Drug – bio-affecting and body treating compositions – Designated organic active ingredient containing – Carbohydrate doai
Reexamination Certificate
1999-09-10
2001-06-12
Jarvis, William R. A. (Department: 1614)
Drug, bio-affecting and body treating compositions
Designated organic active ingredient containing
Carbohydrate doai
C514S056000, C514S059000, C514S062000
Reexamination Certificate
active
06245751
ABSTRACT:
BACKGROUND OF THE INVENTION
The present invention relates generally to a method for treating diseases associated with toxicity of Apolipoprotein E (“apoE”). Specifically, the present invention is a new method for treating a mammal having a condition associated with toxicity of apolipoprotein E cleavage fragments containing residues 130-169, comprising administering to said mammal a pharmacologically effective amount of compound or a pharmaceutically acceptable salt, derivative or fragment thereof to interfere with generation of the cleavage fragment or with the receptor-binding site associated with the cleavage fragment containing residues 130-169 of the apolipoprotein E molecule in said mammal.
Alzheimer's disease is the most common form of both senile and pre-senile dementia in the world and is recognized clinically as relentlessly progressive dementia that presents with increasing loss of memory, intellectual function and disturbances in speech (Merritt, 1979
, A Textbook of Neurology
,. 6th edition, pp. 484-489 Lea & Febiger, Philadelphia). The disease itself usually has a slow and insidious progress that affects both sexes equally, worldwide. It begins with mildly inappropriate behavior, uncritical statements, irritability, a tendency towards grandiosity, euphoria and deteriorating performance at work; it progresses through deterioration in operational judgment, loss of insight, depression and loss of recent memory; it ends in severe disorientation and confusion, apraxia of gait, generalized rigidity and incontinence (Gilroy & Meyer, 1979
, Medical Neurology
, pp.175-179 MacMillan Publishing Co.) Alzheimer's disease afflicts an estimated four million human beings in the United States alone at a cost of 35 billion dollars a year (Hay & Ernst, 1987
, Am. J. Public Health
, 77: 1169-1175). It is found in 10% of the population over the age of 65 and 47% of the population over the age of 85 (Evans et al., 1989, JAMA, 262:2551-2556). In addition, the disease is found at much lower levels in the younger age groups, usually beginning at about 30 years of age and even rarely in late childhood (Adams & Victor, 1977
, Principles of Neurology
, pp. 401-407).
The etiology of Alzheimer's disease is unknown. Evidence for a genetic contribution comes from several important observations such as the familial incidence, pedigree analysis, monozygotic and dizygotic twin studies and the association of the disease with Down's syndrome (for review see Baraitser, 1990
, The Genetics of Neurological Disorders
, 2nd edition, pp. 85-88). Nevertheless, this evidence is far from definitive and it is clear that one or more other factors are also required.
In recent years, research has suggested that apolipoprotein E (“apoE”) plays a potential role in the pathogenesis of Alzheimer's disease. Apolipoprotein E performs various functions as a protein constituent of plasma lipoproteins, including its role in cholesterol metabolism. It was first identified as a constituent of liver-synthesized very low density lipoproteins (“VLDL”) which function in the transport of triglycerides from the liver to peripheral tissues. ApoE is instrumental in lipoprotein metabolism in several ways. Mahley, et al.,
J. Lipid Res
., 25:1277-1294 (1984). It is a recognition site for several cellular lipoprotein receptors, including hepatocyte receptors for chylomicron and VLDL remnants Hui, et al.,
J. Biol. Chem
., 259:860-869 (1984); Shelburne, et al.,
J. Clin. Invest
., 65:652-658 (1980).
ApoE-enriched lipoproteins have also been described to have a function in the immune system by inhibiting mitogen-or antigen-stimulated lymphocyte proliferation in vitro and in vivo. In the ovary, apoE inhibits androgen production by LH-stimulated cultured theca and interstitial cells; Dyer, et al.,
J. Biol. Chem
., 263:10965 (1988).
Further substantiation that apoE and apoB-containing lipoproteins are important regulators of lymphocyte function has come from studies of the inhibitory properties of fetal cord blood plasma lipoproteins (Curtiss, et al.,
J. Immunol
., 133:1379 (1984)). In these studies a direct correlation between apoE and inhibition was established.
There are three major isoforms of ApoE, referred to as ApoE2, ApoE3 and ApoE4 which are products of three alleles at a single gene locus. Three homozygous phenotypes (Apo-E2/2, E3/3, and E4/4) and three heterozygous phenotypes (ApoE3/2, E4/3 and E4/2) arise from the expression of any two of the three alleles. The most common phenotype is ApoE3/3 and the most common allele is E3. See Mahley, R. W.,
Science
240:622-630(1988).
The amino acid sequences of the three types differ only slightly. ApoE4 differs from ApoE3 in that in ApoE4 arginine is substituted for the normally occurring cysteine at amino acid residue 112. The most common form of ApoE2 differs from ApoE3 at residue 158, where cysteine is substituted for the normally occurring arginine. See Mahley,
Science
, supra. ApoE phenotypes and genotypes are well described and known in the art as described above. The established nomenclature system as well as the phenotypes and genotypes for ApoE, are described in, for example, Zannis, et al., J. Lipid. Res. 23:911 et seq. (1982), which is incorporated by reference herein.
Subjects with the ApoE4/4 genotype are as much as eight times as likely to be affected by Alzheimer's disease as subjects with the ApoE2/3 or ApoE3/3 genotypes. Further, the average age of onset of Alzheimer's disease and the average age of survival is lower for those having one ApoE4 allele, and lowest for those having two ApoE4 alleles. Thus, a subjects prognosis for Alzheimer's disease is more likely to be negative if the subject has an ApoE4 allele and most negative if the subject has more than one ApoE4 allele. The negative prognosis can be viewed in terms of increased likelihood of developing the disease, or of dying at an earlier age. Other ApoE-linked diseases include type III Hyperlipidemia and atherosclerosis.
Studies have shown that apoE fragments ranging from 5 to 22 kD are present in the post-mortem cerebral spinal fluid from both control patients and patients with AD. The only major band immunoprecipitated by a monoclonal antibody that recognizes the putative toxic domain runs with an apparent molecular weight of about 22 kD. This fragment likely corresponds to the major thrombin cleavage product, which has been shown to be protease-resistant. Weisgraber, et al.,
J. Biol. Chem
. 258:12348-54 (1983).
Amino acids 130-169 in human apoE encompass an immunoregulatory domain with both cytostatic and cytotoxic activities against IL2-dependent T cells. This finding is consistent with results of previous studies (Cardin, et al., 1988; Dyer, et al., 1991) that implicated residues 141-155 in apoE's antiproliferative effect on naive mitogen-activated T cells. The similar potencies of E130-149 and E130-155 indicate that the cytostatic domain is located within residues 130-149. However, a longer peptide representing residues 130-169 and dimeric peptides of amino acids 141-155 also have potent cytotoxic activity. These results indicate that the positively charged, leucine-rich sequence, corresponding to amino acids 141-149 (Leu-Arg-Lys-Leu-Arg-Lys-Arg-Leu-Leu; referred to as LRKLRKRLL in single letter amino acid shorthand; SEQ. ID. No:1) in the mature protein which represents the overlap between the functional peptides identified, is responsible for both the cytostatic and cytotoxic effect. Clay et al.,
Biochemistry
34:11142-51 (1995). When tested against primary neurons in culture, these peptides were also found to elicit degeneration of neurites.
Purified apoE, derived from transfected HEK cells, subjected to thrombin cleavage and separated using gel filtration to collect the 22 kD fragment, yields enhanced toxicity when tested against primary neurons in culture. The 22 kD fragments purified from the E4 isoform is more toxic than E3derived fragments. The putative toxic site is closely associated with one of two well-characterized heparin binding domains assoc
Crutcher Keith A.
Harmony Judith A. K.
Jarvis William R. A.
Kim Vickie
University of Cincinnati
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