CA2758390A1 - Stem cell targeting with dock-and-lock (dnl) complexes - Google Patents

Abstract

Disclosed herein are compositions and methods of use of dock and lock (DNL) complexes comprising a first antibody or fragment that binds to a stem cell antigen and a second antibody or fragment thereof that binds to an antigen on a diseased or damaged tissue or organ. The DNL complexes are of use for targeting stem cells to diseased or damaged organs or tissues and may be used to treat a variety of diseases or conditions that are responsive to stem cell therapy.

Description

DEMANDES OU BREVETS VOLUMINEUX

LA PRESENTE PARTIE DE CETTE DEMANDE OU CE BREVETS
COMPREND PLUS D'UN TOME.

NOTE: Pour les tomes additionels, veillez contacter le Bureau Canadian des Brevets.

JUMBO APPLICATIONS / PATENTS

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THAN ONE VOLUME.

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STEM CELL TARGETING WITH DOCK-AND-LOCK (DNL) COMPLEXES

CROSS-REFERENCE TO RELATED APPLICATIONS

[001] This application is a continuation-in-part of U.S. Patent Application Serial Nos.
13/219,940, filed 8/29/11, (which was a divisional of U.S. Patent 8,034,352);
13/209,954, filed 8/15/2011; 13/178,092, filed 7/7/11, (which was a divisional of U.S.
Patent 8,003,111);
13/150,613, filed 6/1/11, (which was a divisional of 12/644,146, filed 12/22/09, which was a divisional of U.S. Patent 7,666,400); 13/086,786, filed 4/14/11; 13/036,820, filed 2/28/11;
13/021,302, filed 2/4/11, (which was a divisional of U.S. Patent 7,906,121, which was a divisional of U.S. Patent 7,534,866); 13/012,977, filed 1/25/11, (which was a divisional of U.S. Patent 7,906,118); 13/010,993, filed 1/21/11 (which was a divisional of U.S. Patent 7,901,680); 13/004,349, filed 1/11/2011; 12/968,936, filed 12/15/10, (which was a divisional of U.S. Patent 7,871,622, which was a divisional of U.S. Patent 7,521,056);
12/964,021, filed 12/9/10; 12/949,536, filed 11/18/10, (which was a divisional U.S. Patent 7,858,070, which was a divisional of U.S. Patent 7,527,787); 12/915,515, filed 10/29/10;
12/871,345, filed 8/30/10; 12/869,823, filed 8/27/10; 12/754,140, filed 04/05/10; 12/754,740, filed 4/6/10; and 12/468,589, filed 05/19/09, (which was a divisional of U.S. Patent 7,550,143).
Those applications claimed the benefit under 35 U.S.C. 119(e) of provisional U.S.
Patent Applications 61/508,871, filed 7/18/11; 61/414,592, filed 11/17/10;
61/378,059, filed 8/30/10;
61/374,751, filed 08/18/10; 61/374,449, filed 8/18/10; 61/374,722, filed 08/18/10;
61/324,111, filed 4/14/10; 61/323,960, filed 4/14/10; 61/323,001, filed 4/12/10; 61/316,996, filed 3/24/10; 61/302,682, filed 2/9/10; 61/293,846, filed 1/11/10;
61/267,877, filed 12/9/09;
61/266,305, filed 12/3/09; 61/258,729, filed 11/6/09; 61/258,369, filed 11/5/09; 61/238,424, filed 8/31/09; 61/238,473, filed 8/31/09; 61/168,715, filed 4/13/2009;
61/168,668, filed 4/13/2009; 61/168,657, filed 4/13/2009; 61/168,290, filed 4/10/2009;
61/166,809, filed 4/6/2009; 61/163,666, filed 3/26/2009; 61/119,542, filed 12/3/2008;
61/104,916, filed 10/13/2008; 61/090,487, filed 8/20/2008; 61/043,932, filed 4/10/2008;
60/864,530, filed 11/6/2006; 60/782,332, filed 3/14/2006; 60/751,196, filed 12/16/2005;
60/728,292, filed 10/19/2005; 60/668,603, filed 4/6/2005; each priority application incorporated herein by reference in its entirety.

FIELD OF THE INVENTION

10021 The present invention concerns compositions and methods of use of dock-and-lock (DNL) complexes for targeted delivery of stem cells or stem cell substitutes.
The stern cells are of therapeutic use for treating a variety of diseases or other medical conditions, such as Alzheimer's disease, Parkinson's disease, stroke, amyotrophic lateral sclerosis (ALS), muscular dystrophy, cardiovascular disease (e.g., congestive heart failure, myocardial infarction, coronary artery disease, cardiomyopathy), type 1 or type 2 diabetes, liver degenerative diseases (e.g., cirrhosis, steatosis, cholestasis, Wilson's disease, hepatitis B, hepatitis C, liver toxicity), macular degeneration, osteoarthritis, autoimmune disease (e.g., Crohn's disease, Huntington's disease, celiac disease), graft-versus-host disease, hematopoietic disorders (e.g., leukemia, lymphoma, sickle cell anemia), organ failure, burns and other trauma (e.g., spinal cord injuries). The DNL complexes preferably have a first binding specificity for an antigen expressed on a therapeutic stem cell and a second binding specificity for an antigen expressed by a tissue or organ that is targeted for stem cell therapy. The DNL
complex improves localization, retention and integration of the stern cells in the targeted organ or tissue.

BACKGROUND

[003] Stem cell therapy has been proposed for treating a variety of disease states or medical conditions, such as myocardial infarction (Zhao et at., 2008, J App! Physiol 104:1793-800), spinal cord injury (Liu et al., 2011, Neurol Res 33:686-93), ALS (Lepore &
Maragakis, 2011, Methods Mol Biol 793:479-93), muscular dystrophy (Expert Opin Biol Ther 11:157-76), Parkinson's disease (Azizi et at., 1998, Proc Natl Acad Sci USA 95:3908-13), Huntington's disease (Dinsmore et al., 1996, Cell Transplant 5:131-43), type 1 diabetes (Assady et al., 2001, Diabetes 50:1691-97), graft-versus-host disease (GVHD) (Taupin, 2006, Curr Opin Investig Drugs 7:473-81), Crohn's disease (Taupin, 2006, Curr Opin Investig Drugs 7:473-81) chronic obstructive pulmonary disease (Ribeiro-Paes et al., 2011, Int J Chron Obstruct Pulmon Dis 6:63-71), macular degeneration (Du et al., 2011, Semin Ophthalmol 26:216-24), osteoarthritis (Pak,

2 = CA 02758390 2011-11-14 2011, .1 Med Case Reports 5:296), autoimmune disease (Zcher et al., 2011, Expert Opin Biol Ther 11:1193-201) and organ failure (Russo & Parola, 2011, Cytotherapy 13:135-44).
10041 Administration of stem cells for treating such diseases typically involves delivery by injection at or near a target site (see, e.g., Boudoulas and Hatzopoulos, 2009, Dis Model Mech 2:344-58; Azizi et at., 1998, Proc Natl Acad Sci USA 95:3908-13). However, injection or infusion of stem cells may not result in significant levels of retention and engraftment at the target site (Gundlach et at. 2011, Bioconj Chem 22:1706-14). Direct injection may also affect the frequency of teratoma formation, an undesirable side effect of stem cell administration (see, e.g., Gutierrez-Aranda et al., 2010, Stem Cells 28:1568-70). A need exists for more effective delivery of stem cells to targeted locations, with better retention and engraftment in the target tissue or organ.
10051 One approach to improved stem cell delivery involves use of bispecific antibodies with a first binding site for a stem cell antigen and a second binding site for a target tissue antigen (Lum et al., 2004, Blood Cells Mol Dis 32:82-7; Lum et al., 2006, Exp Hematol 34:1-6; Lee etal., 2007, Stem Cells 25:712-17; Zhao etal., 2008, J App! Physiol 104:1793-800;
Gundlach etal.
2011, Bioconj Chem 22:1706-14). Such bispecific antibodies would serve to localize the stem cell to the tissue targeted for therapy and improve retention at the target site to promote integration into the tissue. Gundlach et al. (2011) used anti-myosin light chain 1 (MLC I) x anti-CD90 bispecific antibodies to target bone marrow-derived multipotent stromal cells (BMMSC) to damaged tissue in infarcted myocardium. The bispecific antibody was reported to promote BMMSC binding to immobilized MLC I in vitro. ,However, no studies were performed to demonstrate localization, retention and integration in vivo. Lee et al. (2007) used a bispecific anti-MLC x anti-CD45 antibody to target hematopoietic stem cells (HSCs) to ischemic myocardium in rats. In the presence of bispecific antibody the CD34+ HSCs were localized to the infarcted region of the rat heart (Id.). Use of bispecific antibody was reported to improve delivery to stem cells to injured myocardium, compared to the absence of antibody, and was correlated with improved myocardial function 5 weeks after infarction (Id.).
Zhao et al. (2008) targeted HSCs to ischemic myocardium with an anti-CD45 x anti-MLC bispecific antibody in mice and reported improved ventricular function to control animals who received no HSCs.
Because of the absence of a control administration of HSCs in the absence of antibody, it was not possible to attribute the improved cardiac function to the bispecific antibody.

3 [6] Existing technologies for the production of bispecific antibodies suffer a number of limitations. For agents generated by recombinant engineering, such limitations may include high manufacturing cost, low expression yields, instability in serum, instability in solution resulting in formation of aggregates or dissociated subunits, undefined batch composition due to the presence of multiple product forms, contaminating side-products, reduced functional activities or binding affinity/avidity attributed to steric factors or altered conformations, etc.
For agents generated by various methods of chemical cross-linking, high manufacturing cost and heterogeneity of the purified product are two major limitations. A need exists in the art for improved bispecific antibody complexes for targeted stem cell delivery.

SUMMARY
[7] The present invention concerns compositions and methods of use of dock-and-lock (DNL) complexes for targeted stem cell delivery. The DNL complexes may comprise a first antibody or antigen-binding fragment thereof that binds to a stem cell antigen and a second antibody or fragment thereof that binds to an antigen expressed in an organ or tissue targeted for stem cell therapy. The DNL complex may comprise two, three, four, five, six or more subunits.
In addition to the first and second antibody or fragment thereof, the DNL
complex may comprise one or more other effector moieties, such as a cytokine, hormone, growth factor or additional antibody fragment. In preferred embodiments, the individual subunits are fusion proteins, each fusion protein comprising an anchoring domain (AD) moiety or a dimerization and docking domain (DDD) moiety. I lowever, in alternative embodiments the subunits may comprise AD or DDD moieties attached to effector moieties by other methods, such as chemical cross-linking, click chemistry conjugation, etc. Most preferably, the DDD moiety comprises the amino acid sequence of a dimerization and docking domain from a human protein kinase A
RN, RI13, RIIct or RIIII regulatory subunit protein, while the AD moiety comprises the amino acid sequence of an anchoring domain from an AKAP (A-kinase anchoring protein).
[8] Where the subject DNL complex comprises one or more antibodies and/or antibody fragments, these may be incorporated as naked antibodies, unconjugated to any therapeutic agent. Alternatively, the antibodies or fragments may be utilized as immunoconjugates, attached to one or more therapeutic agents. (For methods of making immunoconjugates, see, e.g., U.S.

4 Patent Nos. 4,699,784; 4,824,659; 5,525,338; 5,677,427; 5,697,902; 5,716,595;
6,071,490;
6,187,284; 6,306,393; 6,548,275; 6,653,104; 6,962,702; 7,033,572; 7,147,856;
and 7,259,240, the Examples section of each incorporated herein by reference.) [0091 In some embodiments, the antibody or fragment thereof may be a human, chimeric, or humanized antibody or fragment thereof. A humanized antibody or fragment thereof may comprise the complementarity-determining regions (CDRs) of a murine antibody and the constant and framework (FR) region sequences of a human antibody, which may be substituted with at least one amino acid from corresponding FRs of a murine antibody. A
chimeric antibody or fragment thereof may include the light and heavy chain variable regions of a murine antibody, attached to human antibody constant regions. The antibody or fragment thereof may include human constant regions of IgGI, IgG2a, IgG3, or IgG4. Human antibodies may be made by methods known in the art, as discussed below.
[0010] Antibodies or antigen-binding fragments thereof of use in the claimed methods and compositions may comprise antibodies against stem cell antigens. For example, CD34, CD38, CD45, CD117, CD133, CDCP1, c-kit, Thy-1, hSCF (hematopoietic stem cells);
SSEA3, SSEA4, Tra-1-60, Tra-1-81, alkaline phosphatase, CD30, TDGF-1, GCTM-2, SCF, c-kit (embryonic stem cells); CD44, CD90, CDCP1, bone morphogenetic protein receptor, Seal, c-kit, Thy-1 (mesenchymal stem cells); CD133, fetal liver kinase-1 (Flkl) (endothelial progenitor cells);
cytokeratin 19, ABCG2, CD133, Nestin, CD44 (hepatic stem cells), CD133, CDCP1 (neural stem cells). Such antibodies or fragments may be produced by standard techniques as discussed in more detail below. Alternatively, many such antibodies are known in the art and/or available from commercial sources (see, e.g., U.S. Patent Nos. 5,922,847; 7,541,030;
7,576,186; the examples section of each incorporated herein by reference; see also ATCC No.
HB 10716;
DSMZ (Deutsche Sammlung fur Mikroorganismen und Zellkulturen) Nos. DSM
ACC2569, DSM ACC2566, DSM ACC2565, DSM ACC2551; and anti-stem cell antibodies from Abgent, San Diego, CA).
100111 Other antibodies or fragments thereof of use may include antibodies against antigens expressed in target tissues or organs, such as myosin light chain (MLC) or VCAM1 (heart);
smooth muscle cell-specific myosin heavy chain, vascular endothelial cell cadherin (vascular smooth muscle); bone-specific alkaline phosphatase (BAP), hydroxyapatite, osteocalcin (bone);

type II collagen, type IV collagen, keratin, sulfated proteoglycan (cartilage); B-1 integrin (liver);
glial fibrillary acidic protein (GFAP), MAP-2, myelin basic protein (MPB), nestin, 01, 04, synaptophysin (neural tissue); cytokeratin 19, nestin, pancreatic polypeptide (pancreas); VCAM-1, ICAM-2, P63, E-selectin or IL-8 (damaged epithelium).
[0012] A variety of stem cells or stem cell substitutes have been proposed for therapeutic use, including hematopoietic stem cells (Zhao et at., 2008, J Appl Physiol 104:1793-800), embryonic stem cells (Doetschman et al., 1985, J Embryol Exp Morphol 87:27-45; Evans and Kaufman, 1981, Nature 292:154-56; Thomson et al., 1998, Science 282:1145-47), mesenchymal stem cells (Uccelli et al., 2008, Nat Rev Immunol 8:726-36), induced pluripotent stem (iPS) cells (Takahashi et al., 2007, Cell 131:861-72; Wernig et at., 2007, Nature 448:318-24; Okita et at., 2007, Nature 448:313-17), neural precursor cells (NPCs) (Lepore & Maragakis, 2011, Methods Mol Biol 793:479-93), hepatic stem cells (Yang etal., 2010, Gut 59:953-62);
somatic stem cells from human umbilical cord blood (Schira etal., 2011, Brain, Sept. 8 2011 Epub ahead of print) and bone-marrow-derived multipotent stromal cells (BMMSC) (Gundlach et at., 2011, Bioconjug Chem 22:1706-14). Methods for preparing various types of stem cells are disclosed in the publications cited above, as well as in the patent literature (see, e.g., U.S. Patent Nos.

5,922,847; 7,541,030; 7,576,186; 7,696,404; 7,704,739; the Examples section of each incorporated herein by reference). Certain types of stem cells may also be obtained from public or commercial sources (see, e.g., hESC BG01V, ATCC No. SCRC-2002, American Type Culture Collection; PROCHYMAL , Osiris Therapeutics; induced pluripotent stem cells, Fate Therapeutics; bone marrow stromal cells (MSC), Stemcell Technologies; hESC
lines H9, HI, AND 1, AND2, AND3, HS181, ECAT and iPSC lines MSHU-001, iAND4, CB-CD34+ iPSC1, CB-CD34+ iPSC2, The Spanish Stem Cell Bank, Valencia, Spain). Other sources of stem cells are listed at the International Consortium of Stem Cell Networks, such as the European Human Stern Cell Registry and the University of Massachusetts International Stem Cell Registry.
[00131 Also disclosed are methods for treating a disease or condition that include administering to a patient a DNL complex comprising a first antibody or antigen-binding fragment thereof that binds to a stem cell antigen and a second antibody or fragment thereof that binds to an antigen expressed by an organ or tissue targeted for stem cell therapy. The DNL
complex may be administered prior to, simultaneously with, or after administration of a therapeutic stem cell. In preferred embodiments, the disease or condition may be selected from the group consisting of

6 Alzheimer's disease, Parkinson's disease, stroke, amyotrophic lateral sclerosis (ALS), muscular dystrophy, macular degeneration, cardiovascular disease (e.g., congestive heart failure, myocardial infarction, coronary artery disease, cardiomyopathy), type 1 or type 2 diabetes, liver degenerative diseases (e.g., cirrhosis, steatosis, cholestasis, Wilson's disease, hepatitis B, hepatitis C, liver toxicity), macular degeneration, osteoarthritis, autoimmune disease (e.g., Crohn's disease, Huntington's disease, celiac disease), graft-versus-host disease, hematopoietic disorders (e.g., leukemia, lymphoma, sickle cell anemia), organ failure, burns and Other trauma (e.g., spinal cord injuries) and any other disease or condition that may be treated by administration of stem cells.

DETAILED DESCRIPTION
Definitions [0014] As used herein, the terms "a", "an" and "the" may refer to either the singular or plural, unless the context otherwise makes clear that only the singular is meant.
[0015] An "antibody" refers to a full-length (i.e., naturally occurring or formed by normal immunoglobulin gene fragment recombinatorial processes) immunoglobulin molecule (e.g., an IgG antibody) or an immunologically active (i.e., antigen-binding) portion of an immunoglobulin molecule, like an antibody fragment.
[00161 An "antibody fragment" is a portion of an antibody such as F(ab1)2, F(ab)2, Fab', Fab, Fv, scFv, single domain antibodies (DABs or VHHs) and the like, including half-molecules of IgG4 (van der Neut Kolfschoten etal. (Science 2007; 317(14 Sept):1554-1557).
Regardless of structure, an antibody fragment binds with the same antigen that is recognized by the intact antibody. The term "antibody fragment" also includes isolated fragments consisting of the variable regions, such as the 'Tv" fragments consisting of the variable regions of the heavy and light chains and recombinant single chain polypeptide molecules in which light and heavy chain variable regions are connected by a peptide linker ("scFv proteins").
[0017] A "chimeric antibody" is a recombinant protein that contains the variable domains including the complementarity determining regions (CDRs) of an antibody derived from one species, preferably a rodent antibody, while the constant domains of the antibody molecule are

7 derived from those of a human antibody. For veterinary applications, the constant domains of the chimeric antibody may be derived from that of other species, such as a cat or dog.
[00181 A "humanized antibody" is a recombinant protein in which the CDRs from an antibody from one species; e.g., a rodent antibody, are transferred from the heavy and light variable chains of the rodent antibody into human heavy and light variable domains. Additional FR amino acid substitutions from the parent, e.g. murine, antibody may be made. The constant domains of the antibody molecule are derived from those of a human antibody.
[00191 A "human antibody" is an antibody obtained from transgenic mice that have been genetically engineered to produce human antibodies in response to antigenic challenge. In this technique, elements of the human heavy and light chain locus are introduced into strains of mice derived from embryonic stem cell lines that contain targeted disruptions of the endogenous heavy chain and light chain loci. The transgenic mice can synthesize human antibodies specific for human antigens, and the mice can be used to produce human antibody-secreting hybridomas.
Methods for obtaining human antibodies from transgenic mice are described by Green et al., Nature Genet. 7:13 (1994), Lonberg etal., Nature 368:856 (1994), and Taylor et al., Int. Immun.
6:579 (1994). A fully human antibody also can be constructed by genetic or chromosomal transfection methods, as well as phage display technology, all of which are known in the art.
(See, e.g., McCafferty et al., Nature 348:552-553 (1990) for the production of human antibodies and fragments thereof in vitro, from immunoglobulin variable domain gene repertoires from unimmunized donors). In this technique, antibody variable domain genes are cloned in-frame into either a major or minor coat protein gene of a filamentous bacteriophage, and displayed as functional antibody fragments on the surface of the phage particle. Because the filamentous particle contains a single-stranded DNA copy of the phage genome, selections based on the functional properties of the antibody also result in selection of the gene encoding the antibody exhibiting those properties. In this way, the phage mimics some of the properties of the B cell.
Phage display can be performed in a variety of formats, for their review, see, e.g. Johnson and Chiswell, Current Opinion in Structural Biology 3:5564-571 (1993). Human antibodies may also be generated by in vitro activated B cells. (See, U.S. Pat. Nos. 5,567,610 and 5,229,275).
[00201 As used herein, the term "antibody fusion protein" is a recombinantly produced antigen-binding molecule in which an antibody or antibody fragment is linked to another protein or

8 peptide, such as the same or different antibody or antibody fragment or a DDD
or AD peptide.
The fusion protein may comprise a single antibody component, a multivalent or multispecific combination of different antibody components or multiple copies of the same antibody component. The fusion protein may additionally comprise an antibody or an antibody fragment and a therapeutic agent. Examples of therapeutic agents suitable for such fusion proteins include cytokines, growth factors or hormones. However, virtually any protein or peptide may be expressed as a fusion protein with an AD or DDD sequence and incorporated into a DNL
complex, using the methods described below.
Dock-and-Lock (DNL) 100211 In preferred embodiments, the bispecific antibody is formed by a technique known as dock-and-lock (DNL) (see, e.g., U.S. Patent Nos. 7,521,056; 7,527,787;
7,534,866; 7,550,143 and 7,666,400, the Examples section of each of which is incorporated herein by reference.) Generally, the DNI, technique takes advantage of the specific and high-affinity binding interaction between a dimerization and docking domain (DDD) sequence and an anchor domain (AD) sequence. The DDD and AD peptides may be attached to any protein, peptide or other molecule. Because the DDD sequences spontaneously dimerize and bind to the AD
sequence, the DNL technique allows the formation of complexes between any selected molecules that may be attached to DDD or AD sequences. Although the standard DNL complex comprises a trimer with two DDD-linked molecules attached to one AD-linked molecule, variations in complex structure allow the formation of dimers, trimers, tetramers, pentamers, hexamers and other multimers. In some embodiments, the DNL complex may comprise two or more antibodies, antibody fragments or fusion proteins which bind to the same antigenic determinant or to two or more different antigens. The DNL complex may also comprise one or more other effectors, such as proteins, peptides, immunomodulators, cytokines, interleukins, interferons, binding proteins, peptide ligands, carrier proteins, polymers such as PEG, enzymes, therapeutic agents, hormones, or any other molecule or aggregate.
[0022] In more preferred embodiments, the DDD moiety is from a regulatory (R) subunit of cAMP-dependent protein kinase (PKA) and the anchoring domain (AD) is from an A-kinase anchoring protein (AKAP) (Baillie et al., FEBS Letters. 2005; 579: 3264. Wong and Scott, Nat.
Rev. Mol. Cell Biol. 2004; 5: 959). PKA, which plays a central role in one of the best studied

9 signal transduction pathways triggered by the binding of the second messenger cAMP to the R
subunits, was first isolated from rabbit skeletal muscle in 1968 (Walsh et al., J. Biol. Chem.
1968;243:3763). The structure of the holoenzyme consists of two catalytic subunits held in an inactive form by the R subunits (Taylor, J. Biol. Chem. 1989;264:8443).
Isozymes of PKA are found with two types of R subunits (RI and RII), and each type has a and 13 isoforms (Scott, Pharmacol. Ther. 1991;50:123). Thus, the four isoforms of PKA regulatory subunits are Rla, RI13, RIla and RIIP. The R subunits have been isolated only as stable dimers and the dimerization domain has been shown to consist of the first 44 amino-terminal residues (Newton et al., Nat. Struct. Biol. 1999; 6:222). Binding of cAMP to the R subunits leads to the release of active catalytic subunits for a broad spectrum of serine/threonine kinase activities, which are oriented toward selected substrates through the compartmentalization of PKA
via its docking with AKAPs (Scott etal., J. Biol. Chem. 1990;265;21561) [0023] Since the first AKAP, microtubule-associated protein-2, was characterized in 1984 (Eohmann et at., Proc. Natl. Acad. Sci USA. 1984; 81:6723), more than 50 AKAPs that localize to various sub-cellular sites, including plasma membrane, actin cytoskeleton, nucleus, mitochondria, and endoplasmic reticulum, have been identified with diverse structures in species ranging from yeast to humans (Wong and Scott, Nat. Rev. Mol. Cell Biol.
2004;5:959). The AD
of AKAPs for PKA is an amphipathic helix of 14-18 residues (Carrel al., J.
Biol. Chem.
1991;266:14188). The amino acid sequences of the AD are quite varied among individual AKAPs, with the binding affinities reported for RII dimers ranging from 2 to 90 nM (Alto et al., Proc. Natl. Acad. Sci. USA. 2003;100:4445). AKAPs will only bind to dimeric R
subunits. For human Mkt, the AD binds to a hydrophobic surface formed by the 23 amino-terminal residues (Colledge and Scott, Trends Cell Biol. 1999; 6:216). Thus, the dimerization domain and AKAP
binding domain of human Rlla are both located within the same N-terminal 44 amino acid sequence (Newlon et al., Nat. Struct..Biol. 1999;6:222; Newlon et al., EMBO J.
2001;20:1651), which is termed the DDD herein.
[0024] We have developed a platform technology to utilize the DDD of human PKA
and the AD
of AKAP as an excellent pair of linker modules for docking any two entities, referred to hereafter as A and B, into a noncovalent complex, which could be further locked into a DNL
complex through the introduction of cysteine residues into both the DDD and AD
at strategic positions to facilitate the formation of disulfide bonds. The general methodology of the "dock-

10 and-lock" approach is as follows. Entity A is constructed by linking a DDD
sequence to a precursor of A, resulting in a first component hereafter referred to as a.
Because the DDD
sequence would effect the spontaneous formation of a dimer, A would thus be composed of a2.
Entity B is constructed by linking an AD sequence to a precursor of B, resulting in a second component hereafter referred to as b. The dimeric motif of DDD contained in a2 will create a docking site for binding to the AD sequence contained in b, thus facilitating a ready association of a2 and b to form a binary, trimeric complex composed of a2b. This binding event is made irreversible with a subsequent reaction to covalently secure the two entities via disulfide bridges, which occurs very efficiently based on the principle of effective local concentration because the initial binding interactions should bring the reactive thiol groups placed onto both the DDD and AD into proximity (Chrnura et at., Proc. Natl. Acad. Sci. USA. 2001;98:8480) to ligate site-specifically. Using various combinations of linkers, adaptor modules and precursors, a wide variety of DNL complexes of different stoichiometry may be produced and used, including but not limited to dimeric, trimeric, tetrameric, pentameric and hexameric DNL
complexes (see, e.g., U.S. Nos. 7,550,143; 7,521,056; 7,534,866; 7,527,787 and 7,666,400.) [0025J By attaching the DDD and AD away from the functional groups of the two precursors, such site-specific ligations are also expected to preserve the original activities of the two precursors. This approach is modular in nature and potentially can be applied to link, site-specifically and covalently, a wide range of substances, including peptides, proteins, antibodies, antibody fragments, and other effector moieties with a wide range of activities. Utilizing the fusion protein method of constructing AD and DDD conjugated effectors described in the Examples below, virtually any protein or peptide may be incorporated into a DNL complex.
However, the technique is not limiting and other methods of conjugation may be utilized.
[0026] A variety of methods are known for making fusion proteins, including nucleic acid synthesis, hybridization and/or amplification to produce a synthetic double-stranded nucleic acid encoding a fusion protein of interest. SUch double-stranded nucleic acids may be inserted into expression vectors for fusion protein production by standard molecular biology techniques (see, e.g. Sambrook et al., Molecular Cloning, A laboratory manual, 2nd Ed, 1989).
In such preferred embodiments, the AD and/or DDD moiety may be attached to either the N-terminal or C-terminal end of an effector protein or peptide. However, the skilled artisan will realize that the site of attachment of an AD or DDD moiety to an effector moiety may vary, depending on the chemical

11 nature of the effector moiety and the part(s) of the effector moiety involved in its physiological activity. Site-specific attachment of a variety of effector moieties may be performed using techniques known in the art, such as the use of bivalent cross-linking reagents and/or other chemical conjugation techniques.
Structure-Function Relationships in AD and DDD Moieties [0027] For different types of DNL complexes, different AD or DUD sequences may be utilized.
Exemplary DDD and AD sequences are provided below.
DDD I
SHIQIPPGLTELLQGYTVEVLRQQPPDLVEFAVEYFTRLREARA (SEQ ID NO: I) CGHIQIPPGLTELLQGYTVEVLRQQPPDLVEFAVEYFTRLREARA (SEQ ID NO:2) QIEYLAKQIVDNAIQQA (SEQ ID NO:3) CGQIEYLAKQIVDNAIQQAGC (SEQ ID NO:4) [0028] The skilled artisan will realize that DDD 1 and DDD2 are based on the DDD sequence of the human RIla isoform of protein kinase A. However, in alternative embodiments, the DDD
and AD moieties may be based on the DDD sequence of the human Rict form of protein kinase A and a corresponding AKAP sequence, as exemplified in DDD3, DDD3C and AD3 below.

SLRECELYVQKHNIQALLKDSIVQLCTARPERPMAFLREYFERLEKEEAK (SEQ
ID NO:5) MSCGGSLRECELYVQKHNIQALLKDSIVQLCTARPERPMAFLREYFERLEKEEAK
(SEQ ID NO:6) CGFEELAWKIAKMIWSDVFQQGC (SEQ ID NO:7) [0029] In other alternative embodiments, other sequence variants of AD and/or DDD moieties may be utilized in construction of the DNL complexes. For example, there are only four variants of human PKA DDD sequences, corresponding to the DDD moieties of PKA Riot, RlIct, RIP and RII13. The RIla DDD sequence is the basis of DDD I and DDD2 disclosed above.
The four human PKA DDD sequences are shown below. The DDD sequence represents residues 1-44 of

12 RIIa, 1-44 of R1113, 12-61 of RIa and 13-66 of RII3. (Note that the sequence of DDD I is modified slightly from the human PKA Rila DDD moiety.) PKA Rla SLRECELYVQKHNIQALLKDVSIVQLCTARPERPMAFLREYFEKLEKEEAK (SEQ
ID NO:8) PKA RIfi SLKGCELYVQLHGIQQVLKDCIVHLCISKPERPMKFLREHFEKLEKEENRQILA
(SEQ ID NO:9) PKA RIM
SHIQIPPGLTELLQGYTVEVGQQPPDLVDFAVEYFTRLREARRQ (SEQ ID NO:10) PKA R11,0 SIEIPAGLTELLQGFTVEVLRHQPADLLEFALQHFTRLQQENER (SEQ ID NO:! I) [0030] The structure-function relationships of the AD and DDD domains have been the subject of investigation. (See, e.g., Burns-I lamuro et al., 2005, Protein Sci 14:2982-92; Carr et al., 2001, J Biol Chem 276:17332-38; Alto etal., 2003, Proc Nat! Acad Sci USA 100:4445-50;
Hundsrucker et al., 2006, Biochem J 396:297-306; Stokka et al., 2006, Biochem J 400:493-99;
Gold et al., 2006, Mol Cell 24:383-95; Kinderman et al., 2006, Mol Cell 24:397-408, the entire text of each of which is incorporated herein by reference.) [0031] For example, Kinderman et al. (2006, Mol Cell 24:397-408) examined the crystal structure of the AD-DDD binding interaction and concluded that the human DDD
sequence contained a number of conserved amino acid residues that were important in either dimer formation or AKAP binding, underlined in SEQ ID NO:1 below. (See Figure I of Kinderman et al., 2006, incorporated herein by reference.) The skilled artisan will realize that in designing sequence variants of the DDD sequence, one would desirably avoid changing any of the underlined residues, while conservative amino acid substitutions might be made for residues that are less critical for dimerization and AKAP binding.
SHIQIPPGLTELLQGYTVEVLRQQPPDLVEFAVEYFTRLREARA (SEQ ID NO:!) 100321 As discussed in more detail below, conservative amino acid substitutions have been characterized for each of the twenty common L-amino acids. Thus, based on the data of Kinderman (2006) and conservative amino acid substitutions, potential alternative DDD

1_3 sequences based on SEQ ID NO:1 are shown in Table 1. In devising Table 1, only highly conservative amino acid substitutions were considered. For example, charged residues were only substituted for residues of the same charge, residues with small side chains were substituted with residues of similar size, hydroxyl side chains were only substituted with other hydroxyls, etc.
Because of the unique effect of proline on amino acid secondary structure, no other residues were substituted for proline. Even with such conservative substitutions, there are over twenty million possible alternative sequences for the 44 residue peptide (2 X3x2x2x2x2x2x2x2 x2x2x2x2x2x2 x4 x2 x2 x2x2x2x4x2x 4). Alimitednurnberofsuchpotential alternative DDD moiety sequences are shown in SEQ ID NO:12 to SEQ ID NO:31 below. The skilled artisan will realize that an almost unlimited number of alternative species within the genus of DDD moieties can be constructed by standard techniques, for example using a commercial peptide synthesizer or well known site-directed mutagenesis techniques. The effect of the amino acid substitutions on AD moiety binding may also be readily determined by standard binding assays, for example as disclosed in Alto et al. (2003, Proc Natl Acad Sci USA
100:4445-50).

Table 1. Conservative Amino Acid Substitutions in DDD1 (SEQ ID NO:1).
Consensus sequence disclosed as SEQ ID NO: 102.

S HI QIPPGLTELLQGYTVE VLR
T K N A SD NA S

QQP P DL VEF_A VE YF TRL RE ARA
NN E D L D S K K DL K L

V V V
THIQIPPGLTELLQGYTVEVLRQQPPDLVEFAVEYFTRLREARA (SEQ ID NO:12) SKIQIPPGLTELLQGYTVEVLRQQPPDLVEFAVEYFTRLREARA (SEQ ID NO:13) SRIQ1PPGLTELLQGYTVEVLRQQPPDLVEFAVEYFTRLREARA (SEQ ID NO:14) SHINIPPGLTELLQGYTVEVLRQQPPDLVEFAVEYFTRLREARA (SEQ ID NO:15) SHIQIPPALTELLQGYTVEVLRQQPPDLVEFAVEYFTRLREARA (SEQ ID NO:16) SH1QIPPGLSELLQGYTVEVLRQQPPDLVEFAVEYFTRLREARA (SEQ ID NO:17) SHIQIPPGLTDLLQGYTVEVLRQQPPDLVEFAVEYFTRLREARA (SEQ ID NO:18) SHIQIPPGLTELLNGYTVEVLRQQPPDLVEFAVEYFTRLREARA (SEQ ID NO:19) SHIQIPPGLTELLQAYTVEVLRQQPPDLVEFAVEYFTRLREARA (SEQ ID NO:20) SHIQIPPGLTELLQGYSVEVLRQQPPDLVEFAVEYFTRLREARA (SEQ ID NO:21) SHIQIPPGLTELLQGYTVDVLRQQPPDLVEFAVEYFTRLREARA (SEQ ID NO:22) SHIQIPPGLTELLQGYTVEVLKQQPPDLVEFAVEYFTRLREARA (SEQ ID NO:23) SFIIQIPPGLTELLQGYTVEVLRNQPPDLVEFAVEYFTRLREARA (SEQ ID NO:24) SHIQIPPGLTELLQGYTVEVLRQNPPDLVEFAVEYFTRLREARA (SEQ ID NO:25) SHIQIPPGLTELLQGYTVEVLRQQPPELVEFAVEYFTRLREARA (SEQ ID NO:26) SHIQIPPGLTELLQGYTVEVLRQQPPDLVDFAVEYFTRLREARA (SEQ ID NO:27) SHIQIPPGLTELLQGYTVEVLRQQPPDLVEFLVEYFTRLREARA (SEQ ID NO:28) SHIQIPPGLTELLQGYTVEVT,RQQPPDLVEFTVEYFTR T ,RF AR A (SEQ in NO-99) SHIQIPPGLTELLQGYTVEVLRQQPPDLVEFVVEYFTRLREARA (SEQ ID NO:30) SHIQIPPGLTELLQGYTVEVLRQQPPDLVEFAVDYFTRLREARA (SEQ ID NO:31) [0033] Alto et al. (2003, Proc Natl Acad Sci USA 100:4445-50) performed a bioinformatic analysis of the AD sequence of various AKAP proteins to design an Rh I
selective AD sequence called AKAP-IS (SEQ ID NO:3), with a binding constant for DDD of 0.4 nM. The AKAP-IS
sequence was designed as a peptide antagonist of AKAP binding to PKA. Residues in the AKAP-IS sequence where substitutions tended to decrease binding to DDD are underlined in SEQ ID NO:3 below. The skilled artisan will realize that in designing sequence variants of the AD sequence, one would desirably avoid changing any of the underlined residues, while conservative amino acid substitutions might be made for residues that are less critical for DDD
binding. Table 2 shows potential conservative amino acid substitutions in the sequence of AKAP-IS (AD!, SEQ ID NO:3), similar to that shown for DDD1 (SEQ ID NO:1) in Table!
above.
[0034] Even with such conservative substitutions, there are over thirty-five thousand possible alternative sequences for the 17 residue AD I (SEQ ID NO:3) peptide sequence (2 x3x2x4x3 x2x2x2x2x2x2x 4). A limited number of such potential alternative AD moiety sequences are shown in SEQ ID NO:32 to SEQ ID NO:49 below. Again, a very large number of species within the genus of possible AD moiety sequences could be made, tested and used by the skilled artisan, based on the data of Alto et al. (2003). It is noted that Figure 2 of Alto (2003) shows an even larger number of potential amino acid substitutions that may be made, while retaining binding activity to DDD moieties, based on actual binding experiments.

pau!papun -unojos! 0q1 twm paludwoo /)Id Jo Lwojos! Int ail JOJ Ai!Apoolas Jat.pq opmpAutu Jo lam anti uuiqnx US:ON GI WS) aouanbos S1-dVNVIDdns doianap 01 u!u0a.los appd0c1 puu icucluBolluiskip paz.Tin (c6-m-,:tz liaD
'900Z) .1r 13 PI 0 [SE001 (6-VONI GI OAS) AO0IVNGAIONVIARIO
(817:0N al 0As) 1601vNamOxv'1A1i0 (L17:0N at WS) 100IVNCIAIONVIAMO
(WON GI WS) VNOIVNGAIONVIAgIO
(CVON GI WS) VONIVNGAIONVIA3I0 (VVIONI GI WS) Vo0IVOCIAIONV1A1IO
(:ON GI WS) VOOIVNAAIONVIA3I0 (:ON GI WS) VOOPINCIAINNVIAMO
(II7:0N GI WS) VOOIVNCIAIONVIAgIO
(OVON GI WS) VOOIVNCIAIONVAAHIO
(6i...:ON GI WS) VOOIVNCIAIONVIARI0 (8E:ON GI WS) VOOIVNICIAIONVISgIO
(a:ON GI WS) VOOIVNGAIONVIJAIO
(9rON GI WS) V0OIVNGAIONVIIMO
(Si..-:ON (II OHs) vOOlexamOxe-uai0 (17E:oN UI Oas) e0OivNam0->4nAAA0 (:ON GI WS) Vo0IVNGAIMVIATIO
(ZE:ON GI WS) VOIVNn,AkI0)1Y-T.A3IN

A A I
A
N N 0 i N II = I I G
N

'Of :ON ai Oas s1 Pasolasw aauanbas snsuasuo3 Ui OAS) ui suo!inmsqns may ou!Euv aitpumasuop *Z alqul (:ON GI OAS) VOOIVNIGAIONVIA3I0 SI-dr)IV

residues indicate the positions of amino acid substitutions, relative to the AKAP-IS sequence, which increased binding to the DDD moiety of RIIa. In this sequence, the N-terminal Q residue is numbered as residue number 4 and the C-terminal A residue is residue number 20. Residues where substitutions could be made to affect the affinity for RIla were residues 8, 11, 15, 16, 18, 19 and 20 (Gold et at., 2006). It is contemplated that in certain alternative embodiments, the SuperAKAP-IS sequence may be substituted for the AKAP-IS AD moiety sequence to prepare DNL complexes. Other alternative sequences that might be Substituted for the AKAP-IS AD
sequence are shown in SEQ ID NO:51-53. Substitutions relative to the AKAP-IS
sequence are underlined. It is anticipated that, as with the AD2 sequence shown in SEQ ID
NO:4, the AD
moiety may also include the additional N-terminal residues cysteine and glycine and C-terminal residues glycine and cysteine.
SuperAKAP-IS
QIEYVAKQIVDYAIFIQA (SEQ ID NO:50) Alternative AKAP sequences QIEYKAKQIVDHAIHQA (SEQ ID NO:51) QIEYHAKQIVDHAIHQA (SEQ ID NO:52) QIEYVAKQIVDHAIHQA (SEQ ID NO:53) [0036] Figure 2 of Gold et al. disclosed additional DDD-binding sequences from a variety of AKAP proteins, shown below.
RI-Specific AKAPs AKAP-KL
PLEYQAGLLVQNAIQQAI (SEQ ID NO:54) LLIETASSLVKNAIQLSI (SEQ ID NO:55) AKAP-Lbc LIEEAASRIVDAVIEQVK (SEQ ID NO:56) RI-Specific AKAPs AKAPce ALYQFADRFSELVISEAL (SEQ ID NO:57) RIAD
LEQVANQLADQIIKEAT (SEQ ID NO:58) FEELAWKIAKMIWSDVF (SEQ ID NO:59) Dual-Specificity AKAPs ELVRLSKRLVENAVLKAV (SEQ ID NO:60) TAEEVSARIVQVVTAEAV (SEQ ID NO:61) QIKQAAFQLISQVILEAT (SEQ ID NO:62) LAWKIAKMIVSDVMQQ (SEQ ID NO:63) [0037] Stokka et al. (2006, Biochem J 400:493-99) also developed peptide competitors of AKAP
binding to PKA, shown in SEQ ID NO:64-66. The peptide antagonists were designated as Ht31 (SEQ ID NO:64), RIAD (SEQ ID NO:65) and PV-38 (SEQ ID NO:66). The Ht-31 peptide exhibited a greater affinity for the RII isoform of PKA, while the RIAD and PV-38 showed higher affinity for RI.
flt31 DLIEEAASRIVDAVIEQVKAAGAY (SEQ ID NO:64) RIAD
LEQYANQLADQIIKEATE (SEQ ID NO:65) FEELAWKIAKMIWSDVFQQC (SEQ ID NO:66) [00381 Hundsrucker et al. (2006, Biochem J 396:297-306) developed still other peptide competitors for AKAP binding to PKA, with a binding constant as low as 0.4 nM
to the DDD of the RII form of PKA. The sequences of various AKAP antagonistic peptides are provided in Table 1 of Hundsrucker et al., reproduced in Table 3 below. AKAPIS represents a synthetic RII
subunit-binding peptide. All other peptides are derived from the RII-binding domains of the indicated AKAPs.

Table 3. AKAP Peptide sequences Peptide Sequence AKAPIS QIEYLAKQIVDNAIQQA (SEQ ID NO:3) AKAPIS-P QIEYLAKQIPDNAIQQA (SEQ ID NO:67) Ht31 KGADLIEEAASRIVDAVIEQVKAAG (SEQ ID NO:68) Ht3 I -P KGADLIEEAASRIPDAPIEQVKAAG (SEQ ID NO:69) AKAP76-wt-pep PEDAELVRLSKRLVENAVLKAVQQY (SEQ ID NO:70) AKAP76-L304T-pep PEDAELVRTSKRLVENAVLKAVQQY (SEQ ID NO:71) AKAP76-L308D-pep PEDAELVRLSKRDVENAVLKAVQQY (SEQ ID NO:72) AKAP76-P-pep PEDAELVRLSKRLPENAVLKAVQQY (SEQ ID NO:73) AKAP76-PP-pep PEDAELVRLSKRLPENAPLKAVQQY (SEQ ID NO:74) AKAP76-L314E-pep PEDAELVRLSKRLVENAVEKAVQQY (SEQ ID NO:75) AKAP1-pep EEGLDRNEEIKRAAFQIISQVISEA (SEQ ID NO:76) AKAP2-pep LVDDPLEYQAGLLVQNAIQQAIAEQ (SEQ ID NO:77) AKAP5-pep QYETLLIETASSLVKNAIQLSIEQL (SEQ ID NO:78) AKAP9-pep LEKQYQEQLEEEVAKVIVSMSIAFA (SEQ ID NO:79) AKAP 10-pep NTDEAQEELAWKIAKMIVSDIMQQA (SEQ ID NO:80) AKAP11-pep VNLDKKAVLAEKIVAEAIEKAEREL (SEQ ID NO:81) AKAP12-pep NGILELETKSSKLVQNIIQTAVDQF (SEQ ID NO:82) AKAP I4-pep TQDKNYEDELTQVALALVEDVINYA (SEQ ID NO:83) Rab32-pep ETSAKDNINIEEAARFLVEKILVNH (SEQ ID NO:84) [0039] Residues that were highly conserved among the AD domains of different AKAP
proteins are indicated below by underlining with reference to the AKAP IS
sequence (SEQ ID
NO:3). The residues are the same as observed by Alto et al. (2003), with the addition of the C-terminal alanine residue. (See FIG. 4 of Hundsrucker et al. (2006), incorporated herein by reference.) The sequences of peptide antagonists with particularly high affinities for the RII
DDD sequence were those of AKAP-IS, AKAP7o-wt-pep, AKAP76-L304T-pep and AKAP76-L308D-pep.

AKAP-IS
QIEYLAKQIVDNAIQQA (SEQ ID NO:3) 100401 Can et al. (2001, J Biol Chem 276:17332-38) examined the degree of sequence homology between different AKAP-binding DDD sequences from human and non-human proteins and identified residues in the DDD sequences that appeared to be the most highly conserved among different DDD moieties. These are indicated below by underlining with reference to the human PKA RIIa DDD sequence of SEQ ID NO: 1. Residues that were particularly conserved are further indicated by italics. The residues overlap with, but are not identical to those suggested by Kinderman et al. (2006) to be important for binding to AKAP
proteins. The skilled artisan will realize that in designing sequence variants of DDD, it would be most preferred to avoid changing the most conserved residues (italicized), and it would be preferred to also avoid changing the conserved residues (underlined), while conservative amino acid substitutions may be considered for residues that are neither underlined nor italicized..
SHIQ/PPGLTELLOGYTVEVLRQOPPDLVEFAVEYFTRLREARA (SEQ ID NO:1) [0041] A modified set of conservative amino acid substitutions for the DDD I
(SEQ ID NO:1) sequence, based on the data of Carr et al. (2001) is shown in Table 4. Even with this reduced set of substituted sequences, there are over 65,000 possible alternative DDD
moiety sequences that may be produced, tested and used by the skilled artisan without undue experimentation. The skilled artisan could readily derive such alternative DDD amino acid sequences as disclosed above for Table 1 and Table 2.
Table 4. Conservative Amino Acid Substitutions in DDD1 (SEQ ID NO:!).
Consensus sequence disclosed as SEQ ID NO: 104.
S H I QIPPGLTELLQG Y TV EVLR
I =
A

QQP P DL VEFA V E YFT RL R E AR A
I D S K
A , V V
[0042] The skilled artisan will realize that these and other amino acid substitutions in the DDD
or AD amino acid sequences may be utilized to produce alternative species within the genus of AD or DDD moieties, using techniques that are standard in the field and only routine experimentation.
Amino Acid Substitutions [0043] In alternative embodiments, the disclosed methods and compositions may involve production and use of proteins or peptides with one or more substituted amino acid residues. For example, the DDD and/or AD sequences used to make DNL complexes may be modified as discussed above.
[0044] The skilled artisan will be aware that, in general, amino acid substitutions typically involve the replacement of an amino acid with another amino acid of relatively similar properties (i.e., conservative amino acid substitutions). The properties of the various amino acids and effect of amino acid substitution on protein structure and function have been the subject of extensive study and knowledge in the art.
[0045] For example, the hydropathic index of amino acids may be considered (Kyte & Doolittle, 1982, J. Mol. Biol., 157:105-132). The relative hydropathic character of the amino acid contributes to the secondary structure of the resultant protein, which in turn defines the interaction of the protein with other molecules. Each amino acid has been assigned a hydropathic index on the basis of its hydrophobicity and charge characteristics (Kyte &
Doolittle, 1982), these are: isoleucine (+4.5); valine.(+4.2); leucine (+3.8);
phenylalanine (+2.8);
cysteine/cystine (+2.5); methionine (+1.9); alanine (+1.8); glycine (-0.4);
threonine (-0.7); serine (-0.8); tryptophan (-0.9); tyrosine (-1.3); proline (-1.6); histidine (-3.2);
glutamate (-3.5);
glutamine (-3.5); aspartate (-3.5); asparagine (-3.5); lysine (-3.9); and arginine (-4.5). In making conservative substitutions, the use of amino acids whose hydropathic indices are within 2 is preferred, within I are more preferred, and within 0.5 are even more preferred.

100461 Amino acid substitution may also take into account the hydrophilicity of the amino acid residue (e.g., U.S. Pat. No. 4,554,101). Hydrophilicity values have been assigned to amino acid residues: arginine (+3.0); lysine (+3.0); aspartate (+3.0); glutamate (+3.0);
serine (+0.3);
asparagine (+0.2); glutamine (+0.2); glycine (0); threonine (-0.4); proline (-0.5 ±1); alanine (-0.5); histidine (-0.5); cysteine (-1.0); methionine (-1.3); valine (-1.5);
leucine (-1.8); isoleucine (-1.8); tyrosine (-2.3); phenylalanine (-2.5); tryptophan (-3.4). Replacement of amino acids with others of similar hydrophilicity is preferred.
100471 Other considerations include the size of the amino acid side chain. For example, it would generally not be preferred to replace an amino acid with a compact side chain, such as glycine or serine, with an amino ac,id with a bulky side chain, e.g., tryptophan or tyrosine. The effect of various amino acid residues on protein secondary structure is also a consideration. Through empirical study, the effect of different amino acid residues on the tendency of protein domains to adopt an alpha-helical, beta-sheet or reverse turn secondary structure has been determined and is known in the art (see, e.g., Chou & Fasman, 1974, Biochemistry, 13:222-245;
1978, Ann. Rev.
Biochem., 47: 251-276; 1979, Biophys. J., 26:367-384).
100481 Based on such considerations and extensive empirical study, tables of conservative amino acid substitutions have been constructed and are known in the art. For example: arginine and lysine; glutamate and aspartate; serine and threonine; glutamine and asparagine; and valine, leucine and isoleucine. Alternatively: Ala (A) leu, ile, val; Arg (R) gin, asn, lys; Asn (N) his, asp, lys, arg, gin; Asp (D) asn, glu; Cys (C) ala, ser; Gin (Q) glu, asn; Glu (E) gin, asp; Gly (G) ala; His (El) asn, gin, lys, arg; Ile (I) val, met, ala, phe, leu; Leu (L) val, met, ala, phe, ile; Lys (K) gin, asn, arg; Met (M) phe, ile, leu; Phe (F) leu, val, ile, ala, tyr; Pro (P) ala; Ser (S), thr; Thr (T) ser; Trp (W) phe, tyr; Tyr (Y) trp, phe, thr, ser; Val (V) ile, leu, met, phe, ala.
[00491 Other considerations for amino acid substitutions include whether or not the residue is located in the interior of a protein or is solvent exposed. For interior residues, conservative substitutions would include: Asp and Asn; Ser and Thr; Ser and Ala; Thr and Ala; Ala and Gly;
Ile and Val; Val and Leu; Leu and Ile; Leu and Met; Phe and Tyr; Tyr and Trp.
(See, e.g., PROWL website at rockefeller.edu) For solvent exposed residues, conservative substitutions would include: Asp and Asn; Asp and Glu; Glu and Gin; Glu and Ala; Gly and Asn; Ala and Pro; Ala and Gly; Ala and Ser; Ala and Lys; Ser and Thr; Lys and Arg; Val and Leu; Leu and Ile; Ile and Val; Phe and Tyr. (Id.) Various matrices have been constructed to assist in selection of amino acid substitutions, such as the PAM250 scoring matrix, Dayhoff matrix, Grantham matrix, McLachlan matrix, Doolittle matrix, Henikoff matrix, Miyata matrix, Fitch matrix, Jones matrix, Rao matrix, Levin matrix and Risler matrix (Idem.) [0050] In determining amino acid substitutions, one may also consider the existence of intermolecular or intramolecular bonds, such as formation of ionic bonds (salt bridges) between positively charged residues (e.g., His, Arg, Lys) and negatively charged residues (e.g., Asp, Glu) or disulfide bonds between nearby cysteine residues.
[0051] Methods of substituting any amino acid for any other amino acid in an encoded protein sequence are well known and a matter of routine experimentation for the skilled artisan, for example by the technique of site-directed mutagenesis or by synthesis and assembly of oligonucleotides encoding an amino acid substitution and splicing into an expression vector construct.
Preparation of Antibodies [0052] The DNL complexes described herein may Comprise one or more monoclonal antibodies or fragments thereof. Rodent monoclonal antibodies to specific antigens may -be obtained by methods known to those skilled in the art. (See, e.g., Kohler and Milstein, Nature 256: 495 (1975), and Coligan et al. (eds.), CURRENT PROTOCOLS IN IMMUNOLOGY, VOL. 1, pages 2.5.1-2.6.7 (John Wiley & Sons 1991)).
[0053] General techniques for cloning murine immunoglobulin variable domains have been disclosed, for example, by the publication of Orlandi et al., Proc. Nat'l Acad. Sci. USA 86: 3833 (1989). Techniques for constructing chimeric antibodies are well known to those of skill in the art. As an example, Leung et al., Hybridoma 13:469 (1994), disclose how they produced an LL2 chimera by combining DNA sequences encoding the Vk and VH domains of LL2 monoclonal antibody, an anti-CD22 antibody, with respective human and IgGi constant region domains. This publication also provides the nucleotide sequences of the LL2 light and heavy chain variable regions, Vk and VH, respectively. Techniques for producing humanized antibodies are disclosed, for example, by Jones et al., Nature 321: 522 (1986), Riechmann et al., Nature 332: 323 (1988), Verhoeyen et al., Science 239: 1534 (1988), Carter et at., Proc. Nat'l Acad.
Sci. USA 89: 4285 (1992), Sandhu, Crit. Rev. Biotech. 12: 437 (1992), and Singer et at., J.
Immun. 150: 2844 (1993).
100541 A chimeric antibody is a recombinant protein that contains the variable domains including the CDRs derived from one species of animal, such as a rodent antibody, while the remainder of the antibody molecule; i.e., the constant domains, is derived from a human antibody. Accordingly, a chimeric monoclonal antibody can also be humanized by replacing the sequences of the murine FR in the variable domains of the chimeric antibody with one or more different human FR. Specifically, mouse CDRs are transferred from heavy and light variable chains of the mouse immunoglobulin into the corresponding variable domains of a human antibody. As simply transferring mouse CDRs into human FRs often results in a reduction or even loss of antibody affinity, additional modification might be required in order to restore the original affinity of the murine antibody. This can be accomplished by the replacement of one or more some human residues in the FR regions with their murine counterparts to obtain an antibody that possesses good binding affinity to its epitope. (See, e.g., Tempest et al., Biotechnology 9:266 (1991) and Verhoeyen et al., Science 239: 1534 (1988)).
100551 A fully human antibody can be obtained from a transgenic non-human animal. (See, e.g., Mendez et at., Nature Genetics, 15: 146-156, 1997; U.S. Pat. No. 5,633,425.) Methods for producing fully human antibodies using either combinatorial approaches or transgenic animals transformed with human immunoglobulin loci are known in the art (e.g., Mancini et al., 2004, New Microbia 27:315-28; Conrad and Scheller, 2005, Comb. Chem. High Throughput Screen.
8:117-26; Brekke and Loset, 2003, Curr. Opin. Pharmacol. 3:544-50; each incorporated herein by reference). Such fully human antibodies are expected to exhibit even fewer side effects than chimeric or humanized antibodies and to function in vivo as essentially endogenous human antibodies. In certain embodiments, the claimed methods and procedures may utilize human antibodies produced by such techniques.
[0056] In one alternative, the phage display technique may be used to generate human antibodies (e.g., Dantas-Barbosa et al., 2005, Genet. Mol. Res. 4:126-40, incorporated herein by reference).
Human antibodies may be generated from normal humans or from humans that exhibit a particular disease state, such as cancer (Dantas-Barbosa et at., 2005). The advantage to constructing human antibodies from a diseased individual is that the circulating antibody repertoire may be biased towards antibodies against disease-associated antigens.
100571 In one non-limiting example of this methodology, Dantas-Barbosa et al.
(2005) constructed a phage display library of human Fab antibody fragments from osteosarcoma patients. Generally, total RNA was obtained from circulating blood lymphocytes (Id.) Recombinant Fab were cloned from the u, y and K chain antibody repertoires and inserted into a phage display library (Id.) RNAs were converted to cDNAs and used to make Fab cDNA
libraries using specific primers against the heavy and light chain immunoglobulin sequences (Marks et al., 1991, J. Mot. Biol. 222:581-97). Library construction was performed according to Andris-Widhopf et al. (2000, In:.Phage Display Laboratory Manual, Barbas et at. (eds), Is' edition, Cold Spring Harbor Laboratory Press, Cold Spring Harbor, NY pp. 9.1 to 9.22, incorporated herein by reference). The final Fab fragments were digested with restriction endonucleases and inserted into the bacteriophage genome to make the phage display library.
Such libraries may be screened by standard phage display methods. The skilled artisan will realize that this technique is exemplary only and any known method for making and screening human antibodies or antibody fragments by phage display may be utilized.
[00581 In another alternative, transgenic animals that have been genetically engineered to produce human antibodies may be used to generate antibodies against essentially any immunogenic target, using standard immunization protocols as discussed above.
Methods for obtaining human antibodies from transgenic mice are described by Green et al., Nature Genet.
7:13 (1994), Lonberg et al., Nature 368:856 (1994), and Taylor et at., Int.
Immun. 6:579 (1994).
A non-limiting example of such a system is the XENOMOUSE (e.g., Green et al., 1999, J.
Immunot Methods 231:11-23) from Abgenix (Fremont, CA). In the XENOMOUSE and similar animals, the mouse antibody genes have been inactivated and replaced by functional human antibody genes, while the remainder of the mouse immune system remains intact.
[0059) The XENOMOUSE was transformed with germline-configured YACs (yeast artificial chromosomes) that contained portions of the human IgH and Ig kappa loci, including the majority of the variable region sequences, along accessory genes and regulatory sequences. The human variable region repertoire may be used to generate antibody producing B
cells, which may be processed into hybridomas by known techniques. A XENOMOUSE immunized with a target antigen will produce human antibodies by the normal immune response, which may be harvested and/or produced by standard techniques discussed above. A variety of strains of XENOMOUSE are available, each of which is capable of producing a different class of antibody. Transgenically produced human antibodies have been shown to have therapeutic potential, while retaining the pharmacokinetic properties of normal human antibodies (Green et al., 1999). The skilled artisan will realize that the claimed compositions and methods are not limited to use of the XENOMOUSE system but may utilize any transgenic animal that has been genetically engineered to produce human antibodies.
Known Antibodies and Disease Associated Antigens 100601 In various embodiments, the DNL complexes may comprise a variety of antibodies known in the art. Antibodies of use may be commercially obtained from a number of known sources. For example, a variety of antibody secreting hybridoma lines are available from the American Type Culture Collection (ATCC, Manassas, VA). A large number of antibodies against various disease targets have been deposited at the ATCC and/or have published variable region sequences and are available for use in the claimed methods and compositions. See, e.g., U.S. Patent Nos. 7,312,318; 7,282,567; 7,151,164; 7,074,403; 7,060,802;
7,056,509; 7,049,060;
7,045,132; 7,041,803; 7,041,802; 7,041,293; 7,038,018; 7,037,498; 7,012,133;
7,001,598;
6,998,468; 6,994,976; 6,994,852; 6,989,241; 6,974,863; 6,965,018; 6,964,854;
6,962,981;
6,962,813; 6,956,107; 6,951,924; 6,949,244; 6,946,129; 6,943,020; 6,939,547;
6,921,645;
6,921,645; 6,921,533; 6,919,433; 6,919,078; 6,916,475; 6,905,681; 6,899,879;
6,893,625;
6,887,468; 6,887,466; 6,884,594; 6,881,405; 6,878,812; 6,875,580; 6,872,568;
6,867,006;
6,864,062; 6,861,511; 6,861,227; 6,861,226; 6,838,282; 6,835,549; 6,835,370;
6,824,780;
6,824,778; 6,812,206; 6,793,924; 6,783,758; 6,770,450; 6,767,711; 6,764,688;
6,764,681;
6,764,679; 6,743,898; 6,733,981; 6,730,307; 6,720,155; 6,716,966; 6,709,653;
6,693,176;
6,692,908; 6,689,607; 6,689,362; 6,689,355; 6,682,737; 6,682,736; 6,682,734;
6,673,344;
6,653,104; 6,652,852; 6,635,482; 6,630,144; 6,610,833; 6,610,294; 6,605,441;
6,605,279;
6,596,852; 6,592,868; 6,576,745; 6,572;856; 6,566,076; 6,562,618; 6,545,130;
6,544,749;
6,534,058; 6,528,625; 6,528,269; 6,521,227; 6,518,404; 6,511,665; 6,491,915;
6,488,930;
6,482,598; 6,482,408; 6,479,247; 6,468,531; 6,468,529; 6,465,173; 6,461,823;
6,458,356;
6,455,044; 6,455,040, 6,451,310; 6,444,206' 6,441,143; 6,432,404; 6,432,402;
6,419,928;
6,413,726; 6,406,694; 6,403,770; 6,403,091; 6,395,276; 6,395,274; 6,387,350;
6,383,759;

6,383,484; 6,376,654; 6,372,215; 6,359,126; 6,355,481; 6,355,444; 6,355,245;
6,355,244;
6,346,246; 6,344,198; 6,340,571; 6,340,459; 6,331,175; 6,306,393; 6,254,868;
6,187,287;
6,183,744; 6,129,914; 6,120,767; 6,096,289; 6,077,499; 5,922,302; 5,874,540;
5,814,440;
5,798,229; 5,789,554; 5,776,456; 5,736,119; 5,716,595; 5,677,136; 5,587,459;
5,443,953, 5,525,338, the Examples section of each of which is incorporated herein by reference. These are exemplary only and a wide variety of other antibodies and their hybridomas are known in the art.
The skilled artisan will realize that antibody sequences or antibody-secreting hybridomas against almost any disease-associated antigen may be obtained by a simple search of the ATCC, NCBI
and/or USPTO databases for antibodies against a selected disease-associated target of interest.
The antigen binding domains of the cloned antibodies may be amplified, excised, ligated into an expression vector, transfected into an adapted host cell and used for protein production, using standard techniques well known in the art.
[0061] Antibodies of use are publicly known and/or commercially available, including but are not limited to, anti-ABCG2, (LIFESPAN BIOSCIENCES, EPITOMICS, ABCAM, SANTA
CRUZ BIOTECHNOLOGY, SIGMA-ALDRICH, PIERCE, NOVUS BIOLOGICALS); anti-alkaline phosphatase, (MILLIPORE, ABCAM, SIGMA-ALDRICH, SANTA CRUZ
BIOTECHNOLOGY, LIFESPAN BIOSCIENCES, NOVUS BIOLOGICALS); anti-bone morphogenetic protein receptor, (SIGMA-ALDRICH, ABCAM, ABGENT, ABNOVA, PIERCE, BD BIOSCIENCES, NOVUS BIOLOGICALS); anti-CD30 (ABCAM, MILLIPORE, LIFESPAN BIOSCIENCES, NOVUS BIOLOGICALS, SANTA CRUZ BIOTECHNOLOGY);
see also 5F11 (Borchmann et al., 2003, 102:3737-42); SGN-30 (Wahl et al., 2002, Cancer Res 62:3736-42); anti-CD34, (MILLIPORE, LIFESPAN BIOSCIENCES, NOVUS BIOLOGICALS, BIOLEGEND, SANTA CRUZ BIOTECHNOLOGY, ABCAM, MILTENYI BIOTEC); anti-CD38, (LIFESPAN BIOSCIENCES, BIOLEGEND, ABCAM, SANTA CRUZ
BIOTECHNOLOGY, PIERCE, EBIOSCIENCE); anti-CD44, (MILLIPORE., LIFESPAN
BIOSCIENCES, BIOLEGEND, ABCAM); anti-CD90, (MILLIPORE, LIFESPAN
BIOSCIENCES, BIOLEGEND, EBIOSCIENCE, ABCAM, MILTENYI BIOTEC); anti-CD1 17, (LIFESPAN BIOSCIENCES, BIOLEGEND, EPITOMICS, MILTENYI BIOTEC, EBIOSCIENCE); anti-CD 133, (ABCAM, BD BIOSCIENCES, MILTENYI BIOTEC, PIERCE);
CDCP I (LIFESPAN BIOSCIENCES, BIOLEGEND, EVEREST BIOTECH, ABCAM, SIGMA-ALDRICH, NOVUS BIOLOGICALS); cytokeratin 19 (LIFESPAN BIOSCIENCES, EPITOMICS, ABCAM, PIERCE, BIOLEGEND); fetal liver kinase-1 (F1k1), (BD
BIOSCIENCES, NOVUS BIOLOGICALS, PIERCE, BIOLEGEND); GCTM-2 (MILLIPORE, INVITROGEN, ABNOVA, EPITOMICS, NOVUS BIOLOGICALS); c-kit (EPITOMICS, ABCAM, SANTA CRUZ BIOTECHNOLOGY, EBIOSCIENCE); Nestin (LIFESPAN
BIOSCIENCES, SANTA CRUZ BIOTECHNOLOGY, ABCAM, NOVUS BIOLOGICALS);
Scal (EPITOMICS, BIOLEGEND, MILTENYI BIOTEC, ABCAM); Hscf (ABNOVA, BD
BIOSCIENCES, CELL SIGNALING TECHNOLOGY); SSEA3 (ABCAM, NOVUS
BIOLOGICALS, BIOLEGEND, MILTENYI BIOTEC); SSEA4 (ABCAM, BIOLEGEND, INVITROGEN, BD BIOSCIENCES); TDGF-1 (ABCAM, NOVUS BIOLOGICALS, R&D
SYSTEMS); Thy-1 (SANTA CRUZ BIOTECHNOLOGY, EBIOSCIENCE, ENZO LIFE
SCIENCES, MILLIPORE); Tra-1-60 (SANTA CRUZ BIOTECHNOLOGY, ABNOVA, STEMCELL TECHNOLOGIES, BD BIOSCIENCES); Tra-1-81 (ABNOVA, CELL
SIGNALING TECHNOLOGY, MILLIPORE, BD BIOSCIENCES) bone-specific alkaline phosphatase (BAP) (RAYBIOTECH, ABNOVA, ABCAM), type II collagen (RAYBIOTECH, ABNOVA, ABCAM); type IV collagen (ABNOVA, RAYBIOTECH, ACRIS ANTIBODIES, GENETEX); cytokeratin 19 (SANTA CRUZ BIOTECHNOLOGY, ACRIS ANTIBODIES, EPITOMICS, ABD SEROTEC, EBIOSCIENCE); glial fibrillary acidic protein (GFAP) (MILLIPORE, SANTA CRUZ BIOTECHNOLOGY, ABNOVA, SIGMA-ALDRICH); ICAM-2 (SANTA CRUZ BIOTECHNOLOGY, EBIOSCIENCE, CELL SCIENCES, MILLIPORE); IL-8 (BIOLEGEND, SANTA CRUZ BIOTECHNOLOGY, EBIOSCIENCE, INVITROGEN); B-1 integrin (MILLIPORE, SANTA CRUZ BIOTECHNOLOGY, ABCAM, LIFESPAN
BIOSCIENCES); keratin (LIFESPAN BIOSCIENCES, ABD SEROTEC, UNITED STATES
BIOLOGICAL, ABCAM); MAP-2 (MILLIPORE, SANTA CRUZ BIOTECHNOLOGY, COVANCE, INVITROGEN); myelin basic protein (MPB) (RAYBIOTECH, ABCAM, MILLIPORE, ACRIS ANTIBODIES); myosin light chain (MLC) (GENETEX, EPITOMICS, IMGENEX, ABCAM); 01 (SIGMA-ALDRICH, LIFESPAN BIOSCIENCES, EBIOSCIENCE, EBIOSCIENCE); 04 (MILLIPORE, SIGMA-ALDRICH, LIFESPAN BIOSCIENCES, ABCAM); osteocalcin (RAYBIOTECH, ABD SEROTEC, NOVUS BIOLOGICALS, SANTA
CRUZ BIOTECHNOLOGY); P63 (SANTA CRUZ BIOTECHNOLOGY, BIOLEGEND, INVITROGEN, ABNOVA); pancreatic polypeptide (ABCAM, SANTA CRUZ
BIOTECHNOLOGY, ACRIS ANTIBODIES, NOVUS BIOLOGICALS); E-selectin (SANTA

CRUZ BIOTECHNOLOGY, EBIOSCIENCE, RAYBIOTECH); smooth muscle cell-specific myosin heavy chain (GENETEX, PIERCE, UNITED STATES BIOLOGICAL); synaptophysin (MILLIPORE, ABCAM, ABD SEROTEC, EBIOSCIENCE); VCAM1 (SIGMA-ALDRICH, EPITOMICS, LIFESPAN BIOSCIENCES, GENETEX).
[0062] Other antibodies are known to target antigens associated with diseased cells, tissues or organs. For example, bapineuzumab is in clinical trials for therapy of Alzheimer's disease.
Other antibodies proposed for Alzheimer's disease include Alz 50 (Ksiezak-Reding et al., 1987, J
Biol Chem 263:7943-47), gantenerumab, and solanezumab. Anti-CD3 antibodies have been proposed for type 1 diabetes (Cernea etal., 2010, Diabetes Metab Rev 26:602-05). Antibodies to fibrin (e.g., scFv(59D8); T2G1s; MH I) are known and in clinical trials as imaging agents for disclosing fibrin clots and pulmonary emboli, while anti-granulocyte antibodies, such as MN-3, MN-15, anti-NCA95, and anti-CD15 antibodies, can target myocardial infarcts and myocardial ischemia. (See, e.g., U.S. Patent Nos. 5,487,892; 5,632,968; 6,294,173;
7,541,440, the Examples section of each incorporated herein by reference) Anti-macrophage, anti-low-density lipoprotein (LDL) and anti-CD74 (e.g., hLL1) antibodies can be used to target atherosclerotic plaques.
Abciximab (anti-glycoprotein lIbillIa) has been approved for adjuvant use for prevention of restenosis in percutaneous coronary interventions and the treatment of unstable angina (Waldmann et al., 2000, Hematol 1:394-408). Anti-CD3 antibodies have been reported to reduce development and progression of atherosclerosis (Steffens et al., 2006, Circulation 114:1977-84).
Antibodies against oxidized LDL induced a regression of established atherosclerosis in a mouse model (Ginsberg, 2007, J Am Coll Cardiol 52:2319-21). Anti-ICAM-1 antibody was shown to reduce ischemic cell damage after cerebral artery occlusion in rats (Zhang et al., 1994, Neurology 44:1747-51). Commercially available monoclonal antibodies to leukocyte antigens are represented by: OKT anti-T cell monoclonal antibodies (available from Ortho Pharmaceutical Company) which bind to normal 1-lymphocytes; the monoclonal antibodies produced by the hybridomas having the ATCC accession numbers HB44, HB55, HB12, and 1-IB2; G7E11, W8E7, NKPI5 and G022 (Becton Dickinson); NEN9.4 (New England Nuclear); and FMCll (Sera Labs). A description of antibodies against fibrin and platelet antigens is contained in Knight, Semin. Nucl. Med., 20:52-67 (1990).
100631 A further group of suitable targets include CD2, CD3, CD4, CD14, CD18, CD11 a, CD20, CD22, CD23, CD25, CD29, CD38, CD4OL, CD52, CD64, CD83, CD147, and CD154. The CDs are targets on immune cells that would be present in damaged or inflamed tissues. DNL
complexes that target EIMBG-1 may be of use in treating arthritis, particularly collagen-induced arthritis. TF is expressed by various cell types, including monocytes, macrophages and vascular endothelial cells, and is induced by IL-1, TNF-a or bacterial lipopolysaccharides. TF also appears to be involved in a variety of non-hemostatic functions including inflammation, cancer, brain function, immune response, and tumor-associated angiogenesis. Thrombin is the activated form of coagulation factor II (prothrombin); it converts fibrinogen to fibrin and is present in wounds and other injury sites. Targets associated with sepsis and immune dysregulation and other immune disorders include MIF, IL-1, IL-6, IL-8, CD74, CD83, and C5aR. A
recombinant interleukin-1 receptor antagonist, IL-1Ra or anakinra, has shown activity in rheumatoid arthritis (Cohen et al., Ann Rheum Dis 2004; 63:1062-8; Cohen, Rheum Dis Clin North Am 2004; 30:365-80).
100641 In other embodiments, the DNL complexes may bind to a MHC class I, MHC
class II or accessory molecule, such as CD40, CD54, CD80 or CD86. The DNL complex also may bind to a T-cell activation cytokine, or to a cytokine mediator, such as NF-03. In still other embodiments, one of the targets may be associated with graft versus host disease or transplant rejection (Lo etal., Bone Marrow Transplant, 30(6):375-80 (2002)).
[00651 C1J83 has been found to play a role in giant cell arteritis (GCA), which is a systemic vasculitis that affects medium- and large-size arteries, predominately the extracranial branches of the aortic arch and of the aorta itself, resulting in vascular stenosis and subsequent tissue ischemia, and the severe complications of blindness, stroke and aortic arch syndrome (Weyand and Goronzy, N Engl J Med 2003; 349:160-169; Hunder and Valente, In:
Inflammatory Diseases of Blood Vessels. G.S. Hoffman and C.M. Weyand, eds, Marcel Dekker, New York, 2002;
255-265). CD154, a member of the TNF family, is expressed on the surface of CD4-positive T-lymphocytes, and it has been reported that a humanized monoclonal antibody to CD154 produced significant clinical benefit in patients with active systemic lupus erythematosus (SLE) (Grammar et al., J Clin Invest 2003; 112:1506-1520). It also suggests that this antibody might be useful in other autoimmune diseases (Kelsoe, J Clin Invest 2003; 112:1480-1482). Indeed, this antibody was also reported as effective in patients with refractory immune thrombocytopenic purpura (Kuwana et at., Blood 2004; 103:1229-1236). Other antibodies against various cell, tissue, organ or disease-associated antigens are known in the art and any such known antibody may be used in the practice of the claimed methods and compositions.
Antibody Fragments [0066] In various embodiments, the DNL complexes may comprise intact antibodies and/or antibody fragments. Antibody fragments which recognize specific epitopes can be generated by known techniques. The antibody fragments are antigen binding portions of an antibody, such as F(ab)2, Fab', Fab, Fv, scFv and the like. Antibody fragments include, but are not limited to: the F(ab)2 fragments which can be produced by pepsin digestion of the antibody molecule and the Fab' fragments, which can be generated by reducing disulfide bridges of the F(abt)2 fragments.
Alternatively, Fab' expression libraries can he ennqpieted (Huse Pt nl., 1989, Science, 246:1/74-1281) to allow rapid and easy identification of monoclonal Fab' fragments with the desired specificity.
[0067] A single chain Fy molecule (scFv) comprises a VL domain and a VH
domain. The VL and VH domains associate to form a target binding site. These two domains are further covalently linked by a peptide linker. Methods for making scFv molecules and designing suitable peptide linkers are disclosed in U.S. Pat. No. 4,704,692, U.S. Pat. No. 4,946,778, R.
Raag and M.
Whitlow, "Single Chain Fvs." FASEB Vol 9:73-80 (1995) and R. E. Bird and B. W.
Walker, "Single Chain Antibody Variable Regions," TIBTECH, Vol 9: 132-137 (1991).
[0068] An antibody fragment can be prepared by known methods, for example, as disclosed by Goldenberg, U.S. Pat. Nos. 4,036,945 and 4,331,647 and references contained therein. Also, see Nisonoff et al., Arch Biochem_ Biophys. 89: 230 (1960); Porter, Biochem. J.
73: 119 (1959), Edelman et al., in METHODS IN ENZYMOLOGY VOL.1, page 422 (Academic Press 1967), and Coligan at pages 2.8.1-2.8.10 and 2.10.-2.10.4.
[0069] A single complementarity-determining region (CDR) is a segment of the variable region of an antibody that is complementary in structure to the epitope to which the antibody binds and is more variable than the rest of the variable region. Accordingly, a CDR is sometimes referred to as hypervariable region. A variable region comprises three CDRs. CDR
peptides can be obtained by constructing genes encoding the CDR of an antibody of interest.
Such genes are prepared, for example, by using the polymerase chain reaction to synthesize the variable region from RNA of antibody-producing cells. (See, e.g., Larrick et al., Methods: A
Companion to Methods in Enzymology 2: 106 (1991); Courtenay-Luck, "Genetic Manipulation of Monoclonal Antibodies," in MONOCLONAL ANTIBODIES: PRODUCTION, ENGINEERING AND
CLINICAL APPLICATION, Ritter et al. (eds.), pages 166-179 (Cambridge University Press 1995); and Ward et al., "Genetic Manipulation and Expression of Antibodies,"
in MONOCLONAL ANTIBODIES: PRINCIPLES AND APPLICATIONS, Birch et al., (eds.), pages 137-185 (Wiley-Liss, Inc. 1995).
100701 Another form of an antibody fragment is a single-domain antibody (dAb), sometimes referred to as a single chain antibody. Techniques for producing single-domain antibodies are well known in the art (see, e.g., Cossins et at., Protein Expression and Purification, 2007, 51:253-59; Shuntao et al., Molec Immunol 2006, 43:1912-19; Tanha et al., J. Biol.
Chem. 2001, 276:24774-780). Single domain antibodies may be obtained, for example, from camels, alpacas or llamas by standard immunization techniques. (See, e.g., Muyldermans et al., TIBS 26:230-235, 2001; Yau etal., J Immunol Methods 281:161-75, 2003; Maass et al., J
Immunol Methods 324:13-25, 2007). They can have potent antigen-binding capacity and can interact with novel epitopes that are inaccessible to conventional Vii-VL pairs. (Muyldermans et al., 2001). Alpaca serum IgG contains about 50% camelid heavy chain only IgG antibodies (HCAbs) (Maass et al., 2007). Alpacas may be immunized with known antigens, such as TNF-u, and single domain antibodies can be isolated that bind to and neutralize the target antigen (Maass et al., 2007). PCR
primers that amplify virtually all alpaca antibody coding sequences have been identified and may be used to construct single domain phage display libraries, which can be used for antibody fragment isolation by standard biopanning techniques well known in the art (Maass et al., 2007).
[00711 In certain embodiments, the sequences of antibodies or antibody fragments, such as the Fc portions of antibodies, may be varied to optimize their physiological characteristics, such as the half-life in serum. Methods of substituting amino acid sequences in proteins are widely known in the art, such as by site-directed mutagenesis (e.g. Sambrook et al., Molecular Cloning;
A laboratory manual, 2nd Ed, 1989). In preferred embodiments, the variation may involve the addition or removal of one or more glycosylation sites in the Fc sequence (e.g., U.S. Patent No.
6,254,868, the Examples section of which is incorporated herein by reference).
In other preferred embodiments, specific amino acid substitutions in the Fc sequence may be made (e.g., Hornick et al., 2000, J Nucl Med 41:355-62; Hinton et al., 2006, J Immunol 176:346-56; Petkova - et al. 2006, Int Immunol 18:1759-69; U.S. Patent No. 7,217,797).

Bispecific Antibodies [0072] Numerous methods to produce bispecific antibodies have been reported in the prior art.
Methods for construction and use of bispecific and multi-specific antibodies are disclosed, for example, in U.S. Patent No. 7,405,320, the Examples section of which is incorporated herein by reference. Bispecific antibodies can be produced by the quadroma method, which involves the fusion of two different hybridomas, each producing a monoclonal antibody recognizing a different antigenic site (Milstein and Cuello. Nature. 1983; 305:537-540). The fused hybridomas are capable of synthesizing two different heavy chains and two different light chains, which can associate randomly to give a heterogeneous population of 10 different antibody structures of which only one of them, amounting to 1/8 of the total antibody molecules, will be bispecific, and therefore must be further purified from the other forms, which even if feasible will not be cost effective. Furthermore, fused hybridomas are often less stable cytogenetically than the parent hybridomas, making the generation of a production cell line more problematic.
[0073] Another method for producing bispecific antibodies uses heterobifunctional cross-linkers to chemically tether two different monoclonal antibodies, so that the resulting hybrid conjugate will bind to two different targets (Staerz, et al. Nature. 1985; 314:628-631;
Perez, et al. Nature.
1985; 316:354-356). Bispecific antibodies generated by this approach are essentially heteroconjugates of two IgG molecules, which diffuse slowly into tissues and are rapidly removed from the circulation. Bispecific antibodies can also be produced by reduction of each of two parental monoclonal antibodies to the respective half molecules, which are then mixed and allowed to reoxidize to obtain the hybrid structure (Staerz and Bevan. Proc Natl Acad Sci USA.
1986; 83:1453-1457). An alternative approach involves chemically cross-linking two or three separately purified Fa& fragments using appropriate linkers. For example, European Patent Application 0453082 (now withdrawn) disclosed the application of a tri-maleimide compound to the production of bi- or tri-specific antibody-like structures. A method for preparing trivalent and tetravalent monospecific antigen-binding proteins by covalently linking three or four Fab fragments to each other via a connecting structure is provided in U.S. Pat.
No. 6,511,663. All these chemical methods are undesirable for commercial development due to high manufacturing cost, laborious production process, extensive purification steps, low yields (<20%), and heterogeneous products.

100741 Other methods include improving the efficiency of generating hybrid hybridomas by gene transfer of distinct selectable markers via retrovirus-derived shuttle vectors into respective parental hybridomas, which are fused subsequently (DeMonte, et al. Proc Natl Acad Sci USA.
1990, 87:2941-2945); or transfection of a hybridoma cell line with expression plasmids containing the heavy and light chain genes of a different antibody. These methods also face the inevitable purification problems discussed above.
[00751 A method to produce a recombinant bispecific antibody composed of Fab fragments from the same or different antibodies that are brought into association by complementary interactive domains inserted into a region of the antibody heavy chain constant region was disclosed in U.S.
Pat. No. 5,582,996. The complementary interactive domains are selected from reciprocal leucine zippers or a pair of peptide segments, one containing a series of positively charged amino acid residues and the other containing a series of negatively charged amino acid residues. One limitation of such a method is that the individual Fab subunits containing the fused complementary interactive domains appear to have much reduced affinity for their target antigens unless both subunits are combined.
100761 Discrete V11 and VL domains of antibodies produced by recombinant DNA
technology may pair with each other to form a dimer (recombinant Fv fragment) with binding capability (U.S. Pat. No. 4,642,334). However, such non-covalently associated molecules are not sufficiently stable under physiological conditions to have any practical use.
Cognate VH and VL
domains can be joined with a peptide linker of appropriate composition and length (usually consisting of more than 12 amino acid residues) to form a single-chain Fv (scFv) with binding activity. Methods of manufacturing scFvs are disclosed in U.S. Pat. No.
4,946,778 and U.S. Pat.
No. 5,132,405. Reduction of the peptide linker length to less than 12 amino acid residues prevents pairing of VH and VL domains on the same chain and forces pairing of VH and VL
domains with complementary domains on other chains, resulting in the formation of functional multimers. Polypeptide chains of VH and VL domains that are joined with linkers between 3 and 12 amino acid residues form predominantly dimers (termed diabodies). With linkers between 0 and 2 amino acid residues, trimers (termed triabody) and tetramers (termed tetrabody) are favored, but the exact patterns of oligomerization appear to depend on the composition as well as the orientation of V-domains (VH-linker-VL or VL-linker-VH), in addition to the linker length.
=

[0077] Monospecific diabodies, triabodies, and tetrabodies with multiple valencies have been obtained using peptide linkers consisting of 5 amino acid residues or less.
Bispecific diabodies, which are heterodimers of two different scFvs, each scFv consisting of the VH
domain from one antibody connected by a short peptide linker to the VL domain of another antibody, have also been made using a dicistronic expression vector that contains in one cistron a recombinant gene construct comprising VH 1 --linker-VL2 and in the other cistron a second recombinant gene construct comprisingl/H2-linker-VLI (Holliger, et al. Proc Natl Acad Sci USA.
1993; 90: 6444-6448; Atwell, et al. Mol Immunol. 1996; 33:1301-1302; Holliger, etal. Nature Biotechnol. 1997;
15: 632-631; Helfrich, etal. Int. J. Cancer. 1998; 76: 232-239; Kipriyanov, et al. Int J Cancer.
1998; 77: 763-772; Holliger, et al. Cancer Res. 1999; 59: 2909-2916).
[0078] A tetravalent tandem diabody (termed tandab) with dual specificity has also been reported (Cochlovius, et al. Cancer Res. 2000; 60: 4336-4341). The bispecific tandab is a dimer of two identical polypeptides, each containing four variable domains of two different antibodies (VH1, VL I, VH2, VL2) linked in an orientation to facilitate the formation of two potential binding sites for each of the two different specificities upon self-association.
[0079] Methods of manufacturing scFv-based agents of multivalency and multispecificity by varying the linker length were disclosed in U.S. Pat. No. 5,844,094, U.S. Pat.
No. 5,837,242 and WO 98/44001. Methods of manufacturing scFv-based agents of multivalency and multispecificity by constructing two polypeptide chains, one comprising of the VH domains from at least two antibodies and the other the corresponding VL domains were disclosed in U.S. Pat.
No. 5,989,830 and U.S. Pat. No. 6,239,259. Common problems that have been frequently associated with generating scFv-based agents of multivalency and multispecificity by prior art are low expression levels, heterogeneous products, instability in solution leading to aggregates, instability in serum, and impaired affinity.
[0080] A recombinantly produced bispecific or trispecific antibody in which the C-termini of CH I and CL of a Fab are each fused to a scFv derived from the same or different monoclonal antibodies was disclosed in U.S. Pat. No. 6,809,185. Major deficiencies of this "Tribody"
technology include impaired binding affinity of the appended scFvs, heterogeneity of product forms, and instability in solution leading to aggregates.

Immunoconjugates 100811 In certain embodiments, an antibody or antibody fragment in a DNL
complex may be directly attached to one or more therapeutic and/or diagnostic agents to form an immunoconjugate. Therapeutic or diagnostic agents may be attached, for example to reduced SH groups and/or to carbohydrate side chains. A therapeutic or diagnostic agent can be attached at the hinge region of a reduced antibody component via disulfide bond formation. Alternatively, such agents can be attached using a heterobifunctional cross-linker, such as N-succinyl 3-(2-pyridyldithio)propionate (SPDP). Yu et al., Int. J. Cancer 56: 244 (1994).
General techniques for such conjugation are well-known in the art. See, for example, Wong, CHEMISTRY OF
PROTEIN CONJUGATION AND CROSS-LINKING (CRC Press 1991); Upeslacis etal., "Modification of Antibodies by Chemical Methods," in MONOCLONAL ANTIBODIES:
PRINCIPLES AND APPLICATIONS, Birch et al. (eds.), pages 187-230 (Wiley-Liss, Inc.
1995); Price, "Production and Characterization of Synthetic Peptide-Derived Antibodies," in MONOCLONAL ANTIBODIES: PRODUCTION, ENGINEERING AND CLINICAL
APPLICATION, Ritter etal. (eds.), pages 60-84 (Cambridge University Press 1995).
Alternatively, the therapeutic or diagnostic agent can be conjugated via a carbohydrate moiety in the Fc region of the antibody.
[00821 Methods for conjugating functional groups to antibodies via an antibody carbohydrate moiety are well-known to those of skill in the art. See, for example, Shih etal., Int. J. Cancer 41: 832 (1988); Shih et al., Int. J. Cancer 46: 1101(1990); and Shih etal., U.S. Patent No.
5,057,313, the Examples section of which is incorporated herein by reference.
The general method involves reacting an antibody having an oxidized carbohydrate portion with a carrier polymer that has at least one free amine function. This reaction results in an initial Schiff base (imine) linkage, which can be stabilized by reduction to a secondary amine to form the final conjugate.
[00831 The Fe region may be absent if the antibody component of the immunoconjugate is an antibody fragment. However, it is possible to introduce a carbohydrate moiety into the light chain variable region of a full length antibody or antibody fragment. See, for example, Leung et al., J. Immunol. 154: 5919 (1995); U.S. Patent Nos. 5,443,953 and 6,254,868, the Examples section of which is incorporated herein by reference. The engineered carbohydrate moiety is used to attach the therapeutic or diagnostic agent.
[0084] An alternative method for attaching therapeutic or diagnostic agents to an antibody or other effector moiety involves use of click chemistry reactions. The click chemistry approach was originally conceived as a method to rapidly generate complex substances by joining small subunits together in a modular fashion. (See, e.g., Kolb et al., 2004, Angew Chem Int Ed 40:3004-31; Evans, 2007, Aust 1 Chem 60:384-95.) Various forms of click chemistry reaction are known in the art, such as the Huisgen 1,3-dipolar cycloaddition copper catalyzed reaction (Tomoe et al., 2002, J Organic Chem 67:3057-64), which is often referred to as the "click reaction." Other alternatives include cycloaddition reactions such as the Diels-Alder, nucleophilic substitution reactions (especially to small strained rings like epoxy and aziridine compounds), carbonyl chemistry formation of urea compounds and reactions involving carbon-carbon double bonds, such as alkynes in thiol-yne reactions.
[0085] The azide alkyne Huisgen cycloaddition reaction uses a copper catalyst in the presence of a reducing agent to catalyze the reaction of a terminal alkyne group attached to a first molecule.
In the presence of a second molecule comprising an azide moiety, the:azide reacts with the activated alkyne to form a 1,4-disubstituted 1,2,3-triazole. The copper catalyzed reaction occurs at room temperature and is sufficiently specific that purification of the reaction product is often not required. (Rostovstev et al., 2002, Angew Chem Int Ed 41:2596; Tomoe et al., 2002, J Org Chem 67:3057.) The azide and alkyne functional groups are largely inert towards biomolecules in aqueous medium, allowing the reaction to occur in complex solutions. The triazole formed is chemically stable and is not subject to enzymatic cleavage, making the click chemistry product highly stable in biological systems. Although the copper catalyst is toxic to living cells, the copper-based click chemistry reaction may be used in vitro for immunoconjugate formation.
100861 A copper-free click reaction has been proposed for covalent modification of biomolecules. (See, e.g., Agard et al., 2004, J Am Chem Soc 126:15046-47.) The copper-free reaction uses ring strain in place of the copper catalyst to promote a [3 + 2]
azide-alkyne cycloaddition reaction (Id.) For example, cyclooctyne is an 8-carbon ring structure comprising an internal alkyne bond. The closed ring structure induces a substantial bond angle deformation of the acetylene, which is highly reactive with azide groups to form a triazole. Thus, cyclooctyne derivatives may be used for copper-free click reactions (Id) [0087] Another type of copper-free click reaction was reported by Ning et al.
(2010, Angew Chem lot Ed 49:3065-68), involving strain-promoted alkyne-nitrone cycloaddition. To address the slow rate of the original cyclooctyne reaction, electron-withdrawing groups are attached adjacent to the triple bond (Id.) Examples of such substituted cyclooctynes include difluorinated cyclooctynes, 4-dibenzocyclooctynol and azacyclooctyne (Id.) An alternative copper-free reaction involved strain-promoted akyne-nitrone cycloaddition to give N-alkylated isoxazolines (Id.) The reaction was reported to have exceptionally fast reaction kinetics and was used in a one-pot three-step protocol for site-specific modification of peptides and proteins (Id.) Nitrones were prepared by the condensation of appropriate aldehydes with N-methylhydroxylamine and the cycloaddition reaction took place in a mixture of acetonitrile and water (Id.) These and other known click chemistry reactions may be used to attach therapeutic or diagnostic agents to antibodies in vitro.
Therapeutic Agents [0088] A wide variety of therapeutic reagents can be administered concurrently or sequentially with the subject DNL complexes. For example, immunomodulators, hormones, hormone antagonists, other antibodies or fragments thereof, etc. Therapeutic agents may be useful for administration separately with a DNL complex as described above or else conjugated to a subject DNL complex.
[0089] An immunomodulator of use may be selected from the group consisting of a cytokine, a lymphokine, a monokine, a stem cell growth factor, a lymphotoxin, a hematopoietic factor, a colony stimulating factor (CSF), an interferon (IFN), erythropoietin and thrombopoietin.
Specifically useful are lymphotoxins such as tumor necrosis factor (TNF), hematopoietic factors, such as interleukin (IL), colony stimulating factor, such as granulocyte-colony stimulating factor (G-CSF) or granulocyte macrophage-colony stimulating factor (GM-CSF), interferon, such as interferons-a, or -y, and stem cell growth factor, such as that designated "Si factor".
[0090] A cytokine of use may be selected from the group consisting of MIF
(macrophage migration inhibitory factor), HMGB-1 (high mobility group box protein 1), erythropoietin, thrombopoietin tumor necrosis factor-a (INF), TNF-13, granulocyte-colony stimulating factor (G-CSF), granulocyte macrophage-colony stimulating factor (GM-CSF), interferon-a, interferon-P, interferon-y, interferon-X., stem cell growth factor designated "Si factor", human growth hormone, N-methionyl human growth hormone, bovine growth hormone, parathyroid hormone, thyroxine, insulin, proinsulin, relaxin, prorelaxin, follicle stimulating hormone (FSH), thyroid stimulating hormone (TSH), luteinizing hormone (LH), hepatic growth factor, prostaglandin, fibroblast growth factor, prolactin, placental lactogen, OB
protein, mullerian-inhibiting substance, mouse gonadotropin-associated peptide, inhibin, activin, vascular endothelial growth factor, integrin, NGF-B, platelet-growth factor, TGF- a, TGF- B, insulin-like growth factor-I, insulin-like growth factor-II, macrophage-CSF (M-CSF), CCL19, CCL2I, IL-I, EL- l a, IL-2, IL-3, 1L-4, IL-5, IL-6, IL-7, IL-8, IL-9, IL-10, IL-11, 1L-12, IL-13, IL-14, IL-15, IL-16, IL-17, IL-18, IL-21, IL-23, IL-25, LIF, FLT-3, angiostatin, thrombospondin, endostatin, MCP-1, RANTES, MIP-1A, MIP-1B, ENA-78, MCP-1, IP-10, Gro-B, Eotaxin, SCF, PDGF, MSF, CNTF, leptin, oncostatin M, EGF, FGF, P1GF, calcitonin, Factor VIII, somatostatin, tissue plasminogen activator, LIF and LT.
Diagnostic Agents [00911 Diagnostic agents are preferably selected from the group consisting of a radionuclide, a radiological contrast agent, a paramagnetic ion, a metal, a fluorescent label, a chemiluminescent label, an ultrasound contrast agent and a photoactive agent. Such diagnostic agents are well known and any such known diagnostic agent may be used. Non-limiting examples of diagnostic agents may include a radionuclide such as 18F, 52Fe, "0In, I I lin, 177Lu, 18F, 52Fe, 62cu, ocu, ocu, 67Ga, "Ga, 86y, 90y, 89zr, 94mTc, 94Tc, 99Mm, 1201, 1231, 124 1251, 1311, 154-I58Gd, 32P, ''C, 13N, ISO, 186-R '88Re, 5IMn, 52n1Mn, "Co, 72As, 75Br, 76Br, Kb 83Sr, or other gamma-, beta-, or positron-emitters.
[00921 Paramagnetic ions of use may include chromium (III), manganese (II), iron (III), iron (II), cobalt (II), nickel (II), copper (II), neodymium (III), samarium (III), ytterbium (III), gadolinium (III), vanadium (II), terbium (III), dysprosium (III), holmium (III) or erbium (III). Metal contrast agents may include lanthanum (III), gold (III), lead (II) or bismuth (III).
[00931 Ultrasound contrast agents may comprise liposomes, such as gas filled liposomes.
Radiopaque diagnostic agents may be selected from compounds, barium compounds, gallium compounds, and thallium compounds. A wide variety of fluorescent labels are known in the art, including but not limited to fluorescein isothiocyanate, rhodamine, phycoerytherin, phycocyanin, al lophycocyanin, o-plithaldehyde and fluorescamine. Chemiluminescent labels of use may =

include luminol, isoluminol, an aromatic acridinium ester, an imidazole, an acridinium salt or an oxalate ester.
Methods of Therapeutic Treatment [00941 Therapeutic DNL complexes can be formulated according to known methods to prepare pharmaceutically useful compositions, whereby the therapeutic DNL complex is combined in a mixture with a pharmaceutically suitable excipient. Sterile phosphate-buffered saline is one example of a pharmaceutically suitable excipient. Other suitable excipients are well-known to those in the art. See, for example, Ansel et at, PHARMACEUTICAL DOSAGE FORMS
AND
DRUG DELIVERY SYSTEMS, 5th Edition (Lea & Febiger 1990), and Gennaro (ed.), REMINGTON'S PHARMACEUTICAL SCIENCES, 18th Edition (Mack Publishing Company 1990), and revised editions thereof.
100951 The therapeutic DNL complex can be formulated for intravenous administration via, for example, bolus injection or continuous infusion. Preferably, the therapeutic DNL complex is infused over a period of less than about 4 hours, and more preferably, over a period of less than about 3 hours. For example, the first 25-50 mg could be infused within 30 minutes, preferably even 15 min, and the remainder infused over the next 2-3 hrs. Formulations for injection can be presented in unit dosage form, e.g., in ampoules or in multi-dose containers, with an added preservative. The compositions can take such forms as suspensions, solutions or emulsions in oily or aqueous vehicles, and can contain formulatory agents such as suspending, stabilizing and/or dispersing agents. Alternatively, the active ingredient can be in powder form for constitution with a suitable vehicle, e.g., sterile pyrogen-free water, before use.
100961 More generally, the dosage of an administered therapeutic DNL complex for humans will vary depending upon such factors as the patient's age, weight, height, sex, general medical condition and previous medical history. It may be desirable to provide the recipient with a dosage of therapeutic DNL complex that is in the range of from about 1 mg/kg to 25 mg/kg as a single intravenous infusion, although a lower or higher dosage also may be administered as circumstances dictate. A dosage of 1-20 mg/kg for a 70 kg patient, for example, is 70-1,400 mg, or 41-824 mg/m2 for a I .7-m patient. The dosage may be repeated as needed, for example, once per week for 4-10 weeks, once per week for 8 weeks, or once per week for 4 weeks. It may also be given less frequently, such as every other week for several months, or monthly or quarterly for many months, as needed in a maintenance therapy.

100971 Alternatively, a therapeutic DNL complex may be administered as one dosage every 2 or 3 weeks, repeated for a total of at least 3 dosages. Or, the therapeutic DNL
complex may be administered twice per week for 4-6 weeks. If the dosage is lowered to approximately 200-300 mg/m2(340 mg per dosage for a 1.7-m patient, or 4.9 mg/kg for a 70 kg patient), it may be administered once or even twice weekly for 4 to 10 weeks. Alternatively, the dosage schedule may be decreased, namely every 2 or 3 weeks for 2-3 months. It has been determined, however, that even higher doses, such as 20 mg/kg once weekly or once every 2-3 weeks can be administered by slow i.v. infusion, for repeated dosing cycles. The dosing schedule can optionally be repeated at other intervals and dosage may be given through various parenteral routes, with appropriate adjustment of the dose and schedule.
[0098] Additional pharmaceutical methods may be employed to control the duration of action of the therapeutic DNL complex. Control release preparations can be prepared through the use of polymers to complex or adsorb the DNL complex. For example, biocompatible polymers include matrices of poly(ethylene-co-vinyl acetate) and matrices of a polyanhydride copolymer of a stearic acid dimer and sebacic acid. Sherwood et al., Bio/Technology 10: 1446 (1992). The rate of release of a DNL complex from such a matrix depends upon the molecular weight of the DNL
complex, the amount of DNL complex _within the matrix, and the size of dispersed particles.
Saltzman et al., Biophys. J. 55: 163 (1989); Sherwood et al., supra. Other solid dosage forms are described in Ansel et al., PHARMACEUTICAL DOSAGE FORMS AND DRUG DELIVERY
SYSTEMS, 5th Edition (Lea & Febiger 1990), and Gennaro (ed.), REMINGTON'S
PHARMACEUTICAL SCIENCES, 18th Edition (Mack Publishing Company 1990), and revised editions thereof.
Therapy of Autoimmune Disease [0099] DNL complexes can be used to treat immune dysregulation disease and related autoimmune diseases, including Class-III autoimmune diseases, immune-mediated thrombocytopenias, such as acute idiopathic thrombocytopenic purpura and chronic idiopathic thrombocytopenic purpura, dermatomyositis, Sjogren's syndrome, multiple sclerosis, Sydenham's chorea, myasthenia gravis, systemic lupus erythematosus, lupus nephritis, rheumatic fever, polyglandular syndromes, bullous pemphigoid, diabetes mellitus, Henoch-Schonlein purpura, post-streptococcal nephritis, erythema nodosum, Takayasu's arteritis, Addison's disease, rheumatoid arthritis, sarcoidosis, ulcerative colitis, erythema multiforme, IgA nephropathy, polyarteritis nodosa, ankylosing spondylitis, Goodpasture's syndrome, thromboangitis obliterans, primary biliary cirrhosis, Hashimoto's thyroiditis, thyrotoxicosis, scleroderma, chronic active hepatitis, polymyositis/dermatomyositis, polychondritis, pemphigus vulgaris, Wegener's granulomatosis, membranous nephropathy, amyotrophic lateral sclerosis, tabes dorsalis, giant cell arteritis/polymyalgia, pernicious anemia, rapidly progressive glomerulonephritis and fibrosing alveolitis.
Kits [0100] Various embodiments may concern kits containing DNL complexes and/or other components. If the composition containing components for administration is not formulated for delivery via the alimentary canal, such as by oral delivery, a device capable of delivering the kit components through some other route may be included. One type of device, for applications such as parenteral delivery, is a syringe that is used to inject the composition into the body of a subject. Inhalation devices may also be used for certain applications.
101011 The kit components may be packaged together or separated into two or more containers.
In some embodiments, the containers may be vials that contain sterile, lyophilized formulations of a composition that are suitable for reconstitution. A kit may also contain one or more buffers suitable for reconstitution and/or dilution of other reagents. Other containers that may be used include, but are not limited to, a pouch, tray, box, tube, or the like. Kit components may be packaged and maintained sterilely within the containers. Another component that can be included is instructions to a person using a kit for its use.
EXAMPLES
[0102] Various embodiments of the present invention are illustrated by the following examples, without limiting the scope thereof.
Example 1. Preparation of Dock-and-Lock (DNL) Constructs DDD and AD Fusion Proteins [0103] The DNL technique can be used to make dimers, trimers, tetramers, hexamers, etc.
comprising virtually any antibody, antibody fragment, immunomodulator, cytokine, PEG moiety, toxin, antigen or xenoantigen or other effector moiety. For certain preferred embodiments, antibodies and cytokines may be produced as fusion proteins comprising either a dimerization and docking domain (DDD) or anchoring domain (AD) sequence. Although in preferred embodiments the DDD and AD moieties may be joined to antibodies, antibody fragments, cytokines or other effector moieties as fusion proteins, the skilled artisan will realize that other methods of conjugation exist, such as chemical cross-linking, click chemistry reaction, etc.
[0104] The technique is not limiting and any protein or peptide of use may be produced as an AD-or DDD fusion protein for incorporation into a DNL complex. Where chemical cross-linking is utilized, the AD and DDD conjugates may comprise any molecule that may be cross-linked to an AD or DDD sequence using any cross-linking technique known in the art.
Expression Vectors [0105] The plasmid vector pdFIL2 has been used to produce a number of antibodies and antibody-based constructs. See Gillies et at., J Immunol Methods (1989), 125:191-202; Losman et at., Cancer (Phila) (1997), 80:2660-6. The di-cistronic mammalian expression vector directs ' the synthesis of the heavy and light chains of IgG. The vector sequences are mostly identical for many different IgG-pdHL2 constructs, with the only differences existing in the variable domain (VH and VL) sequences. Using molecular biology tools known to those skilled in the art, these IgG expression vectors can be converted into Fab-DDD or Fab-AD expression vectors.
[0106] To generate Fab-DDD expression vectors, the coding sequences for the hinge, CH2 and CH3 domains of the heavy chain were replaced with a sequence encoding the first 4 residues of the hinge, a 14 residue Gly-Ser linker and a DDD moiety, such as the first 44 residues of human Rita (referred to as DDD I, SEQ ID NO:1). To generate Fab-AD expression vectors, the sequences for the hinge, CH2 and Cl-13 domains of IgG were replaced with a sequence encoding the first 4 residues of the hinge, a 15 residue Gly-Ser linker and an AD
moiety, such as a 17 residue synthetic AD called AKAP-/S (referred to as AD!, SEQ ID NO:3), which was generated using bioinformatics and peptide array technology and shown to bind RIIcx dimers with a very high affinity (0.4 nM). See Alto, et at. Proc. Natl. Acad. Sci., U.S.A (2003), 100:4445-50.
[0107] Two shuttle vectors were designed to facilitate the conversion of IgG-pdHL2 vectors to either Fab-DDD1 or Fab-AD1 expression vectors, as described below.

Preparation of CH I
101081 The CHI domain was amplified by PCR using the pdHL2 plasmid vector as a template.
The left PCR primer consisted of the upstream (5') end of the CHI domain and a Sacll restriction endonuclease site, which is 5' of the CH1 coding sequence. The right primer consisted of the sequence coding for the first 4 residues of the hinge (PKSC, SEQ ID NO:85) followed by four glycines and a serine, with the final two codons (GS) comprising a Bain HI
restriction site. The 410 bp PCR amplimer was cloned into the PGEMT PCR
cloning vector (PROMEGAO, Inc.) and clones were screened for inserts in the T7 (5') orientation.
[0109] A duplex oligonucleotide was synthesized to code for the amino acid sequence of DDD1 preceded by 11 residues of the linker peptide, with the first two codons comprising a BamHI
restriction site. A stop codon and an Eagl restriction site are appended to the 3'end. The encoded polypeptide sequence is shown below.

GSGGGGSGGGGSHIQIPPGLTELLQGYTVEVLRQQPPDLVEFAVEYFTRLREARA (SEQ
ID NO:86) [0110] Two oligonucleotides, designated RIIA1-44 top and RIIA1-44 bottom, which overlap by 30 base pairs on their 3' ends, were synthesized and combined to comprise the central 154 base pairs of the 174 bp DDD I sequence. The oligonucleotides were annealed and subjected to a primer extension reaction with Taq polymerase. Following primer extension, the duplex was amplified by PCR. The amplimer was cloned into PGEMT and screened for inserts in the T7 (5') orientation.
[0111] A duplex oligonucleotide was synthesized to code for the amino acid sequence of AD I
preceded by 11 residues of the linker peptide with the first two codons comprising a BamHI
restriction site. A stop codon and an Eagl restriction site are appended to the 3'end. The encoded polypeptide sequence is shown below.
GSGGGGSGGGGSQIEYLAKQIVDNAIQQA (SEQ ID NO:87) [01121 Two complimentary overlapping oligonucleotides encoding the above peptide sequence, designated AKAP-IS Top and AKAP-IS Bottom, were synthesized and annealed. The duplex was amplified by PCR. The amplimer was cloned into the PGEMT vector and screened for inserts in the T7 (5') orientation.

Ligating DDD I with CHI
[0113] A 190 bp fragment encoding the DDD1 sequence was excised from PGEMTO
with BamHI and Notl restriction enzymes and then ligated into the same sites in Cl1-PGEMTO to generate the shuttle vector CH I -DDD I -PGEMTO.
Ligating AD I with CH I
[0114] A 110 bp fragment containing the AD I sequence was excised from PGEMTC) with BamHI and Notl and then ligated into the same sites in CHI-PGEMTO to generate the shuttle vector CHI-AD1-PGEMTO.
Cloning CH I -DDD1 or Cl1-AD1 into pdHL2-Based Vectors 10115] With this modular design either CH1-DDD1 or CHI-AD1 can be incorporated into any IgG construct in the pdHL2 vector. The entire heavy chain constant domain is replaced with one of the above constructs by removing the SacII/EagI restriction fragment (CH I-CH3) from pdHL2 and replacing it with the SacII/EagI fragment of CH1-DDD I or CH I-AD I, which is excised from the respective PGEMTO shuttle vector.
Construction of h679-Fd-AD1-pdHL2 [0116] h679-Fd-ADI-pdHL2 is an expression vector for production of h679 Fab (see U.S Patent No. 7,666,415) with AD I coupled to the carboxyl terminal end of the CHI
domain of the Fd via a flexible Gly/Ser peptide spacer composed of 14 amino acid residues. A pdHL2-based vector containing the variable domains of h679 was converted to h679-Fd-AD1-pdHL2 by replacement of the SacII/EagI fragment with the CHI-AD I fragment, which was excised from the CH1-AD I -SV3 shuttle vector with SacII and Eagl.
Production and Purification of h679-Fab-AD1 [01171 The h679-Fd-AD1-pdHL2 vector was linearized by digestion with Sal I
restriction endonuclease and transfected into Sp/EEE myeloma cells by electroporation. The di:cistronic expression vector directs the synthesis and secretion of both h679 kappa light chain and h679 Fd-AD I, which combine to form h679 Fab-ADI. Following electroporation, the cells were plated in 96-well tissue culture plates and transfectant clones were selected with 0.05 jiM methotrexate (MTX). Clones were screened for protein expression by ELISA using microtiter plates coated with a BSA-IMP260 (HSG) conjugate and detection with HRP-conjugated goat anti-human Fab.
BIAcore analysis using an HSG (IMP239) sensorchip was used to determine the productivity by measuring the initial slope obtained from injection of diluted media samples.
The highest producing clone had an initial productivity of approximately 30 mg/L. h679-Fab-AD1 was purified from roller bottle culture by single-step IMP291 affinity chromatography. SE-HPLC
analysis of the eluate shows a single sharp peak with a retention time consistent with a 50 kDa protein (not shown). Only two bands, which represent the polypeptide constituents of h679-AD1, were evident by reducing SDS-PAGE analysis (not shown).
Construction of C-DDD1-Fd-hMN-14-pdHL2 [01181 C-DDD I -Fd-hMN-14-pdHL2 is an expression vector for production of a stable dimer that comprises two copies of a fusion protein C-DDD1-Fab-hMN-14, in which DDD1 is linked to hMN-14 Fab (see U.S Patent No. 5,874,540) at the carboxyl terminus of CH1 via a flexible peptide spacer. The plasmid vector hMN-14(1)-pdHL2, which has been used to produce hMN-14 IgG, was converted to C-DDD1-Fd-hMN-14-pdHL2 by digestion with Sad! and Eagl restriction endonucleases to remove the CII1-CH3 domains and insertion of the fragment, which was excised from the CH1-DDD1-SV3 shuttle vector with SacII
and Eagl.
[01191 The same technique has been utilized to produce plasmids for Fab expression of a wide Variety of known antibodies, such as hLL I (U.S. Patent No. 7,312,318), hLL2 (U.S. Patent No.
7,074,403), hPAM4 (U.S. Patent No. 7,282,567), hR1 (U.S. Patent Application 12/772,645), hRS7 (U.S. Patent No. 7,238,785), hMN-14 (U.S. Patent No. 6,676,924), hMN-15 (U.S. Patent No. 7,541,440), hAl9 (U.S. Patent No. 7,109,304), hA20 (U.S. Patent No.
7,251,164) and many others. Generally, the antibody variable region coding sequences were present in a pdHL2 expression vector and the expression vector was converted for production of an AD- or DDD-fusion protein as described above. The AD- and DDD-fusion proteins comprising a Fab fragment of any of such antibodies may be combined, in an approximate ratio of two DDD-fusion proteins per one AD-fusion protein, to generate a trimeric DNL complex comprising two Fab fragments of a first antibody and one Fab fragment of a second antibody.
[01201 C-DDD1-Fab-hMN- 14 was produced and purified as described above for h679-Fab-AD I , using affinity chromatography on ADI-Affigel. The initial productivity of the highest producing C-DDD I -Fab-hMN14 Fab clone was 60 mg/L.
[01211 Binding activity of the hMN-14 moiety was determined using WI2 (a rat anti-id monoclonal antibody to hMN-14) and SE-HPLC analysis of samples. A sample prepared by mixing WI2 Fab and C-DDD1-Fab-hMN-14 at a molar ratio of 0.75:1 showed three peaks, which were attributed to unbound C-DDDI-Fab-hMNI4 (8.71 min), C-DDDI-Fab-hMN-14 =
bound to one WI2 Fab (7.95 min), and C-DDD1-Fab-hMN14 bound to two WI2 Fabs (7.37 min) (not shown). When a sample containing WI2 Fab and C-DDD1-Fab-hMN-14 at a molar ratio of 4 was analyzed, only a single peak at 7.36 minutes was observed (not shown).
These results demonstrated that hMN14-Fab-DDD1 is dimeric and has two active binding sites.
A competitive ELISA demonstrated that C-DDDI-Fab-hMN-14 binds to CEA with an avidity similar to hMN-- 14 IgG, and significantly stronger than monovalent hMN-14 Fab (not shown).
C-DDD2-Fd-hMN-14-pdfiL2 [0122] C-DDD2-Fd-hMN-14-pdHL2 is an expression vector for production of C-DDD2-Fab-hMN-14, which possesses a dimerization and docking domain sequence of DDD2 (SEQ ID
NO:2) appended to the carboxyl terminus of the Fd of hMN-14 via a 14 amino acid residue Gly/Ser peptide linker. The fusion protein secreted is composed of two identical copies of hMN-14 Fab held together by non-covalent interaction of the DDD2 domains.
[0123] The expression vector was engineered as follows. Two overlapping, complimentary oligonucleotides, which comprise the coding sequence for part of the linker peptide and residues 1-13 of DDD2, were made synthetically. The oligonucleotides were annealed and phosphorylated with T4 PNK, resulting in overhangs on the 5' and 3' ends that are compatible for ligation with DNA digested with the restriction endonucleases BamHI and Pstl, respectively.
[0124] The duplex DNA was ligated with the shuttle vector CH1-DDDI-PGEMT , which was prepared by digestion with BamHI and Pstl, to generate the shuttle vector CH1-PGEMTO. A 507 bp fragment was excised from CH I -DDD2-PGEMTS with SacII and EagI
and ligated with the IgG expression vector hMN-14(I)-pdHL2, which was prepared by digestion with SacII and Eagl. The final expression construct was designated C-DDD2-Fd-hMN-14-pdHL2. Similar techniques have been utilized to generated DDD2-fusion proteins of the Fab fragments of a number of different humanized antibodies.
h679-Fd-AD2-pdHL2 [0125] h679-Fab-AD2, was designed to pair to C-DDD2-Fab-hMN-14. h679-Fd-AD2-pdHL2 is an expression vector for the production of h679-Fab-AD2, which possesses an anchoring domain sequence of AD2 (SEQ ID NO:4) appended to the carboxyl terminal end of the CH1 domain via a 14 amino acid residue Gly/Ser peptide linker. AD2 has one cysteine residue preceding and another one following the anchor domain sequence of AD I .

Production of Trimeric DNL Constructs 101261 The TF2 DNL construct was prepared from C-DDD2-Fab-hMN-14 and h679-Fab-AD2.
The trimeric DL construct was stable in serum and both antibody moieties exhibited the antibody binding characteristics of the parent antibodies (not shown). The DNL
construct was used for pretargeting studies and showed localization to target tissues expressing the CEA antigen (not shown).
[0127] A similar protocol was used to generate a trimeric TF 10 DNL complex;
comprising two copies of a C-DDD2-Fab-hPAM4 and one copy of C-AD2-Fab-679. The TF10 bispecific ({hPAM412 x h679) antibody was produced using the method disclosed for production of the (anti CEA)2 x anti HSG bsAb TF2, as described above. The TF10 construct bears two humanized PAM4 Fabs (see U.S. Patent No. 7,282,567) and one humanized 679 Fab. The TF10 DNI, construct showed the antigen-binding characteristics of the parent antibodies (not shown).
Example 2. Production of AD- and DDD-linked Fab and IgG Fusion Proteins From Multiple Antibodies [0128] Using the techniques described in the preceding Examples, the IgG and Fab fusion proteins shown in Table 5 were constructed and incorporated into DNL
complexes. The fusion proteins retained the antigen-binding characteristics of the parent antibodies and the DNL
complexes exhibited the antigen-binding activities of the incorporated antibodies or antibody fragments.
Table 5. Fusion proteins comprising IgG or Fab Fusion Protein Binding Specificity C-AD1-Fab-h679 HSG
C-AD2-Fab-h679 HSG
C-(AD)2-Fab-h679 HSG
C-AD2-Fab-h734 Indium-DTPA
C-AD2-Fab-hA20 CD20 C-AD2-Fab-hA2OL CD20 C-AD2-Fab-hL243 HLA-DR
C-AD2-Fab-hLL2 CD22 N-AD2-Fab-hLL2 CD22 C-AD2-IgG-hMN-14 CEACAM5 =
C-AD2-IgG-hR1 IGF-1R
C-AD2-IgG-hRS7 EGP-1 C-AD2-IgG-hPAM4 MUC
C-AD2-IgG-hLL1 CD74 C-DDD1-Fab-hMN-14 CEACAM5 C-DDD2-Fab-hMN-14 CEACAM5 C-DDD2-Fab-h679 HSG
C-DDD2-Fab-hAl9 CD19 C-DDD2-Fab-hA20 CD20 C-DDD2-Fab-hAFP AFP
C-DDD2-Fab-hL243 HLA-DR
C-DDD2-Fab-hLL1 CD74 C-DDD2-Fab-hLL2 CD22 C-DDD2-Fab-hMN-3 CEACAM6 C-DDD2-Fab-hMN-15 CEACAM6 C-DDD2-Fab-hPAM4 MUC
C-DDD2-Fab-hR1 IGF-1R
C-DDD2-Fab-hRS7 EGP-1 N-DDD2-Fab-hMN-14 CEACAM5 Example 3. Molecular Engineering of DDD3-CH2-CH3-AD2 and DDD3C-CH2-101291 Two PCR reactions were performed to generate the DDD3 and DDD3C
sequences using a human RIa cDNA clone (INVITROGEN IMAGE clone #5531156) as a template. Both reactions used the oligonucleotide RI BgIII right as the 3' PCR primer. The oligonucleotides RI
BspHI Left and RI-C BspHI Left were used as 5 primers for DDD3 and DDD3C, respectively.
RI BgIll Right 5'-AGATCTGCCTTTTGCCTCCTCCTTCTC-3' (SEQ ID NO:88) RI BspHI Left . 5'-TCATGAGCCTTCGAGAATGTGAGCTC-3' (SEQ ID NO:89) RI-C BspHI Left 5'-TCATGAGTTGTGGCGGAAGCCTTCGAGAATGTGAGC-3' (SEQ ID NO:90) [01301 The Fc (CI-12 and CH3 domains) was amplified using the pdHL2 vector as a template and the oligonucleotides Fc BglII Left and Fc Bam-EcoRI Right as primers. Each of the amplimers was cloned in the PGEMT PCR cloning vector. The Fc insert fragment was excised from PGEMT with BglII and EcoRI restriction enzymes and cloned into those same sites in the SV3 shuttle vector to generate the intermediate clone Fc-SV3.
[01311 The DDD3 and DDD3C inserts were then excised from the PGEMT vectors with BspHI and BglII and ligated with Fc-SV3 vector that was digested with NcoI
(BspHI compatible ends) and BglII to generate the shuttle vectors DDD3-Fc-SV3 and DDD3C-Fc-SV3, respectively. Finally, the expression cassettes were excised from the SV3 shuttle vectors with XbaI and BamI II and ligated with AD2-pdHL2 vector that was prepared by digestion of h679-AD2-pdHL2 with XbaI and Bam1-11. The final expression constructs are DDD3-Fc-AD2-pdHL2 and DDD3C-Fc-AD2-pdHL2.
Example 4. Hexavalent DNL complexes 101321 The DNL technology described above for formation of trivalent DNL
complexes was applied to generate hexavalent IgG-based DNL structures (HIDS). Because of the increased number of binding sites for target antigens, hexavalent constructs might be expected to show greater affinity and/or efficacy against target cells. Two types of modules, which were produced as recombinant fusion proteins, were combined to generate a variety of HIDS.
Fab-DDD2 modules were as described for use in generating trivalent Fab structures (Rossi et al. Proc Nat!
Acad Sci USA .2006; 103(18): 6841-6). The Fab-DDD2 modules form stable homodimers that bind to AD2-containing modules. To generate HIDS, two types of IgG-AD2 modules were created to pair with the Fab-DDD2 modules: C-H-AD2-IgG and N-L-AD2-IgG.
101331 C-H-AD2-IgG modules have an AD2 peptide fused to the carboxyl terminus (C) of the heavy (H) chain of IgG via a 9 amino acid residue peptide linker. The DNA
coding sequences for the linker peptide (GSGGGGSGG, SEQ ID NO:91) followed by the AD2 peptide (CGQIEYLAKQIVDNAIQQAGC, SEQ ID NO:4) are coupled to the 3' end of the CH3 (heavy chain constant domain 3) coding sequence by standard recombinant DNA
methodologies, resulting in a contiguous open reading frame. When the heavy chain-AD2 polypeptide is co-expressed with a light chain polypeptide, an IgG molecule is formed possessing two AD2 peptides, which can therefore bind two Fab-DDD2 dimers. The C-H-AD2-IgG
module. can be combined with any Fab-DDD2 module to generate a wide variety of hexavalent structures composed of an Fc fragment and six Fab fragments. If the C-H-AD2-IgG module and the Fab-DDD2 module are derived from the same parental monoclonal antibody (MAb) the resulting HIDS is monospecific with 6 binding arms to the same antigen. If the modules are instead derived from two different MAbs then the resulting HIDS are bispecific, with two binding arms for the specificity of the C-H-AD2-IgG module and 4 binding arms for the specificity of the Fab-DDD2 module.
[0134] N-L-AD2-IgG is an alternative type of IgG-AD2 module in which an AD2 peptide is fused to the amino terminus (N) of the light (L) chain of IgG via a 13 amino acid residue peptide linker. The L chain can be either Kappa (K) or Lambda (X) and will also be represented as K.
The DNA coding sequences for the AD2 peptide (CGQIEYLAKQIVDNAIQQAGC, SEQ ID
NO:4) followed by the linker peptide (GGGGSGGGSGGG, SEQ ID NO:92) are coupled to the 5' end of the coding sequence for the variable domain of the L chain (VO, resulting in a contiguous open reading frame. When the AD2-kappa chain polypeptide is co-expressed with a heavy chain polypeptide, an IgG molecule is formed possessing two AD2 peptides, which can therefore bind two Fab-DDD2 dimers. The N-L-AD2-IgG module can be combined with any Fab-DDD2 module to generate a wide variety of hexavalent structures composed of an Fc fragment and six Fab fragments.
Example 5. Creation of C-H-AD2-IgG-pdHL2 expression vectors.
[0135] The pdHL2 mammalian expression vector has been used to mediate the expression of many recombinant IgGs. A plasmid shuttle vector was produced to facilitate the conversion of any IgG-pdHL2 vector into a C-H-AD2-IgG-pdHL2 vector. The gene for the Fc (CH2 and CH3 domains) was amplified using the pdHL2 vector as a template and Fc Bg111 Left and Fc Barn-EcoRI Right primers. The amplimer was cloned in the PGEMTO PCR cloning vector.
The Fc insert fragment was excised from PGEMTO with Xbal and BamHI restriction enzymes and ligated with AD2-pdHL2 vector that was prepared by digestion of h679-Fab-AD2-pdHL2 with XbaI and BamHI, to generate the shuttle vector Fc-AD2-pdHL2.
Fc BgIlI Left 5'-AGATCTGGCGCACCTGAACTCCTG-3' (SEQ ID NO:93) Fc Bam-EcoRI Right 5'-GAATTCGGATCCTTTACCCGGAGACAGGGAGAG-3' (SEQ ID NO:94) [0136] To convert any IgG-pdHL2 expression vector to a C-H-AD2-IgG-pdFIL2 expression vector, an 861 bp BsrGI / NdeI restriction fragment is excised from the former and replaced with a 952 bp BsrGI / NdeI restriction fragment excised from the Fc-AD2-pdHL2 vector. BsrGI cuts in the CH3 domain and NdeI cuts downstream (3') of the expression cassette.
Example 6. Production of AD2-Linked IgG Species Production of C-H-AD2-hLL2 IgG
101371 Epratuzumab, or hLL2 IgG (U.S. Patent No. 7,074,403), is a humanized anti-human CD22 MAb. An expression vector for C-H-AD2-hLL2 IgG was generated from hLL2 IgG-pdHL2, as described in the Example above, and used to transfect Sp2/0 myeloma cells by electroporation. Following transfection, the cells were plated in 96-well plates and transgenic clones were selected in media containing methotrexate. Clones were screened for C-H-AD2-hLL2 IgG productivity by a sandwich ELISA using 96-well microtiter plates coated with an hLL2-specific anti-idiotype MAb and detection with peroxidase-conjugated anti-human IgG.
Clones were expanded to roller bottles for protein production and C-H-AD2-hLL2 IgG was purified from the spent culture media in a single step using Protein-A
affinity chromatography.
SE-HPLC analysis resolved two protein peaks (not shown). The retention time of the slower eluted peak was similar to hLL2 IgG (not shown). The retention time of the faster eluted peak was consistent with a ¨300 kDa protein (not shown). It was later determined that this peak represents disulfide linked dimers of C-H-AD2-hLL2-IgG. This dimer is reduced to the monomeric form during the DNL reaction. SDS-PAGE analysis demonstrated that the purified C-H-AD2-hLL2-IgG consisted of both monomeric and disulfide-linked dimeric forms of the module (not shown). Protein bands representing these two forms are evident by SDS-PAGE
under non-reducing conditions, while under reducing conditions all of the forms are reduced to two bands representing the constituent polypeptides (Heavy chain-AD2 and kappa chain). No other contaminating bands were detected.
Production of C-H-AD2-hA20 IgG

[0138] hA20 IgG (U.S. Patent No. 7,251,164) is a humanized anti-human CD20 MAb. An expression vector for C-H-AD2-hA20 IgG was generated from hA20 IgG-pDHL2, as described above, and used to transfect Sp2/0 myeloma cells by electroporation. Following transfection, the cells were plated in 96-well plates and transgenic clones were selected in media containing methotrexate. Clones were screened for C-H-AD2-hA20 IgG productivity by a sandwich ELISA
using 96-well microtiter plates coated with a hA20-specific anti-idiotype MAb and detection with peroxidase-conjugated anti-human IgG. Clones were expanded to roller bottles for protein production and C-H-AD2-11A20 IgG was purified from the spent culture media in a single step using Protein-A affinity chromatography. SE-HPLC and SDS-PAGE analyses gave very similar results to those obtained for C-H-AD2-hLL2 IgG (not shown).
Example 7. Generation of Hexavalent DNL complexes Generation of Hex-hA20 [0139] The DNL method was used to create Hex-hA20, a monospecific anti-CD20 HIDS, by " combining C-H-AD2-hA20 IgG with hA20-Fab-DDD2. The Hex-hA20 structure contains six anti-CD20 Fab fragments and an Fc fragment, arranged as four Fab fragments and one IgG
antibody. Hex-hA20 was made in four steps.
[0140] Stepl, Combination: A 210% molar equivalent of (hA20-Fab-DDD2)2 was mixed with C-1-1-AD2-hA20 IgG. This molar ratio was used because two Fab-DDD2 dimers are coupled to each C-H-AD2-hA20 IgG molecule and an additional 10% excess of the former ensures that the coupling reaction is complete. The molecular weights of C-H-AD2-hA20 IgG and (hA20-Fab-DDD2)2 are 168 kDa and 107 kDa, respectively. As an example, 134 mg of hA20-Fab-DDD2 would be mixed with 100 mg of C-H-AD2-hA20 IgG to achieve a 210% molar equivalent of the former. The mixture is typically made in phosphate buffered saline, pH 7.4 (PBS) with 1 mM
EDTA.
[0141] Step 2, Mild Reduction: Reduced glutathione (GSH) was added to a final concentration of 1 mM and the solution is held at room temperature (16 - 25 C) for 1-24 hours.
[0142] Step 3, Mild Oxidation: Following reduction, oxidized glutathione (GSSH) was added directly to the reaction mixture to a final concentration of 2 mM and the solution was held at room temperature for 1-24 hours.

[0143] Step 4, Isolation of the DNL product: Following oxidation, the reaction Mixture was loaded directly onto a Protein-A affinity chromatography column. The column was washed with PBS and the Hex-hA20 was eluted with 0.1 M glycine, pH 2.5. Since excess hA20-Fab-DDD2 was used in the reaction, there was no unconjugated C-H-AD2-hA20 IgG, or incomplete DNL
structures containing only one (hA20-Fab-DDD2)2 moiety. The unconjugated excess hA20-Fab-DDD2 does not bind to the affinity resin. Therefore, the Protein A-purified material contains only the desired product.
[0144] The calculated molecular weight from the deduced amino acid sequences of the constituent polypeptides is 386 kDa. Size exclusion HPLC analysis showed a single protein peak with a retention time consistent with a protein structure of 375 ¨400 kDa (not shown). SDS-PAGE analysis under non-reducing conditions showed a cluster of high molecular weight bands indicating a large covalent structure (not shown). SDS-PAGE under reducing conditions showed the presence of only the three expected polypeptide chains: the AD2-fused heavy chain (HC-AD2), the DDD2-fused Fd chain (Fd-DDD2), and the kappa chains (not shown).
Generation of Hex-hLL2 [0145] The DNL method was used to create a monospecific anti-CD22 HIDS (Hex-hLL2) by combining C-H-AD2-hLL2 IgG with hLL2-Fab-DDD2. The DNL reaction was accomplished as described above for Hex-hA20. The calculated molecular weight from the deduced amino acid sequences of the constituent polypeptides is 386 kDa. Size exclusion HPLC
analysis showed a single protein peak with a retention time consistent with a protein structure of 375 ¨400 kDa (not shown). SDS-PAGE analysis under non-reducing conditions showed a cluster of high molecular weight bands, which were eliminated under reducing conditions to leave only the three expected polypeptide chains: HC-AD2, Fd-DDD2, and the kappa chain (not shown).
Generation of DNL1 and DNL1C
[0146] The DNI, method was used to create bispecific HIDS by combining C-H-AD2-hLL2 IgG
with either hA20-Fab-DDD2 to obtain DNL I or hMN-14-DDD2 to obtain DNL1C. DNL
I has four binding arms for CD20 and two for CD22. As hMN-14 is a humanized MAb to carcinoembryonic antigen (CEACAM5), DNL1C has four binding arms for CEACAM5 and two for CD22. The DNL reactions were accomplished as described for Hex-hA20 above.

[0147] For both DNL1 and DNL1C, the calculated molecular weights from the deduced amino acid sequences of the constituent polypeptides are ¨386 kDa. Size exclusion IIPLC analysis showed a single protein peak with a retention time consistent with a protein structure of 375 ¨
400 kDa for each structure (not shown). SDS-PAGE analysis under non-reducing conditions showed a cluster of high molecular weight bands, which were eliminated under reducing conditions to leave only the three expected polypeptides: HC-AD2, Fd-DDD2, and the kappa chain (not shown).
Generation of DNL2 and DNL2C
[0148] The DNL method was used to create bispecific HIDS by combining C-H-AD2-hA20 IgG
with either hi.L2-Fab-DF)D2 to obtain DNL2 or hMN-14-nnm to obtain DNL2C. DNL2 has four binding arms for CD22 and two for CD20. DNL2C has four binding arms for and two for CD20. The DNL reactions were accomplished as described for Hex-hA20.
[0149] For both DNL2 and DNL2C, the calculated molecular weights from the deduced amino acid sequences of the constituent polypeptides are ¨386 kDa. Size exclusion HPLC analysis showed a single protein peak with a retention time consistent with a protein structure of 375 ¨
400 kDa for each structure (not shown). SDS-PAGE analysis under non-reducing conditions showed high molecular weight bands, but under reducing conditions consisted solely of the three expected polypeptides: HC-AD2, Fd-DDD2, and the kappa chain (not shown).
Example 8. In vitro Characterization of Hexavalent DNL complexes Stability in Serum [01501 The stability of DNL1 and DNL2 in human serum was determined using a bispecific ELISA assay. The protein structures were incubated at 101,1g/m1 in fresh pooled human sera at 37 C and 5% CO2 for five days. For day 0 samples, aliquots were frozen in liquid nitrogen immediately after dilution in serum. ELISA plates were coated with an anti-Id to hA20 IgG and bispecific binding was detected with an anti-Id to 11LL2 IgG. Both DNL I and DNL2 were highly stable in serum and maintained complete bispecific binding activity.
= Binding Activity [01511 The HIDS generated as described above retained the binding properties of their parental Fab/IgGs. Competitive ELISAs were used to investigate the binding avidities of the various HIDS using either a rat anti-idiotype MAb to hA20 (WR2) to assess the bin-ding activity of the hA20 components or a rat anti-idiotype MAb to hLL2 (WN) to assess the binding activity of the hLL2 components. To assess hA20 binding, ELISA plates were coated with hA20 IgG and the HIDS were allowed to compete with the immobilized IgG for WR2 binding. To assess hLL2 binding, plates were coated with hLL2 IgG and the HIDS were allowed to compete with the immobilized IgG for WN binding. The relative amount of anti-Id bound to the immobilized IgG
was detected using peroxidase-conjugated anti-Rat IgG.
[0152) Comparing the relative CD20 binding avidities, DNL2, which has two CD20 binding groups, showed a similar binding avidity to hA20 IgG, which also has two CD20-binding arms (data not shown). DNL1, which has four CD20-binding groups, had a stronger (-4-fold) relative avidity than DNL2 or hA20 IgG (not shown). Hex-hA20, which has six CD20-binding groups, had an even stronger (-10-fold) relative avidity than hA20 IgG (not shown).
[0153] Similar results were observed for CD22 binding (not shown). DNL I, which has two CD20 binding groups, showed a similar binding avidity to hLL2 IgG, which also has two CD22-binding arms (not shown). DNL2, which has four CD22-binding groups, had a stronger (>5-fold) relative avidity than DNL1 or hLL2 IgG. Hex-hLL2, which has six CD22-binding groups, had an even stronger (>10-fold) relative avidity than hLL2 IgG (not shown).
[0154] Some of the HIDS were observed to have potent anti-proliferative activity on lymphoma cell lines. DNL I, DNL2 and Hex-hA20 inhibited cell growth of Daudi Burkitt Lymphoma cells in vitro (not shown). Treatment of the cells with 10 nM concentrations was substantially more effective for the HIDS compared to rituximab (not shown). Using a cell counting assay, the potency of DNL1 and DNL2 was estimated to be more than 100-fold greater than that of rituximab, while the Hex-hA20 was shown to be even more potent (not shown).
This was confirmed with an MTS proliferation assay in which dose-response curves were generated for Daudi cells treated with a range of concentrations of the HIDS (not shown).
Compared to rituximab, the bispecific HIDS (DNL I and DNL2) and Hex-hA20 were >100-fold and >10000-fold more potent, respectively.
Example 9. Comparative Effects of Hexavalent DNL complexes and Parent IgG on Lymphoma Cell Lines [0155] Dose-response curves for HIDS (DNL1, DNL2, I Iex-hA20) versus a parent IgG (hA20 IgG) were compared for three different lymphoma cell lines, using an MTS
proliferation assay.
In Daudi lymphoma cells, the bispecific structures DNL I and DNL2 showed >100-fold more potent anti-proliferative activity and Hex-hA20 showed >10,000-fold more potent activity than the parent hA20 IgG (not shown). Hex-hLL2 and the control structures (DNL1-C
and DNL2-C) had very little anti-proliferative activity in this assay (not shown).
[0156] In Raji lymphoma cells, Hex-hA20 displayed potent anti-proliferative activity, but DNL2 showed only minimal activity compared with hA20 IgG (not shown). In Ramos lymphoma cells, both DNL2 and Hex-hA20 displayed potent anti-proliferative activity, compared with hA20 IgG
(not shown). These results show that the increased potency of HIDS relative to the parent IgGs is not limited to particular cell lines, but rather is a general phenomenon for cells displaying the appropriate targets.
Example 10. CDC and ADCC Activity of Hcxavalent DNL complexes [0157] In vivo, anti-CD20 monoclonal antibodies such as rituximab and hA20 can utilize complement-dependent cytotoxicity (CDC), antibody-dependent cellular cytotoxicity (ADCC) and signal transduction induced growth inhibition/apoptosis for tumor cell killing. The hexavalent DNL structures (DNL I, DNL2, Hex-hA20) were tested for CDC activity using Daudi cells in an in vitro assay. Surprisingly, none of the hexavalent structures that bind CD20 exhibited CDC activity (not shown). The parent hA20 IgG exhibited potent CDC
activity (not shown), while as expected the hLL2 antibody against CD22 showed no activity (not shown).
The lack of effect of DNL2 and Hex-hA20 was of interest, since they comprise hA20-IgG-Ad2, which showed similar positive CDC activity to hA20 IgG (not shown).
[0158] DNL I was assayed for ADCC activity using freshly isolated peripheral blood mononuclear cells. Both rituximab and hA20 IgG showed potent activity on Daudi cells, while .
DNL I did not exhibit any detectable ADCC activity (not shown).
[0159] These data suggest that the Fc region may become inaccessible for effector functions (CDC and ADCC) when four additional Fab groups are tethered to its carboxyl termini.
Therefore, the hexavalent DNL structures appear to rely only on signal transduction induced growth inhibition/apoptosis for in vivo anti-tumor activity.

Example 11. Formation of PEGylated DNL complexes Generation of PEG-AD2 Modules [0160] In certain embodiments, PEG moieties may be incorporated into DNL
complexes, for example to provide for a reproducible and homogeneous PEGylated product of an effector moiety, such as a cytokine. The Examples below provide compositions and methods of use of such DNL-based PEGylation products. As a first step, peptide subunits capable of covalent conjugation to PEG moieties for incorporation into DNL.complexes were synthesized.
Synthesis of IMP350 CGQIEYLAKQIVDNAIQQAGC(SS-tbu)-NH2 (SEQ ID NO:95) 101611 IMP350, incorporating the sequence of AD2, was made on a 0.1 mmoi scale with Sieber Amide resin using Fmoc methodology on an automated peptide synthesizer.
Starting from the C-terminus the protected amino acids used were Fmoc-Cys(t-Buthio)-014, Fmoc-Gly-OH, Fmoc-Ala-OH, Fmoc-Gln(Trt)-0H, Fmoc-Gln(Trt)-OH, Fmoc-Ala-OH, Fmoc-Asn(Trt)-01-1, Fmoc-Asp(OBut)-0H, Fmoc-Val-OH, Fmoc-Ile-OH, Fmoc-Gln(Trt)-0H, Fmoc-Lys(Boc)-OH, Fmoc-Ala-OH, Fmoc-Leu-OH, Fmoc-Tyr(But)-0H, Fmoc-Glu(0But)-0H, Fmoc-Ile-OH, Fmoc-Gln(Trt)-OH, Fmoc-Gly-OH and Fmoc-Cys(Trt)-0H. The peptide was cleaved from the resin and purified by reverse phase (RP)-HPLC.
Synthesis of PEG20-IMP350 [0162] IMP350 (0.0104 g) was mixed with 0.1022 g of mPEG-OPTE (20kDa, Nektar Therapeutics) in 7 mL of 1 M Tris buffer at pH 7.81. Acetonitrile, 1 mL, was then added to dissolve some suspended material. The reaction was stirred at room temperature for 3 h and then 0.0527 g of TCEP was added along with 0.0549 g of cysteine. The reaction mixture was stirred for 1.5 hand then purified on a PD-10 desalting column, which was equilibrated with 20%
methanol in water. The sample was eluted, frozen and lyophilized to obtain 0.0924 g of crude PEG20-IMP350 (MH+ 23508 by MALDI).
Synthesis of IMP360 CGQIEYLAKQIVDNAIQQAGC(SS-tbu)-G-EDANS (SEQ ID NO:96) [0163] IMP360, incorporating the AD2 sequence, was synthesized on a 0.1 mmol scale with Fmoc-Gly-EDANS resin using Fmoc methodology on an automated peptide synthesizer. The Fmoc-Gly-OH was added to the resin manually using 0.23 g of FmoC-Gly-OH, 0.29 g of HATU, 26 !AL of DIEA, 7.5 mL of DMF and 0.57 g of EDANS resin (Nova Biochem). The reagents were mixed and added to the resin. The reaction was mixed at room temperature for 2.5 hr and the resin was washed with DMF and IPA to remove the excess reagents. Starting from the C-terminus the protected amino acids used were Fmoc-Cys(t-Buthio)-0H, Fmoc-Gly-OH, Fmoc-Ala-OH, Fmoc-Gln(Trt)-OH, Fmoc-Gln(Trt)-0H, Fmoc-Ile-OH, Fmoc-Ala-OH, Fmoc-Asn(Trt)-OH, Fmoc-Asp(OBut)-0H, Fmoc-Val-OH, Fmoc-Ile-OH, Fmoc-Gln(Trt)-OH, Fmoc-Lys(Boc)-OH, Fmoc-Ala-OH, Fmoc-Leu-OH, Fmoc-Tyr(But)-0H, Fmoc-Glu(0But)-0H, Fmoc-Ile-OH, Fmoc-Gln(Trt)-0H, Fmoc-Gly-OH and Fmoc-Cys(Trt)-0H. The peptide was cleaved from the resin and purified by RP-HPLC.
Generation of IMP362 and IMP413 [0164] The two linear PEG-AD2 modules were prepared by coupling IMP360 to mPEG-OPTE
(Nectar Therapeutics, San Carlos, CA) of 20-kDa or 30-kDa, resulting in IMP362 or IMP413, respectively. To prepare IMP362, IMP360 (11.5 mg) was mixed with 20-kDa mPEG-OPTE (127 mg) in 7 mL of 1 M Tris-HCL, pH 7.8. Acetonitrile (1 mL) was added to dissolve some suspended material. The reaction was stirred at room temperature for 4 h to effect the attachment of mPEG to the amino-terminal cysteine via an amide bond. Subsequently, 41 mg of Tris [2-carboxyethyl] phosphine hydrochloride (TCEP) and 43 mg of cysteine were added to de-protect the remaining cysteine. The reaction mixtures were stirred for 1 h and desalted using PD-10 columns, which had been equilibrated with 20 % methanol in water. The samples were lyophilized to obtain approximately 150 mg of IMP362 (MH+ 23713). IMP413 (MH+
34499) was made similarly using 30-kDa mPEG-OPTE (190 mg).
Synthesis of IMP4 I 3 (PEG 30-IMP360) [0165] For synthesis of IMP413, IMP360 (0.0103 g) was mixed with 0.1601 g of mPEG-OPTE
(30kDa, Nektar Therapeutics) in 7 mL of 1 M Tris buffer at pH 7.81.
Acetonitrile (I mL) was then added to dissolve some suspended material. The reaction was stirred at room temperature for 4.5 h and then 0.0423 g of TCEP was added along with 0.0473 g of cysteine.
The reaction mixture was stirred for 2 h followed by dialysis for two days. The dialyzed material was frozen and lyophilized to obtain 0.1552 g of crude IMP413 (MH+ 34499).

Synthesis of IMP421 IMP421 Ac-C-PEG3-C(S-tBu)GQIEYLAKQIVDNAIQQAGC(S-tBu)G-NH2 (SEQ ID
NO:97) [01661 The AD2-containing peptide (IMP421, MYr 2891 was made for derivatizing mPEG2-MAL-40K (Nectar Therapeutics) to obtain the branched PEG-AD2 module (IMP457).

was made on NOVASYNO TGR resin (487.6 mg, 0.112 mmol) by adding the following amino acids to the resin in the order shown: Fmoc-Gly-OH, Fmoc-Cys(t-Buthio)-0H, Fmoc-Gly-OH, Fmoc-Ala-OH, Fmoc-Gln(Trt)-0H, Fmoc-Gln(Trt)-0H, Fmoc-Ile-OH, Fmoc-Ala-OH, Fmoc-Asn(Trt)-0H, Fmoc-Asp(OBut)-0H, Fmoc-Val-OH, Fmoc-Ile-OH, Fmoc-Gln(Trt)-0H, Fmoc-IL,y'S(BOC)-01-1, Frnoc-Ala-OH, Fmoc-Leu-OH, Frnoc-T-yr(But)-0H, Finoc-Glu(OBut)-0Trl, Fmoc-Ile-OH, Fmoc-Gln(Trt)-OH, Fmoc-Gly-OH, Fmoc-Cys(t-Buthio)-0H, Fmoc-NH-COOH, Fmoc-Cys(Trt)-0H. The N-terminal amino acid was protected as an acetyl derivative.
The peptide was then cleaved from the resin and purified by RP-HPLC to yield 32.7 mg of a white solid.
Synthesis of IMP457 [0167] IMP421, incorporating the sequence of AD2, was synthesized by standard chemical means. To a solution of 15.2 mg (5.26 i.tmol) IMP421 (F.W. 2890.50) and 274.5 mg (6.86 mop mPEG2-MAL-40K in 1 mL of acetonitrile was added 7 mL 1 M Tris pH 7.8 and allowed to react at room temperature for 3 h. The excess mPEG2-MAL-40K was quenched with 49.4 mg L-cysteine, followed by S-S-tBu deprotection over one hour with 59.1 mg TCEP.
The reaction mixture was dialyzed overnight at 2-8 C using two 10K dialysis cassettes (4 ml in each cassette) into 5 L of 5 mM ammonium acetate, pH 5Ø Three more 5 L buffer changes of 5 mM
ammonium acetate, pH 5.0 were made the next day with each dialysis lasting at least 21/2 h. The purified product (19.4 mL) was transferred into two 20 mL scintillation vials, frozen and lyophilized to yield 246.7 mg of a white solid. MALDI-TOF gave results of mPEG2-MAL-40K
42,982 and 1MP457 45,500.
Generation of DDD module based on Interferon (IFN)-a2b Construction of IFN-a2b-DDD2-pdHL2 for expression in mammalian cells [01681 The cDNA sequence for IFN-a2b was amplified by PCR, resulting in a sequence comprising the following features, in which XbaI and BamHI are restriction sites, the signal peptide is native to IFN-a2b, and 6 His (SEQ ID NO:98) is a hexahistidine tag:
Xbal---Signal peptide--- IFNa2b ---6 His---BamHI. The resulting secreted protein consists of IFN-a2b fused at its C-terminus to a polypeptide consisting of SEQ ID NO:99.
KSHHHHHHGSGGGGSGGGCGHIQIPPGLTELLQGYTVEVLRQQPPDLVEFAVEYFTRLR
EARA (SEQ ID NO:99) [0169] PCR amplification was accomplished using a full length human IFNa2b cDNA clone (Invitrogen ULTIMATETm ORE human clone eat# HORFO1Clone ID 10H35221) as a template and the following oligonucleotides as primers:
IFNA2 Xba I Left 5'-TCTAGACACAGGACCTCATCATGGCCTTGACCTTTGCTTTACTGG-3' (SEQ ID
NO:100) IFNA2 BainIII right 5'-GGATCCATGATGGTGATGATGGTGTGACTTTTCCITACTTCTTAAACTTTCTTGC-3' (SEQ ID NO:101) [0170] The PCR amplimer was cloned into the pGEMO-T vector. A DDD2-pdHL2 mammalian expression vector was prepared for ligation with IFN-a2b by digestion with Xbal and Barn HI
restriction endonucleases. The IFN-a2b amplimer was excised from PGEMTO with XbaI and Barn HI and ligated into the DDD2-pdHL2 vector to generate the expression vector 1FN-a2b-DDD2-pdHL2.
Mammalian expression of IFN-a2b-DDD2 [0171] IFN-a2b-DDD2-pdHL2 was linearized by digestion with Sall enzyme and stably transfected into Sp/EEE myeloma cells by electroporation (see. e.g., U.S.
Patent No. 7,537,930, the Examples section of which is incorporated herein by reference). Two clones were found to have detectable levels of IFN-a2b by ELISA. One of the two clones, designated 95, was adapted to growth in serum-free media without substantial decrease in productivity.
The clone was subsequently amplified with increasing methotrexate (MTX) concentrations from 0.1 to 0.8 [rM
over five weeks. At this stage, it was sub-cloned by limiting dilution and the highest producing sub-clone (95-5) was expanded. The productivity of 95-5 grown in shake-flasks was estimated to be 2.5 mg/L using commercial rIFN-a2b (Chemicon IF007, Lot 06008039084) as a standard.
[0172] Clone 95-5 was purified by immobilized metal affinity chromatography (IMAC) on a Ni-NTA column. The product was eluted with 250 mM imidazole, 0.02% Tween 20, 150 mM
NaCI, 50 mM NaH2PO4, pH 7.5. Approximately 6 mg of IFNa2b-DDD2 was purified.
Example 12. Generation of PEGylated IFN-a.2b by DNL
Preparation and purification of oc2b-362 (IFN-a2b-DDD2-IMP362) [0173] The structure of oc2b-362 has two copies of IFNa2b-DDD2 coupled to a 20 kDa PEG-AD. A DNL reaction was performed by the addition of 11 mg of reduced and lyophilized IMP362 in 10-fold molar excess to 2.25 mg (3.5 ml) of IFN-cc2b-DDD2 in 250 mM
imidazole, 0.02% Tween 20, 150 mM NaC1, 1 mM EDTA, 50 mM NaH2PO4, pH 7.5. After 6 hat room temperature in the dark, the reaction mixture was dialyzed against CM Loading Buffer (150 mM
NaCI, 20 mM NaAc, pH 4.5) at 4 C in the dark. The solution was loaded onto a 1-mL Hi-Trap CM-FF column (Amersham), which was pre-equilibrated with CM Loading buffer.
After sample loading, the column was washed with CM loading buffer to baseline, followed by washing with 15 mL of 0.25 M NaCI, 20 mM NaAc, pH 4.5. The PEGylated product was eluted with 12.5 mL
of 0.5 M NaCl, 20 mM NaAc, pH 4.5.
[0174] The conjugation process was analyzed by SDS-PAGE with Coomassie blue staining, fluorescence imaging and anti-IFNa immunoblotting (not shown). To normalize the samples for direct protein mass comparison, each fraction eluted from the CM-FF column was concentrated to 3_5 mL to match the reaction volume. Under non-reducing conditions, the Coomassie blue-stained gel revealed the presence of a major band at a Mr of 110 kDa in the reaction mixture, which was absent in the unbound or 0.25 M NaCI wash fraction, but evident in the 0.5 M NaCI
fraction (not shown). Fluorescence imaging, which was used to detect the EDANS
tag on IMP362, demonstrated that the 110 kDa band contained IMP362 and the presence of excess IMP362 in the reaction mixture and the unbound fraction, which did not stain with Coomassie blue (not shown). Anti-IFNa immunoblotting confirmed the association of IFN-a2b with the 110 kDa band (not shown).
[0175] These data together indicate that the DNL reaction resulted in the site-specific and covalent conjugation of IMP362 with a dimer of IFN-a2b. Under reducing conditions, which breaks the disulfide linkage, the components of the DNL structures were resolved (not shown).
The calculated MW of a2b-362 was ¨75 kDa, which matches well the mass of 76,728 Da determined by MALDI TOF. The observed discrepancy between the calculated mass and the estimated Mr by SDS-PAGE is due to PEG, which is known to inflate the molecular size when PEGylated products are analyzed by SDS-PAGE or SE-HPLC. Overall, the DNL
reaction resulted in a near quantitative yield of a homogeneous product that was > 90%
pure after purification by cation-exchange chromatography (not shown).
Preparation and purification of a2b-457 (IFN-a2b-DDD2-IMP457) [0176] A DNL reaction was performed by the addition of 2.5 mg of reduced and lyophilized IMP457 in 10-fold molar excess to I mg (1.7 ml) of IFN-a2b-DDD2 in 250 mM
imidazole, 0.02% Tween 20, 150 mM NaC1, 1 mM EDTA, 50 mM NaH2PO4, pH 7.5. After 60 hat room temperature, 1mM oxidized glutathione was added to the reaction mixture, which was then held for an additional 2 h. The mixture was diluted 1:20 with CM Loading Buffer (150 mM NaC1, 20 mM NaAc, pH 4.5) and titrated to pH 4.5 with acetic acid. The solution was loaded onto a 1-mL
CM-FF column, which was pre-equilibrated with CM Loading Buffer. After sample loading, the column was washed with CM Loading Buffer to baseline, followed by washing with 15 mL of 0.25 M NaCl, 20 mM NaAc, pH 4.5. The PEGylated product was eluted with 20 mL
of 0.5 M
NaC1, 20 mM NaAc, pH 4.5, then concentrated to 2 mL and diafiltered into 0.4 M
PBS, pH 7.4.
The final yield was approximately 1 mg of a2b-457 of >90% purity as determined by SDS-PAGE and IFNa ELISA.
Preparation and purification of a2b-413 (IFN-a2b-DDD2-IMP413) [0177] The structure of a2b-413 has two copies of IFNa2b-DDD2 coupled to a 30 kDa PEG-AD2. a2b-413 was prepared as described immediately above using IMP413 instead of IMP362.
Example 13. In Vivo Evaluation of cc2b-413 and oc2b-362 Pharmacokinetics [0178] The study was performed in adult female Swiss-Webster mice (-35 g).
There were 4 different treatment groups of 2 mice each. Each reagent (test and control) was administered at equimolar protein doses (3 jig of rhuIFN-a2a, 5 jig of PEGINTRON , 11 jig of cc2b-362, and

13 jig of a2b-413) as a single bolus i.v. injection. Mice were bled via the retro-orbital method at various time-points (pre-dose, 5-min, 2-, 8-, 24-, 48-, 72-, 96-, and 168-h post-injection). The blood was allowed to clot, centrifuged, and the serum was isolated and stored at ¨70 C until assayed for IFN-a concentration and subsequent PK-analysis.
[0179] Concentrations of IFN-a in the serum samples were determined using a human interferon alpha ELISA kit following the manufacturer's instructions (PBL Interferon Source). Briefly, the serum samples were diluted appropriately according to the human IFN-a standard provided in the kit. An antibody coupled to the microtiter plate wells captured interferon. A second antibody was then used to reveal the bound interferon, which was quantified by anti-secondary antibody conjugated to horseradish peroxidase (HRP) following the addition of Tetramethyl benzidine (TMB) substrate. The plates were read at 450nm.
[0180] As expected, rhIFN-a2a had the most rapid clearance from the blood of injected mice.
Its clearance was approximately 3-fold faster than the PEGINTRONO and more than I3-fold faster than the DNL-IFN reagents. The PEGINTRONO was in turn cleared greater than 4-fold faster than a2b-362 or a2b-413. There was little difference in the elimination rates between a2b-362 and a2b-413.
[0181] In terms of mean residence time (MRT), there is a clear correlation with size among the various reagents. The 19-kDa rhIFN-cc2a had a MRT that was 7-fold less than the 31 kDa PEGINTRONO (0.7 h versus 5.1 h, respectively), which had a 2-fold lower MRT
when compared to the 70 kDa a2b-362 (10.3 h). The MRT for the 80 kDa a2b-413 (21.7 h) was 2-fold longer than a2b-362. Finally, a test for bioequivalence showed that none of the reagents tested were the same in terms of PK, indicating that the differences are genuine (i.e., circulating half-life for a2b-413 > a2b-362 > PEGINTRONTm > rhIFN-a2a).
[0182] Survival curves were generated (not shown). PEGINTRONO, oc2b-362, and a2b-413 all demonstrated significant improvement in survival when compared to saline control mice (P<0.0016) (not shown). Except for the 3,500 IU dose of a2b-362, both a2b-413 and a2b-362 were superior to PEGINTRONO when administered at equal activity doses (P<0.0027) (not shown). a2b-362 showed more than twice the potency of PEGINTRONO (not shown).
Doses of 7,000 IU and 3,500 IU of a2b-362 were superior to 14,600 ILI (P=0.0016) and 7,000 IU
(P=0.0027) doses of PEGINTRON , respectively (not shown). a2b-413 is more than four times as potent as PEGINTRONO since a 3,500 IU dose of the former was superior to

14,000 IU of the latter (P=0.0027) (not shown). a2b-413 was significantly better than a2b-362 (P<0.0025) when administered at equivalent doses. However, there were no statistically significant differences among the three doses of a2b-413, even though the 14,000 IU dose resulted in a median survival of 60 days in comparison to the 3,500 IU dose and its 46 day median survival (P=0.1255). The in vivo efficacy observed for a2b-362, a2b-413, and PEGINTRONO
thus correlate well with the PK data.
[01831 The increased bioavailability of a2b-362 anci' a2b-413 demonstrated by analy=sis contributes to the enhanced in vivo anti-tumor potency of DNL-PEGylated IFNcc.
In turn, these two factors allow for a less frequent dosing schedule used in tumor therapy.
This was demonstrated with a similar in vivo tumor therapy study as above, in which equal units of activity of PEGINTRONO or a2b-413 were administered with varied dosing schedules. This study was performed in 8-week-old female SCID mice injected i.v. with Daudi 1.5 x 107 cells.
There were 7 different treatment groups of 6-7 mice each. Each reagent (test and control) was administered at 14,000 IU via a s.c. injection in either the left or right flank. Therapy was commenced 1 day after the Daudi-cells were administered to the mice. One set of mice was dosed once a week for 4 weeks (q7dx4), another dosed on a bi-weekly schedule over 8 weeks (q2wkx4), while the third set of mice was dosed once every 3 weeks over 12 weeks (q3wkx4).
All the mice received a total of 4 injections.
101841 All animals that received either form of interferon at any of the various schedules had significantly improved survival in comparison to saline control mice (P<0.0009) (not shown).
Importantly, all the IFN-IMP413-treated mice had significantly improved survival when compared to those animals treated at the same schedule with PEGINTRONO
(P<0.0097) (not shown). Of note, those mice treated every other week with IFN-IMP413 (q2wkx4) not only had significantly improved survival in comparison to those treated with PEGINTRONO
at the same schedule (MST= >54 days versus 28 days, respectively; P=0.0002), but were also significantly better than those animals treated weekly (q7dx4) with PEGINTRONO (MST=36.5 days;
P=0.0049) (not shown). Further, survival of mice treated every three weeks with IFN-IMP413 (q3wkx4) was significantly better than those treated with PEGINTRONO every two weeks (MST= 54 days versus 28 days; P=0.002) and approaches significance when compared to those treated weekly with PEGINTRONO (P=0.0598) (not shown).
[0185] In another study, we found that administering a2b-413 at 14,000 IU
every 4 weeks increased the median survival to 56 days from 23 days of the saline control and was more potent than PEGINTRONO given 14,000 IU every week (not shown).
Example 14. In Vitro and In Vivo Characterization of cab-457 [01861 For a better comparison with PEGASYSO, we conjugated IFNa2b-DDD2 to IMP457, an AD2-module of 40-kDa branched PEG, and obtained a resulting a2b-457. Gel electrophoresis showed that a2b-457 was of substantial purity in a 0.5 M NaC1 fraction eluted from a CM
column (not shown).
[0187] The in vitro biological activities of a2b-457 were determined by three different assays to be lower than PEGINTRON , comparable to a2b-413, and considerably higher than PEGASYSO (not shown). The PK data obtained in mice with a single s.c.
injection indicate a longer circulating half-life of a2b-457 than either a2b-413 or PEGASYSO, with all three clearing much slower than PEGINTRONO (not shown).
[0188] The observed differences between a2b-457 and each of a2b-413, PEGASYSO, and PEGINTRON , or between a2b-413 and PEGASYSO or PEGINTRONO, were significant.
When given once every four weeks at a low dose of 20 pmol, a2b-457 was more effective than PEGINTRON given as a mole-equivalent dose once weekly. Administration of a2b-extended the median survival of Daudi-bearing mice to 47 days from 23 days when compared to the saline group (not shown). In the same study, a2b-457 at 20 pmol was significantly better than either a2b-413 or PEGINTRONO at 20 pmol (MST=47 days versus 41 and 37 days, respectively; P<0.0151) (not shown). The 20 pmol dose of a2b-413 also improved survival in comparison to PEGINTRONO (P=0.002) (not shown). At 10 pmol, there was no difference between a2b-457 and a2b-413 but both significantly improved survival over PEGINTRON
treated mice (P<0.00I) (not shown).
[0189] These studies demonstrated that DNL-PEGylation of IFNa2b resulted in improved and long-lasting efficacy, even when compared with other PEGylated forms of IFNa2b, allowing for less frequent dosing. Similar enhancements are realized when this technology is applied to other cytokines (such as G-CSF and EPO), growth factors, enzymes, antibodies, immunomodulators, hormones, peptides, drugs, interference RNA, oligonucleotides, vaccines and other biologically active agents.
Example 15. Generation of DDD module Based on Granulocyte-Colony Stimulating Factor (G-CSF) Construction of G-CSF-DDD2-pdHL2 for expression in mammalian cells [0190] The cDNA sequence for G-CSF was amplified by PCR resulting in an amplified construct similar to that disclosed above for INF-u2b. The resulting secreted protein consisted of G-CSF fused at its C-terminus to a polypeptide consisting of SEQ ID NO:99. PCR
amplification was accomplished using a full-length human G-CSF cDNA clone (INVITROGEN IMAGE
human cat# 97002RG Clone ID 5759022) as a template and oligonucleotide primers. The PCR
amplimer was cloned into the pGEMO-T vector. A DDD2-pdHL2 mammalian expression vector was prepared for ligation with G-CSF by digestion with Xbal and Barn HI
restriction endonucleases. The G-CSF amplimer was excised from PGEMTO with Xbal and Barn HI and ligated into the DDD2-pdHL2 vector to generate the expression vector G-CSF-DDD2-pdHL2.
Mammalian expression of G-CSF-DDD2 [0191] G-CSF-pdHL2 was linearized by digestion with Sall enzyme and stably transfected into Sp/EEE myeloma cells by electroporation. Clones were selected with media containing 0.15 jiM
MTX. Clone #4 was shown to produce 0.15 mg/L of G-CSF-DDD2 by sandwich ELISA.
Purification of G-CSF-DDD2 from batch cultures grown in roller bottles [0192] Approximately 3 mg of G-CSF-DDD2 is purified as descried above for INF-a2b. Clone 4 is expanded to 34 roller bottles containing a total of 20 L of Hybridoma SFM
with 0.411M MTX
and allowed to reach terminal culture. The supernatant fluid is clarified by centrifugation, filtered (0.2 vtM), diafiltered into 1X Binding buffer (10 mM lmidazole, 0.5 M NaC1, 50 mM NaH2PO4, pH 7.5 and concentrated. The concentrate is loaded onto a Ni-NTA column, which is washed with 0.02% Tween 20 in 1X binding buffer and then 30 mM imidazole, 0.02% Tween 20, 0.5 M
NaCI, 50 mM NaH2PO4, p14 7.5. The product is eluted with 250 mM imidazole, 0.02% Tween.

20, 150 mM NaCI, 50 mM NaH2PO4, p11 7.5.
Generation of PEGylated G-CSF by DNL
[0193] A DNL reaction is performed by the addition of reduced and lyophilized IMP4I3 in 10-fold molar excess to G-CSF-DDD2 in PBS. After 6 h at room temperature in the dark, the reaction mixture is purified by immobilized metal affinity chromatography using Ni-NTA.
Example 16. Production and Use of a DNL complex Comprising Two Different Antibody Moieties and a Cytokine [0194] In certain embodiments, the trimeric DNL complexes may comprise three different effector moieties, for example two different antibody moieties and a cytokine moiety.
[0195] We report here the generation and characterization of the first bispecific MAb-IFNa, designated 20-C2-2b, which comprises two copies of IFN-a2b and a stabilized F(ab)2of hL243 (humanized anti-HLA-DR; IMMU-114, U.S. Patent No. 7,612,180) site-specifically linked to veltuzumab (humanized anti-CD20, U.S. Patent No. 7,151,164). In vitro, 20-C2-2b inhibited each of four lymphoma and eight myeloma cell lines, and was more effective than monospecific CD20-targeted MAb-IFNa or a mixture comprising the parental antibodies and IFNa in all but one (HLA-DR7CD20-) myeloma line, suggesting that 20-C2-2b should be useful in the treatment of various hematopoietic malignancies. The 20-C2-2b displayed greater cytotoxicity against KMS12-BM (CD20+/HLA-DR+ myeloma) than monospecific MAb-IFNa that targets only HLA-DR or CD20, indicating that all three components in 20-C2-2b can contribute to toxicity.
Our findings indicate that a given cell's responsiveness to MAb-1FNa depends on its sensitivity to IFI\loc and the specific antibodies, as well as the expression and density of the targeted antigens.
[0196] Because 20-C2-2b has antibody-dependent cellular cytotoxicity (ADCC), but not CDC, and can target both CD20 and HLA-DR, it is useful for therapy of a broad range of hematopoietic cancers that express either or both antigens. The bispecific immunocytokine appears to be particularly effective in the elimination of the putative cancer stem cells associated with myeloma, which are resistant to current therapy regimens and reportedly express CD20.
Antibodies and cell culture [0197] The abbreviations used in the following discussion are: 20 (CH3-AD2-IgG-v-mab, anti-CD20 IgG DNL module); C2 (CH I -DDD2-Fab-hL243, anti-HLA-DR Fab2 DNL module);
2b (dimeric IFNa2B-DDD2 DNL module); 734 (anti-in-DTPA IgG DNL module used as non-targeting control). The following MAbs were provided by Immunomedics, Inc.:
veltuzumab or v-mab (anti-CD20 IgGI), hL243y4p (Immu-114, anti-HLA-DR IgG4), a murine anti-IFNa MAb, and rat anti-idiotype MAbs to v-mab (WR2) and hL243 (WT).
[0198] Sp/ESF cells, a cell line derived from Sp2/0 with superior growth properties were maintained in Hybridoma Serum-Free Media. The NHL and MM cells were grown in RPM' 1640 medium with 10% FBS, 1 mM sodium pyruvate, 10 mM L-glutamine, and 25 mM
HEPES.
Daudi, Ramos, Raj i, Jeko-1, NCI-H929, and U266 human lymphoma cell lines were purchased from ATCC (Manassas, VA). The sources of MM cell lines are as follows: KMS11, KMS12-PE, and KMS12-BM from Dr. Takemi Otsuki (Kawasaki Medical School, Okayama, Japan);
CAG, OPM-6 and MM.1R from Dr. Joshua Epstein (University of Arkansas, Little Rock, AK), Dr.
Kenji Oritani (Osaka University, Osaka, Japan) and Dr. Steven Rosen (Northwestern University, Chicago, IL), respectively. All cell lines were authenticated by the supplier, obtained within 6 months of their use and passaged less than 50 times. We did not re-authenticate the cell lines.
DNL complexes [0199] Monospecific MAb-IFNa (20-2b-2b, 734-2b-2b and C2-2b-2b) and the bispecific HexAb (20-C2-C2) were generated by combination of an IgG-AD2-module with DDD2-modules using the DNL method, as described in the preceding Examples. The 734-2b-2b, which comprises tetrameric IFNoc2b and MAb h734 [anti-Indium-DTPA IgGi], was used as a non-targeting control MAb-IFNa.
[0200] The construction of the mammalian expression vector as well as the subsequent generation of the production clones and the purification of CH3-AD2-IgG-v-mab are disclosed in the preceding Examples. The expressed recombinant fusion protein has the AD2 peptide linked to the carboxyl terminus of the CH3 domain of v-mab via a 15 amino acid long flexible linker peptide. Co-expression of the heavy chain-AD2 and light chain polypeptides results in the formation of an IgG structure equipped with two AD2 peptides. The expression vector was transfected into Sp/ESF cells (an engineered cell line of Sp2/0) by electroporation. The pdHL2 vector contains the gene for dihydrofolate reductase, thus allowing clonal selection, as well as gene amplification with methotrexate (MTX). Stable clones were isolated from 96-well plates selected with media containing 0.2 [EM MTX. Clones were screened for CH3-AD2-IgG-vmab productivity via a sandwich ELISA. The module was produced in roller bottle culture with serum-free media.
[0201] The DDD-module, IFNa2b-DDD2, was generated as discussed above by recombinant fusion of the DDD2 peptide to the carboxyl terminus of human IFNa2b via an 18 amino acid long flexible linker peptide. As is the case for all DDD-modules, the expressed fusion protein spontaneously forms a stable homodimer.
[0202] The CH1-DDD2-Fab-hL243 expression vector was generated from hL243-IgG-pdHL2 vector by excising the sequence for the CH1-Hinge-CH2-CH3 domains with Sad!
and EagI
restriction enzymes and replacing it with a 507 bp sequence encoding CHI-DDD2, which was excised from the C-DDD2-hMN-14-pdHL2 expression vector with the same enzymes.
Following transfection of CH1-DDD2-Fab-hL243-pdHL2 into Sp/ESF cells by electroporation, stable, MTX-resistant clones were screened for productivity via a sandwich ELISA using 96-well microtiter plates coated with mouse anti-human kappa chain to capture the fusion protein, which was detected with horseradish peroxidase-conjugated goat anti-human Fab.
The module was produced in roller bottle culture.
[0203] Roller bottle cultures in serum-free H-SFM media and fed-batch bioreactor production resulted in yields comparable to other IgG-AD2 modules and cytokine-DDD2 modules generated to date. CH3-AD2-IgG-v-mab and IFNa2b-DDD2 were purified from the culture broths by affinity chromatography using MABSELECTTm (GE Healthcare) and HIS-SELECT HF
Nickel Affinity Gel (Sigma), respectively, as described previously (Rossi et al., Blood 2009, 114:3864-71). The culture broth containing the C111-DDD2-Fab-hL243 module was applied directly to KAPPASELECTO affinity gel (GE-Healthcare), which was washed to baseline with PBS and eluted with 0.1 M Glycine, pH 2.5.
[0204] The purity of the DNL modules was assessed by SDS-PAGE and SE-HPLC (not shown).
Analysis under non-reducing conditions showed that, prior to the DNL reaction, IFNa2b-DDD2 and CH1-DDD2-Fab-hL243 exist as disulfide-linked dimers (not shown). This phenomenon, which is always seen with DDD-modules, is beneficial, as it protects the reactive sulfhydryl groups from irreversible oxidation. In comparison, CH3-AD2-IgG-v-mab (not shown) exists as both a monomer and a disulfide-linked dimer, and is reduced to monomer during the DNL
reaction. SE-HPLC analyses agreed with the non-reducing SDS-PAGE results, indicating monomeric species as well as dimeric modules that were converted to monomeric forms upon reduction (not shown). The sulfhydryl groups are protected in both forms by participation in disulfide bonds between AD2 cysteine rescclues. Reducing SDS-PAGE demonstrated that each module was purified to near homogeneity and identified the component polypeptides comprising each module (not shown). For CH3-AD2-IgG-v-mab, heavy chain-AD2 and kappa light chains were identified. hL243-Fd-DDD2 and kappa light chain polypeptides were resolved for CH 1-DDD2-Fab-hL243 (not shown). One major and one minor band were resolved for IFNa2b-DDD2 (not shown), which were determined to be non-glycosylated and 0-glycosylated species, respectively.
Generation of 20-C2-2b by DNL
[0205] Three DNL modules (CH3-AD2-IgG-v-mab, CH I-DDD2-Fab-hL243, and IFN-a2b-DDD2) were combined in equimolar quantities to generate the bsMAb-IFNa, 20-C2-2b.
Following an overnight docking step under mild reducing conditions (1mM
reduced glutathione) at room temperature, oxidized glutathione was added (2mM) to facilitate disulfide bond formation (locking). The 20-C2-2b was purified to near homogeneity using three sequential affinity chromatography steps. Initially, the DNL mixture was purified with Protein A
(MABSELECTTm), which binds the CH3-AD2-IgG-v-MAb group and eliminates un-reacted IFNa2b-DDD2 or CH I-DDD2-Fab-hL243. The Protein A-bound material was further purified by IMAC using HIS-SELECT HF Nickel Affinity Gel, which binds specifically to the IFNa2b-DDD2 moiety and eliminates any constructs lacking this group. The final process step, using an hL243-anti-idiotype affinity gel removed any molecules lacking CH1-DDD2-Fab-hL243.
[0206] The skilled artisan will realize that affinity chromatography may be used to purify DNL
complexes comprising any combination of effector moieties, so long as ligands for each of the three effector moieties can be obtained and attached to the column material.
The selected DNL
complex is the one that binds to each of three columns containing the ligand for each of the three effector moieties and can be eluted after washing to remove unbound complexes.
[0207] The following Example is representative of several similar preparations of 20-C2-2b.
Equimolar amounts of C113-AD2-IgG-v-mab (15 mg), CH I -DDD2-Fab-hL243 (12 mg), and IFN-a2b-DDD2 (5 mg) were combined in 30-mL reaction volume and 1 mM reduced glutathione was added to the solution. Following 16 h at room temperature, 2 mM oxidized glutathione was added to the mixture, which was held at room temperature for an additional 6 h. The reaction mixture was applied to a 5-mL Protein A affinity column, which was washed to baseline with PBS and eluted with 0.1 M Glycine, pH 2.5. The eluate, which contained ¨20 mg protein, was neutralized with 3 M Tris-HCI, p1-1 8.6 and dialyzed into HIS-SELECT binding buffer (10 mM
imidazole, 300 mM NaCl, 50 mM NaH2PO4, pH 8.0) prior to application to a 5-mL
HIS-SELECT IMAC column. The column was washed to baseline with binding buffer and eluted with 250 mM imidazole, 150 mM NaCI, 50 mM NaH2PO4, pH 8Ø
[0208] The IMAC eluate, which contained ¨11.5 mg of protein, was applied directly to a WP
(anti-hL243) affinity column, which was washed to baseline with PBS and eluted with 0.1 M
glycine, pH 2.5. The process resulted in 7 mg of highly purified 20-C2-2b.
This was approximately 44% of the theoretical yield of 20-C2-2b, which is 50% of the total starting material (16 mg in this example) with 25% each of 20-2b-2b and 20-C2-C2 produced as side products.
Analytical methods [0209] Immunoreactivity was assessed by mixing excess WT, anti-IFNa, or WR2 with 20-C2-2b prior to analysis of the resulting immune complex by SE-HPLC. SDS-PAGE was performed under reducing and non-reducing conditions using 12% and 4 - 20% gradient Tris-glycine gels (Invitrogen, Gaithersburg, MD), respectively.
[0210] Electrospray ionization time of flight (ESI-TOF) liquid chromatography/mass spectrometry (LC/MS) was performed with a 1200-series HPLC coupled with a 6210 TOF MS
(Agilent Technologies, Santa Clara, CA). The 20-C2-2b was reduced with 10 mM
Tris(2-carboxyethyl)phosphine at 60 C for 30 min and resolved by reversed phase HPLC
(RP-HPLC).
For the TOF MS, the capillary and fragmentor voltages were set to 5500 and 200 V, respectively.
[0211] IFNa2b specific activities were determined using the ILITETm Human Interferon Alpha Cell-Based Assay Kit (PBL Interferon Source, Piscataway, NJ). Peginterferon alfa-2b (Schering Corp) was used as a positive control.
= Cell binding and apoptosis [0212] Cell binding and apoptosis were assessed by flow cytometry using a GUAVA PCA and the reagents, software and suggested protocols for GUAVA Express and GUAVA
Nexin, respectively (Millipore, Billerica, MA). For binding assays, live cells were incubated for 1 h at 4 C with MAbs or MAb-IFNcc diluted in 1% BSA-PBS. Cells were pelleted and washed twice with 1% BSA-PBS before incubation for 1 h at 4 C with 2 vig/mL PE-conjugated mouse-anti human IgG-Fc (Southern Biotech, Birmingham, AL). After three washes, binding was measured by flow cytometry. For apoptosis assays, cells (5 x 105/mL) were incubated with the indicated MAb or MAb-IFNa in 24-well plates for 48 h before quantification of the %
annexin-V-positive cells.
In-vitro cytotoxicity [0213] Cells were seeded in 48-well plates (300 vtL/well) at pre-determined optimal initial densities (1 ¨2.5 x 105cells/mL) in the presence of increasing concentrations of the indicated agents and incubated at 37 C until the density of untreated cells increased ?_10-fold (4 - 7 days).
Relative viable cell densities at the end of the assay were determined using a CellTiter 96 Cell Proliferation Assay (Promega, Madison, WI).
Ex-vivo depletion of Daudi from whole blood [0214] Blood specimens were collected under a protocol approved by the New England Institutional Review Board (Wellesley, MA). Daudi (5 x 104) cells were mixed with heparinized whole blood (150 L) from healthy volunteers and incubated with MAbs or MAb-IFNa at 1 nM
for 2 days at 37 C and 5% CO2. Cells were stained with FITC-anti-CD19, FITC-anti-CD14, APC-anti-CD3 or APC-mouse IgGi isotype control MAb (BD Biosciences, San Jose, CA) and analyzed by flow cytometry using a FACSCALIBUR (BD Biosciences). Daudi cells are CD19+ and in the monocyte gate. Normal B and T cells are CD19+ and CD3+ cells, respectively, in the lymphocyte gate. Monocytes are CD14+ cells in the monocyte gate.
Generation and characterization of 20-C2-2b [0215] The bispecific MAb-IFNa was generated by combining the IgG-AD2 module, IgG-v-mab, with two different dimeric DDD-modules, CH I-DDD2-Fab-hL243 and IFNa2b-DDD2. Due to the random association of either DDD-module with the two AD2 groups, two side-products, 20-C2-C2 and 20-2b-2b are expected to form, in addition to 20-C2-2b.
[0216] Non-reducing SDS-PAGE (not shown) resolved 20-C2-2b (-305 kDa) as a cluster of bands positioned between those of 20-C2-C2 (-365 kDa) and 20-2b-2b (255 kDa).
Reducing SDS-PAGE resolved the five polypeptides (v-mab HC-AD2, hL243 Fd-DDD2, IFNa2b-and co-migrating v-mab and hL243 kappa light chains) comprising 20-C2-2b (not shown).
IFNa2b-DDD2 and hL243 Fd-DDD2 are absent in 20-C2-C2 and 20-2b-2b. MABSELECTTm binds to all three of the major species produced in the DNL reaction, but removes any excess IFNa2b-DDD2 and CH1-DDD2-Fab-hL243. The HIS-SELECT unbound fraction contained mostly 20-C2-C2 (not shown). The unbound fraction from WT affinity chromatography comprised 20-2b-2b (not shown). Each of the samples was subjected to SE-HPLC
and immunoreactivity analyses, which corroborated the results and conclusions of the SDS-PAGE
analysis.
102171 Following reduction of 20-C2-2b, its five component polypeptides were resolved by RP-HPLC and individual ESI-TOF deconvoluted mass spectra were generated for each peak (not shown). Native, but not bacterially-expressed recombinant IFNa2, is 0-glycosylated at Thr-106 (Adolf et al., Biochem J 1991;276 ( Pt 2):511-8). We determined that ¨15% of the polypeptides comprising the IFNa2b-DDD2 module are 0-glycosylated and can be resolved from the non-glycosylated polypeptides by RP-HPLC and SDS-PAGE (not shown). LC/MS analysis of 20-C2-2b identified both the 0-glycosylated and non-glycosylated species of IFNa2b-DDD2 with mass accuracies of 15 ppm and 2 ppm, respectively (not shown). The observed mass of the 0-glycosylated form indicates an 0-linked glycan having the structure NeuGc-NeuGc-Gal-GalNAc, which was also predicted (<1 ppm) for 20-2b-2b (not shown). LC/MS
identified both v-mab and hL243 kappa chains as well as hL243-Fd-DDD2 (not shown) as single, unmodified species, with observed masses matching the calculated ones (<35 ppm). Two major glycoforms of v-mab HC-AD2 were identified as having=masses of 53,714.73 (70%) and 53,877.33 (30%), indicating GOF and GlF N-glycans, respectively, which are typically associated with IgG (not shown). The analysis also confirmed that the amino terminus of the HC-AD2 is modified to pyroglutamate, as predicted for polypeptides having an amino terminal glutamine.
[0218] SE-HPLC analysis of 20-C2-2b resolved a predominant protein peak with a retention time (6.7 min) consistent with its calculated mass and between those of the larger 20-C2-C2 (6.6 min) and smaller 20-2b-2b (6.85 min), as well as some higher molecular weight peaks that likely represent non-covalent dimers formed via self-association of IFNa2b (not shown).
102191 Immunoreactivity assays demonstrated the homogeneity of 20-C2-2b with each molecule containing the three functional groups (not shown). Incubation of 20-C2-2b with an excess of -antibodies to any of the three constituent modules resulted in quantitative formation of high molecular weight immune complexes and the disappearance of the 20-C2-2b peak.
The HIS-SELECT and WT affinity unbound fractions were not immunoreactive with WT and anti-IFNa, respectively (not shown).
Cell binding [02201 The MAb-IFNa showed similar binding avidity to their parental MAbs (not shown). At sub-saturating concentrations, similar binding levels were observed for 20-C2-2b and hL243y4p.
The antigen density of HLA-DR is ¨6-fold greater than CD20 in these cells, allowing more binding of 20-C2-2b compared to 20-2b-2b. Binding curves, which were analyzed using a one-site binding non-linear regression model, demonstrated that 20-C2-2b can achieve a 4.7-fold higher Bmax compared to 20-2b-2b, with no significant difference observed between their binding affinities (Kd ¨4 nM) (not shown).
IFNa biological activity [0221] The specific activities for various MAb-IFNa were measured using a cell-based reporter gene assay and compared to peginterferon alfa-2b (not shown). Expectedly, the specific activity of 20-C2-2b (2454 IU/pmol), which has two IFNa2b groups, was significantly lower than those of 20-2b-2b (4447 IU/pmol) or 734-2b-2b (3764 IU/pmol), yet greater than peginterferon alfa-2b (P<0.001). The difference between 20-2b-2b and 734-2b-2b was not significant.
The specific activity among all agents varies minimally when normalized to IU/pmol of total IFNcc. Based on these data, the specific activity of each IFNoc2b group of the MAb-IFNa is approximately 30%
of recombinant IFNa2b (-4000 IU/pmol).
102221 In-vitro cytotoxicity: NHL The relative antigen densities of HLA-DR and CD20 for each cell line has been reported (Stein et al., 2010, Blood 115:5180-90). The targeting index (TI) represents the fold-increase in potency of a targeted MAb-IFNa compared to non-targeted MAb-IFNa (734-2b-2b), with the EC50 values converted to total IFNcc concentration (I-EC50). Daudi is very sensitive to cell killing by IFNa2, as demonstrated with the non-targeting MAb-IFNa, 734-2b-2b (I-EC50=14 pM). Targeting CD20 on Daudi with the monospecific 20-2b-2b (I-EC50=0.4 pM) further enhanced the potency 25-fold (T1-25), consistent with previous results (Rossi et al., Blood 2009, 114:3864-71). The potency enhancement for the bispecific 20-C2-2b (I-EC50=0.08 PM; TI-125) was 5-fold greater than 20-2b-2b, which can be attributed to the added antigen density of HLA-DR and possibly its high-avidity tetravalent tumor binding. It is less likely that hL243-induced signaling contributes additional cytotoxicity at these low concentrations. The mixture of v-mab, hL243y4p and 734-2b-2b (v-mab+hL243+734-2b) was equal to 734-2b-2b alone, supporting the conclusion that hL243-induced signaling does not contribute to the high TI
of 20-C2-2b.
102231 Apoptosis was induced in Daudi with only 1 pM of any MAb-IFNa but not with 10 pM

of v-mab or hL243y4p (not shown). Treatment with 20-2b-2b or 20-C2-2b resulted in significantly more apoptotic cells than 734-2b-2b or v-mab+hL243+734-2b (P<0.0005) (not shown). There was no significant difference observed between 734-2b-2b and the mixture (not shown).
[0224] The 734-2b-2b had less effect on Raj i (I-EC50=32 nM) and Ramos (I-EC50>80 nM), resulting in maximal inhibition (1,,) of only 62% and 35%, respectively. Under these conditions, hL243y4p, but not v-mab (not shown), inhibited these Burkitt lymphoma lines. The observed enhancement in potency of 20-C2-2b (TI=118) was >50-fold greater than 20-2b-2b (TI=2) for Raj i, which has much greater HLA-DR antigen density than CD20.
Unlike Daudi and Raji, the densities of HLA-DR and CD-20 are similar on Ramos, yet the TI for 20-C2-2b was 15-fold greater than 20-2b-2b, indicating additive activities of hL243 and IFNa2b.
[0225] The v-mab+hL234+734-2b mixture was more potent than any of the single agents alone for Raj i and Ramos. Targeting the IFNa2b was critical for achieving maximal potency. In each of the three Burkitt lymphoma lines, 20-C2-2b was more effective than v-mab+hL234+734-2b, which comprises the same number of anti-CD20 and anti-HLA-DR Fabs and twice the amount (and activity) of IFNa2b.
[0226] The mantle cell lymphoma, Jeko-1, was considerably more responsive to hL243y4p (EC50=0.4 nM) and less sensitive to IFNa2b (minimal effect with 734-2b-2b).
Any treatment comprising hL243 was superior to 20-2b-2b (EC50=1 nM). The 20-C2-2b exhibited two-fold enhanced potency compared to hL243y4p or v-mab+hL243+734-2b. At 0.5 nM, hL243y4p and 734-2b-2b induced similar levels of apoptosis and their effects are apparently additive, since treatment with v-mab+hL243+734-2b resulted in approximately twice the number of annexin-V-positive cells compared to either agent alone (not shown). Presumably, v-mab has little contribution in the mixture, since alone it had only a modest effect. Both 20-C2-2b and the mixture were superior to 20-2b-2b (P<0.002), due to the action of hL243.
Effector functions and stability in human serum [0227] We previously reported that 20-2b-2b exhibited enhanced ADCC compared to its parent v-mab (Rossi et al., Blood 2009;114:3864-71). By design, hL243y4p has diminished ADCC
(Stein et at., Blood 2006;108:2736-44). However, 20-C2-C2 induced significantly (P=0.0091) greater ADCC compared to v-mab (not shown). Notably, 20-C2-2b induced significantly greater ADCC than either 20-2b-2b (P=0.0040) or 20-C2-C2 (P=0.0115), indicating an enhancement of the effector function by the presence of IFNa.2b. As was demonstrated previously for 20-2b-2b (Rossi etal., Blood 2009;114:3864-71), 20-C2-2b does not induce CDC in vitro (not shown).
[0228] Two different assays for stability of 20-C2-2b in human serum gave very similar results, indicating a loss of ¨3.5%/day with roughly 65% remaining after 11 days at 37 C (not shown).
Ex-vivo depletion of NHL from whole human blood [0229] Daudi cells were depleted from whole blood (ex vivo) more effectively by 20-C2-2b (91%) compared to 20-2b-2b (69%), v-mab (49% depletion), hL243y4p (46%) or 734-2b-2b (10%). Both targeted MAb-IFNa were less toxic to normal B cells compared to Daudi. Under these conditions, B cells were significantly depleted by 20-C2-2b (57%) and hL243y4p (41%), but not by v-mab, 734-2b, or 20-2b-2b. Monocytes were depleted by hL243y4p (48%), 734-2b-2b (30%), and 20-2b-2b (21%), but not by v-mab. The 20-C2-2b (98%) was highly toxic to monocytes. None of the agents had a significant effect on T cells. Statistical significance with P<0.001 was determined by Student's t-test for each of the differences in A
depletion indicated above.
[0230] The bispecific MAb-IFNa 20-C2-2b is attractive for the treatment of NHL, because each of the three components is active against this disease. This study shows that 20-C2-2b may also be useful for the therapy of MM and other hematopoietic malignancies.
[0231] The skilled artisan will realize that the approach described here to produce and use bispecific immunocytokine, or other DNL complexes comprising three different effector moieties, may be utilized with any combinations of antibodies, antibody fragments, cytokines or other effectors that may be incorporated into a DNL complex.
Example 17. Use of DNL Complexes for Targeted Stem Cell Delivery in Cardiac Disease [0232] Antibodies - Anti-human CD45 antibody is obtained from BD PHARMINGEN
(San Diego, CA, Cat. No. 347460), while anti-MLC3 antibody is obtained from ABCAM
(Cambridge, MA, Cat. No. AB678). A trimeric DNL complex comprising anti-CD45 Fab x anti-MLC
(myosin light chain) Fab is constructed as described in Examples 1-4 above.
The CD45 component binds to CD34+ human hematopoietic stem cells (hHSCs) while the MLC
component binds to injured myocardium (Lee et al., 2007, Stem Cells 25:712-17). The Fab fragments are prepared as fusion proteins attached to the AD2 and DDD2 peptides, resulting in a trimeric DNL complex that is covalently cross-linked by disulfide bonds. The bispecific DNL

= CA 02758390 2011-11-14 complex is formed with very high efficiency and only a single product is observed by SE-HPLC
and non-reducing SDS-PAGE. Thus, the DNL technique is superior to prior reported methods of preparing bispecific antibodies by chemical conjugation, which result in a mixture of monomers, dimers and multimers (see, e.g., U.S. Patent 7,576,186, Example 4). The dose of DNL complex administered is 50 ng per million purified CD34+ cells, pre-incubated for I
hour at 4 C.
102331 Stem Cells - G-CSF-primed PBMCs are obtained by leukapheresis (Lee et al., 2007, Stem Cells 25:712-17). CD34+ purified cells are obtained by positive selection using a clinical ISOLEXO 300i column and CD34+ selection kit (Baxter, Deerfield, IL). The fraction of CD34+
cells is 0.5% in the PBMC population and 99% in the ISOLEXO purified fraction.
Purified CD34+ cells are incubated with bispecific anti-CD45 x anti-MLC DNL complex and administered within 24 hours.
102341 Myocardial Injury Model - An ischemia reperfusion model in nude rats is prepared according to Lee et al. (2007, Stem Cells 25:712-17). Two days after myocardial infarction, the preincubated CD34+ cells (2 x 106) are intravenously injected via the right internal jugular vein.
In control experiments, animals are administered cells alone in the absence of antibody.
Results =
10235] CD34+ cells pre-incubated with bispecific DNL complex are preferentially localized to damaged myocardium, where they differentiate into cardiomyocytes. CD34+ cells in the absence of the bispecific DNL complex are only rarely found in the damaged myocardial tissue.
Animals administered CD34+ cells pre-incubated with bispecific DNI, complex show significant improvement in left ventricular function and cardiac output compared to control animals treated with cells in the absence of bispecific DNL complex as well as animals that are not treated with CD34+ cells. The study demonstrates the feasibility of using bispecific DNL
complexes for targeted delivery of stem cells.
Example 18. Use of DNL Complexes for Targeted Stem Cell Delivery in Diabetes [02361 Antibodies - Anti-human SSEA-3 antibody is obtained from ABCAM
(Cambridge, MA, Cat. No. AB16286). Anti-human islet cell antibody is also obtained from ABCAM
(Cambridge, MA, Cat. No. AB227I3). A trimeric DNL complex comprising anti-SSEA3 Fab x anti-islet cell Fab is constructed as described in Examples 1-4 above. The SSEA3 component binds to human embryonic stem cells (hES cells) while the islet cell component binds to islet cells in the pancreas. The Fab fragments are prepared as fusion proteins attached to the AD2 and DDD2 peptides, resulting in a trimeric DNL complex that is covalently cross-linked by disulfide bonds.
The bispecific DNL complex is formed with very high efficiency and only a single product is observed by SE-HPLC and non-reducing SDS-PAGE. The dose of DNL complex administered is 50 ng per million purified hESC cells, pre-incubated for 1 hour at 4 C.
102371 Stem Cells - hES-H9 cells are prepared and induced for insulin production according to Assady et al. (2001, Diabetes 50:1691-97). Induced hES cells are incubated with bispecific anti-SSEA3 Fab x anti- islet cell DNL complex and administered within 24 hours. The DNL targeted induced hES cells are administered to individuals with type 2 diabetes.
Results 102381 hES cells pre-incubated with bispecific DNL complex are preferentially localized to the pancreas, where they produce and secrete insulin. hES cells in the absence of the bispecific DNL
complex are only rarely found in the pancreas. Subjects administered induced hES cells pre-incubated with bispecific DNL complex show improvement in insulin production and control of blood glucose levels. The study demonstrates the feasibility of using bispecific DNL complexes for targeted delivery of insulin-secreting stem cells to the pancreas.
Example 19. Use of DNL Complexes for Targeted Stem Cell Delivery to Regenerating Liver 102391 Liver degeneration can occur in a number of different diseases or conditions, such as hepatitis A, B or C, alcohol damage, cirrhosis, biliary atresia, alpha-1 antitrypsin deficiency, progressive familiar intrahepatic cholestasis, hepatic cancer, fatty liver, liver toxicity of drugs such as acetaminophen, etc. Although normal liver regeneration may compensate in part for loss of liver tissue, in cases of severe liver degeneration or liver failure it is desirable to administer stem cells to the liver.
102401 Antibodies - Anti-human CD133 is obtained from MILTENYI BIOTEC (Auburn, CA, Cat. No. 130-092-395), while anti-human AFP is the hIMMU31 antibody from Immunomedics, Inc. (Morris Plains, NJ), prepared as described in U.S. Patent No. 7,501,498.
A trimeric DNL
complex comprising anti-CD133 Fab x anti-alpha fetoprotein (AFP) Fab is constructed as described in Examples 1-4 above. The CD133 component binds to umbilical cord blood derived mesenchymal stem cells (uMSCs) while the AFP component binds to liver tissue.
The Fab fragments are prepared as fusion proteins attached to the AD2 and DDD2 peptides, resulting in a trimeric DNL complex that is covalently cross-linked by disulfide bonds. The bispecific DNL

complex is formed with very high efficiency and only a single product is observed by SE-HPLC
and non-reducing SDS-PAGE. The dose of DNL complex administered is 50 ng per million purified uMSC cells, pre-incubated for 1 hour at 4 C.
[0241] Stem Cells - uMSC cells are prepared according to Peters et al. (2010, PLoS ONE
5:e15689). Purified uMSC cells are incubated with bispecific anti-CD133 Fab x anti-AFP DNL
complex and administered within 24 hours. The DNL targeted uMSC cells are administered (4 x 5,000,000 cells) to an individual in advanced liver disease, with 43 U/L SGOT, and very low serum albumin.
Results [0242] uMSC cells pre-incubated with bispecific DNL complex are preferentially localized to the liver. Following administration of DNL-targeted uMSC cells, the subject showed decreased SGOT and SGPT and increased serum albumin, with decreased fatigue and improved appetite.
The study demonstrates the feasibility of using bispecific DNL complexes for targeted delivery of stem cells to the liver.
Example 20. In Vivo Generation of Hematopoietic Stem Cells for Therapy of Cardiac Disease [0243] A DNL complex comprising anti-CD45 Fab x anti-MLC (myosin light chain) Fab is constructed as described in Example 17 above. The CD45 component binds to CD34+ human hematopoietic stem cells (hEISCs) while the MLC component binds to injured myocardium (Lee et al., 2007, Stem Cells 25:712-17). Hematopoietic stem cells are produced in vivo by administration of G-CSF, as disclosed in de Haan et al. (1995, Blood, 86:2986-92). Starting at 1 day after the beginning of G-CSF administration, the anti-CD45 x anti-MLC DNL
complex is administered. The DNL complex and G-CSF are co-administered for 14 days.
[0244] In vivo administration of G-CSF mobilizes hHSC production (de Haan et al., 1995, Blood, 86:2986-92), which migrate from the bone marrow into the blood. In contrast to the results of de Haan et al. (1995), where the mobilized HSCs migrated to the spleen, in the presence of bispecific DNL construct the mobilized HSCs are directed to myocardium, where they engraft in and proliferate at sites of damaged myocardium. Compared to either G-CSF in the absence of DNL construct, or DNL construct administered in the absence of G-CSF, the co-administration of G-CSF and DNL construct results in an improvement in cardivascular function following ischemic injury.

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Claims (13)

What is claimed

1. A method of targeting stem cells to diseased or damaged tissues or organs comprising:

a) obtaining a DNL complex comprising (i) a first antibody or fragment thereof that binds to a stem cell antigen; and (ii) a second antibody or fragment thereof that binds to an antigen on a diseased or damaged tissue or organ; and b) administering a stem cell to an individual with a diseased or damaged tissue or organ in the presence of the DNL complex.

2. The method of claim 1, wherein the first and second antibodies or fragments thereof are fusion proteins, wherein each fusion protein comprises an AD moiety or a DDD
moiety and wherein two copies of the DDD moiety form a dimer that binds to the AD moiety to form the DNL complex.

3. The method of claim 2, wherein (i) the first antibody or fragment thereof is attached to a DDD moiety and the second antibody or fragment thereof is attached to an AD
moiety; or (ii) the first antibody or fragment thereof is attached to an AD moiety and the second antibody or fragment thereof is attached to a DDD moiety.

4. The method of claim 1, wherein the DNL complex is administered to the individual before, simultaneously with or after the stem cell is administered to the individual.

5. The method of claim 1, wherein the DNL complex is pre-incubated with the stem cell before the stem cell and DNL complex are administered to the individual.

6. The method of claim 2, wherein the amino acid sequence of the AD moiety is selected from the group consisting of SEQ ID NO:3, SEQ ID NO:4, SEQ ID NO:7, SEQ ID NO:32, SEQ
ID NO:33, SEQ ID NO:34, SEQ ID NO:35, SEQ ID NO:36, SEQ ID NO:37, SEQ ID
NO:38, SEQ ID NO:39, SEQ ID NO:40, SEQ ID NO:41, SEQ ID NO:42, SEQ ID NO:43, SEQ ID NO:44, SEQ ID NO:45, SEQ ID NO:46, SEQ ID NO:47, SEQ ID NO:48, SEQ ID
NO:49, SEQ ID NO:50, SEQ ID NO:51, SEQ ID NO:52, SEQ ID NO:53, SEQ ID NO:54, SEQ ID NO:55, SEQ ID NO:56, SEQ ID NO:57, SEQ ID NO:58, SEQ ID NO:59, SEQ ID
NO:60, SEQ ID NO:61, SEQ ID NO:62, SEQ ID NO:63, SEQ ID NO:64, SEQ ID NO:65, SEQ ID NO:66, SEQ ID NO:67, SEQ ID NO:68, SEQ ID NO:69, SEQ ID NO:70, SEQ ID
NO:71, SEQ ID NO:72, SEQ ID NO:73, SEQ ID NO:74, SEQ ID NO:75, SEQ ID NO:76, SEQ ID SEQ ID NO:78, SEQ ID NO:79, SEQ ID NO:80, SEQ ID NO:81, SEQ ID
NO:82, SEQ ID NO:83 and SEQ ID NO:84.

7. The method of claim 2, wherein the amino acid sequence of the DDD moiety is selected from the group consisting of SEQ ID NO:1, SEQ ID NO:2, SEQ ID NO:5, SEQ ID NO:6, SEQ ID
NO:8, SEQ ID NO:9, SEQ ID NO:10, SEQ ID NO:11, SEQ ID NO:12, SEQ ID NO:13, SEQ

ID NO:14, SEQ ID NO:15, SEQ ID NO:16, SEQ ID NO:17, SEQ ID NO:18, SEQ ID
NO:19, SEQ ID NO:20, SEQ ID NO:21, SEQ ID NO:22, SEQ ID NO:23, SEQ ID NO:24, SEQ ID NO:25, SEQ ID NO:26, SEQ ID NO:27, SEQ ID NO:28, SEQ ID NO:29, SEQ ID
NO:30 and SEQ ID NO:31.

R The method of claim 1, wherein the individual has a disease or condition selected from the group consisting of neurologic disease, Alzheimer's disease, Parkinson's disease, stroke, amyotrophic lateral sclerosis (ALS), muscular dystrophy, macular degeneration, chronic obstructive pulmonary disease, cardiovascular disease, congestive heart failure, myocardial infarction, coronary artery disease, cardiomyopathy, type 1 diabetes, type 2 diabetes, liver degenerative disease, cirrhosis, steatosis, cholestasis, Wilson's disease, hepatitis B, hepatitis C, osteoarthritis, autoimmune disease, immune dysfunction disease, Crohn's disease, Huntington's disease, celiac disease, graft-versus-host disease, leukemia, lymphoma, sickle cell anemia, organ failure, burns, trauma and spinal cord injury.

9. The method of claim 1, wherein the first antibody or fragment thereof binds to a stem cell antigen selected from the group consisting of ABCG2, alkaline phosphatase, bone morphogenetic protein receptor, CD30, CD34, CD38, CD44, CD45, CD90, CD117, CD133, CDCP1, cytokeratin 19, fetal liver kinase-1 (F1k1), GCTM-2, c-kit, Nestin, Seal, hSCF, SSEA3, SSEA4, TDGF-1, Thy-1, Tra-1-60 and Tra-1-81.

10. The method of claim 1, wherein the second antibody or fragment thereof binds to a tissue antigen selected from the group consisting of bone-specific alkaline phosphatase (BAP), type II collagen, type IV collagen, cytokeratin 19, glial fibrillary acidic protein (GFAP), hydroxyapatite, ICAM-2, IL-8, B-1 integrin, keratin, MAP-2, myelin basic protein (MPB), myosin light chain (MLC), nestin, 01, 04, osteocalcin, P63, pancreatic polypeptide, E-selectin, smooth muscle cell-specific myosin heavy chain, sulfated proteoglycan, synaptophysin vascular endothelial cell cadherin and VCAM1.

11. The method of claim 1, wherein the stem cell is selected from the group consisting of a hematopoietic stem cell, an embryonic stem cell, a mesenchymal stem cell, an induced pluripotent stem cell (iPS), a neural precursor cell, a hepatic stem cell, a human umbilical cord stem cell and a bone-marrow-derived multipotent stromal cell (BMMSC).

12. The method of claim 1, wherein the DNL complex further comprises an immunomodulator, a cytokine, a lymphokine, a monokine, a hormone, a growth factor, a stem cell growth factor, a hematopoietic factor, an interleukin, an interferon, a colony stimulating factor, a transforming growth factor, an insulin-like growth factor, erythropoietin, thrombopoietin, G-CSF, GM-CSF or S1 factor.
11. A DNL complex comprising:
a) a first antibody or fragment thereof that binds to a stem cell antigen; and b) a second antibody or fragment thereof that binds to an antigen on a diseased or damaged tissue or organ wherein each antibody or fragment thereof is attached to an AD moiety or a DDD
moiety and wherein two copies of the DDD moiety form a dimer that binds to one copy of the AD moiety to form the DNL complex.
14. The DNL complex of claim 13, wherein (i) the first antibody or fragment thereof is attached to a DDD moiety and the second antibody or fragment thereof is attached to an AD moiety;
or (ii) the first antibody or fragment thereof is attached to an AD moiety and the second antibody or fragment thereof is attached to a DDD moiety.
15. The DNL complex of claim 13, wherein the DDD moiety is from a human protein kinase A
RI.alpha., RI.beta., RII.alpha. or RII.beta. regulatory subunit protein and the AD moiety is from an AKAP (A-kinase anchoring protein).
16. The DNL complex of claim 13, wherein the amino acid sequence of the AD
moiety is selected from the group consisting of SEQ ID NO:3, SEQ ID NO:4, SEQ ID NO:7, SEQ ID
NO:32, SEQ ID NO:33, SEQ ID NO:34, SEQ ID NO:35, SEQ ID NO:36, SEQ ID NO:37, SEQ ID NO:38, SEQ ID NO:39, SEQ ID NO:40, SEQ ID NO:41, SEQ ID NO:42, SEQ ID
NO:43, SEQ ID NO:44, SEQ ID NO:45, SEQ ID NO:46, SEQ ID NO:47, SEQ ID NO:48, SEQ ID NO:49, SEQ ID NO:50, SEQ ID NO:51, SEQ ID NO:52, SEQ ID NO:53, SEQ ID

NO:54, SEQ ID NO:55, SEQ ID NO:56, SEQ ID NO:57, SEQ ID NO:58, SEQ ID NO:59, SEQ ID NO:60, SEQ ID NO:61, SEQ ID NO:62, SEQ ID NO:63, SEQ ID NO:64, SEQ ID
NO:65, SEQ ID NO:66, SEQ ID NO:67, SEQ ID NO:68, SEQ ID NO:69, SEQ ID NO:70, SEQ ID NO:71, SEQ ID NO:72, SEQ ID NO:73, SEQ ID NO:74, SEQ ID NO:75, SEQ ID
NO:76, SEQ ID NO:77, SEQ ID NO:78, SEQ ID NO:79, SEQ ID NO:80, SEQ ID NO:81, SEQ ID NO:82, SEQ ID NO:83 and SEQ ID NO:84.
17. The DNL complex of claim 13, wherein the amino acid sequence of the DDD
moiety is selected from the group consisting of SEQ ID NO:1, SEQ ID NO:2, SEQ ID NO:5, SEQ ID
NO:6, SEQ ID NO:8, SEQ ID NO.9, SEQ ID NO:10, SEQ ID NO:11, SEQ ID NO:12, SEQ
ID NO:13, SEQ ID NO:14, SEQ ID NO:15, SEQ ID NO:16, SEQ ID NO:17, SEQ ID
NO:18, SEQ ID NO:19, SEQ ID NO:20, SEQ ID NO:21, SEQ ID NO:22, SEQ ID NO:23, SEQ ID NO:24, SEQ ID NO:25, SEQ ID NO:26, SEQ ID NO:27, SEQ ID NO:28, SEQ ID
NO:29, SEQ ID NO:30 and SEQ ID NO:31.
18. The DNL complex of claim 13, wherein the first antibody or fragment thereof binds to a stem cell antigen selected from the group consisting of ABCG2, alkaline phosphatase, bone morphogenetic protein receptor, CD30, CD34, CD38, CD44, CD45, CD90, CD117, CD133, CDCP1, cytokeratin 19, fetal liver kinase-1 (F1k1), GCTM-2, c-kit, Nestin, Scal, hSCF, SSEA3, SSEA4, TDGF-1, Thy-1 , Tra-1-60 and Tra-1-81.
19. The DNL complex of claim 13, wherein the second antibody or fragment thereof binds to a tissue antigen selected from the group consisting of bone-specific alkaline phosphatase (BAP), type II collagen, type IV collagen, cytokeratin 19, glial fibrillary acidic protein (GFAP), hydroxyapatite, ICAM-2, IL-8, B-1 integrin, keratin, MAP-2, myelin basic protein (MPB), myosin light chain (MLC), nestin, O1, O4, osteocalcin, P63, pancreatic polypeptide, E-selectin, smooth muscle cell-specific myosin heavy chain, sulfated proteoglycan, synaptophysin vascular endothelial cell cadherin .and VCAM1.
20. The DNL complex of claim 13, further comprising an immunomodulator, a cytokine, a lymphokine, a monokine, a hormone, a growth factor, a stem cell growth factor, a hematopoietic factor, an interleukin, an interferon, a colony stimulating factor, a transforming growth factor, an insulin-like growth factor, erythropoietin, thrombopoietin, G-CSF, GM-CSF or S1 factor.

21. A method of treating a disease or condition that is responsive to stem cell therapy comprising:
a) obtaining a DNL complex comprising (i) a first antibody or fragment thereof that binds to a stem cell antigen; and (ii) a second antibody or fragment thereof that binds to an antigen on a diseased or damaged tissue or organ, wherein each antibody or fragment thereof is attached to an AD moiety or a DDD moiety and wherein two copies of the DDD
moiety form a dimer that binds to one copy of the AD moiety to form the DNL complex;
and b) administering a stem cell to an individual with the disease or condition.
22. The method of claim 21, wherein the first and second antibodies or fragments thereof are fusion proteins, wherein each fusion protein comprises an AD moiety or a DDD
moiety.
23. The method of claim 22, wherein (i) the first antibody or fragment thereof is attached to a DDD moiety and the second antibody or fragment thereof is attached to an AD
moiety; or (ii) the first antibody or fragment thereof is attached to an AD moiety and the second antibody or fragment thereof is attached to a DDD moiety.
24. The method of claim 21, wherein the DNL complex is administered to the individual before, simultaneously with or after the stem cell is administered to the individual.
25. The method of claim 21, wherein the DNL complex is pre-incubated with the stem cell before the stem cell and DNL complex are administered to the individual.
26. The method of claim 21, wherein the amino acid sequence of the AD moiety is selected from the group consisting of SEQ ID NO:3, SEQ ID NO:4, SEQ ID NO:7, SEQ ID NO:32, SEQ
ID NO:33, SEQ ID NO:34, SEQ ID NO:35, SEQ ID NO:36, SEQ ID NO:37, SEQ ID
NO:38, SEQ ID NO:39, SEQ ID NO:40, SEQ ID NO:41, SEQ ID NO:42, SEQ ID NO:43, SEQ ID NO:44, SEQ ID NO:45, SEQ ID NO:46, SEQ ID NO:47, SEQ ID NO:48, SEQ ID
NO:49, SEQ ID NO:50, SEQ ID NO:51, SEQ ID NO:52, SEQ ID NO:53, SEQ ID NO:54, SEQ ID NO:55, SEQ ID NO:56, SEQ ID NO:57, SEQ ID NO:58, SEQ ID NO:59, SEQ ID
NO:60, SEQ ID NO:61, SEQ ID NO:62, SEQ ID NO:63, SEQ ID NO:64, SEQ ID NO:65, SEQ ID NO:66, SEQ ID NO:67, SEQ ID NO:68, SEQ ID NO:69, SEQ ID NO:70, SEQ ID
NO:71, SEQ ID NO:72, SEQ ID NO:73, SEQ ID NO:74, SEQ ID NO:75, SEQ ID NO:76, SEQ ID NO:77, SEQ ID NO:78, SEQ ID NO:79, SEQ ID NO:80, SEQ ID NO:81, SEQ ID
NO:82, SEQ ID NO:83 and SEQ ID NO:84.
27. The method of claim 21, wherein the amino acid sequence of the DDD moiety is selected from the group consisting of SEQ ID NO:1, SEQ ID NO:2, SEQ ID NO:5, SEQ ID
NO:6, SEQ ID NO:8, SEQ ID NO:9, SEQ ID NO:10, SEQ ID NO:11, SEQ ID NO:12, SEQ ID
NO:13, SEQ ID NO:14, SEQ ID NO:15, SEQ ID NO:16, SEQ ID NO:17, SEQ ID NO:18, SEQ ID NO:19, SEQ ID NO:20, SEQ ID NO:21, SEQ ID NO:22, SEQ ID NO:23, SEQ ID
NO:24, SEQ ID NO:25, SEQ ID N0:26, SEQ ID NO:27, SEQ ID NO:28, SEQ ID NO:29, SEQ ID NO:30 and SEQ ID NO:31.
28. The method of claim 1, wherein the disease or condition is selected from the group consisting of neurologic disease, Alzheimer's disease, Parkinson's disease, stroke, amyotrophic lateral sclerosis (ALS), muscular dystrophy, macular degeneration, chronic obstructive pulmonary disease, cardiovascular disease, congestive heart failure, myocardial infarction, coronary artery disease, cardiomyopathy, type 1 diabetes, type 2 diabetes, liver degenerative disease, cirrhosis, steatosis, cholestasis, Wilson's disease, hepatitis B, hepatitis C, osteoarthritis, autoimmune disease, immune dysfunction disease, Crohn's disease, Huntington's disease, celiac disease, graft-versus-host disease, leukemia, lymphoma, sickle cell anemia, organ failure, burns, trauma and spinal cord injury.
29. The method of claim 21, wherein the first antibody or fragment thereof binds to a stem cell antigen selected from the group consisting of ABCG2, alkaline phosphatase, bone morphogenetic protein receptor, CD30, CD34, CD38, CD44, CD45, CD90, CD117, CD133, CDCP1, cytokeratin 19, fetal liver kinase-1 (Flk1), GCTM-2, c-kit, Nestin, Seal , hSCF, SSEA3, SSEA4, TDGF-1, Thy-1, Tra-1-60 and Tra-1-81.
30. The method of claim 21, wherein the second antibody or fragment thereof binds to a tissue antigen selected from the group consisting of bone-specific alkaline phosphatase (BAP), type II collagen, type IV collagen, cytokeratin 19, glial fibrillary acidic protein (GFAP), hydroxyapatite, ICAM-2, IL-8, B-1 integrin, keratin, MAP-2, myelin basic protein (MPB), myosin light chain (MLC), nestin, O1, O4, osteocalcin, P63, pancreatic polypeptide, E-selectin, smooth muscle cell-specific myosin heavy chain, sulfated proteoglycan, synaptophysin vascular endothelial cell cadherin and VCAM1.

31. The method of claim 21, wherein the stem cell is selected from the group consisting of a hematopoietic stem cell, an embryonic stem cell, a mesenchymal stem cell, an induced pluripotent stem cell (iPS), a neural precursor cell, a hepatic stem cell, a human umbilical cord stem cell and a bone-marrow-derived multipotent stromal cell (BMMSC).
32. The method of claim 21, wherein the DNL complex further comprises an immunomodulator, a cytokine, a lymphokine, a monokine, a hormone, a growth factor, a stem cell growth factor, a hematopoietic factor, an interleukin, an interferon, a colony stimulating factor, a transforming growth factor, an insulin-like growth factor, erythropoietin, thrombopoietin, G-CSF, GM-CSF or S1 factor.

13. The method of Claim 78, wherein the autoimmune disease is selected from the group consisting of acute idiopathic thrombocytopenic purpura, chronic idiopathic thrombocytopenic purpura, dermatomyositis, Sydenham's chorea, myasthenia gravis, systemic lupus erythematosus, lupus nephritis, rheumatic fever, polyglandular syndromes, bullous pemphigoid, diabetes mellitus, Henoch-Schonlein purpura, post-streptococcal nephritis, erythema nodosum, Takayasu's arteritis, Addison's disease, rheumatoid arthritis, multiple sclerosis, sarcoidosis, ulcerative colitis, erythema multiforme, IgA
nephropathy, polyarteritis nodosa, ankylosing spondylitis, Goodpasture's syndrome, thromboangitis obliterans, Sjogren's syndrome, primary biliary cirrhosis, Hashimoto's thyroiditis, thyrotoxicosis, scleroderma, chronic active hepatitis, polymyositis/dermatomyositis, polychondritis, pemphigus vulgaris, Wegener's granulomatosis, membranous nephropathy, amyotrophic lateral sclerosis, tabes dorsalis, giant cell arteritis/polymyalgia, pernicious anemia, rapidly progressive glomerulonephritis, psoriasis and fibrosing alveolitis.