2 18.4 252.7
ISGZOLl 19.9 159.7 166.4 8.0
IGTP 164.5 1836.5 1147 11.2
048583 -3.5 27.8 109.6 27.8
Loc100048583 -3.5 27.8 109.6 20.4
GVINl 45.4 458.2 976.11.11.11.11.11111011.
PSMBQ 15.4 114.6 142.3 7.4
PSMDll 6.1 62.8 0.6 10.3
PSMD3 -5.7 15.5 132.5 15.5
“iawwtinfi‘msosw
|BRDC3 177 699
LNX1 1.4 10.9
UBD 17.4 85.8
03702 20.4 60.9
USP2 6.2 15.6
USP23 2.7 8.7 3238.36 -1.8&\\\\
USP25 6.9 15.6
USP37 5.5 19.2
USP38 22.9 45.5
USP42 1 2.9
USP48 4.8 17.1
USP27X -0.9 8.7 —1.5 8.7
USP29 -2.8 7 10.1 7.0
usp37 19 330.9 294.3 17.4
USP43 10.1 108.8 30.8 10.8
USP8 -2.4 27.9 5.3 27.9
USP9X -3 37.8 115.3 37.8
CUL4A 0.5 22.4 6.2 22.4
UBD 13.4 446.1 278.5 33.3
LINCR 24.7 1194.7 109.8 >4
Table2
DTX3L 166.3 1484.1 608.4 8.9
MARCHl 10.5 75.1 134.7 7.2
11111111111
FLNB
CCTS 288.6 2407.1 1216.1 8.3
CDC42EP1 13.6 110.1 113.6 8.1
CDC42EP5 2 52.5 48.1 26.3
CEP350 —2.3 54.4 167.6 54.4
ARPC4 19.9 155 138.7 7.8
ARPMl -1.1 10 3.2 10.0
ACTB 3142.5 7089.1 6166
ARC 16.7 320.9 83.63 .
ABLIM3 1 4.8 7.9 #REF! -5.9 17.4 13 17.4
ACTL7B -2.4 13.6 0.9 13.6
ACTR6 -1.4 9.4 28.3 9.4
SCIN 54 597.9 49.63 59.7 1853 14mm
TUBA6 1429.6 2863.9 2070
TUBBZB 940.9 2963.8 1731
DUOXA2 1 280.8 11.5 878 25.2
EHD1 131.3 725.6 115.1 808.1 615.6Q
111111.11111111:
GPR109A 131.7 4123.4 1185.8 1111:
GPRCSA 39.6 421.2 251.8WW106
RAI3 24.4 212.5 117.6
LPAR2 32.4 221.4
LPAR3 129.6 660.7
RGS16 R6516 387.9 372.6
RN01 1.6 11
RN03 157 806.7
GPR84 1 65.4
GNAS —1 267.2
LPAR2 12.3 94.5
KRT161 150 8.2 1w
HAS1 22.7 939.7 1378.5 11:11
SPRR2G 1.8 70 11.3 1 9.6 817.1 19.2§\\\\\\
PCDH1O 1 38.4 7.4 .11.11 -0.9 89 90.9&\\\\
PCDH10 -1.4 9.9 11.2 9 9
Table 2
PCDHA7
PCDHBS
AM|G02
CATNAL1
479_9 \fl
COL5A2
\\\\\
Table 2
H868T1 395.4 1824.5 349
ITGA2 5.6 49.3 13.1
ITGAS 157.4 332.9 164
ITGA6 1 9 4.1
ITGAD 1.5 3 —0. 2.1 18.2 —5.4§§\\\\\\
ITGAE 1 10 8.4 10.0
ITGAV 59.2 172.4
ITGB2 2.7 53.1 8 19.7
ITGB6 180 620.7
ITGB6 1253.2 3474.8
ITGB6 513.8 1370.7
ITGP 1 10.6
KRT14 254.8 1063
KRT1-5 1 18.6 -2.1 18.6
KRT16 1 150 1.2 148 16
K8723 679.4 4234.8
KRT36 6.5 60.5
K8717 7.7 103.2 65.5 13.4
KRT33B -1.8 7.9 0.8 7.9
K8735 -4.4 12.1 85.9 12.1
K8782 -0.6 18.2 3.6 18.2
K8784 0.8 8.1 20.4 8.1
K8786 -1.7 12.9 4.6 12.9
6-5 0.3 14.1 34.6 14.1
KRTAP3-2 -2.7 7.9 -5.9 7.9
KRTAP9-1 —1 7.7 49 7.7
KRTDAP 19.2 157.7 258.3 8.2
10x14 2.7 21.6 7.6
SPRRZD 6.1 1052.3 -0.1 1.1 3215.9 14.1
SPRRZE 1 245.5 -8.1 —1.9 772.1 —4.5
SPRRZF 14.4 137.8 9.1 9.6 5.9 2404.5 45.6
SPRRZG 1.8 70 11.3 a 9.6 817.1 19.2&
CDCP1 5.8 43.7 21875
AMICAl 22.2 372.2 455 16.8
CDH2 10.2 74.1 10.8 7.3
10x14 43 469.9 373.6 10.9
NRXN2 6.5 78.9 153 12.1
Emfi‘fiifilf 388838333 8383838288838
VCAM1 5.4 68.1 34.9 0.8 45 -6.6
VCAM1 637.4 4462.9 3422.1 0.9 14.9 9.4
ICAM1 329.6 7607.4 4220.4 256.4 2069.1 705.5
SELP 36.5 225.9 1068. 28 756.9
. 2978.1§
SELL 4.3 10 6.6 8.8 84.1 26.8 9.6
CEACAMl 12 137.2 72.8 11.4
CEACAMl 42.4 303.9 59.4 7.2
CEACAM2 50.4 408.1 22 8.1
REL 1 132.3
NFKBIZ 147.6 6159.8
NFKBID 40.9 1493.2
IKBKE 90.1 569
NFIB 3.5 9
NFKB1 20.5 151.3 7.4 69.9 144§\\\\\\
NFKB1 561.3 2247 840.7;
NFKB2 1 6.8 -0.5§
NFKBIA 630 11386.8 6795.9 18.1 18.1 301.2 226.9
NFKBIA 27.7 338.8 182.1 12.2
NFKBIB 19.8 200.7 46.8 10.1 17.9 264.1 221.6
NFKBID 40.9 1493.2 362.5 2 27.8 399 248.8
NFKBIE 8.1 180.2 29.6 22.2 60.2 536 169.6
NFKBIE 60.2 731.7 136 12.2 164.2 3145.7 2250.7
NFKBIZ 147.6 6159.8 2878.9;
REL 1 132.3 263
RELA 5
1948.7 4768.8 2897
RELB 106.2 1265.6 336
HSPA1A 64.7 744.8
HSPA1A 35.2 239.8
HSPA1A 1469.1 5421.2 g
HSPA1 B 22.6 227.3 22.7 10.1
HSPA1 B 135 1184.7 193.7 8.8
HSP90AA1 6.6 49.3 77.1 7.5
HSPA14 -11.8 8 -3.9 8.0
HSPBB -0.4 19.8 44.3 19.8
c0x4|2 22.2 236.9 358.2 10.7
LTB4R1 28.9 222 363.3 7.7
NKIRASl 14.9 135.5 189.4 9.1
RIPK2 79.7 819.8 ::::::::::::::lQ-:3
:mmmgw:
KCNE2 | 1.8 68.8
MCOLN2 12.8 42.3 7.2 108.2 7.9
0ch 33.1 66.2 10.2 116.5 193.5k
CL|C4 121.4 459
CLIC6 33.9 494.6 73.1..-.
CACNAlF 1 10 4.1
CACNG3 -8.9 9.4 -0.8 .
CACNGS -1.6 16.1 47.9 16.1
CACNG6 1 13 7.9 13.0
CLCA3 5.3 46.1 -4.1 8.7
CLCN3 1.3 10.7 -2.6 8.2
CLCNKA -0.8 7.3 5.3 7.3
CLIC6 33.9 494.6 73.1 14.6
Table 2
KCNAlO
KCNA7
KCNABl
KCNC2
KCNDZ
KCND3
KCNElL
KCNH4
KCNJl
KCNK13
KCNK15
KCNK9
KCNQ2
KCNQ2
KCNQ5
KCNS3
SCN2A1
SCN8A
SCNMl
SCNMl
TPCNl
MCOLN2
Table 2
RANBP3L
RANGAPl
CDGAP
IRGC
RAB20
RAB32
RHOF
RABl
RABlB
RAB3B
RAB3|P2—PEND
RABSB
RAB7
RAPlA
RASALl
RASGEFlA
RASGRPl
RASSFlO
RASSF4
RASSF6
RASSF9
ARHGAPlS
ARHGAP25
ARHGAPS
ARHGEFl
ARHGEF7
We “L.
>¢Ax 3
E“? $§KE€§E§$“ '
SERPINASF . . . \\\\-~
SERPINASG . . .
SERPINA3H . . .
i \v“ SERPINASN .
B1A .
SERPINB2
SERPINA12
SERPINAlC
SERPINA3G
SERPINA3M
SERPINB3B
SERPINEZ
SERPINFZ
CST6
STFAl
Table 2
SLClOAS . . . 27.5
SLC10A6
SLC10A6 \
SLC1 1A2 .
SLC1 1A2
SLC12A1 14.1
SLC12A2 . . . 7.4
SLC13A3 . 7.8
SLC14A2 . 29.0
SLC15A3 \N.
SLC16A3
SLC1 6A5
SLC1 6A9 E ' \\\\““at; “A k a V‘}
SLC17A3
SLC17A6
SLC1 A4
SLC25A25
SLC2A6
SLC22A6
SLC22A9
SLC24A5
SLC25A2
SLC25A34
SLC25A4
SLC25A4O
SLC25A4O
SLC26A4
SLC26A7
SLC29A4
SLCZAZ
SLC2A6
SLC3OA3
SLC3OA4
SLC34A2
SLC35F4
SLC36A3
SLC38A1
SLC38A2
SLC39A8
SLC39A8
SLC45A3
SLC39A4
SLC39A5
SLC3A2
SLC45A2
Table 2
SLC4A1
SLC4A4
SLC5A1
SLC5A10
SLC5A2
SLC6A12
SLC6A15
SLC6A16
SLC6A2
SLC6A4
SLC7A11
SLC7A2
SLC7A9
SLC8A2
SLC9A6
SLC01A5
SLCO4A1
SLCO6B1
OLFRl
OLFR100
OLFR1000
OLFR101
OLFR1015
OLFR1024
OLFR1040
OLFR1042
OLFR1048
OLFR1056
OLFR1061
OLFR1065
Table 2
OLFR1085
OLFR1102
OLFR1109
OLFR1112
OLFR1129
OLFR113
OLFR113O
OLFR1133
OLFR1138
OLFR1148
OLFR115
OLFR1170
OLFR1176
OLFR1178
OLFR1181
OLFR1186
OLFR1198
OLFR120
OLFR1223
OLFR1232
OLFR1249
OLFR1250
OLFR1260
OLFR1288
OLFR1309
OLFR1320
OLFR1323
OLFR1331
OLFR1333
OLFR1337
OLFR1344
OLFR1347
OLFR1348
OLFR1349
OLFR1361
OLFR1384
OLFR139O
OLFR1406
OLFR1412
OLFR1424
OLFR1437
OLFR1443
OLFR1444
OLFR1453
OLFR1474
Table 2
OLFR1475
OLFR148
OLFR1489
OLFR1508
OLFR1513
OLFR159
OLFR165
OLFR166
OLFR167
OLFR168
OLFR168
OLFR171
OLFR176
OLFR192
OLFR26
OLFR262
OLFR27O
OLFR272
OLFR293
OLFR31
OLFR312
OLFR351
OLFR362
OLFR376
OLFR380
OLFR415
OLFR429
OLFR432
OLFR434
OLFR458
OLFR464
OLFR467
OLFR470
OLFR478
OLFR48
OLFR486
OLFR49O
OLFR5
OLFR510
OLFR516
OLFR517
OLFR524
OLFR525
OLFR530
OLFR535
OLFR536
Table 2
OLFR538
OLFR558
OLFR56
OLFR566
OLFR57
OLFR578
OLFR597
OLFR606
OLFR616
OLFR618
OLFR619
OLFR62
OLFR630
OLFR638
OLFR639
OLFR64
OLFR654
OLFR658
OLFR659
OLFR665
OLFR677
OLFR681
OLFR691
OLFR692
OLFR698
OLFR702
OLFR710
OLFR716
OLFR722
OLFR725
OLFR731
OLFR744
OLFR748
OLFR76
OLFR761
OLFR781
OLFR786
OLFR796
OLFR812
OLFR816
OLFR821
OLFR824
OLFR826
OLFR828
OLFR829
OLFR851
Table 2
OLFR855
OLFR868
OLFR869
OLFR871
OLFR872
OLFR881
OLFR906
OLFR910
OLFR912
OLFR917
OLFR951
OLFR974
OLFR976
OLFR98O
OLFR983
OLFR987
OLFR99
OLFR995
WM? 31:“? ’1
V1RA2
VlRBQ
V1RC10
V1RC8
V1RD12
V1RD2
V1RD20
V1RD3
V1RE12
V1RE13
V1RF3
V1RG3
V1RH13
V1RH21
v1m1
V1RJ3
VlRLl
Sismifix..- u
CHSTll
ASPN
Table 2
PCDHlO
PCDHlO
PCDHAll
PCDHA7
PCDHA7
PCDHB6
PCDHGAlO
PCDHGB6
PCDHGB7
PCDHGB8
Table 2
PRL2C2 -3.4 20.1 6.9 20.1
PRL2C3 -3.5 8.2 21.6 8.2
PRL3D3 1 10.7 40.5 10.7
PRL4A1 -5.4 7.6 —2.5 7.6
PRL7A2 -6.8 7.6 —5.3 7.6
Pmiagiifi § § ‘
PRLR 22.5 173.6 257.9 7.7
"NNN {Nd TNNWNNN 8.3
TNF 1 854.3 94.3 0.5 21.4 4.2
TNF 3 1170.4 143.3 390.1 -4.2 9.3 17.7
T\FA|P2 685 9076.5 1738.9 13.3
T\FA|P2 951.4 10471.8 2463.2 11.0
T\FA|P2 1876.9 15829.8 5120 8.4
T\FA|P3 42.3 2753.3 1202.9 0.5 21.4 4.2
TNFSFlO -4.6 40.8 111.2 40.8
T\FRSF1OB 20 104.7 28.5 5.2 -4.2 9.3 17.7
T\FRSF1OB 12.1 41.2 21.9 3.4 -4.1 21.7 —5.7k
T\FRSF12A 307.7 1962.6 1503 6.4
T\FRSF1B 19.7 62.1 36.3 3.2
T\FSF11 4.5 66.1 35.1 14.7
T\FSF12—TNF 2.6 20.4 10.3 7.8
TNFSF13B -0.9 7.2 1.2 7.2
4 4.3 29.5 74 29.5
TNKS 3 84.9 116.2:::::::::::::::28.:3
TNFSF9
TN|P1 9.4 40.4
TN|P1 149.9 601.5
TRAF1 12.6 52.6
TRAFG 37.9 96.8
BATS 104 898 31386
\NQNN § 3“ 888.3 NM“
NR4A2 8.1 97.3 97.2 12.0
NR4A3 1 30.7 25.5 7
NR4A3 1 28.9 23.8 28.9
Table 2
QfififlgfifiQS
VAVl
umpmm
ERAF
HA may: :wfhd§wmshw
Al987692
AIM1 L
AKAP1
AKAP12
AKAP2
AKAP2
AKAP2
AKAP4
AKAP8
AKR1BB
AMD2
ANGPTL4
ANKRD1
ANKRD1
Table 2
ARG1
ATP10D
AXUD1
B230378H13R
BACH1
BCAR3
BDH1
C330006D17R
6P03R
C730046CO1R
CCDC155
CCDC21
CCDC49
CCDCBSB
CCDC89
CCDCQQ
CCT7
CDCSL
CDCA4
CDCA5
CLN5
000108
000108
CTPS
CYR61
DGAT2
DONSON
DONSON
ERRH1
Table 2
GTLFSA 40.6
HDC 137.9
HP 508.4
HP 334.8
HP 938.3
IDS 21.8
IHH 23.2
|NSl 11.8
|NS|G1 217.4
|NS|G1 221.6
INSR 8.7
14.1
48.6
13.6
57.5
16.3
49.4
KLH L25 383.8
LDLR 136.3
LPK 50.6
IVARCKSL1 162.6
MARCO 11.9
IVA—2A 107.7
IVA"2A 412.6
IVA—2A 173.3
IVA"2A 5883.3
IVA"N4 6.8
|VCM10 9.3
IVCM1O 42.9
IVCOLN2 42.3
MFSD2 1933.3
|V|D1 48.5
|VOBKL1A 2.9 15.9
|VOBKL2A 79 209.2
lVOGAT2 22.2 72.5
lVOGAT2 6.7 16
1 3 21.8
IVRGPRAZ 5.5 20.2
11776.7 23326.9
45.3 178.4
MTMR14 59.2 173.6
MTMR14 50.8 118.4
MVD 423.3 1508.7
MYBBP1A 97.9 191.9
MYD116 256.8 1849
MYOM2 4.2 27.9
Table 2
NFXU
NFYA
NGFB
NGFB
NHLRCS
NLE1
NOC3L
NOL1
NRG1
NRP3
NSUN5
NUAK2
NUPR1
OASL1
OASL1
PCDH1O
PDE4A
PDE4B
PDE4B
PDE4B
PDE6G
PDGFB
PDGFB
PEU1
PEUB
PHLDA1
HK3C2A
PLCXD3
PLEK
PLEKHG2
PLEKHG2
PMAP1
PMAP1
PMP22
POF1B
PPAN
PRDM2
PRDM2
PRR7
PRSSZ2
PRSSZB
PRSSZ7
PTGES
PTGES
PTGFRN
PTPN12
PTPN12
PTPN12
PTPN12
PTPN2
RAMP3
RCAN1
RDH10
RCAN1
RDH10
RETNLG
RRP1B
RUNX1
SBNO2
SGK1
SHSBP2
SNAB
SNFlLK
SPSB1
ST3GAL1
STK35
SYNGRZ
TAC1
TAL1
TAX1BP3
TBC1D1OA
TBC1D1OA
TGF1
TGM1
THBS1
'HMP1
TREX1
TR|M21
TR|M27
TRPV4
TRPV4
TSSK6
TTCSQB
UPP1
VPS3YB
VVDR4
VVDR43
VVDR46
VVDRTO
VVDR82
VVDR92
VVNT1OB
Table 2
VVNT7B 3534
VVSB1 12897
YBX3 175592
ZFP295 30.4
ZFP36 66829
ZFP57 6&7
ZFP607 1145
ZSMHM4 6567
ARMCl
CHD7
CHKA
EEF1A2
FABPS
FBN1
FFARZ
Table 2
SLAM F8
SPINK8
T| MELESS
Table 2
ATG4D
ATP50
BACE2
BNPl
CALCA
CH25H
CRYBG3
DDAHl
EPSTIl
GNGlS
LOC100047934
047963
LOC100048556
LOC638301
NEK6
OSMR
PCNP
SCL0002368.1
STFAl
STFAZ
APOLD1
30037703
CH25H
Table 2
-7.6
\1 671.7 .§\\ th Mr. \\\\V§$:&$&N\\\\\\‘
PSORS102
A630077B13R
A230065H1 6R
1190003J15R|
1500041 J02R|
2310014HO1R
2310016C08R
2310016008R
2210008FO6RI
AI607873
A|987692
AIM-1 L
231 00141.101 RIK
2310016008R|K
2310016C08R|K
2310025JO1R|K
2310051F22RIK
2410025L10R1K
2810402K13R|K
2E14RIK
5033413D16R|K
5530400801 RIK
583045701 OHIK
9930023K05RIK
9930122J16R|K
A130051J06RIK
A130082|\/|07RIK
5H16R|K
L0C10004623
Table 2
LOC1 0004726
LOC1 0004733
LOC1 0004777
LOC1 0004793:
LOC10004855
LOC1 0004855
LOC212399
LOC381 140
LOC638301
D17H6856E-3
D17H6856E-5
D330008|21R|1
D7BWG061 1 E
D930038018R
D930039D09R
Claims (23)
1. Use of a Toll-Like Receptor (TLR) agonist for the manufacture of a medicament for the treatment of cancer in a , n the cancer is present in a tissue that expresses TLR5, the TLR agonist comprising an amino acid sequence of at least 95% identity with SEQ ID NO:
2. The use of claim 1, wherein the cancer is a metastatic.
3. The use of claim 1 or 2, wherein the cancer does not express TLR.
4. The use of any one of the preceding claims, n the tissue is ed from the group consisting of liver, lung, bladder, and intestinal.
5. The use of any one of claims 1 to 4, wherein the cancer is ed from the group consisting of melanoma, colon, breast, prostate, and a hematological malignancy.
6. The use of any one of claims 1 to 5, wherein the cancer is a tumor.
7. The use of claim 5, wherein the hematological malignancy is lymphoma.
8. The use of any one of claims 1 to 7, wherein the medicament is used as a monotherapy.
9. The use of any one of claims 1 to 8, wherein the mammal is not receiving a combination cancer therapy.
10. The use of claim 9, wherein the mammal is not receiving chemotherapy or radiation therapy.
11. The use of any one of claims 1 to 10, wherein the mammal has sufficient innate immunity.
12. The use of claim 11, wherein the sufficient immunity level is equivalent to the level required for eligibility for a first or subsequent round of chemotherapy.
13. The use of claim 11 or 12, wherein the mammal has a white blood cell count that is within the range of clinically normal.
14. Use of a Toll-Like Receptor (TLR) agonist for the cture of a ment for the treatment of cancer in a mammal, wherein the cancer is present in a tissue that expresses TLR5, the TLR agonist comprising the amino acid sequence of SEQ ID NO: 8.
15. The use of claim 15, wherein the cancer does not express TLR.
16. The use of claim 14 or 15, wherein the tissue is selected from the group consisting of liver, lung, r, and intestinal.
17. The use of any one of claims 14-16, n the cancer is ed from the group consisting of melanoma, colon, breast, prostate, and a hematological malignancy.
18. The use of claim 4, wherein the tissue is liver.
19. The use of claim 18, wherein the cancer is metastatic colon cancer.
20. The use of claim 18, wherein the cancer is metastatic lymphoma.
21. The use of claim 16, n the tissue is liver.
22. The use of claim 21, wherein the cancer is metastatic colon cancer.
23. The use of claim 21, wherein the cancer is metastatic lymphoma.
Applications Claiming Priority (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US201161431313P | 2011-01-10 | 2011-01-10 | |
| US61/431,313 | 2011-01-10 | ||
| PCT/US2012/020844 WO2012097012A1 (en) | 2011-01-10 | 2012-01-10 | Use of toll-like receptor agonist for treating cancer |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| NZ612615A NZ612615A (en) | 2015-08-28 |
| NZ612615B2 true NZ612615B2 (en) | 2015-12-01 |
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