CN109069440A - 用于免疫治疗的激活sting的纳米疫苗 - Google Patents
用于免疫治疗的激活sting的纳米疫苗 Download PDFInfo
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Abstract
在一些方面,本公开内容提供了包含抗原和二嵌段共聚物的疫苗组合物,其中所述二嵌段共聚物是pH响应性的。在一些实施方案中,这些组合物激活STING和/或干扰素受体途径。在一些实施方案中,所述二嵌段共聚物的pKa为约6至约7.5。本文中还提供了使用这些组合物来治疗感染性疾病或癌症的治疗方法。
Description
本申请要求于2016年3月2日提交的美国临时申请序列号62/302,637的优先权,其的全部内容通过引用并入本文。
本发明在由国立卫生研究院(National Institutes of Health)授予的授权号R01AI093967、R01EB013149和R01CA129011的政府支持下完成。政府在本发明中具有一定的权利。
背景
1.技术领域
本公开内容一般地涉及疫苗组合物领域。更具体地,其涉及用于癌症或感染性疾病之免疫治疗的疫苗组合物。
2.背景技术
大多数癌细胞仅具有弱免疫原性。因此,免疫治疗需要使用佐剂来提高免疫系统的反应以产生适当的免疫应答。通常来说,这涉及递送抗原以促进疾病标志物抗体的产生。肿瘤特异性T细胞的产生对于癌症免疫治疗至关重要(Rosenberg和Restifo,2015;Tumeh等,2014)。实现稳健适应性T细胞应答的主要挑战是具有固有刺激的抗原呈递细胞(antigen presenting cell,APC)中的抗原递送的空间-时间编排(spatio-temporalorchestration)和交叉呈递(Hubbell等,2009;Abbas等,2014;Chen和Mellman,2013)。鉴于在用于癌症以及感染性疾病的疫苗的开发中的这些和其他挑战,需要新的疫苗组合物。
发明概述
在一些方面,本公开内容提供了可用于通过STING途径促进对疾病或病症之免疫应答的组合物。在一些方面,本公开内容提供了包含以下的组合物:
(A)抗原;
(B)pH敏感性二嵌段共聚物;
其中抗原被共聚物包封。在一些实施方案中,抗原是抗癌抗原。在一些实施方案中,抗原是肿瘤相关抗原或肿瘤新抗原。在一些实施方案中,肿瘤相关抗原是人乳头瘤病毒E6蛋白、E7蛋白或其片段,例如LHEYMLDLQPETVDLDLLMGTLGIVCPICSQ(SEQ ID NO:1)或DTPTLHEYMLDLQPETVDLYCYE(SEQ ID NO:2)。在另一些实施方案中,肿瘤相关抗原是间皮素或其片段,例如GQKMNAQAIALVACYLRGGGQLDEDMV(SEQ ID NO:3)。在另一些实施方案中,抗癌抗原是黑素瘤肿瘤相关抗原或新抗原,例如HASSTFTITDQVPFSVSVSQLQAL(SEQ ID NO:4)、SHEGPAFLTWHRYHLLQLERDMQE(SEQ ID NO:5)、QPQIANCSVYDFFVWLHYYSVRDT(SEQ ID NO:6)、REGVELCPGNKYEMRRHGTTHSLVIHD(SEQ ID NO:7)、DSGSPFPAAVILRDALHMARGLKYLHQ(SEQ IDNO:8)、VVDRNPQFLDPVLAYLMKGLCEKPLAS(SEQ ID NO:9)、、PSKPSFQEFVDWENVSPELNSTDQPFL(SEQ ID NO:10)、或NHSGLVTFQAFIDVMSRETTDTDTADQ(SEQ ID NO:11)。在一些实施方案中,抗癌抗原是膀胱癌、血癌、骨癌、脑癌、乳腺癌、中枢神经系统癌症、宫颈癌、结肠癌、子宫内膜癌、食管癌、胆囊癌、胃肠道癌、外生殖器癌、泌尿生殖道癌、头癌、肾癌、喉癌、肝癌、肺癌、肌肉组织癌症、颈癌、口腔或鼻黏膜癌、卵巢癌、胰腺癌、前列腺癌、皮肤癌、脾癌、小肠癌、大肠癌、胃癌、睾丸癌或甲状腺癌的抗原。在一些实施方案中,抗癌抗原是间皮瘤、黑素瘤、胰腺癌、卵巢癌或宫颈癌的抗原。
在另一些实施方案中,抗原是病毒抗原。在一些实施方案中,病毒抗原是乙型肝炎病毒抗原,例如HBV表面抗原(HBsAg)、HBV核心抗原(HBcAg)或其片段。在另一些实施方案中,病毒抗原是流感病毒抗原,例如血凝素抗原(HA)、神经氨酸酶抗原(NA)或其片段。在另一些实施方案中,病毒抗原是西尼罗病毒抗原(West Nile virus antigen),例如包膜蛋白(E)、前膜蛋白(prM)或其片段。在另一些实施方案中,病毒抗原是登革病毒抗原(Denguevirus antigen),例如80E亚基蛋白或其片段。在另一些实施方案中,病毒抗原是埃博拉病毒抗原(Ebola virus antigen),例如糖蛋白(GP)或其片段。在另一些实施方案中,病毒抗原是HIV抗原,例如HIV包膜蛋白gp41、gp120或其片段。在另一些实施方案中,抗原是细菌抗原,例如结核分枝杆菌(mycobacterium tuberculosis,Mtb)抗原,例如重组Ag85A、Ag85B、ESAT6、TB10.4或其片段。在另一些实施方案中,抗原是疟疾抗原,例如环子孢子蛋白(circumsporozoite protein,CSP)、子孢子和肝阶段抗原(sporozoite and liver-stageantigen,SALSA)、恶性疟原虫(Plasmodium falciparum)的裂殖子表面蛋白(merozoitesurface protein,MSP)、或其片段。
在一些实施方案中,如通过pH滴定所计算的,二嵌段共聚物在水中的pKa为约6至约7.5。在一些实施方案中,由二嵌段共聚物形成的纳米粒在低于pKa的pH下解离。在一些实施方案中,二嵌段共聚物包含亲水性嵌段和疏水性嵌段。在一些实施方案中,亲水性嵌段是PEG聚合物、PVP聚合物或MPC聚合物。在一些实施方案中,亲水性嵌段是PEG聚合物。在一些实施方案中,疏水性嵌段包含胺基团,其具有约6至约7.5的pKa。在一些实施方案中,疏水性嵌段在胺基团质子化后变为亲水性的。在一些实施方案中,胺基团是环胺基团。在一些实施方案中,二嵌段共聚物进一步由下式定义:
其中:
R1是氢、烷基(C≤12)、环烷基(C≤12)、经取代的烷基(C≤12)、经取代的环烷基(C≤12);
n是1至500的整数;
R2和R2’各自独立地选自氢、烷基(C≤12)、环烷基(C≤12)、经取代的烷基(C≤12)或经取代的环烷基(C≤12);
R3是下式的基团:
其中:
nx是1至10;
X1、X2和X3各自独立地选自氢、烷基(C≤12)、环烷基(C≤12)、经取代的烷基(C≤12)或经取代的环烷基(C≤12);并且
X4和X5各自独立地选自烷基(C≤12)、环烷基(C≤12)或这些基团中任一种的经取代形式,或者X4和X5合在一起并且是烷二基(alkanediyl)(C≤12)、烷氧二基(alkoxydiyl)(C≤12)、烷氨二基(alkylaminodiyl)(C≤12)或这些基团中任一种的经取代形式;
x是1至150的整数;
R4是下式的基团:
其中:
ny是1-10;
X1’、X2’和X3’各自独立地选自氢、烷基(C≤12)、环烷基(C≤12)、经取代的烷基(C≤12)或经取代的环烷基(C≤12);并且
X4’和X5’各自独立地选自氢、烷基(C≤12)、环烷基(C≤12)、酰基(C≤12)、经取代的烷基(C≤12)、经取代的环烷基(C≤12)、经取代的酰基(C≤12)、染料或荧光猝灭剂,或者X4’和X5’合在一起并且是烷二基(C≤12)、烷氧二基(C≤12)、烷氨二基(C≤12)或这些基团中任一种的经取代形式;
y是0到150的整数;
R5是氢、卤素、羟基、烷基(C≤12)或经取代的烷基(C≤12),
其中R3和R4可以在所述聚合物内以任意顺序出现,前提是R3和R4不是相同基团。在一些实施方案中,二嵌段共聚物进一步限定为:
其中:
R1是氢、烷基(C≤12)、环烷基(C≤12)、经取代的烷基(C≤12)、经取代的环烷基(C≤12);
n是1至500的整数;
R2和R2’各自独立地选自氢、烷基(C≤12)、环烷基(C≤2)、经取代的烷基(C≤12)或经取代的环烷基(C≤12);
R3是下式的基团:
其中:
X4和X5各自独立地选自烷基(C≤12)、环烷基(C≤12)或这些基团中任一种的经取代形式,或者X4和X5合在一起并且是烷二基(C≤12)、烷氧二基(C≤12)、烷氨二基(C≤12)或这些基团中任一种的经取代形式;
x是1至150的整数;
R4是下式的基团:
其中:
X4’和X5’各自独立地选自氢、烷基(C≤12)、环烷基(C≤12)、酰基(C≤12)、经取代的烷基(C≤12)、经取代的环烷基(C≤12)、经取代的酰基(C≤12)、染料或荧光猝灭剂,或者X4’和X5’合在一起并且是烷二基(C≤12)、烷氧二基(C≤12)、烷氨二基(C≤12)或这些基团中任一种的经取代形式;
y是0到150的整数;
R5是氢、卤素、羟基、烷基(C≤12)或经取代的烷基(C≤12),
其中R3和R4可以在所述聚合物内以任意顺序出现,前提是R3和R4不是相同基团。在一些实施方案中,二嵌段共聚物进一步限定为:
其中:
R1是氢、烷基(C≤12)、环烷基(C≤12)、经取代的烷基(C≤12)、经取代的环烷基(C≤12);
n是1至500的整数;
R3是下式的基团:
其中:
X4和X5各自独立地选自烷基(C≤12)、环烷基(C≤12)或这些基团中任一种的经取代形式,或者X4和X5合在一起并且是烷二基(C≤12)、烷氧二基(C≤12)、烷氨二基(C≤12)或这些基团中任一种的经取代形式;
x是1至150的整数;
R4是下式的基团:
其中:
X4’和X5’各自独立地选自氢、烷基(C≤12)、环烷基(C≤12)、酰基(C≤12)、经取代的烷基(C≤12)、经取代的环烷基(C≤12)、经取代的酰基(C≤12)、染料或荧光猝灭剂,或者X4’和X5’合在一起并且是烷二基(C≤12)、烷氧二基(C≤12)、烷氨二基(C≤12)或这些基团中任一种的经取代形式;
y是0到15的整数;
R5是氢、卤素、羟基、烷基(C≤12)或经取代的烷基(C≤12),
前提是R3和R4不是相同基团。在一些实施方案中,二嵌段共聚物进一步限定为;
其中:
R1是氢、烷基(C≤12)、环烷基(C≤12)、经取代的烷基(C≤12)、经取代的环烷基(C≤12);
n是1至500的整数;
R3是下式的基团:
其中:
X4和X5各自独立地选自烷基(C≤12)、环烷基(C≤12)或这些基团中任一种的经取代形式,或者X4和X5合在一起并且是烷二基(C≤12)、烷氧二基(C≤12)、烷氨二基(C≤12)或这些基团中任一种的经取代形式;
x是1至150的整数;
R5是氢、卤素、羟基、烷基(C≤12)或经取代的烷基(C≤12),
前提是R3和R4不是相同基团。
在一些实施方案中,R1是烷基(C≤12),例如甲基。在一些实施方案中,n为50至200。在一些实施方案中,n为75至150。在一些实施方案中,n为114。
在一些实施方案中,X4是烷基(C≤12)或环烷基(C≤12)。在一些实施方案中,X4是烷基(C≤12),例如乙基、异丙基、正丙基、正丁基或正戊基。在一些实施方案中,X4是烷基(C1-3)。在一些实施方案中,X5是烷基(C≤12)或环烷基(C≤12)。在一些实施方案中,X5是烷基(C≤12),例如乙基、异丙基、正丙基、正丁基或正戊基。在一些实施方案中,X4是烷基(C1-3)。在一些实施方案中,X4和X5合在一起并且是烷二基(C≤12)、烷氧二基(C≤12)、烷氨二基(C≤12)或这些基团中任一种的经取代形式。在一些实施方案中,X4和X5合在一起并且是烷二基(C≤12)或经取代的烷二基(C≤12)。在一些实施方案中,X4和X5合在一起并且是-CH2CH2CH2CH2CH2-、-CH2CH2CH2CH2CH2CH2-、-CH2CH2CH2CH2CH2CH2CH2-、-CH2CH2CH(CH3)CH2CH2-或-CH2CH(CH3)CH2CH(CH3)CH2-。
在一些实施方案中,x为50至120。在一些实施方案中,x为60至100。在一些实施方案中,y为0。在另一些实施方案中,y为1、2、3、4或5。在一些实施方案中,X4’是染料,例如荧光染料或荧光猝灭剂。在一些实施方案中,X4’是烷基(C≤12)。在一些实施方案中,X4’和X5’合在一起并且是烷二基(C≤12)。在一些实施方案中,X5’是氢。在一些实施方案中,X5’是烷基(C≤12)。在一些实施方案中,二嵌段共聚物是PEG114-b-PDEA70、PEG114-b-PEPA70、PEG114-b-PDPA70、PEG114-b-PDBA70、PEG114-b-PD5A70、PEG114-b-PC6A70、PEG114-b-PC7A70、PEG114-b-PC8A70、PEG114-b-PC6S1A70或PEG114-b-PC6S2A70。在一些实施方案中,二嵌段共聚物是PEG114-b-PEPA70、PEG114-b-PC6A7o、PEG114-b-PC7A70、PEG114-b-PC6S1A70或PEG114-b-PC6S2A70。
在一些实施方案中,组合物还包含溶剂。在一些实施方案中,溶剂是水。在一些实施方案中,溶剂是水性缓冲液,例如磷酸缓冲盐水(PBS)。在一些实施方案中,组合物激活STING途径。在一些实施方案中,组合物激活干扰素受体途径。
在另一方面,本公开内容提供了激活STING途径的包含佐剂和抗原的组合物,并且所述佐剂形成纳米粒。
在另一方面,本发明提供了激活一种或更多种干扰素受体蛋白的包含佐剂和抗原的组合物,并且所述佐剂形成纳米粒。
在另一方面,本发明提供了包含以下的组合物:
(A)佐剂;以及
(B)抗原;
其中所述组合物是粒度小于50nm、在所述佐剂上包含多个杂环烷基的纳米粒,其中所述杂环烷基中的至少一个杂原子是氮原子,并且pH转变点从约6.5到约7.4。在一些实施方案中,粒度为5nm至50nm。在一些实施方案中,多个杂环烷基为10至200个杂环烷基。在一些实施方案中,多个杂环烷基为40至160个杂环烷基。在一些实施方案中,杂环烷基是氮杂环庚烷。在一些实施方案中,pH转变点为6.5至7.2。在一些实施方案中,pH转变点为6.8至7.0。
在另一方面,本发明提供了包含以下的药物组合物:
(A)本文中所述的组合物;以及
(B)赋形剂。
在一些实施方案中,药物组合物配置成用于注射。在一些实施方案中,药物组合物配置成用于静脉内、肌内、腹膜内或皮下注射。在一些实施方案中,药物组合物配制成单位剂量。
在一些实施方案中,药物组合物还包含第二活性剂。在一些实施方案中,第二活性剂是检查点抑制剂。在一些实施方案中,检查点抑制剂是PD-1抑制剂。在一些实施方案中,PD-1抑制剂是抗PD-1抗体。抗PD-1抗体是纳武单抗(nivolumab)、派姆单抗(pembrolizumab)、BMS 936559、MPDL328OA或皮地利珠单抗(pidilizumab)。
在另一方面,本公开内容提供了在有此需要的患者中治疗疾病或病症的方法,其包括向患者施用治疗有效量的本文中所述的组合物。
在一些实施方案中,所述疾病或病症是癌症。在一些实施方案中,癌症是上皮癌(carcinoma)、肉瘤、淋巴瘤、白血病、黑素瘤、间皮瘤、多发性骨髓瘤或精原细胞瘤。在一些实施方案中,癌症是膀胱癌、血癌、骨癌、脑癌、乳腺癌、中枢神经系统癌症、宫颈癌、结肠癌、子宫内膜癌、食管癌、胆囊癌、胃肠道癌、外生殖器癌、泌尿生殖道癌、头癌、肾癌、喉癌、肝癌、肺癌、肌肉组织癌症、颈癌、口腔或鼻黏膜癌、卵巢癌、胰腺癌、前列腺癌、皮肤癌、脾癌、小肠癌、大肠癌、胃癌、睾丸癌或甲状腺癌。在一些实施方案中,癌症是黑素瘤间皮瘤或宫颈癌。
在一些实施方案中,该方法还包括第二抗癌治疗。在一些实施方案中,第二抗癌治疗是手术、化学治疗、放射治疗、基因治疗或第二免疫治疗。在一些实施方案中,第二抗癌治疗是第二免疫治疗。在一些实施方案中,第二免疫治疗是检查点治疗。在一些实施方案中,免疫治疗是PD-1的抑制剂。在一些实施方案中,免疫治疗是纳武单抗、派姆单抗、皮地利珠单抗、BMS 936559或MPDL328OA。在另一些实施方案中,第二抗癌治疗是放射治疗。在一些实施方案中,放射治疗施用两次或更多次,组合物施用两次或更多次,或者这二者施用两次或更多次。
在另一些实施方案中,疾病或病症是感染性疾病。在一些实施方案中,疾病或病症是疟疾。在一些实施方案中,疾病或病症是病毒感染,例如HIV、乙型肝炎、埃博拉、登革或西尼罗病毒。在另一些实施方案中,疾病或病症是细菌感染,例如结核病。在另一些实施方案中,疾病或病症是自身免疫病。
在一些实施方案中,患者是哺乳动物。在一些实施方案中,患者是人。在一些实施方案中,该方法包括施用组合物一次。在另一些实施方案中,该方法包括施用组合物两次或更多次。
在另一方面,本公开内容提供了在患者中激活STING途径的方法,其包括向有此需要的患者施用包含抗原和佐剂的组合物,其中所述佐剂形成纳米粒。在一些实施方案中,佐剂是合成聚合物。
如本文中说明书中所用的,没有数量词修饰的名词表示一个/种或更多个/种。如本文中权利要求中所用的,当与词语“包含/包括”连用时,没有数量词修饰的名词表示一个/种或更多个/种。
权利要求书中使用术语“或”用于意指“和/或”,除非明确指出仅是指“或者”,或是供选择的方案是相互排斥的,尽管本公开内容支持所指的仅仅是“或者”和“和/或”的定义。如本文中所用的,“另一个/种”可意指至少第二个/种或更多。
本申请的通篇中,术语“约/大约”用来说明这样的值,其包括用来测定所述值的方法、装置的误差的固有变化,或者研究对象之间存在的变化。
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附图简述
以下附图构成本说明书的一部分,并且包括在内以进一步说明本公开内容的某些方面。通过与本文中给出的具体实施方案的详细描述组合参考这些附图中的一幅或更多幅,可更好地理解本公开内容。
图1A-D。PC7A NP诱导稳健的抗原特异性CTL和Th1应答。(图1A)筛选产生强OVA特异性CTL应答的聚合物结构的CFSE方法的示意图。使用OVA作为模型抗原(10μg)并加载到不同的聚合物NP(30μg)中。(图1B)在不同NP组中(每组n=3)定量比较OVA特异性CTL应答鉴定了PC7A NP为最佳候选物。如通过不同疫苗组诱导的,IgG1(图1C)和IgG2c(图1D)的OVA特异性产生。在每个分类中,PC7A NP产生了与已知佐剂相当或比其更好的广泛的CTL、Th1和Th2应答。在图1B-D中,来自三个独立实验的代表性数据表示为平均值±s.e.m.。
图2A-G。PC7A NP改善APC中的抗原递送和交叉呈递并刺激CD8T细胞应答。(图2A)在C57BL/6小鼠(n=5)的尾基部皮下注射AF647-OVA-PC7A NP之后24小时,对淋巴结内三种APC亚型中的OVA阳性细胞进行定量。(图2B)体外检测BMDC中抗原交叉呈递和CD8+T细胞激活的示意图。(图2C)在用单独的AF647-OVA、AF647-OVA-PC7A NP或AF647-OVA-PD5A NP孵育4小时之后,通过流式细胞术定量BMDC中AF647-OVA的摄取。测定BMDC中AF647-OVA+细胞的平均荧光强度(mean fluorescence intensity,MFI)(n=3)。(图2D)在由PC7A或PD5A NP诱导的BMDC中H-2Kb上的抗原呈递水平(n=3)。(图2E)在用不同OVA-NP处理的BMDC孵育OT-ICD8+T细胞之后,OT-I CD8+T细胞的IFN-γ分泌(n=3)。(图2F)脾中CD8+T细胞的H-2kb/SIINFEKL四聚体染色的代表性流点图(flow dot plot)。(图2G)通过流式细胞术测量OVA(SIINFEKL)特异性CD8+T细胞的百分比(n=4)。在图2A、2C-E和2G中,来自三个独立实验的代表性数据表示为平均值±s.e.m.。通过t-检验(Student’s t-test)计算统计学显著性,***P<0.001,**P<0.01,*P<0.05。NS,不显著。
图3A-F。PC7A NP激活引流淋巴结中的APC并刺激STING依赖性适应性免疫应答。(图3A)在注射纳米疫苗之后24小时,共刺激物CD86在腹股沟淋巴结中的CD8α+和CD8α-DC上的表达(每组n=5)。关于巨噬细胞和B细胞的数据显示在图7D中。(图3B-C)通过qPCR测量干扰素刺激基因(IRF7和CXCL10)在注射部位的表达水平(n=6)。(图3D)不同敲除小鼠组中OVA特异性CTL应答的定量比较(每组n=5)。通过ELISA测定血清中的IgG1(图3E)和IgG2c(图3F)抗体滴度(每组n=5)。数据表示为平均值±s.e.m.。通过t-检验计算统计学显著性,***P<0.001,**P<0.01,*P<0.05。NS,不显著。
图4A-G。PC7A纳米疫苗在荷瘤小鼠中抑制肿瘤生长并延长存活。(图4A)PC7A纳米疫苗的极简化设计的示意图。(图4B-C)用OVA肽、PC7A纳米疫苗、CpG、聚(I∶C)和明矾加肽(0.5μg)处理接种有1.5×105个B16-OVA肿瘤细胞的C57BL/6小鼠(每组n=10)。显示了荷瘤小鼠的肿瘤生长(图4B)和Kaplan-Meier存活曲线(图4C)。(图4D)B16F10黑素瘤的肿瘤生长抑制研究。在用箭头表示的特定时间点,用PC7A NP中的肿瘤相关抗原的混合物(Gp10021-41、Trp1214-237、Trp2173-196)处理接种有1.5×105个B16F10肿瘤细胞接种的C57BL/6小鼠(每组n=10)。(图4E)C57BL/6小鼠中MC38结肠癌的肿瘤生长抑制研究。用PC7A NP中的新抗原的混合物(Reps1P45A、AdpgkR304M、Dpagt1V213L)处理接种有1.0×106个MC38肿瘤细胞的小鼠(每组n=10),并在第10天和第15天在已建立的肿瘤(100-200mm3)中施用纳米疫苗。在HPV肿瘤模型中,在用1.5×105个TC-1肿瘤细胞接种肿瘤后,分析C57BL/6小鼠(每组n=10)的肿瘤生长抑制(图4F)和存活数据(图4G)。在图4B和4D-F中,数据表示为平均值±s.e.m.。通过t检验计算统计学显著性,***P<0.001,**P<0.01,*P<0.05。通过对数秩检验(log-ranktest)计算4C和4G中存活分析的统计学显著性,***P<0.001,**P<0.01,*P<0.05。
图5A-C。超pH敏感性(UPS)PEG-b-PR嵌段共聚物的合成和pH滴定。(图5A)使用原子转移自由基聚合(atom-transfer radical polymerization,ATRP)方法的嵌段共聚物的示意性合成。使用PEG-Br(MW=5kD)作为引发剂,并且使用具有不同叔胺侧链的甲基丙烯酸酯作为单体。(图5B)来自库的共聚物的表征。通过GPC使用THF作为洗脱剂确定数均分子量(Mn);通过使用4M NaOH对聚合物溶液进行pH滴定来确定pKa。使用动态光散射测量尺寸,平均值±s.d.。(图5C)UPS共聚物的pH滴定显示出pH 4至8的pH特异性缓冲效应。对于环状系列,研究了环状环的尺寸(即,6元、7元和8元)和六元环上甲基取代的数量(例如,0、1和2)二者。具有相似疏水强度的共聚物(例如,PC7A对PC6S1A;PC8A对PC6S2A)具有相似的pKa值,尽管具有不同的聚合物结构和CTL应答(参见图1B)。
图6A-D。通过物理混合操作在PC7A NP中高效加载OVA。(图6A)通过超滤法测量胶束纳米粒中的OVA加载效率。(图6B)在不同时间点在含有5%胎牛血清的PBS缓冲液(pH7.4)中检查在PC7A胶束中OVA的加载稳定性。(图6C)染料缀合的PEG-b-PC7A共聚物的示意性合成。使用Cy3.5作为染料实例。(图6D)Cy3.5标记的PC7A、AF647-OVA和PC7A+OVA混合物的荧光光谱在混合物组中显示强荧光共振电子转移(fluorescence resonance electrontranfer,FRET)效应,表明PC7A NP内的OVA加载。(图6E)将AF647-OVA(100μg/mL)与在PBS缓冲液(pH=7.4)中连续稀释的Cy3.5缀合的PC7A一起孵育,虚线显示纳米疫苗的工作浓度及其FRET效率。在图6A-B中,来自三个独立实验的代表性数据表示为平均值±s.e.m.。
图7A-D。PC7A NP改善引流淋巴结中的抗原递送、诱导LN炎症和APC成熟。(图7A)在C57BL/6小鼠(n=3)的尾基部皮下注射后,淋巴器官中ICG标记的PC7A NP积聚的近红外成像。24小时后,收集淋巴结和主要器官,且离体成像显示淋巴结中PC7A NP积聚高于其他器官。(图7B)来自C57BL/6小鼠的切除的引流淋巴结的中线横截面(最大表面)显示出PC7A NP相对于单独的OVA使结增大。(图7C)在24小时时定量引流淋巴结中总细胞数。PC7A NP组中增大的淋巴结和提高的细胞数表明固有刺激(n=5)。(图7D)在注射纳米疫苗之后24小时,腹股沟淋巴结中CD8α+DC、CD8α-DC、巨噬细胞和B细胞中CD86表达的定量比较(每组n=5)。在图7C-D中,来自三个独立实验的代表性数据表示为平均值±s.e.m.。通过t-检验计算统计学显著性,***P<0.001,**P<0.01,*P<0.05。NS,不显著。
图8A-B。PC7A NP在酸性pH下破坏膜。(图8A)在不同pH介质中用PC7A或PD5A共聚物处理后的红细胞的溶血分析。(图8B)通过作为pH之函数的血红蛋白进入介质的释放来定量PC7A或PD5ANP的溶血百分比(n=3)。这两种聚合物浓度均控制在20μg/mL。在图8B中,来自三个独立实验的代表性数据表示为平均值±s.e.m.。
图9A-J。PC7A NP通过STING途径激活I型IFN诱导的基因。将小鼠骨髓来源的巨噬细胞(BMDM,图9A)、人THP-1单核细胞(图9B)与PC7A NP一起以指定的浓度和时间孵育,随后通过qPCR测量CXCL10 mRNA(n=3)。使用由lipofectamine转染的STING激活剂cGAMP作为阳性对照。结果显示CXCL10在这两种细胞系中的STING依赖性表达。(图9C)BMDM用DNA酶I转染1小时,且随后用PC7A NP处理。通过qPCR测量CXCL10 mRNA(n=3)。(图9D)PC7A NP处理THP-1细胞,引起链霉亲和素改性的dynabead拉下STING蛋白。PD5A-生物素和仅PC7A(不含生物素)的对照未显示任何STING拉下。(图9E)经纯化的人STING C端结构域(CTD,139-379AA)的直接拉下测定。PC7A-生物素共聚物拉下STING CTD,但其他共聚物或仅PC7A的对照则没有。(图9F)通过等温量热法(isothermal calorimetry,ITC)实验滴定与STING CTD结合的PC7A。显示了原始滴定迹线(顶部)和整合数据(底部)。使用PC7A-牛血清白蛋白(BSA)的ITC作为阴性对照,且使用cGAMP-STING CTD作为阳性对照。(图9G)ITC实验中结合亲和力的概述。在PC7A与BSA之间发现可忽略的结合。(图9H)在皮下注射不同共聚物(150μg,n=5)后测量脾细胞中的IDO酶活性。使用PEI-DNA(30μg)作为阳性对照。用不同的NP处理(图9I)人THP-1和(图9J)小鼠BMDM细胞,随后通过qPCR测量IDO-1和CXCL10 mRNA(n=3)。使用PEI-DNA、聚(I∶C)和cGAMP作为阳性对照。在图9A-C和图9I-J中,来自三个独立实验的代表性数据表示为平均值±s.e.m.。在图9H中,来自两个独立实验的代表性数据表示为平均值±s.e.m.。通过t检验计算统计学显著性,***P<0.001,**P<0.01,*P<0.05。NS,不显著。
图10A-D。APC是在体内摄取PC7A NP并激活STING途径的主要细胞群。在C57BL/6小鼠的尾基部皮下注射PC7A NP-Cy5,且包含注射PBS的小鼠作为对照(n=5)。24小时后,分离腹股沟LN和皮下组织并制成单细胞悬液。首先在活细胞上对细胞进行设门,然后将其分为白细胞(CD45+)和非白细胞(CD45-)。通过PC7A NP的荧光,将来自NP处理的小鼠的细胞分成NP+和NP-群。在这些子集中评估pIRF3表达和DC标志物CD11c。(图10A)LN中CD45+NP+和CD45+NP-细胞的比较评估。(图10B)通过流式细胞术对LN中的NP+和NP-细胞的表型分析。(图10C)评估来自皮下组织的CD45+和CD45-细胞二者中的NP积聚的细胞(NP+)。(图10D)通过流式细胞术对皮下组织中的CD45+NP-和CD45+NP+细胞进行表型分析。在图10A和10C中,来自两个独立实验的代表性数据表示为平均值±s.e.m.。通过t检验计算统计学显著性,***P<0.001。NS,不显著。
图11A-F。PC7A纳米疫苗抑制肿瘤生长并延长存活。首先用1.5×105个B16-OVA肿瘤细胞接种C57BL/6小鼠(每组n=10),并随后用OVA肽(0.5μg)、OVAp-PD5A NP、单独的PC7A、或OVAp-PC7A NP处理。没有OVAp的单独的PC7A NP在肿瘤生长抑制(图11A)或动物存活曲线(图11B)中没有可观察到的效果。(图11C)由新抗原-PC7A NP处理的B16F10的肿瘤生长抑制。在用箭头表示的每个时间点,用PC7A NP(每种肽0.5μg,30μg聚合物)中的新抗原(Obsl1T1764M、Kif18bK739N、Def8R255G)混合物处理接种有1.5×105个B16F10肿瘤细胞的C57BL/6小鼠(每组n=10)。(图11D)用E7肽(E7p,0.5μg)和E7p-PC7A NP免疫接种C57BL/6小鼠(每组n=3)。使用体内细胞毒性杀伤测定测量E7特异性细胞毒性。(图11E)用1×106个TC-1肿瘤细胞攻击TC-1模型中的肿瘤接种之后82天的初始小鼠或无肿瘤小鼠(每组n=10)。在手术之后第30天,用1×106个TC-1肿瘤细胞再次攻击小鼠。在60天中纳米疫苗治疗组中的记忆T细胞完全抑制肿瘤生长。(图11F)在接种有1.5×105个TC-1肿瘤细胞并在当肿瘤在约100mm3建立时的第10天和第15天用纳米疫苗处理的C57BL/6小鼠(每组n=10)中的肿瘤生长抑制曲线。在图11A和11C-F中,数据表示为平均值±s.e.m.。通过t检验计算统计学显著性,***P<0.001,**P<0.01,*P<0.05。NS,不显著。通过对数秩检验计算图11B中存活分析的统计学显著性,***P<0.001。NS,不显著。
图12A-F。纳米疫苗和抗PD-1抗体在两种肿瘤模型中的协同作用。(图12A)用OVA肽、PC7A纳米疫苗,单独的抗PD-1和抗PD-1与PD7A纳米疫苗的组合处理接种有1.5×105个B16-OVA肿瘤细胞的C57BL/6小鼠。显示了荷瘤小鼠的Kaplan-Meier存活曲线。(图12B)接种有1.5×105个TC-1肿瘤细胞,随后用E7p(0.5μg)、PC7A纳米疫苗和抗PD-1与纳米疫苗的组合处理的C57BL/6小鼠(每组n=10)中的长期肿瘤生长抑制曲线。(图12C)单独的OVAp、OVAp-PC7A NP和OVAp-PC7A NP与抗PD-1组合的个体肿瘤生长曲线。(图12B)B16-OVA肿瘤中的PD-L1表达谱。相对于同种型对照,PD-L1在MDSC(CD11b+Gr1+)和巨噬细胞(CD11b+F4/80+)中高度表达,而在DC(CD11c+)和B16-OVA黑素瘤细胞(CD45-)中的表达是适度的。(图12E)单独的E7p、E7p-PC7A NP和E7p-PC7A NP与抗PD-1组合的个体肿瘤生长曲线。数据显示50%和90%的小鼠分别在E7p-PC7A NP和E7p-PC7A NP/抗PD-1组中具有无肿瘤存活。(图12F)TC-1肿瘤中的PD-L1表达谱。相对于同种型对照,PD-L1表达在DC、MDSC和巨噬细胞中高度表达,而在TC-1肿瘤细胞中的表达是适度的。在图12B中,数据表示为平均值±s.e.m.。通过t检验计算统计学显著性,**P<0.01。通过对数秩检验计算图12A中存活分析的统计学显著性,*P<0.05。
图13。与聚(I:C)对照相比,PC7A纳米疫苗显示出较低的全身性细胞因子水平。向C57BL/6小鼠(每组n=5)皮下注射10μgOVA加150μg PC7A NP或相同剂量的聚(I:C)。通过基于珠的Bio-Plex Pro小鼠细胞因子23-plex测定随时间测量血清中的全身性细胞因子和趋化因子。IL-1α、IL-2、IL-3、IL-4、IL-5、IL-9、IL-10、IL-12(p70)、IL-13、IL-17、GM-CSF在所有组中未显示任何显著差异并且未包括在本图中。数据表示为平均值±s.e.m.。通过t检验计算统计学显著性,***P<0.001,**P<0.01,*P<0.05。
图14。用于PC7A纳米疫苗的安全性评估的主要器官组织学分析。重复注射10μgOVA加150μg PC7A NP或相同剂量的聚(I∶C)后,来自C57BL/6小鼠的主要器官的代表性H&E切片。第二次注射之后24小时处死小鼠(每组n=5)。聚(I∶C)组中的肝显示出指示脂肪性肝炎的膨胀的肝细胞。所有组的脾、肾和心脏均没有显示异常。
图15。通过体内细胞毒性杀伤测定比较不同NP组中的OVA特异性CTL应答。在注射分别用OVA257-264肽进行未脉冲或脉冲的CFSE高和CFSE低标记的脾细胞的1∶1混合物后,通过流式细胞术分析经免疫接种小鼠的血液样品以确定CFSE高和CFSE低细胞的百分比。来自每组的三个独立实验的代表性流式细胞术图。每个图中的值代表血液中比裂解(specificlysis)的平均百分比±s.e.m.。
图16A-16C。评价肽抗原的物理加载相对于共价缀合对CTL应答的影响。(图16A)肽缀合到PEG-b-PC7A胶束纳米粒的表面或核心用于抗原加载的两种合成途径。(图16B)由三种不同策略产生的纳米疫苗的示意图。(图16C)在不同纳米疫苗组(每组n=3)之间OVA特异性CTL应答的定量比较。使用OVAp-聚(I∶C)作为对照。数据代表平均值±s.e.m.,***P<0.001,**P<0.01,*P<0.05,NS,不显著。
图17A-E。用流感病毒H1N1HA抗原和PC7A纳米粒进行疫苗接种的小鼠产生抗HA抗体,并保护其免受H1N1流感病毒的致死性感染。对于图17A-C,从加强之后一周的经疫苗接种小鼠中收集血清,通过ELISA测量其中循环抗H1N1HA总IgG(图17A)水平。还测量了经疫苗接种小鼠血清中的循环抗H1N1HA IgG1(图17B)和IgG2b(图17C)水平。用单独的H1N1 PR8HA或与明矾或PC7A组合i.m.致敏B6WT小鼠(n=5/组)。在致敏之后10天施用加强剂量。对于图17D-E,在加强之后1.5周,用10×MLD50(半数致死剂量(median lethal dose),50%死亡率)的A/PR/8/34(H1N1)病毒攻击经鼻内疫苗接种的小鼠。每天追踪体重(图17D)和存活(图17E)持续两周。
图18。与放射治疗(radiation therapy,RT)组合的纳米疫苗可诱导已建立的HPV肿瘤消退。将2×105个TC-1细胞皮下注射到C57BL/6小鼠(n=8/组)的背部。在14天之后当肿瘤达到约200mm3的尺寸时,以20Gy辐射肿瘤。对于疫苗接种处理,在电离辐射的同一天,将纳米疫苗(30μg PC7A+0.5μg肽E743-62(GQAEPDRAHYNIVTFCCKCD,SEQ ID NO:26))皮下注射到位于尾基部的小鼠背部。六天之后,用相同剂量的纳米疫苗的另一次注射对小鼠进行加强。随后由不知情的研究者使用数字卡尺每周两次测量肿瘤生长,并计算为0.5×长度×宽度2。当肿瘤大小达到1500mm3时处死小鼠。相对于单独的辐射或纳米疫苗处理,组合的纳米疫苗和放射治疗显示出显著改善的治疗协同作用。
发明详述
在一些方面,本公开内容提供了可用于产生对疾病抗原(例如癌症或感染性疾病)的免疫应答的疫苗组合物。这些疫苗组合物可在体内激活STING和/或干扰素受体途径,引起增强的免疫应答。在一些实施方案中,疫苗组合物包含抗原和pH敏感性二嵌段共聚物。这些组合物可用于治疗多种疾病和病症,例如癌症或感染性疾病。
I.疫苗组分
本文中所述的组合物可包含一种或更多种免疫刺激剂。免疫刺激剂包括但不限于抗原或抗原化合物、免疫调节剂、APC、佐剂或载体。还考虑与本公开内容的组合物一起使用的其他免疫增强化合物,例如多糖,包括描述于美国专利5,980,912(其通过引用并入本文)中的壳聚糖(chitosan)。多种(多于一种)抗原可彼此交联(例如,聚合)。使用小肽用于抗体产生或疫苗接种也可需要肽与免疫原性载体蛋白的缀合。
普通技术人员将知晓多种测定以确定是否产生针对肿瘤相关肽的免疫应答。短语“免疫应答”包括细胞和体液免疫应答二者。多种B淋巴细胞测定是公知的,例如ELISA、使用外周血淋巴细胞(peripheral blood lymphocyte,PBL)的增殖测定、细胞因子产生和抗体产生测定。参见Benjamini等(1991),其通过引用并入本文。
A.抗原
在一些方面,本公开内容提供了具有一种或更多种抗原性组分的组合物。抗原是促进免疫应答的物质,从而特异性地产生针对该物质的抗体。一些物质具有更高的免疫原性,且因此免疫系统将很容易产生适当的免疫应答,但其他物质需要帮助以产生足以产生针对抗原之抗体的免疫应答。大多数癌症可需要额外的激活以增强针对抗原之抗体的产生。抗原的一些非限制性实例包括癌症特异性表面蛋白或癌细胞过表达的表面蛋白质的蛋白质或其片段。另外,抗原可以是表1中包含的肽或蛋白质之一:
表1:蛋白质和肽抗原的一些非限制性实例的序列
此外,本文中考虑了用于特定适应症(包括数种不同的感染性疾病、毒素和癌症)的抗原。
i.细菌病原体
尽管数十年来努力开发抗生素剂,但革兰氏阳性和革兰氏阴性家族二者中仍存在数百种在全世界引起重大疾病和死亡的细菌病原体。实际上,抗生素抗性是细菌性疾病中日益增长的问题。
疾病负担最高的细菌性疾病之一是由细菌结核分枝杆菌引起的结核病,其每年导致约200万人死亡,大多数在撒哈拉以南非洲。结核分枝杆菌抗原的一些非限制性实例包括重组Ag85A、Ag85B、ESAT6、TB10.4或其片段,包括Ottenhoff和Kaufmann,2012(其通过引用并入本文)所教导的那些。致病细菌导致其他全球性重大疾病,例如可由链球菌(Streptococcus)和假单胞菌(Pseudomonas)的细菌引起的肺炎,以及可由例如志贺菌(Shigella),弯曲杆菌(Campylobacter)和沙门菌(Salmonella)的细菌引起的食源性疾病。致病细菌还引起感染,例如破伤风、伤寒、白喉、梅毒和麻风。
条件致病细菌仅在某些条件下(例如伤口促进细菌进入血液或免疫功能降低)是致病性的。例如,葡萄球菌(Staphylococcus)或链球菌也是正常人体菌群的一部分,且通常存在于皮肤上或鼻内而不引起疾病,但可能引起皮肤感染、肺炎、脑膜炎、以及甚至爆发性脓毒症(overwhelming sepsis)(一种产生休克、大量血管扩张和死亡的全身性炎症反应)。一些种类的细菌,例如铜绿假单胞菌(Pseudomonas aeruginosa)、洋葱伯克氏菌(Burkholderia cenocepacia)和鸟分枝杆菌(Mycobacterium avium),是机会性病原体,且主要在患有免疫抑制或囊性纤维化的人中引起疾病。
另一些细菌总是在人中引起疾病,例如专性细胞内寄生生物(例如,衣原体(Chlamydophila)、埃立克体(Ehrlichia)、立克次体(Rickettsia)),其仅在其他生物体的细胞内能够生长和繁殖。然而,细胞内细菌的感染可以是无症状的,例如在潜伏期期间。细胞内细菌的一个实例是立克次体。一种立克次体引起斑疹伤寒,而另一种引起落基山斑疹热。衣原体是另一种专性细胞内寄生生物的门(phylum),其包含可引起肺炎或尿路感染和可与冠心病有关的物种。分枝杆菌(Mycobacterium)、布鲁氏菌(Brucella)、弗朗西斯氏菌(Francisella)、军团菌(Legionella)和李斯特菌(Listeria)可存在于细胞内,尽管它们是兼性(非专性)细胞内寄生生物。这些细菌的抗原可用于本发明的组合物中。
ii.病毒病原体
可针对可获得保护性抗体的任何病毒病原体开发疫苗。这些包括呼吸道病毒,例如腺病毒、禽流感、甲型流感病毒、乙型流感病毒、麻疹、副流感病毒、呼吸道合胞病毒(Respiratory syncytial virus,RSV)、鼻病毒和SARS-CoV;胃肠病毒,例如柯萨奇病毒;肠病毒,例如脊髓灰质炎病毒和轮状病毒;肝炎病毒,例如乙型肝炎病毒、丙型肝炎病毒、牛病毒性腹泻病毒(替代品);疱疹病毒,例如单纯疱疹病毒1、单纯疱疹病毒2、人巨细胞病毒和水痘带状疱疹病毒;逆转录病毒,例如人类免疫缺陷病毒1(HIV-1)、人类免疫缺陷病毒2(HIV-2);以及登革病毒、汉坦病毒、出血热病毒、淋巴细胞性脉络丛脑膜炎病毒、天花病毒、埃博拉病毒、狂犬病病毒、西尼罗病毒和黄热病病毒。一些非限制性病毒抗原包括乙型肝炎病毒HBV表面和核心抗原、流感病毒血凝素和神经氨酸酶抗原、西尼罗病毒包膜蛋白(E)和前膜蛋白(prM)、登革病毒80E亚基蛋白、埃博拉病毒糖蛋白、HIV包膜蛋白质gp41和gp120,或其片段。其他HIV抗原可见于de Taeye等,2016,其通过引用并入本文。这些病毒病原体中任一种的抗原可用于本发明的组合物中。
iii.真菌病原体
致病真菌是在人或其他生物体中引起疾病的真菌。以下仅是少数几个实例。
念珠菌属(Candida)物种是重要的人病原体,其在免疫低下宿主(例如,移植患者、AIDS患者和癌症患者)中引起机会性感染是最为人所知的。感染很难治疗并且可非常严重。曲霉属(Aspergillus)可以并确实以三种主要方式引起疾病:通过产生霉菌毒素;通过诱导变应原性应答(allergenic response);以及通过局部或全身性感染。对于后两类,宿主的免疫状态是关键的。最常见的致病物种是烟曲霉(Aspergillus fumigatus)和黄曲霉(Aspergillus flavus)。新型隐球菌(Cryptococcus neoformans)可在患有HIV感染和AIDS的患者中引起严重形式的脑膜炎和脑膜脑炎。大多数隐球菌属(Cryptococcus)物种生活在土壤中,不在人中引起疾病。已知罗伦隐球菌(Cryptococcus laurentii)和浅白色隐球菌(Cryptococcus albidus)偶尔在免疫力低下的人患者中引起中度至重度疾病。格特隐球菌(Cryptococcus gattii)是非洲大陆和澳大利亚的热带地区特有的,可在非免疫功能低下的人中引起疾病。荚膜组织胞浆菌(capsoplasma capsulatum)可在人、狗和猫引起组织胞浆菌病。耶氏肺孢子菌(Pneumocystis jirovecii)(或卡氏肺孢子菌(Pneumocystiscarinii))可在免疫系统减弱的人(例如早产儿、老年人、移植患者和AIDS患者)中引起一种形式的肺炎。纸葡萄穗霉(Stachybotrys chartarum)或“黑霉菌”可引起呼吸系统损害和严重头痛。其经常出现在长期潮湿的地区的房屋中。来自这些真菌的抗原可包含在本文中所述的组合物中。
iv.寄生虫
寄生虫是重大健康问题,特别是在全世界欠发达国家中。重要的致病性寄生虫包括溶组织内阿米巴(Entamoeba histolytica)、蓝氏贾第虫(Giardia lamblia)、阴道毛滴虫(Trichomonas vaginalis)、恶性疟原虫(Plasmodium falciparum)、三日疟原虫(Plasmodium malariae)、卵形疟原虫(Plasmodium ovale)、间日疟原虫(Plasmodiumvivax)、冈比亚锥虫(Trypanosoma gambiense)、罗德西亚锥虫(Trypanosomarhodesiense)、克氏锥虫(Trypanosoma cruzi)、似蚓蛔线虫(Ascaris lumbricoides)、旋毛虫(Trichinella spiralis)、刚地弓形虫(Toxoplasma gondii)、杜氏利什曼原虫(Leishmania donovani)、热带利什曼原虫(Leishmania tropica)、巴西利什曼原虫(Leishmania braziliensis)、曼氏血吸虫(Schistosoma mansoni)、日本血吸虫(Schistosoma japonicum)、埃及血吸虫(Schistosoma haematobium)和耶氏肺孢子菌(Pneumocystis jiroveci)。来自疟疾寄生虫的抗原可包括但不限于环子孢子蛋白(circumsporozoite protein,CSP)、子孢子和肝阶段抗原(sporozoite and liver-stageantigen,SALSA)、恶性疟原虫的裂殖子表面蛋白(merozoite surface protein,MSP)、或其片段,以及Carvalho等,2002(其通过引用并入本文)中描述的那些。来自这些寄生虫的抗原可包含在本文中所述的组合物中。
v.毒素
毒素对发达国家和欠发达国家二者的人口构成重大威胁。生物毒素本质上是生物的,即它们由许多活生物体(包括细菌、昆虫、蛇和植物)产生。这些包括多种昆虫毒素,例如蜘蛛、蝎子、蜜蜂黄蜂、或蚂蚁;蛇毒素,其中许多是神经毒素至血液毒素;蓝藻毒素(blue-green algae)、水母毒素、蓖麻毒素、肉毒毒素(botulism toxin)、破伤风类毒素和真菌毒素。
另一方面,环境毒素是非生物来源的毒素,并且可以是天然或人造的。这些包括工业和农业化学品,例如邻苯二甲酸盐、多氯联苯(polychlorinated biphenyl,PCB)、杀虫剂、二英、石棉、氯、氯仿、挥发性有机化合物(volatile organic compound,VOC),以及例如铅、镉和砷的重金属。这些毒素中任一种可用于本发明的组合物中以促进免疫应答。
vi.癌症
多种不同的肽、蛋白质片段或蛋白质可用作本发明组合物中的抗原。一些非限制性实例包括5T4、707-AP(707丙氨酸脯氨酸)、9D7、AFP(甲胎蛋白)、AlbZIP HPG1、α5β1-整联蛋白、α5β6-整联蛋白、α-甲基酰基-辅酶A消旋酶、ART-4(由T细胞4识别的腺癌抗原)、B7H4、BAGE-1(B抗原)、BCL-2、BING-4、CA15-3/CA 27-29、CA 19-9、CA 72-4、CA 125、钙网蛋白、CAMEL(黑色瘤上的CTL识别抗原)、CASP-8(胱天蛋白酶-8)、组织蛋白酶B、组织蛋白酶L、CD19、CD20、CD22、CD25、CD30、CD33、CD40、CD52、CD55、CD56、CD80、CEA(癌胚抗原)、CLCA2(钙激活氯通道-2)、CML28、毛状蛋白样蛋白(Coactosin-like protein)、胶原蛋白XXIII、COX-2、CT-9/BRD6(溴结构域睾丸特异性蛋白)、Cten(C端张力蛋白样蛋白)、细胞周期蛋白B1、细胞周期蛋白D1、cyp-B(亲环蛋白B)、CYPB1(细胞色素P450 1B1)、DAM-10/MAGE-B1(分化抗原黑素瘤10)、DAM-6/MAGE-B2(分化抗原黑素瘤6)、EGFR/Her1、EMMPRIN(肿瘤细胞相关细胞外基质基质金属蛋白酶诱导物)、EpCam(上皮细胞黏附分子)、EphA2(肝配蛋白A型受体2)、EphA3(肝配蛋白A型受体3)、ErbB3、EZH2(Zeste同源物2的增强子)、FGF-5(成纤维细胞生长因子-5)、FN(纤连蛋白)、Fra-1(Fos相关抗原-1)、G250/CAIX(糖蛋白250)、GAGE-1(G抗原1)、GAGE-2(G抗原2)、GAGE-3(G抗原3)、GAGE-4(G抗原4)、GAGE-5(G抗原5)、GAGE-6(G抗原6)、GAGE-7b(G抗原7b)、GAGE-8(G抗原8)、GDEP(前列腺中差异表达的基因)、GnT-V(N-乙酰葡糖胺转移酶V)、gp100(糖蛋白100kDa)、GPC3(磷脂酰肌醇蛋白聚糖(glypican)3)、HAGE(解旋酶抗原)、HAST-2(人印戒肿瘤-2)、hepsin、Her2/neu/ErbB2(人表皮受体-2/神经)、HERV-K-MEL、HNE(人中性粒细胞弹性蛋白酶)、同源框NKX3.1、HOM-TES-14/SCP-1、HOM-TES-85、HPV-E6、HPV-E7、HST-2、hTERT(人端粒酶逆转录酶)、iCE(肠羧基酯酶)、IGF-1R、IL-13Ra2(白介素13受体α2链)、IL-2R、IL-5、未成熟层粘连蛋白受体、激肽释放酶2、激肽释放酶4、Ki67、KIAA0205、KK-LC-1(北九州肺癌抗原1(Kita-kyushu lung cancer antigen1))、KM-HN-1、LAGE-1(L抗原)、生存蛋白(livin)、MAGE-A1(黑素瘤抗原-A1)、MAGE-A10(黑素瘤抗原-A10)、MAGE-A12(黑素瘤抗原-A12)、MAGE-A2(黑素瘤抗原-A2)、MAGE-A3(黑素瘤抗原-A3)、MAGE-A4(黑素瘤抗原-A4)、MAGE-A6(黑素瘤抗原-A6)、MAGE-A9(黑素瘤抗原-A9)、MAGE-B1(黑素瘤抗原-B1)、MAGE-B10(黑素瘤抗原-B10)、MAGE-B16(黑素瘤抗原-B16)、MAGE-B17(黑素瘤抗原-B17)、MAGE-B2(黑素瘤抗原-B2)、MAGE-B3(黑素瘤抗原-B3)、MAGE-B4(黑素瘤抗原-B4)、MAGE-B5(黑素瘤抗原-B5)、MAGE-B6(黑素瘤抗原-B6)、MAGE-C1(黑素瘤抗原-C1)、MAGE-C2(黑素瘤抗原-C2)、MAGE-C3(黑素瘤-抗原-C3)、MAGE-D1(黑素瘤抗原-D1)、MAGE-D2(黑素瘤抗原-D2)、MAGE-D4(黑素瘤抗原-D4)、MAGE-E1(黑素瘤抗原-E1)、MAGE-E2(黑素瘤抗原-E2)、MAGE-F1(黑素瘤抗原-F1)、MAGE-H1(黑素瘤抗原-H1)、MAGEL2(MAGE样2)、乳腺珠蛋白A、MART-1/Melan-A(由T细胞-1识别的黑素瘤抗原/黑素瘤抗原A)、MART-2(由T细胞-2识别的黑素瘤抗原)、基质蛋白22、MC1R(黑皮质素1受体)、M-CSF(巨噬细胞集落刺激因子基因)、间皮素、MG50/PXDN、MMP 11(M期磷蛋白11)、MN/CA IX-抗原、MRP-3(多药耐药相关蛋白3)、MUC1(黏蛋白1)、MUC2(黏蛋白2)、NA88-A(患者M88的NA cDNA克隆)、N-乙酰葡糖氨转移酶-V、新-PAP(新聚(A)聚合酶)、NGEP、NMP22、NPM/ALK(核仁磷蛋白/间变性淋巴瘤激酶融合蛋白)、NSE(神经特异性烯醇化酶)、NY-ESO-1(纽约食管1)、NY-ESO-B、OA1(眼白化病1型蛋白)、OFA-iLRP(癌胚抗原-未成熟层粘连蛋白受体)、OGT(O-连接的N-乙酰葡糖胺转移酶基因)、OS-9、骨钙蛋白、骨桥蛋白、p15(蛋白15)、p15、p190次要bcr-abl、p53、PAGE-4(前列腺GAGE样蛋白-4)、PAI-1(纤溶酶原激活物抑制剂1)、PAI-2(纤溶酶原激活物抑制剂2)、PAP(前列腺酸性磷酸酶)、PART-1、PATE、PDEF、Pim-1-激酶、Pinl(丙基异构酶)、POTE、PRAME(优先表达的黑素瘤抗原)、prostein、蛋白酶-3、PSA(前列腺特异性抗原)、PSCA、PSGR、PSM、PSMA(前列腺特异性膜抗原)、RAGE-1(肾抗原)、RHAMM/CD168(透明质酸介导的能动性受体)、RU1(肾普遍存在1)、RU2(肾普遍存在1)、S-100、SAGE(肉瘤抗原)、SART-1(鳞状抗原排斥肿瘤1)、SART-2(鳞状抗原排斥肿瘤1)、SART-3(鳞状抗原排斥肿瘤1)、SCC(鳞状细胞癌抗原)、Sp17(精子蛋白17)、SSX-1(滑膜肉瘤X断点1)、SSX-2/HOM-MEL-40(滑膜肉瘤X断点)、SSX-4(滑膜肉瘤X断点4)、STAMP-1、STEAP(六次跨膜上皮抗原前列腺)、存活、存活蛋白-2B(保留内含子2的存活蛋白)、TA-90、TAG-72、TARP、TGFb(TGFβ)、TGFbRII(TGFβ受体II)、TGM-4(前列腺特异性转谷氨酰胺酶)、TRAG-3(紫杉醇抗性相关蛋白3)、TRG(簇集素相关基因)、TRP-1(酪氨酸相关蛋白1)、TRP-2/6b(TRP-2/新外显子6b)、TRP-2/INT2(TRP-2/内含子2)、Trp-p8、酪氨酸酶、UPA(尿激酶型纤溶酶原激活物)、VEGF(血管内皮生长因子)、VEGFR-2/FLK-1(血管内皮生长因子受体-2)、WT1(Wilm肿瘤基因),或者可包括例如癌症疾病中表达的突变抗原,其选自包括但不限于以下的组:α-辅肌动蛋白-4/m、ARTC1/m、bcr/abl(断点簇区域-Abelson融合蛋白)、β-联蛋白/m(β-联蛋白)、BRCAl/m、BRCA2/m、CASP-5/m、CASP-8/m、CDC27/m(细胞分裂周期27)、CDK4/m(细胞周期蛋白依赖性激酶4)、CDKN2A/m、CML66、COA-1/m、DEK-CAN(融合蛋白)、EFTUD2/m、ELF2/m(延伸因子2)、ETV6-AML1(Ets变体基因6/急性髓性白血病1基因融合蛋白)、FN1/m(纤连蛋白1)、GPNMB/m、HLA-A*0201-R170I(HLA-A2基因α2结构域α-螺旋的残基170处的精氨酸至异亮氨酸交换)、HLA-A11/m、HLA-A2/m、HSP70-2M(热休克蛋白70-2突变)、KIAA0205/m、K-Ras/m、LDLR-FUT(LDR-岩藻糖基转移酶融合蛋白)、MART2/m、MEl/m、MUM-1/m(黑素瘤普遍存在突变1)、MUM-2/m(黑素瘤普遍存在突变2)、MUM-3/m(黑素瘤普遍存在突变3)、I类肌球蛋白/m、新PAP/m、NFYC/m、N-Ras/m、OGT/m、OS-9/m、p53/m、Pml/RARα(早幼粒细胞性白血病/视黄酸受体α)、PRDX5/m、PTPRK/m(受体型蛋白酪氨酸磷酸酶K)、RBAF600/m、SIRT2/m、SYT-SSX-1(突触结合蛋白I/滑膜肉瘤X融合蛋白)、SYT-SSX-2(突触结合蛋白I/滑膜肉瘤X融合蛋白)、TEL-AML1(易位Ets-家族白血病/急性髓性白血病1融合蛋白)、TGFβRII(TGFβ受体II)、TPI/m(磷酸丙糖异构酶)。
vii.其他物质
多种其他物质可用于根据本公开内容开发的疫苗。例如,可引起例如疯牛病和库鲁病之疾病的朊病毒(蛋白质感染性颗粒)的抗原可用于本文中所述的组合物中。此外,来自本身嵌入皮肤中之小昆虫(例如蜱、臭虫或虱子)的抗原可用于来自本发明组合物的宿主免疫应答。
B.二嵌段共聚物
在一些方面,本文中所述的二嵌段共聚物可充当免疫原性组合物中的佐剂。本文中公开的pH响应性胶束和纳米粒包含嵌段共聚物。嵌段共聚物包含亲水性聚合物链段和疏水性聚合物链段。疏水性聚合物链段对pH敏感。例如,疏水性聚合物链段可包含可电离的胺基团以提供pH敏感性。在疏水性聚合物链段内,可使用多个不同的单体(例如1个、2个、3个或更多个不同的单体)来调节疏水性聚合物链段的pKa敏感性。嵌段共聚物基于这些可电离嵌段共聚物的超分子自组装形成pH可激活的胶束(pHAM)纳米粒。在较高的pH下,嵌段共聚物组装成胶束,而在较低的pH下,疏水性聚合物链段中的胺基团离子化导致胶束的解离。可电离基团可在不同pH值下充当可调亲水性/疏水性嵌段,这可以直接影响胶束的动态自组装。
在一些方面,嵌段共聚物具有pH转变值,其是嵌段共聚物从纳米粒变为解离形式的pH值。pH转变值可从6.0至7.4、从6.5至7.4、从6.5至7.2、从6.8至7.4、从6.8至7.2、或从6.0、6.2、6.4、6.5、6.6、6.7、6.8、6.85、6.9、6.95、7.0、7.05、7.1、7.2至7.4,或可从其中来源的任何范围。在一些方面,嵌段共聚物形成粒度小于50nm的纳米粒。在一些实施方案中,纳米粒的粒度可以是1nm至50nm、5nm至50nm、10nm至50nm、10nm至40nm、20nm至40nm、或5nm、10nm、15nm、20nm、22nm、24nm、26nm、28nm、30nm、32nm、34nm、35nm、40nm、45nm至50nm,或可从其中来源的任何范围。
i.亲水性嵌段
在一些实施方案中,亲水性聚合物链段包含聚(环氧乙烷)(PEO)。在一些实施方案中,亲水性聚合物链段包含聚(甲基丙烯酸酯磷脂酰胆碱)(MPC)。在一些实施方案中,亲水性聚合物链段包含聚乙烯吡咯烷酮(PVP)。通常来说,亲水性聚合物链段中的PEO、MPC或PVP聚合物的尺寸为约2kD至约20kD。在一些实施方案中,聚合物的尺寸为约2kD至约10kD。在一些实施方案中,聚合物的尺寸为约2kD至约5kD。在一些实施方案中,聚合物的尺寸为约3kD至约8kD。在一些实施方案中,聚合物的尺寸为约4kD至约6kD。在一些实施方案中,聚合物的尺寸为约5kD。在一些实施方案中,聚合物具有约100至约130个单体单元。在一些实施方案中,聚合物具有约110至约120个单体单元。在一些实施方案中,聚合物具有约114个单体单元。可使用本领域已知的方法制备或可购买用作二嵌段共聚物的亲水性嵌段的合适亲水性聚合物链段。例如,MPC聚合物(例如窄分布的MPC聚合物)可通过原子转移自由基聚合(ATRP)利用市售的小分子引发剂(例如2-溴-2-甲基丙酸乙酯(Sigma Aldrich))制备。这些得到的MPC聚合物可用作大分子A TRP引发剂,以进一步与其他单体共聚形成嵌段聚合物,例如MPC-b-PDPA。PEO-b-PR嵌段共聚物可使用原子转移自由基聚合(ATRP)或可逆加成断裂链转移(reversible addition fragmentation chain transfer,RAFT)法合成(参见例如Australian Journal of Chemistry,第58卷,第6期,第379-410页(2005);Progress inPolymer Science,第32卷,第1期,第93-146页(2007))。ATRP或RAFT允许可产生具有窄多分散性(<1.1)的PEO-b-PR共聚物的活性聚合。不同的甲基丙烯酸酯或丙烯酸酯单体可用于产生具有不同pH敏感性的PR链段。
ii.疏水性嵌段
在一些方面,使用pH敏感性的含胺的甲基丙烯酸酯单元制备疏水性聚合物链段。疏水性聚合物链段可包含具有x个重复单元的聚合物。在一些实施方案中,x总计为约40至约100个。在一些实施方案中,x总计为约50至约100个。在一些实施方案中,x总计为约40至约70个。在一些实施方案中,x总计为约60至约80个。疏水性聚合物链段可根据例如原子转移自由基聚合(ATRP)或可逆加成-断裂链转移(RAFT)或如以下实施例中所述进行合成。
在一些方面,疏水性聚合物链段包含重复单元,其中X4和X5是具有C1-C3碳原子的烷基或者合在一起并且具有C4-C8碳原子。在一些实施方案中,优化这些碳原子的长度以获得pKa为约6.0至约7.5的疏水性聚合物链段。在一些实施方案中,pKa为约6.5至约7.4。pKa可使用本领域技术人员已知的方法(例如pH滴定)测量。
C.另外的佐剂
还如本领域中公知的,特定免疫原组合物的免疫原性可通过使用称为佐剂的免疫应答非特异性刺激物来增强。已经实验性地使用佐剂来促进针对弱免疫原性抗原之免疫力的普遍提高(例如,美国专利4,877,611)。免疫接种方案已经使用佐剂刺激反应多年,且因此这些佐剂是本领域普通技术人员公知的。一些佐剂影响抗原呈递的方式。例如,当蛋白质抗原吸附至明矾时,免疫应答提高。抗原的乳化也延长抗原呈递的持续时间并引发固有免疫应答。合适的分子佐剂包括所有可接受的免疫刺激性化合物,例如细胞因子、毒素或合成组合物。
在一些方面,本文中所述的组合物还可包含其他佐剂。尽管明矾是用于人类的经批准佐剂,但实验动物中的佐剂包括完全弗氏佐剂(含有死结核分枝杆菌的非特异性免疫应答刺激物)、不完全弗氏佐剂和氢氧化铝佐剂。同样可用于动物和有时用于人类的其他佐剂包括白介素(IL)-1、IL-2、IL-4、IL-7、IL-12、干扰素、卡介苗(Bacillus Calmette-Guérin,BCG)、氢氧化铝、胞壁酰二肽(muramyl dipeptide,MDP)化合物,例如thur-MDP和nor-MDP(N-乙酰胞壁酰-L-丙氨酰-D-异谷氨酰胺MDP)、脂质A和单磷酰脂质A(monophosphoryllipid A,MPL)。还考虑了RIBI,其含有在2%鲨烯/吐温80乳剂中的从细菌中提取的三种组分:MPL、海藻糖二霉菌酸酯(trehalose dimycolate,TDM)和细胞壁骨架(cell wallskeleton,CWS)。甚至可使用MHC抗原。
在一个方面,并且被批准用于人,通过使用在磷酸缓冲盐水中的约0.05%至约0.1%的溶液中使用的试剂(例如明矾)来实现佐剂效果。或者,在实验动物中,将抗原制成与糖的合成聚合物作为约0.25%溶液使用。通过用约70℃至约101℃的温度分别进行30秒至2分钟时间的热处理,通过疫苗中的抗原聚集也可实现佐剂效果。也可使用通过用经胃蛋白酶处理之(Fab)抗体再激活向白蛋白聚集,与细菌细胞(例如短小棒状杆菌(C.parvum))、革兰氏阴性细菌的内毒素或脂多糖成分的混合物,在生理学可接受的油载剂(例如二缩甘露醇单油酸酯(Aracel A))中的乳剂,或具有用作嵌段替代物的全氟化碳20%溶液的乳剂。
一些佐剂(例如从细菌获得的某些有机分子)作用于宿主而不是作用于抗原。一个实例是细菌肽聚糖MDP。与大多数佐剂一样,MDP的作用尚未完全了解,尽管发明人现在已经开始认识到它们激活固有免疫系统的细胞,例如树突细胞、巨噬细胞、中性粒细胞、NKT细胞、NK细胞等。MDP刺激巨噬细胞,但也显示直接刺激B细胞。因此,佐剂的作用不是抗原特异性的。然而,如果它们与经纯化抗原一起施用,它们可用于选择性地促进对抗原的应答。
在某些实施方案中,血蓝蛋白(hemocyanin)和血红质(hemoerythrin)也可用于本公开内容的组合物中。在某些实施方案中优选使用来自钥孔戚(keyhole limpet,KLH)的血蓝蛋白,尽管可使用其他软体动物和节肢动物的血蓝蛋白和血红质。
还可使用多种多糖佐剂。例如,已经描述了对小鼠抗体应答使用多种肺炎球菌多糖佐剂(Yin等,1989)。产生最佳应答或在其他情况下不产生抑制的剂量应按照指示使用(Yin等,1989)。多胺类多糖是特别优选的,例如几丁质和壳聚糖,包括脱乙酰化几丁质。
另一组佐剂是细菌肽聚糖的胞壁酰二肽(MDP,N-乙酰胞壁酰-L-丙氨酰-D-异谷氨酰胺)组。还考虑胞壁酰二肽的衍生物,例如氨基酸衍生物苏氨酰-MDP和脂肪酸衍生物胞壁酰三肽磷脂酰乙醇酰胺(MTPPE)。
美国专利4,950,645描述了胞壁酰二肽的亲脂性二糖-三肽衍生物,其被描述用于由磷脂酰胆碱和磷脂酰甘油形成的人造脂质体。这在激活人单核细胞和破坏肿瘤细胞方面是有效的,但在通常高剂量下是无毒的。考虑美国专利4,950,645和PCT专利申请WO 91/16347的化合物与本公开内容的细胞载体和其他实施方案一起使用。
在有或没有海藻糖二霉菌酸酯的情况下,BCG和BCG-细胞壁骨架(CWS)也可作为佐剂使用。可使用海藻糖二霉菌酸酯本身。已显示在小鼠中海藻糖二霉菌酸酯的施用与对流感病毒感染的增强抗性相关(Azuma等,1988)。海藻糖二霉菌酸酯可如美国专利4,579,945中所述制备。BCG是重要的临床工具,因为它具有免疫刺激特性。BCG用于刺激网状内皮系统(RES)、激活自然杀伤(NK)细胞和提高造血干细胞的增殖。已证明BCG的细胞壁提取物具有优异的免疫佐剂活性。分枝杆菌的分子遗传学工具和方法提供了将外源基因引入到BCG中的方法(Jacobs等,1987;Snapper等,1988;Husson等,1990;Martin等,1990)。活BCG是在全球范围内用于预防结核病的有效且安全的疫苗。BCG和其他分枝杆菌是高度有效的佐剂,并且已经广泛研究了对分枝杆菌的免疫应答。通过近20亿次免疫接种,BCG具有在人中安全使用的长期记录(Luelmo,1982;Lotte等,1984)。其是少数几种可在出生时给予的疫苗之一,只需单剂就能产生长期的免疫应答,并且BCG疫苗接种有具有经验的全球分布网络。示例性BCG疫苗作为TICEBCG(Organon Inc.,West Orange,NJ)销售。
两亲性和表面活性剂(例如皂苷及衍生物(例如QS21(Cambridge Biotech)))形成与本公开内容的免疫原一起使用的另一组佐剂。也可使用非离子嵌段共聚物表面活性剂(Rabinovich等,1994)。寡核苷酸是另一种可用的佐剂组(Yamamoto等,1988)。Quil A和lentinen是可在本公开内容的某些实施方案中使用的另一些佐剂。
另一组佐剂是去毒内毒素,例如美国专利4,866,034的精制去毒内毒素。这些精制去毒内毒素在哺乳动物中产生佐剂应答中有效。当然,去毒内毒素可与其他佐剂组合以制备并入多佐剂的细胞。例如,如美国专利4,435,386中所述,特别地考虑脱毒内毒素与海藻糖二霉菌酸酯的组合。还考虑去毒内毒素与海藻糖二霉菌酸酯和内毒素糖脂的组合(美国专利4,505,899),以及如美国专利4,436,727、4,436,728和4,505,900中所述,脱毒内毒素与cCWS或CWS和海藻糖二霉菌酸酯的组合。如美国专利4,520,019中所述,还预见了仅CWS和海藻糖二霉菌酸酯的组合(没有去毒内毒素)是可用的。
本领域技术人员将知晓可根据本发明内容与疫苗缀合并且被批准用于人对实验用途的不同种类的佐剂。这些包括烷基溶血磷脂(ALP);BCG;以及生物素(包括生物素化衍生物)等。特别地考虑使用的某些佐剂是来自革兰氏阴性细菌细胞的磷壁酸。这些包括脂磷壁酸(lipoteichoic acid,LTA)、核糖醇磷壁酸(ribitol teichoic acid,RTA)和甘油磷壁酸(glycerol teichoic acid,GTA)。它们的合成对应物的活性形式也可与本公开内容的组合物联合使用(Takada等,1995)。
多种佐剂,甚至那些不常用于人类的佐剂,仍可用于动物。佐剂可由核酸(例如,DNA或RNA)编码。考虑这样的佐剂也可在编码抗原的核酸(例如,表达载体)中或在单独的载体或其他构建体中编码。编码佐剂的核酸可例如用脂质或脂质体直接递送。
D.生物应答调节剂(Biological Response Modifier,BRM)
除佐剂外,可期望共施用已显示上调T细胞免疫或下调抑制细胞活性的BRM。此类BRM包括但不限于西咪替丁(CIM;1200mg/d)(Smith/Kline,PA);低剂量环磷酰胺(CYP;300mg/m2)(Johnson/Mead,NJ)、细胞因子(例如干扰素、IL-2或IL-12)或编码参与免疫辅助功能之蛋白质(例如B-7)的基因。另外的生物应答调节剂包括在Gupta和Kanodia,2002和Bisht等,2010中描述的那些,二者均通过引用并入本文。
E.趋化因子
趋化因子、编码趋化因子的核酸和/或表达趋化因子的细胞也可作为疫苗组分使用。趋化因子通常充当化学引诱物以将免疫效应细胞募集至趋化因子表达的部位。表达与例如细胞因子编码序列组合的特定趋化因子编码序列以增强其他免疫系统组分向治疗部位的募集可以是有利的。这样的趋化因子包括例如RANTES、MCAF、MIP1-α、MIP1-β、IP-10及其组合。技术人员将认识到,某些细胞因子还已知具有化学引诱作用,并且也可归类为术语趋化因子。
F.免疫原性载体蛋白
在一些实施方案中,本文中所述的疫苗组合物可与载体化学偶联或与免疫原性载体肽或多肽(例如,抗原-载体融合肽或多肽)一起重组表达以增强免疫反应。示例性和优选的免疫原性载体氨基酸序列包括乙型肝炎表面抗原(HBSA)、破伤风类毒素(TT)、钥孔戚血蓝蛋白(KLH)和BSA。在人中,TT会是有利的,因为其已经是经批准的蛋白质疫苗。对于实验动物,其他白蛋白(例如OVA、小鼠血清白蛋白或兔血清白蛋白)也可作为免疫原性载体蛋白使用。用于将多肽或肽与免疫原性载体蛋白缀合的方法是本领域中公知的并且包括例如戊二醛、m-马来酰亚胺基苯甲酰基-N-羟基琥珀酰亚胺酯、碳二亚胺和双-重氮联苯胺(bis-biazotized benzidine)。
II.药物制剂和治疗方法
A.药物制剂和施用途径
在考虑临床应用的情况下,有必要以适用于预期应用的形式制备药物组合物。在一些实施方案中,考虑具有本公开内容化合物的此类制剂。通常来说,这将需要制备基本上不含热原以及其他可对人或动物有害之杂质的组合物。
人们通常会希望使用适当的盐和缓冲剂以使组合物稳定并允许靶细胞摄取。当将组合物引入到患者中时,也将使用缓冲剂。本公开内容的水性组合物包含溶解或分散在可药用载体或水性介质中的有效量的疫苗组合物。这样的组合物被称为接种物。短语“药学上或药理学上可接受的”是指当施用于动物或人时不产生不利的、变应性的或其他不良反应的分子实体和组合物。本文中使用的“可药用载体”包括任何和所有溶剂、分散介质、涂层、抗细菌剂和抗真菌剂、等张剂和吸收延迟剂等。这样的介质和试剂用于药物活性物质的用途是本领域中公知的。除非在任何常规介质或试剂与本公开内容的组合物不相容的情况下,否则考虑其在治疗组合物中的用途。补充的活性成分也可并入到组合物中。
本公开内容的活性组合物可包括经典的药物制剂。根据本公开内容的这些组合物的施用将通过任何常规途径,只要靶组织可通过该途径获得即可。此类途径包括经口、经鼻、含服、经直肠、经阴道或表面途径。或者,可通过原位(orthotopic)、皮内、皮下、肌内、瘤内、腹膜内或静脉内注射施用。这样的组合物通常作为如上所述的可药用组合物施用。
本文中使用的“可药用载体”包括任何和所有溶剂、分散介质、涂层、抗细菌剂和抗真菌剂、等张剂和吸收延迟剂等。此类介质和药剂用于药物活性物质的用途是本领域中公知的。除非在任何常规介质或试剂与活性成分不相容的情况下,否则考虑其在治疗组合物中的用途。补充的活性成分也可并入到组合物中。
对于经口施用,本文中所述的疫苗组合物可与赋形剂合并并以不可摄入的漱口剂(mouthwash)和洁齿剂(dentifrice)的形式使用。可通过将活性成分以所需量并入合适的溶剂(例如四硼酸钠溶液(Dobell溶液))中来制备漱口剂。或者,可将活性成分并入到含有四硼酸钠、甘油和碳酸氢钾的抗菌洗液(antiseptic wash)中。活性成分还可分散在洁齿剂中,包括:凝胶、糊状物、粉末和浆料。活性成分可以以治疗有效量添加至可包含水、黏合剂、研磨剂、矫味剂、发泡剂和润湿剂的糊状洁齿剂中。
根据本公开内容的递送药物组合物的一种方法是全身性的。然而,如美国专利5,543,158、美国专利5,641,515和美国专利5,399,363(各自特别地通过引用整体并入本文)中所述,取决于上下文,本文中公开的药物组合物可作为替选地肠胃外、静脉内、皮下、皮内、肌内、透皮或甚至腹膜内施用。
注射可通过注射器或用于注射溶液的任何其他方法进行,只要该药剂可通过注射所需的特定针号即可。已经描述了新的无针注射系统(美国专利5,846,233),其具有限定用于容纳溶液的安瓿室的喷嘴和用于将溶液从喷嘴推出至递送部位的能量装置。
作为游离碱或药理学上可接受的盐的活性化合物的溶液可在与表面活性剂(例如羟丙基纤维素)适当混合的水中制备。还可在甘油、液体聚乙二醇及其混合物中和在油中制备分散剂。在通常的储存和使用条件下,这些制剂含有防腐剂以防止微生物的生长。适于注射用途的药物形式包括无菌水性溶液或分散体和用于临时制备无菌可注射溶液或分散体的无菌粉末(美国专利5,466,468,特别地通过引用整体并入本文)。在所有情况下,该形式必须是无菌的并且必须以存在易注射性的程度流动。其必须在制造和储存的条件下稳定,并且必须防止微生物(例如细菌和真菌)的污染作用。载体可以是溶剂或分散介质,其包含例如水、乙醇、多元醇(例如,甘油、丙二醇和液体聚乙二醇等)、其合适的混合物、和/或植物油。例如,通过使用涂层(例如卵磷脂),通过在分散的情况下维持所需的粒度和通过使用表面活性剂,可保持适当的流动性。可通过多种抗细菌剂和抗真菌剂,例如对羟基苯甲酸酯、氯丁醇、苯酚、山梨酸、硫柳汞等来实现防止微生物的作用。在许多情况下,优选包括等张剂,例如糖或氯化钠。通过在组合物中使用延迟吸收的试剂(例如,单硬脂酸铝和明胶),可实现可注射组合物的延长吸收。
例如,对于在水性溶液中的肠胃外施用,如果需要,溶液应适当地缓冲,并且首先用足够的盐水或葡萄糖使液体稀释剂等张。这些特定的水性溶液尤其适用于静脉内、肌内、皮下和腹膜内施用。就此而言,根据本公开内容,可使用的无菌水性介质对于本领域技术人员而言是已知的。例如,可将一个剂量溶解在1ml等张NaCl溶液中,并且将其添加至1000mL的皮下输液(hypodermolysis)流体中或者在建议的输注部位注射(参见例如,“Remington’s Pharmaceutical Sciences”,第15版,第1035至1038页和第1570至1580页)。剂量必然会根据所治疗的对象的状况而发生一些变化。无论如何,负责施用的人员将决定个体对象的适当剂量。此外,对于人施用,制剂应符合FDA生物制品局标准要求的无菌性、致热原性、一般安全性和纯度标准。
通过将适当溶剂中所需量的活性化合物与上面列举的多种其他成分根据需要合并、随后过滤灭菌来制备无菌可注射溶液。通常来说,通过将多种无菌活性成分并入含有基础分散介质和来自上面列举的那些的所需其他成分的无菌载剂中来制备分散体。在无菌粉末用于制备无菌可注射溶液的情况下,优选的制备方法是真空干燥和冷冻干燥技术,其从其先前无菌过滤的溶液中得到活性成分加任何其他期望成分的粉末。
本文中公开的组合物可配制成中性或盐形式。可药用盐包括与无机酸(例如盐酸或磷酸)或有机酸(例如乙酸、草酸、酒石酸、扁桃酸等)形成的酸加成盐(与蛋白质的游离氨基形成)。与游离羧基形成的盐也可来源于无机碱,例如氢氧化钠、氢氧化钾、氢氧化铵、氢氧化钙或氢氧化铁;以及有机碱,例如异丙胺、三甲胺、组氨酸、普鲁卡因等。在配制后,溶液将以与剂量制剂相容的方式并以治疗有效量施用。制剂以多种剂量形式(例如可注射溶液、药物释放胶囊等)容易地施用。
本文中使用的“缓冲液或稀释剂”包括任何和所有溶剂、分散介质、载剂、涂层、稀释剂、赋形剂、抗细菌剂和抗真菌剂、等张剂和吸收延迟剂、缓冲液、溶液、混悬剂、胶体等。此类介质和药剂用于药物活性物质的用途是本领域中公知的。除非在任何常规介质或试剂与活性成分不相容的情况下,否则考虑其在治疗组合物中的用途。补充的活性成分也可并入组合物中。
短语“可药用”或“药理学上可接受的”是指当施用于人时不产生变应性或类似不良反应的分子实体和组合物。含有蛋白质作为活性成分的水性组合物的制备在本领域中是充分理解的。通常来说,将这样的组合物制成注射剂(液体溶液或混悬剂);也可制备适于在注射前溶解或混悬在液体中的固体形式。
B.治疗方法
特别地,本文中公开了可用于在对象(例如,人对象)中治疗癌症的组合物。上述组合物优选以有效量(即,能够在受治疗的对象中产生期望结果(例如,引起癌细胞的凋亡)的量)施用于哺乳动物(例如,啮齿动物、人、非人灵长类、犬、牛、羊、马、猫等)。本公开内容的方法中使用的组合物的毒性和治疗效力可通过标准药学程序测定。如在医学和兽医领域中所公知的,用于任何一种动物的剂量取决于许多因素,包括对象的尺寸、体表面积、体重、年龄、待施用的特定组合物、施用的时间和途径、一般健康状况、感染或癌症的临床症状以及同时施用的其他药物。如通过确定血液学参数(全血细胞计数-CBC)或癌细胞生长或增殖的降低所测定的,通常以抑制细菌细胞生长或增殖、抑制生物膜生长或诱导癌细胞死亡(例如,诱导癌细胞凋亡)的剂量施用本文中所述的组合物。在一些实施方案中,用于诱导癌细胞凋亡的米亚霉素(meayamycin)、泰抑素A(thailanstatin A)甲基酯及其类似物的量计算为约0.01mg至约10,000mg/天。在一些实施方案中,所述量为约1mg至约1,000mg/天。在一些实施方案中,这些剂量可基于特定患者的生物学因素(例如如果经口施用,药物的代谢分解提高或降低或者消化道的摄取降低)降低或提高。另外,本文中所述的疫苗组合物可能更有效,因此需要更小的剂量来实现类似的效果。这样的剂量通常每天施用一次持续几周或直至达到癌细胞的充分降低。
本公开内容的治疗方法(其包括预防性治疗)通常包括向有此需要的对象(包括哺乳动物,特别是人)施用治疗有效量的本文中所述组合物。这样的治疗将适当地施用于患有、具有、易患疾病、病症或其症状,或处于其风险中的对象,特别是人。可通过诊断性测试或者对象或健康护理提供者(例如,遗传试验、酶或蛋白质标志物、标志物(如本文中所限定)、家族史等)的意见的任何主观或客观确定来确定这些对象“处于风险中”。
在一个实施方案中,本公开内容提供了监测治疗进展的方法。该方法包括在患有或易患与癌症(例如,白血病)相关的病症或其症状的对象中(在其中对象已经施用治疗有效量的本文中所述组合物)确定血液学参数和/或用细胞表面蛋白作为诊断性标志物(其可包括例如但不限于CD34、CD38、CD90和CD117)的癌干细胞(cancer stem cell,CSC)分析或诊断性测量(例如,筛选、测定)的改变水平的步骤。可将该方法中确定的标志物水平与健康正常对照中或其他患病患者中的已知标志物水平进行比较以确立对象的疾病状态。在一些优选的实施方案中,在晚于确定第一水平的时间点确定对象中标志物的第二水平,并比较这两个水平以监测疾病进程或治疗效力。在某些优选的实施方案中,根据本文中所述的方法在开始治疗之前确定对象中标记物的治疗前水平;然后可将该标志物的治疗前水平与治疗开始后对象中的标志物水平进行比较,以确定治疗效力。
III.组合治疗
预见本文中所述的疫苗组合物可与一种或更多种另外的治疗或减轻患者所经历的一种或更多种副作用的化合物一起用于组合治疗。在医学领域中组合治疗方式是常见的。以下是可与本公开内容的治疗组合使用的治疗的一般讨论。
为了使用本公开内容的方法和组合物治疗疾病或病症,通常向患者施用所述组合物和至少一种其他治疗。这些治疗将以有效实现一种或更多种疾病参数降低的组合量提供。该过程可涉及使细胞/对象与两种药剂/治疗同时接触,例如,使用包含这两种药剂的单一组合物或药理学制剂,或通过使细胞/对象与两种不同的组合物或制剂同时接触,其中一种组合物包含疫苗组合物,且另一种包含另一种药剂。
或者,本文中所述的疫苗组合物可在其他治疗之前或之后,间隔数分钟至数周。通常应确保在每次递送的时间之间有效的时间没有到期,使得治疗仍然能够对细胞/对象产生有利的组合效果。在这种情况下,考虑可在彼此约12至24小时内、在彼此约6至12小时内或者仅约1至2小时的延迟时间内以这两种方式接触细胞。在某些情况下,可期望显著延长治疗时间;然而,在各施用之间相隔数天(2、3、4、5、6或7天)至数周(1、2、3、4、5、6、7或8周)。此外,还考虑这些治疗中的每一种可组合或单独施用两次或更多次。例如,第一治疗可与第二治疗一起施用,且随后第一治疗可单独或再次与第二治疗组合施用第二次。
还可想到,将期望多于一次施用疫苗组合物或其他治疗。可采用多种组合,其中本公开内容的疫苗组合物是“A”,而另一种治疗是“B”,如下所示:
还考虑其他组合。以下是可与本公开内容的组合物组合使用的其他治疗的一般讨论。
A.化学治疗
术语“化学治疗”是指使用药物治疗癌症。“化学治疗剂”用于表示在癌症治疗中施用的化合物或组合物。这些药剂或药物通过其在细胞内的活动模式进行分类,例如,是否影响细胞周期和在什么阶段影响细胞周期。或者,可基于其直接交联DNA、嵌入DNA或通过影响核酸合成来诱导染色体和有丝分裂畸变的能力来表征药剂。大多数化学治疗剂分为以下几类:烷化剂、抗代谢物、抗肿瘤抗生素、有丝分裂抑制剂和亚硝基脲类。
化学治疗剂的实例包括烷化剂,例如噻替派和环磷酰胺;烷基磺酸酯类,例如白消安、英丙舒凡和哌泊舒凡;氮丙啶类,例如苯佐替哌(benzodopa)、卡波醌(carboquone)、美妥替哌(meturedopa)和乌瑞替哌(uredopa);乙撑亚胺类(ethylenimines)和甲基蜜胺类(methylamelamines),包括六甲蜜胺(altretamine)、三乙撑蜜胺(triethylenemelamine)、三乙撑磷酰胺(trietylenephosphoramide)、三乙撑硫代磷酰胺(triethylenethiophosphoramide)和三羟甲蜜胺(trimethylolomelamine);番荔枝内酯类(acetogenin)(尤其是布拉他辛(bullatacin)和布拉他辛酮(bullatacinone));喜树碱(camptothecin)(包括合成类似物拓扑替康(topotecan))、苔藓抑素(bryostatin);卡利抑素(callystatin);CC-1065(包括其阿多来新(adozelesin)、卡折来新(carzelesin)和比折来新(bizelesin)合成类似物);隐藻素类(cryptophycins)(特别是隐藻素1和隐藻素8);海兔毒素(dolastatin);倍癌霉素(duocarmycin)(包括合成类似物KW-2189和CB1-TM1);艾榴塞洛素(eleutherobin);水鬼蕉碱(pancratistatin);匍枝珊瑚醇(sarcodictyin);海绵抑素(spongistatin);氮芥类(nitrogen mustards),例如氯丁酸氮芥(chlorambucil)、萘氮芥(chlornaphazine)、胆磷酰胺(cholophosphamide)、雌氮芥(estramustine)、异磷酰胺(ifosfamide)、双氯乙基甲胺(mechlorethamine)、盐酸甲氧氮芥(mechlorethamineoxidehydrochloride)、美法仑、新氮芥(novembichin)、苯芥胆甾醇(phenesterine)、泼尼莫司汀(prednimustine)、曲磷胺(trofosfamide)、尿嘧啶氮芥(uracil mustard);硝基脲类(nitrosureas),例如卡莫司汀(carmustine)、氯脲菌素(chlorozotocin)、福莫司汀(fotemustine)、洛莫司汀(lomustine)、尼莫司汀(nimustine)和雷莫司汀(ranimustine);抗生素类,例如烯二炔类(enediyne)抗生素(例如,加利车霉素(calicheamicin),尤其是加利车霉素γ1和加利车霉素ω1;达内霉素(dynemicin),包括达内霉素A;尤西拉霉素(uncialamycin)及其衍生物;二膦酸盐类(bisphosphonate),例如氯膦酸盐(clodronate);埃斯波霉素(esperamicin);以及新抑癌菌素(neocarzinostatin)生色团和相关色蛋白烯二炔类抗生素生色团、阿克拉霉素(aclacinomysins)、放线菌素、氨茴霉素(authramycin)、氮丝氨酸(azaserine)、博来霉素、放线菌素C(cactinomycin)、卡柔比星(carabicin)、洋红霉素(carminomycin)、嗜癌霉素(carzinophilin)、色霉素(chromomycin)、放线菌素D(dactinomycin)、柔红霉素(daunorubicin)、地托比星(detorubicin)、6-二氮-5-氧-L-正亮氨酸、多柔比星(包括吗啉代多柔比星、氰基吗啉代-多柔比星、2-吡咯代-多柔比星和脱氧多柔比星)、表柔比星、依索比星(esorubicin)、依达比星(idarubicin)、麻西罗霉素(marcellomycin)、丝裂霉素(例如丝裂霉素C)、霉酚酸(mycophenolic acid)、诺加霉素(nogalamycin)、橄榄霉素(olivomycin)、培来霉素(peplomycin)、泊非霉素(potfiromycin)、嘌呤霉素、三铁阿霉素(quelamycin)、罗多比星(rodorubicin)、链黑菌素(streptonigrin)、链脲霉素(streptozocin)、杀结核菌素(tubercidin)、乌苯美司(ubenimex)、净司他丁(zinostatin)或佐柔比星(zorubicin);抗代谢物类,例如甲氨喋呤、5-氟尿嘧啶(5-FU);叶酸类似物,例如二甲叶酸(denopterin)、甲氨喋呤、蝶罗呤(pteropterin)、三甲曲沙(trimetrexate);嘌呤类似物,例如氟达拉滨(fludarabine)、6-巯基嘌呤、硫咪嘌呤、硫鸟嘌呤;嘧啶类似物,例如安西他滨(ancitabine)、阿扎胞苷(azacitidine)、6-氮尿苷、卡莫氟(carmofur)、阿糖胞苷(cytarabine)、双脱氧尿苷(dideoxyuridine)、多西氟尿啶(doxifluridine)、依诺他滨(enocitabine)、氟尿苷(floxuridine);雄激素类,例如卡鲁睾酮(calusterone)、丙酸屈他雄酮(dromostanolonepropionate)、表硫雄醇(epitiostanol)、美雄烷(mepitiostane)、睾内酯(testolactone);抗肾上腺类,例如氨鲁米特(aminoglutethimide)、米托坦(mitotane)、曲洛司坦(trilostane);叶酸补充剂,例如亚叶酸;醋葡醛内酯(aceglatone);醛磷酰胺糖苷(aldophosphamide glycoside);氨基酮戊酸(aminolevulinic acid);恩尿嘧啶(eniluracil);氨苯吖啶(amsacrine);阿莫斯汀(bestrabucil);比生群(bisantrene);依达曲沙(edatraxate);地磷酰胺(defofamine);地美可辛(demecolcine);地吖醌(diaziquone);依氟鸟氨酸(elformithine);醋酸羟吡咔唑(elliptinium acetate);埃博霉素类(epothilone);依托格鲁(etoglucid);硝酸镓;羟基脲;香菇多糖(lentinan);氯尼达明(lonidamine);美登木素生物碱类(maytansinoids),例如美登素(maytansine)和安丝菌素(ansamitocin));米托胍腙(mitoguazone);米托蒽醌(mitoxantrone);莫哌达醇(mopidamol);二胺硝吖啶(nitracrine);喷司他丁(pentostatin);苯来美特(phenamet);吡柔比星(pirarubicin);洛索蒽醌(losoxantrone);鬼臼酸(podophyllinic acid);2-乙基酰肼;丙卡巴肼(procarbazine);PSK多糖复合物;雷佐生(razoxane);根霉素(rhizoxin);西索菲兰(sizofiran);锗螺胺(spirogermanium);细交链孢菌酮酸(tenuazonic acid);三亚胺醌(triaziquone);2,2’,2”-三氯三乙胺;单端孢菌素类(trichothecenes)(尤其是T-2毒素、疣孢菌素A(verracurin A)、杆孢菌素A(roridin A)和蛇形菌素(anguidine));聚氨酯;长春地辛(vindesine);达卡巴嗪(dacarbazine);甘露醇氮芥(mannomustine);二溴甘露醇(mitobronitol);二溴卫矛醇(mitolactol);哌泊溴烷(pipobroman);加西托星(gacytosine);阿糖胞苷(arabinoside)(“Ara-C”);环磷酰胺;噻替哌;紫杉烷类(taxoids),例如紫杉醇(paclitaxel)和多西他塞(doxetaxel);苯丁酸氮芥(chloranbucil);吉西他滨;6-硫鸟嘌呤;巯基嘌呤;甲氨喋呤;铂配位络合物,例如顺铂、奥沙利铂和卡铂;长春碱(vinblastine);铂;依托泊苷(VP-16);异磷酰胺;米托蒽醌;长春新碱;长春瑞滨;诺安托(novantrone);替尼泊苷;依达曲沙;柔红霉素;氨基蝶呤;希罗达(xeloda);伊拜膦酸盐(ibandronate);伊立替康(例如,CPT-11);拓扑异构酶抑制剂RFS2000;二氟甲基鸟氨酸(DMFO);类视黄醇,例如视黄酸;卡培他滨;顺铂(CDDP)、卡铂、丙卡巴肼、二氯甲基二乙胺、环磷酰胺、喜树碱、异环磷酰胺、美法仑、苯丁酸氮芥、白消安、亚硝酸脲、放线菌素D、柔红霉素、多柔比星、博来霉素、普卡霉素(plicomycin)、丝裂霉素、依托泊苷(VP16)、他莫昔芬、雷洛昔芬、雌激素受体结合剂、泰素(taxol)、紫杉醇、多西他赛、吉西他滨、诺维本、法呢基蛋白转移酶抑制剂、反铂、5-氟尿嘧啶、长春新碱、长春碱和甲氨蝶呤,以及以上任一种的可药用盐、酸或衍生物。
B.放射治疗
放射治疗也称为放疗,即用电离辐射治疗癌症和其他疾病。电离辐射沉积能量,这通过损坏正被治疗的区域中细胞的遗传物质使得这些细胞不可能继续生长来损伤或破坏所述细胞。尽管辐射损害癌细胞和正常细胞二者,但是后者能够修复自己并正常运作。
根据本公开内容使用的放射治疗可包括但不限于使用γ-射线、X-射线和/或向肿瘤细胞定向递送放射性同位素。还考虑其他形式的DNA损伤因素,例如微波和UV辐照。最有可能所有这些因素对DNA、DNA的前体、DNA的复制和修复以及染色体的组装和维持引起广泛的损害。X射线的剂量范围为50至200伦琴每日剂量持续一段长的时间(3至4周)到2000至6000伦琴的单剂量。放射性同位素的剂量范围变化很大,取决于同位素的半衰期、所发射辐射的强度和类型以及赘生性细胞的摄取。
放射治疗可包括使用放射性标记的抗体将辐射剂量直接递送至癌症部位(放射免疫治疗)。抗体是由身体响应于抗原(被免疫系统识别为外源的物质)之存在而产生的高度特异性蛋白质。一些肿瘤细胞含有触发产生肿瘤特异性抗体的特异性抗原。大量的这些抗体可在实验室中制备并附着于放射性物质(称为放射性标记的过程)。一旦注射到体内,抗体就会主动寻找癌细胞,其被辐射的细胞杀伤(细胞毒性)作用破坏。这种方法可将对健康细胞的辐射损伤的风险降至最低。
适形放射治疗使用与正常的放射治疗相同的放射治疗机、直线加速器,但是金属块被放置在x射线束的路径中以改变其形状从而匹配癌症的形状。这确保了向肿瘤给予更高的辐射剂量。健康的周围细胞和附近的结构接受较低剂量的辐射,因此降低了副作用的可能性。已经开发了称为多叶准直器的装置并且其可用作金属块的替代物。多叶准直器由固定于直线加速器的多个金属片组成。可调整各层,使得放射治疗束可成形为治疗区域,而不需要金属块。放射治疗机的精确定位对于适形放射治疗非常重要,可在每次治疗开始时使用特殊的扫描机检查内脏的位置。
高分辨率强度调制的放射治疗也使用多叶准直器。在该治疗期间,在给予治疗的同时移动多叶准直器的层。该方法很可能实现治疗束的甚至更精确的成形,并且使放射治疗剂量在整个治疗区域上是恒定的。
尽管研究表明,适形放射治疗和强度调制放射治疗可降低放射治疗的副作用,但精确地对治疗区域进行成形有可能会阻止刚好在治疗区域外的微观癌细胞被破坏。这意味着使用这些专门的放射治疗技术,未来癌症复发的风险可更高。
科学家们也在寻找提高放射治疗有效性的方法。正在研究两种类型的研究中药物对经受辐射的细胞的影响。放射增敏剂使肿瘤细胞更可能被破坏,且放射防护剂保护正常组织免受辐射的影响。也正在研究使用热量的过热在使组织对辐射敏感方面的有效性。
C.免疫治疗
在癌症治疗的情况下,免疫治疗剂通常依赖于使用免疫效应细胞和分子来靶向和破坏癌细胞。曲妥珠单抗(HerceptinTM)是这样的例子。免疫效应物可以是例如对肿瘤细胞表面上的一些标志物特异的抗体。单独的抗体可充当治疗的效应物,或者其可募集其他细胞以实际影响细胞杀伤。抗体还可与药物或毒素(化学治疗剂、放射性核素、蓖麻毒素A链、霍乱毒素、百日咳毒素等)缀合,并且仅充当靶向剂。或者,效应物可以是携带表面分子的淋巴细胞,其直接或间接地与肿瘤细胞靶标相互作用。多种效应细胞包括细胞毒性T细胞和NK细胞。治疗方式(即,直接的细胞毒性活性和抑制或降低ErbB2)的组合将在治疗ErbB2过度表达的癌症中提供治疗益处。
在免疫治疗的一个方面中,肿瘤细胞必须具有适合靶向的一些标志物,即不存在于大多数其他细胞上的标志物。存在许多肿瘤标志物,并且这些肿瘤标志物中的任何一种可适合于在本公开内容的情况下的靶向。常见的肿瘤标志物包括癌胚抗原、前列腺特异性抗原、泌尿系肿瘤相关抗原(urinary tumor associated antigen)、胎儿抗原、酪氨酸酶(p97)、gp68、TAG-72、HMFG、唾液酸路易斯抗原、MucA、MucB、PLAP、雌激素受体、层粘连蛋白受体、erb B和p155。免疫治疗的一个作为替代的方面是将抗癌作用与免疫刺激作用组合。还存在免疫刺激分子,其包括:细胞因子(例如IL-2、IL-4、IL-12、GM-CSF、γ-IFN)、趋化因子(例如MIP-1、MCP-1、IL-8)和生长因子(例如FLT3配体)。使免疫刺激分子组合(无论作为蛋白质还是与肿瘤抑制剂组合使用基因递送)已经显示出增强抗肿瘤作用(Ju等,2000)。此外,可使用针对任何这些化合物的抗体来靶向本文中讨论的抗癌剂。
目前正在研究或正在使用的免疫治疗的实例是免疫佐剂,例如牛结核分枝杆菌(Mycobacterium bovis)、恶性疟原虫(Plasmodium falciparum)、二硝基氯苯和芳香族化合物(美国专利5,801,005和5,739,169;Hui和Hashimoto,1998;Christodoulides等,1998),细胞因子治疗,例如,干扰素α、β和γ;IL-1、GM-CSF和TNF(Bukowski等,1998;Davidson等,1998;Hellstrand等,1998),基因治疗,例如TNF、IL-1、IL-2、p53(Qin等,1998;Austin-Ward和Villaseca,1998;美国专利5,830,880和5,846,945)和单克隆抗体,例如,抗神经节苷脂GM2、抗HER-2、抗p185(Pietras等,1998;Hanibuchi等,1998;美国专利5,824,311)。考虑可使用本文中所述的基因沉默治疗进行一种或更多种抗癌治疗。
在主动免疫治疗中,通常与不同的细菌佐剂一起施用抗原肽、多肽或蛋白质、或者自体或同种异体肿瘤细胞组合物或“疫苗”(Ravindranath 和Morton,1991;Morton等,1992;Mitchell等,1993)。
在过继性免疫治疗中,患者的循环淋巴细胞或肿瘤浸润的淋巴细胞在体外被分离,被淋巴因子(例如IL-2)激活或用肿瘤坏死基因转导并被重新施用(Rosenberg等,1988;1989)。
D.外科手术
大约60%的癌症患者将进行某种类型的手术,其包括预防性、诊断性或分期、治愈性和姑息性外科手术。治愈性外科手术是可与其他治疗(例如本公开内容的治疗、化学治疗、放射治疗、激素治疗、基因治疗、免疫治疗和/或替代治疗)结合使用的癌症治疗。
治疗性手术包括其中全部或部分癌组织被物理去除、切除和/或破坏的切除术。肿瘤切除术是指物理去除肿瘤的至少一部分。除肿瘤切除术外,手术治疗包括激光手术、冷冻手术、电外科手术和显微控制的手术(莫氏手术(Mohs’surgery))。进一步考虑本公开内容可与移除浅表癌、癌前病变(precancer)或附带量的正常组织结合使用。
在切除部分或全部癌细胞、组织或肿瘤后,可在体内形成腔。治疗可通过灌注、直接注射或在该区域局部施用另外的抗癌治疗来完成。可重复这种治疗,例如每1、2、3、4、5、6或7天,或每1、2、3、4周和5周或每1、2、3、4、5、6、7、8、9、10、11或12个月。这些治疗也可以是不同的剂量。
在一些特定的实施方案中,在去除肿瘤后,用本公开内容的化合物进行的辅助治疗被认为在降低肿瘤的再复发方面特别有效。此外,本发明的化合物还可用于新辅助环境。
E.其他药剂
考虑其他药剂可与本公开内容一起使用。这些另外的药剂包括免疫调节剂,影响细胞表面受体上调和GAP连接的药剂、细胞抑制剂和分化剂、细胞黏附抑制剂、提高过度增殖细胞对凋亡诱导剂之敏感性的药剂或其他生物剂。免疫调节剂包括肿瘤坏死因子;干扰素α、β和γ;IL-2和其他细胞因子;F42K和其他细胞因子类似物;或MIP-1、MIP-1β、MCP-1、RANTES和其他趋化因子。进一步考虑细胞表面受体或其配体(例如Fas/Fas配体、DR4或DR5/TRAIL(Apo-2配体))的上调将通过建立对过度增殖细胞发挥作用的自分泌或旁分泌来增强本公开内容的凋亡诱导能力。通过提高GAP连接数来提高细胞间信号传导将提高对相邻过度增殖细胞群的抗过度增殖作用。在另一些实施方案中,细胞生长抑制剂或分化剂可与本公开内容组合使用以改善治疗的抗增殖效力。考虑细胞黏附抑制剂以改善本公开内容的效力。细胞黏附抑制剂的实例是黏着斑激酶(focal adhesion kinase,FAK)抑制剂和洛伐他汀。进一步考虑可与本公开内容组合使用提高过度增殖细胞对细胞凋亡之敏感性的其他试剂(例如抗体c225)以改善治疗效力。
在引入细胞毒性化学治疗药物后,癌症治疗中取得了许多进展。然而,化学治疗的后果之一是耐药表型的形成/获得和多重耐药性的形成。耐药性的形成仍然是治疗此类肿瘤的主要障碍,因此,显然需要例如基因治疗的替代方法。
与化学治疗、放射治疗或生物治疗结合使用的其他治疗形式包括过热,其是将患者组织暴露于高温(高至106°F)的过程。外部或内部加热装置可涉及局部、区域或全身过热的应用。局部过热涉及向小面积(例如肿瘤)施加热量。可从身体外部的装置的以靶向肿瘤的高频波在外部产生热量。内部热量可涉及无菌探针,包括薄的加热线或填充有温水、植入的微波天线或射频电极的中空管。
患者的器官或肢体被加热用于区域治疗,其使用产生高能量的装置(例如磁体)来实现。或者,可将患者的一些血液取出并加热,之后再灌注到将被内部加热的区域中。在癌症遍及全身的情况下也可实施全身加热。为此,可使用温水毯、热蜡、感应线圈和热室。
技术人员参考“Remington’s Pharmaceutical Sciences”第15版,第33章,特别是第624至652页。剂量必然会根据所治疗的对象的状况而发生一些变化。无论如何,负责施用的人员将决定个体对象的适当剂量。此外,对于人施用,制剂应符合FDA生物制品局标准要求的无菌性、致热原性、一般安全性和纯度标准。
F.抗生素
术语“抗生素”是可通过抑制细菌生长或杀伤细菌来治疗细菌感染的药物。不受理论束缚,认为抗生素可分为两大类:杀伤细菌的杀菌剂或减缓或阻止细菌生长的抑菌剂。
第一种市售抗生素在20世纪30年代发布。从那时起,许多不同的抗生素已经被开发并广泛开处方。2010年,平均每五个美国人中就有四个人每年被开抗生素处方。鉴于抗生素的普遍,细菌已开始对特定抗生素和抗生素机制产生抗性。不受理论束缚,抗生素与另一种抗生素组合使用可调节抗性并增强一种或这两种药剂的效力。
在一些实施方案中,抗生素可以分成很多种类别。在一些实施方案中,本公开内容的化合物可与另一种抗生素联合使用。在一些实施方案中,所述化合物可与靶向特定细菌类型的窄谱抗生素联合使用。在杀菌抗生素的一些非限制性实例中,包括青霉素、头孢菌素、多黏菌素、利福霉素类、闰年霉素(lipiarmycin)、喹诺酮类和磺胺类。在抑菌抗生素的一些非限制性实例中,包括大环内酯类、林可酰胺类或四环素类。在一些实施方案中,抗生素是氨基糖苷类,例如卡那霉素和链霉素;安沙霉素,例如利福昔明和格尔德霉素;碳头孢烯类(carbacephem),例如劳拉卡比(loracarbef);碳青霉烯类,例如厄他培南(ertapenem)、亚胺培南(imipenem);头孢菌素类,例如头孢氨苄、头孢克肟、头孢吡肟和头孢吡普;糖肽类,例如万古霉素或替考拉宁;林可酰胺类,例如林可霉素和克林霉素;脂肽类,例如达托霉素;大环内酯类,例如克拉霉素、螺旋霉素、阿奇霉素、泰利霉素;单环内酰胺类,例如氨曲南(aztreonam);硝基呋喃类,例如呋喃唑酮、呋喃妥因(nitrofurantoin);唑烷酮类,例如利奈唑胺(linezolid);青霉素类,例如阿莫西林、阿洛西林、氟氯西林、青霉素G;抗生素多肽类,例如杆菌肽、多黏菌素B和黏菌素;喹诺酮类,例如环丙沙星、左氧氟沙星和加替沙星;磺胺类,例如磺胺嘧啶银、磺胺米隆(mefenide)、磺胺地索辛(sulfadimethoxine)或柳氮磺吡啶(sulfasalazine);或四环素类,例如地美环素(demeclocycline)、多西环素(doxycycline)、米诺环素(minocycline)、土霉素(oxytetracycline)或四环素(tetracycline)。在一些实施方案中,化合物可与作用于分枝杆菌的药物组合,所述药物例如环丝氨酸、卷曲霉素、乙硫异烟胺、利福平(rifampicin)、利福布汀(rifabutin)、利福喷汀(rifapentine)和链霉素。考虑用于组合治疗的其他抗生素可包括胂凡纳明(arsphenamine)、氯霉素、磷霉素、夫西地酸(fusidic acid)、甲硝唑、莫匹罗星、平板霉素(platensimycin)、奎奴普丁(quinupristin)、达福普汀(dalfopristin)、甲砜霉素(thiamphenicol)、替加环素(tigecycline)、替硝唑或甲氧苄啶(trimethoprim)。
G.抗病毒剂
术语“抗病毒剂”是可用于治疗病毒感染的药物。通常来说,抗病毒剂通过两种主要机制发挥作用:阻止病毒进入细胞和抑制病毒合成。不受理论束缚,可通过使用模拟病毒相关蛋白并因此阻断细胞受体的试剂,或使用模拟细胞受体并因此阻断病毒相关蛋白的试剂来抑制病毒复制。此外,引起病毒脱壳的药剂也可用作抗病毒剂。
病毒抑制的第二种机制是阻止或中断病毒合成。这样的药物可靶向与病毒DNA复制相关的不同蛋白质,包括逆转录酶、整合酶、转录因子或核酶。此外,治疗剂通过充当反义DNA株、抑制蛋白质加工或组装的形成、或充当病毒蛋白酶抑制剂中断翻译。最后,抗病毒剂可在细胞中病毒产生后另外抑制病毒的释放。
此外,抗病毒剂可调节身体自身的免疫系统以对抗病毒感染。不受理论束缚,刺激免疫系统的抗病毒剂可用于很多种病毒感染。
在一些实施方案中,本公开内容提供了在与如上所述的抗病毒剂的组合治疗中使用所公开化合物的方法。在一些非限制性实例中,抗病毒剂是阿巴卡韦(abacavir)、阿昔洛维(aciclovir)、阿昔洛韦(acyclovir)、阿德福韦(adefovir)、金刚烷胺(amantadine)、安普那韦(amprenavir)、安普利近(ampligen)、阿比多尔(arbidol)、阿扎那韦(atazanavir)、atripla、balavir、boceprevirertet、西多福韦(cidofovir)、双汰芝(combivir)、度鲁特韦(dolutegravir)、地瑞那韦(darunavir)、地拉韦啶(delavirdine)、地达诺新(didanosine)、二十二烷醇、依度尿苷(edoxudine)、依法韦仑(efavirenz)、恩曲他滨(emtricitabine)、恩夫韦地(enfuvirtide)、恩替卡韦(entecavir)、ecoliever、泛昔洛韦(famciclovir)、福米韦生(fomivirsen)、福沙那韦(fosamprenavir)、膦甲酸(foscarnet)、膦乙醇(fosfonet)、更昔洛韦(ganciclovir)、伊巴他滨(ibacitabine)、imunovir、碘苷(idoxuridine)、咪喹莫特、茚地那韦(indinavir)、肌苷、干扰素(I型、II型和III型)、拉米夫定、洛匹那韦、洛韦胺、马拉韦罗(maraviroc)、吗啉胍(moroxydine)、美替沙腙(methisazone)、奈非那韦(nelfinavir)、奈韦拉平(nevirapine)、nexavir、奥司他韦(oseltamivir)、喷昔洛韦(penciclovir)、帕拉米韦(peramivir)、pleconaril、鬼臼毒素(podophyllotoxin)、雷特格韦(raltegravir)、利巴韦林、金刚乙胺(rimantadine)、利托那韦(ritonavir)、嘧啶、沙奎那韦(saquinavir)、索非布韦(sofosbuvir)、司他夫定(stavudine)、特拉匹韦(telaprevir)、替诺福韦、替诺福韦二吡呋酯(tenofovirdisoproxil)、替拉那韦(tipranavir)、三氟尿苷(trifluridine)、三协唯(trizivir)、醋胺金刚胺(tromantadine)、特鲁瓦达(truvada)、traporved、伐昔洛韦(valaciclovir)、缬更昔洛韦(valganciclovir)、vicriviroc、阿糖腺苷(vidarabine)、viramidine、扎西他滨(zalcitabine)、扎那米韦(zamamivir)、或齐多夫定(viramidine)。在一些实施方案中,抗病毒剂是抗逆转录病毒剂、融合抑制剂、整合酶抑制剂、干扰素、核苷类似物、蛋白酶抑制剂、逆转录酶抑制剂、协同增强剂或天然产物(例如茶树油)。
还应该指出的是,任何前述治疗本身可证明其在治疗癌症或其感染中有用。
IV定义
当在化学基团的情况下使用时:“氢”意指-H;“羟基”意指-OH;“氧代”意指=O;“羰基”意指-C(=O)-;“羧基”意指-C(=O)OH(也写作-COOH或-CO2H);“卤代”独立地意指-F、-Cl、-Br或-I;“氨基”意指-NH2;“羟氨基”意指-NHOH;“硝基”意指-NO2;亚氨基意指=NH;“氰基”意指-CN;“异氰酸酯”意指-N=C=O;“叠氮基”意指-N3;在一价的情况下,“磷酸酯”意指-OP(O)(OH)2或其去质子化形式;在二价的情况下,“磷酸酯”意指-OP(O)(OH)O-或其去质子化形式;“巯基”意指-SH;并且“硫代”意指=S;“磺酰基”意指-S(O)2-;并且“亚磺酰基”意指-S(O)-。
在化学式的情况下,符号“-”意指单键,“=”意指双键,且“≡”意指三键。符号“----”表示任选的键,其如果存在的话则为单键或双键。符号表示单键或双键。因此,式涵盖例如 并且应了解,没有一个这样的环原子形成多于一个双键的一部分。此外,注意,当连接一个或两个立体异构源(stereogenic)原子时,共价键符号“-”并不表示任何优选的立体化学。相反,其涵盖所有的立体异构体及其混合物。当与键垂直交叉绘制时(例如,对于甲基的),符号表示该基团的连接点。注意,连接点通常仅对于较大的基团以这种方式指示以帮助读者明确地识别连接点。符号意指单键,其中与楔形物的较厚端连接的基团“离开页面”。符号意指单键,其中与楔形物的较厚端连接的基团“进入页面”。符号意指单键,其中双键周围的几何形状(例如,E或Z)未限定。因此,指示两种选择以及其组合。在本申请中示出的结构的原子上任何未限定的化合价隐含地表示与该原子键合的氢原子。碳原子上的粗点表示连接至该碳上的氢定向于纸平面之外。
当环体系上基团“R”被描述为“浮动基团(floating group)”时,例如,在下式中:
则R可取代与任何环原子连接的任何氢原子,包括所描绘的、隐含的或明确限定的氢,只要形成稳定的结构即可。当在稠环体系上的基团“R”被描述为“浮动基团”时,例如在下式中:
则除非另有说明,否则R可替换与稠环之一的任一环原子连接的任一氢。可替换的氢包括所描绘的氢(例如,上式中与氮连接的氢)、隐含的氢(例如,上式未示出但理解为存在的氢)、明确限定的氢和任选的其存在取决于环原子之特性的氢(例如,当X等于-CH-时,与基团X连接的氢),只要形成稳定的结构即可。在所示的实例中,R可位于稠环体系的5元环或6元环上。在上式中,紧随在括号中的基团“R”之后的下标字母“y”表示数字变量。除非另有规定,否则该变量可以是0、1、2或任何大于2的整数,其仅受环或环体系的可替换氢原子的最大数目限制。
对于化学基团和化合物类别,基团或类别中碳原子数如下所示:“Cn”限定在该基团/类别中碳原子的确切数目(n)。“C≤n”限定可在基团/类别中的碳原子的最大数目(n),其中对于所讨论的基团/类别,最小数目尽可能小,例如,应理解,在基团“烯基(C≤8)”或类别“烯烃(C≤8)”中最小碳原子数目为两个。“烷氧基(C≤10)”表示具有1至10个碳原子的烷氧基。“Cn-n’”限定基团中碳原子的最小数目(n)和最大数目(n’)。因此,“烷基(C2-10)”表示具有2至10个碳原子的那些烷基。这些碳数指示符可在其所修饰的化学基团或类别之前或之后,并且可包括或可不包括在括号中,而不表示含义的任何变化。因此,术语“C5烯烃”、“C5-烯烃”、“烯烃(C5)”和“烯烃C5”都是同义词。当本文中限定的任何化学基团或化合物类别被术语“经取代”修饰时,不计算取代氢原子的部分中的任何碳原子。因此,具有总共7个碳原子的甲氧基己基是经取代烷基(C1-6)的实例。
当用于修饰化合物或化学基团时,术语“饱和”意指化合物或化学基团不具有碳-碳双键且不具有碳-碳三键,除非如下所述。当该术语用于修饰原子时,其意指该原子不是任何双键或三键的一部分。在饱和基团的经取代形式的情况下,可存在一个或更多个碳氧双键或碳氮双键。且当存在这样的键时,则不排除可作为酮-烯醇互变异构或亚胺/烯胺互变异构的一部分出现的碳-碳双键。当术语“饱和”用于修饰物质的溶液时,其意指更多的该物质不能溶解在该溶液中。
当在没有“经取代”修饰语的情况下使用时,术语“脂肪族”表示如此修饰的化合物或化学基团是无环或环状但非芳香族的烃化合物或基团。在脂肪族化合物/基团中,碳原子可以以直链、支链或非芳香族环(脂环族)连接在一起。脂肪族化合物/基团可以是饱和的(其通过单碳-碳键(烷烃/烷基)连接),或不饱和的(与一个或更多个碳-碳双键(烯烃/烯基)或一个或更多个碳-碳三键(炔烃/炔基)连接)。
当用于修饰化合物或化学基团时,术语“芳香族”是指在完全共轭的环状π体系中具有4n+2个电子的平面不饱和原子环。
当在没有“经取代”修饰语的情况下使用时,术语“烷基”是指这样的单价饱和脂肪族基团,其具有碳原子作为连接点,直链或支链的无环结构,并且不含碳和氢以外的原子。基团-CH3(Me)、-CH2CH3(Et)、-CH2CH2CH3(n-Pr或丙基)、-CH(CH3)2(i-Pr,iPr或异丙基)、-CH2CH2CH2CH3(n-Bu)、-CH(CH3)CH2CH3(仲丁基)、-CH2CH(CH3)2(异丁基)、-C(CH3)3(叔丁基、t-butyl、t-Bu或tBu)和-CH2C(CH3)3(新戊基)是烷基的一些非限制性实例。当不使用“经取代”修饰语时,术语“烷二基”是指这样的二价饱和脂族基团,其具有一个或两个饱和碳原子作为连接点,直链或支链的无环结构,不含碳-碳双键或三键,并且不含除碳和氢之外的原子。基团-CH2-(亚甲基)、-CH2CH2-、-CH2C(CH3)2CH2-和-CH2CH2CH2-是烷二基的一些非限制性实例。当在没有“经取代”修饰语的情况下使用时,术语“亚烷基”是指二价基团=CRR’,其中R和R’独立地为氢或烷基。亚烷基的一些非限制性实例包括:=CH2、=CH(CH2CH3)和=C(CH3)2。“烷烃”是指具有式H-R的一类化合物,其中R是如上文所定义的术语烷基。当这些术语中的任何一个与“经取代”修饰语一起使用时,一个或更多个氢原子已被-OH、-F、-Cl、-Br、-I、-NH2、-NO2、-CO2H、-CO2CH3、-CN、-SH、-OCH3、-OCH2CH3、-C(O)CH3、-NHCH3、-NHCH2CH3、-N(CH3)2、-C(O)NH2、-C(O)NHCH3、-C(O)N(CH3)2、-OC(O)CH3、-NHC(O)CH3、-S(O)2OH或-S(O)2NH2独立地取代。以下基团是经取代烷基的一些非限制性实例:-CH2OH、-CH2Cl、-CF3、-CH2CN、-CH2C(O)OH、-CH2C(O)OCH3、-CH2C(O)NH2、-CH2C(O)CH3、-CH2OCH3、-CH2OC(O)CH3、-CH2NH2、-CH2N(CH3)2和-CH2CH2Cl。术语“卤代烷基”是经取代烷基的子集,其中氢原子替换被限制为卤素(即-F、-Cl、-Br或-I),使得除碳、氢和卤素之外不存在其他原子。基团-CH2Cl是卤代烷基的一些非限制性实例。术语“氟代烷基”是经取代的烷基的子集,其中氢原子替换被限制为氟,使得除碳、氢和氟之外不存在其他原子。基团-CH2F、-CF3和-CH2CF3是氟代烷基的一些非限制性实例。
当在没有“经取代”修饰语的情况下使用时,术语“环烷基”是指这样的单价饱和脂肪族基团,其具有碳原子作为连接点(所述碳原子形成一个或更多个非芳香族环结构的一部分),不含碳-碳双键或三键,并且不含除碳和氢以外的原子。非限制性实例包括:-CH(CH2)2(环丙基)、环丁基、环戊基或环己基(Cy)。当在没有“经取代”修饰语的情况下使用时,术语“环烷二基”是指这样的二价饱和脂肪族基团,其具有两个碳原子作为连接点,不含碳-碳双键或三键,并且不含除碳和氢以外的原子。基团是环烷二基的一些非限制性实例。“环烷烃”是指具有式H-R的一类化合物,其中R是上文所定义的术语环烷基。当这些术语中的任何一个与“经取代”修饰语一起使用时,一个或更多个氢原子已被-OH、-F、-Cl、-Br、-I、-NH2、-NO2、-CO2H、-CO2CH3、-CN、-SH、-OCH3、-OCH2CH3、-C(O)CH3、-NHCH3、-NHCH2CH3、-N(CH3)2、-C(O)NH2、-C(O)NHCH3、-C(O)N(CH3)2、-OC(O)CH3、-NHC(O)CH3、-S(O)2OH或-S(O)2NH2独立地取代。
当在没有“经取代”修饰语的情况下使用时,术语“杂环烷基”是指具有碳原子或氮原子作为连接点的一价非芳香族基团,所述碳原子或氮原子形成一个或更多个非芳香族环的一部分结构,其中至少一个环原子是氮、氧或硫,并且其中杂环烷基不包含碳、氢、氮、氧和硫之外的原子。如果存在多于一个环,那么这些环可以是稠合的或未稠合的。如本文中使用的术语不排除存在与环或环体系连接的一个或更多个烷基(碳数限制允许)。此外,该术语不排除在环或环体系中存在一个或更多个双键,前提是所得基团仍为非芳香族。杂环烷基的一些非限制性实例包括氮杂环丙烷基、氮杂环丁烷基、吡咯烷基、哌啶基、哌嗪基、吗啉基、硫代吗啉基、四氢呋喃基、四氢噻吩基、四氢吡喃基、吡喃基、氧杂环丙烷基和氧杂环丁烷基(oxetanyl)。术语“N-杂环烷基”是指具有氮原子作为连接点的杂环烷基。N-吡咯烷基是这样的基团的一个例子。当这些术语与“经取代”修饰语一起使用时,一个或更多个氢原子已被-OH、-F、-Cl、-Br、-I、-NH2、-NO2、-CO2H、-CO2CH3、-CN、-SH、-OCH3、-OCH2CH3、-C(O)CH3、-NHCH3、-NHCH2CH3、-N(CH3)2、-C(O)NH2、-C(O)NHCH3、-C(O)N(CH3)2、-OC(O)CH3、-NHC(O)CH3、-S(O)2OH或-S(O)2NH2独立地取代。
当在没有“经取代”修饰语的情况下使用时,术语“酰基”是指基团-C(O)R,其中R为氢、烷基、环烷基或芳基,正如上文所定义的那些术语。基团-CHO、-C(O)CH3(乙酰基,Ac)、-C(O)CH2CH3、-C(O)CH(CH3)2、-C(O)CH(CH2)2、-C(O)C6H5和-C(O)C6H4CH3是酰基的一些非限制性实例。“硫代酰基”以类似的方式定义,不同之处在于基团-C(O)R的氧原子已被替换为硫原子,即-C(S)R。术语“醛”对应于如上所定义的烷基,与-CHO基团连接。当这些术语中的任何一个与“经取代”修饰语一起使用时,一个或更多个氢原子(包括与羰基或硫代羰基的碳原子直接连接的氢原子,如果有的话)已经被-OH、-F、-Cl、-Br、-I、-NH2、-NO2、-CO2H、-CO2CH3、-CN、-SH、-OCH3、-OCH2CH3、-C(O)CH3、-NHCH3、-NHCH2CH3、-N(CH3)2、-C(O)NH2、-C(O)NHCH3、-C(O)N(CH3)2、-OC(O)CH3、-NHC(O)CH3、-S(O)2OH或-S(O)2NH2独立地取代。基团-C(O)CH2CF3、-CO2H(羧基)、-CO2CH3(甲基羧基)、-CO2CH2CH3、-C(O)NH2(氨甲酰基)和-CON(CH3)2是经取代酰基的一些非限制性实例。
当在没有“经取代”修饰语的情况下使用时,术语“烷氧基”是指基团-OR,其中R为烷基,正如上文所定义的该术语。非限制性实例包括:-OCH3(甲氧基)、-OCH2CH3(乙氧基)、-OCH2CH2CH3、-OCH(CH3)2(异丙氧基)、-OC(CH3)3(叔丁氧基)、-OCH(CH2)2、-O-环戊基和-O-环己基。当在没有“经取代”修饰语的情况下使用时,术语“环烷氧基”、“烯氧基”、“炔氧基”、“芳氧基”、“芳烷氧基”、“杂芳氧基”、“杂环烷氧基”和“酰氧基”是指定义为-OR的基团,其中R分别为环烷基、烯基、炔基、芳基、芳烷基、杂芳基、杂环烷基和酰基。术语“烷氧基二基”是指二价基团-O-烷二基-、-O-烷二基-O-或-烷二基-O-烷二基-。当在没有“经取代”修饰语的情况下使用时,术语“烷硫基”和“酰硫基”是指基团-SR,其中R分别是烷基和酰基。术语“醇”对应于如上定义的烷烃,其中至少一个氢原子已替换为羟基。术语“醚”对应于如上定义的烷烃,其中至少一个氢原子已替换为烷氧基。当这些术语中的任何一个与“经取代”修饰语一起使用时,一个或更多个氢原子已被-OH、-F、-Cl、-Br、-I、-NH2、-NO2、-CO2H、-CO2CH3、-CN、-SH、-OCH3、-OCH2CH3、-C(O)CH3、-NHCH3、-NHCH2CH3、-N(CH3)2、-C(O)NH2、-C(O)NHCH3、-C(O)N(CH3)2、-OC(O)CH3、-NHC(O)CH3、-S(O)2OH或-S(O)2NH2独立地取代。
当在没有“经取代”修饰语的情况下使用时,术语“烷基氨基”是指基团-NHR,其中R为烷基,正如上文所定义的该术语。非限制性实例包括:-NHCH3和-NHCH2CH3。当在没有“经取代”修饰语的情况下使用时,术语“二烷基氨基”是指基团-NRR’,其中R和R’可以是相同或不同的烷基,或者R和R’可一起表示烷二基。二烷基氨基的一些非限制性实例包括:-N(CH3)2和-N(CH3)(CH2CH3)。当在没有“经取代”修饰语的情况下使用时,术语“环烷基氨基”、“烯基氨基”、“炔基氨基”、“芳基氨基”、“芳烷基氨基”、“杂芳基氨基”、“杂环烷基氨基”、“烷氧基氨基”和“烷基磺酰基氨基”是指定义为-NHR的基团,其中R分别为环烷基、烯基、炔基、芳基、芳烷基、杂芳基、杂环烷基、烷氧基和烷基磺酰基。芳基氨基的一些非限制性实例是-NHC6H5。当在没有“经取代”修饰语的情况下使用时,术语“酰氨基”(酰基氨基)是指基团-NHR,其中R为酰基,正如上文所定义的该术语。酰氨基的一些非限制性实例是-NHC(O)CH3。当在没有“经取代”修饰语的情况下使用时,术语“烷基亚氨基”是指二价基团=NR,其中R为烷基,正如上文所定义的该术语。术语“烷氨二基”是指二价基团-NH-烷二基-、-NH-烷二基-NH-或-烷二基-NH-烷二基-。当这些术语中的任何一个与“经取代”修饰语一起使用时,与碳原子连接的一个或更多个氢原子已被-OH、-F、-Cl、-Br、-I、-NH2、-NO2、-CO2H、-CO2CH3、-CN、-SH、-OCH3、-OCH2CH3、-C(O)CH3、-NHCH3、-NHCH2CH3、-N(CH3)2、-C(O)NH2、-C(O)NHCH3、-C(O)N(CH3)2、-OC(O)CH3、-NHC(O)CH3、-S(O)2OH或-S(O)2NH2独立地取代。基团-NHC(O)OCH3和-NHC(O)NHCH3是经取代的酰氨基的一些非限制性实例。
当与权利要求书和/或说明书中的术语“包含”一起使用时,使用单词“一个”或“一种”可以意味着“一个/种”,但是它也符合“一个/种或更多个/种”、“至少一个/种”、“一个/种或多于一个/种”的含义。
贯穿本申请中,术语“约”用于表示值包括用于确定值的方法、装置误差的固有变化或研究对象之间存在的变化。
“活性成分”(AI)(也称为活性化合物、活性物质、活性剂、药用剂、药剂、生物活性分子或治疗化合物)是药用药物或杀虫剂中的具有生物活性的成分。类似的术语活性药物成分(active pharmaceutical Ingredient,API)和主体活性剂(bulk active)也用于药物中,并且术语活性物质可用于杀虫剂制剂。
术语“包含”、“具有”和“包括”是开放式连接动词。这些动词中一种或更多种的形式或时态,例如“包含(comprises)”、“包含(comprising)”、“具有(has)”、“具有(having)”、“包括(includes)”和“包括(including)”也是开放式的。例如,“包含”、“具有”或“包括”一个或更多个步骤的任何方法不限于仅具有那些一个或更多个步骤并且还包括其他未列出的步骤。
在说明书和/或权利要求书中使用的术语“有效的”意指足以实现期望的、预期的或想要的结果。当在用化合物治疗患者或对象的情况下使用时,“有效量”、“治疗有效量”或“药学有效量”意指当向对象或患者施用以治疗或预防疾病时化合物的量是足以实现疾病的这种治疗或预防的量。
“赋形剂”是与药物、药物组合物、制剂或药物递送系统的活性成分一起配制的可药用物质。赋形剂可用于例如使组合物稳定、使组合物增大(因此当用于此目的时通常称为“填充剂(bulking agent)”、“填料”或“稀释剂”),或者赋予最终剂量形式中的活性成分以治疗性增强,例如促进药物吸收、降低黏度或增强溶解度。赋形剂包括抗黏附剂、黏合剂、涂料、着色剂、崩解剂、矫味剂、助流剂、润滑剂、防腐剂、吸着剂、甜味剂和载剂(vehicle)的可药用形式。充当输送活性成分的介质的主要赋形剂通常称为载剂。赋形剂也可用于制造过程,例如除了有助于体外稳定性(例如防止在预期的保质期内变性和聚集)外,还例如通过促进粉末流动性或非黏性性质有助于活性物质的处理。赋形剂的适用性将通常根据施用途径、剂量形式、活性成分以及其他因素而变化。
本文中使用的术语“IC50”是指为所获得的最大响应之50%的抑制剂量。这种定量量度表明抑制给定的生物、生化或化学过程(或过程的组分,即酶、细胞、细胞受体或微生物)的一半需要多少特定药物或其他物质(抑制剂)。
第一化合物的“异构体”是其中每个分子含有与第一化合物相同的组成原子的独立化合物,但是三维中这些原子的构型不同。
本文中使用的术语“患者”或“对象”是指活的哺乳动物生物体,例如人、猴、牛、绵羊、山羊、狗、猫、小鼠、大鼠、豚鼠或其转基因物种。在某些实施方案中,患者或对象是灵长类。人患者的一些非限制性实例是成年人、青少年、婴儿和胎儿。
本文中通常使用的“可药用”是指在合理的医学判断范围内适用于与人和动物的组织、器官和/或体液接触而无过度的毒性、刺激性、变态反应的与合理的效益/风险比相称的其他问题或并发症的那些化合物、材料、组合物和/或剂量形式。
“可药用盐”意指本公开内容化合物的盐,其是如上定义的可药用的并且具有期望的药理学活性。这样的盐包括与无机酸形成的酸加成盐,所述无机酸例如盐酸、氢溴酸、硫酸、硝酸、磷酸等;或与有机酸形成的酸加成盐,所述有机酸例如1,2-乙二磺酸、2-羟基乙磺酸、2-萘磺酸、3-苯基丙酸、4,4’亚甲基双(3-羟基-2-烯-1-羧酸)、4-甲基双环[2.2.2]辛-2-烯-1-羧酸、乙酸、脂肪族单羧酸和二羧酸、脂肪族硫酸、芳香族硫酸、苯磺酸、苯甲酸、樟脑磺酸、碳酸、肉桂酸、柠檬酸、环戊烷丙酸、乙磺酸、富马酸、葡庚糖酸、葡糖酸、谷氨酸、乙醇酸、庚酸、己酸、羟基萘甲酸、乳酸、月桂基硫酸、马来酸、苹果酸、丙二酸、扁桃酸、甲磺酸、黏康酸、o-(4-羟基苯甲酰基)苯甲酸、草酸、对氯苯磺酸、苯基取代的烷酸、丙酸、对甲苯磺酸、丙酮酸、水杨酸、硬脂酸、琥珀酸、酒石酸、叔丁基乙酸、三甲基乙酸等。可药用盐还包括当存在酸性质子时能够可与无机或有机碱反应形成的碱加成盐。可接受的无机碱包括氢氧化钠、碳酸钠、氢氧化钾、氢氧化铝和氢氧化钙。可接受的有机碱包括乙醇胺、二乙醇胺、三乙醇胺、氨丁三醇、N-甲基葡糖胺等。应认识到,构成本发明的任何盐的一部分的特定阴离子或阳离子不是关键的,只要该盐作为整体在药理学上是可接受的即可。可药用盐及其制备和使用方法的另外的实例示于Handbook of Pharmaceutical Salts:Properties,andUse(P.H.Stahl和C.G.Wermuth编辑,Verlag Helvetica Chimica Acta,2002)中。
“可药用载体”、“药物载体”或简称“载体”是与活性成分药物一起配制的可药用物质,其参与携带、递送和/或运输化学试剂。药物载体可以用于改善药物的递送和有效性,包括例如控制释放技术以调节药物生物利用度、降低药物代谢和/或降低药物毒性。一些药物载体可提高药物递送至特定靶部位的有效性。载体的实例包括:脂质体、微球(例如,由聚(乳酸-乙醇酸)共聚物制成)、白蛋白微球、合成聚合物、纳米纤维、蛋白质-DNA复合物、蛋白质缀合物、红细胞、病毒微体(virosome)和树枝状聚合物。
“药用药物”(也称为药物、药物制备物、药物组合物、药物制剂、药物产品、医药产品、药、药品、药剂或简称药物)是用于诊断、治愈、治疗或预防疾病的药物。活性成分(active ingredient,AI)(如上所定义)是药用药物或杀虫剂中具有生物活性的成分。在医学中也使用类似的术语活性药物成分(API)和主体活性剂,且术语活性物质可用于杀虫剂制剂。某些药物和杀虫剂产品可含有多于一种活性成分。与活性成分相反,非活性成分通常在药用情况中被称为赋形剂(如上所定义)。
“预防”或“防止”包括:(1)在可能处于疾病风险和/或易患疾病但尚未经历或显示疾病的任何或所有病理状况或症状的对象或患者中抑制疾病的发作,和/或(2)在可能处于疾病风险和/或易患疾病但尚未经历或显示疾病的任何或全部病理状况或症状的对象或患者中减缓疾病之病理状况或症状的发作。
“治疗”包括(1)在经历或显示疾病之病理状况或症状的对象或患者中抑制疾病(例如,阻止病理状况或症状的进一步发展),(2)在经历或显示疾病之病理状况或症状的对象或患者中改善疾病(例如,逆转病理状况或症状),和/或(3)在经历或显示疾病之病理状况或症状的对象或患者中实现疾病的任何可测量的降低。
上述定义代替通过引用并入本文的任何参考文献中的任何冲突定义。然而,定义某些术语的事实不应被视为指示任何未定义的术语是不明确的。相反,认为所用的所有术语明确地描述本发明,使得本领域普通技术人员可理解本公开内容的范围和实践。
V.实施例
包含以下实施例以示出本公开内容的一些优选实施方案。本领域技术人员应理解,在遵循发明人发现的代表技术的实施例中公开的技术在本发明的实践中运行良好,并因此可认为构成其实践的优选模式。然而,根据本公开内容,本领域技术人员应当理解,在不脱离本公开内容的精神和范围的情况下,可对所公开的具体实施方案进行许多改变,并仍然获得相同或相似的结果。
实施例1-方法和材料
A.材料
单体甲基丙烯酸2-(二乙基氨基)乙酯(DEA-MA)和甲基丙烯酸2-氨基乙基酯(AMA-MA)购买自Polyscience Company。卵清蛋白和OVA257-263、CpG ODN购买自Invivogen。ImjectAlum购自Thermo Scientific,LPS和聚(I∶C)购买自Sigma-Aldrich。OVA257-280(SIINFEKLTEWTSSNVMEERKIKV(SEQ ID NO:27))、E743-62(GQAEPDRAHYNIVTFCCKCD(SEQ IDNO:26))、E749-57(RAHYNIVTF(SEO ID NO:28))、Gp10021-41(VGALEGSRNQDWLGVPRQLVT(SEQ IDNO:29))、Trp1214-237(SHEGPAFLTWHRYHLLQLERDMQE(SEQ ID NO:5))、Trp2173-196(QPQIANCSVYDFFVWLHYYSVRDT(SEQ ID NO:6))、ObsllT1764M(EGVELCPGNKYEMRRHGTTHSLVIHD(SEQ ID NO:7))、Kif18bK739N(PSKPSFQEFVDWENVSPELNSTDQPFL(SEQ ID NO:10))、Def8R255G(SHCHWNDLAVIPAGVVHNWDFEPRKVS(SEO ID NO:30))、Reps1P45A(GRVLELFRAAQLANDVVLQIMELCGATR(SEQ ID NO:31))、AdpgkR304M(GIPVHLELASMTNMELMSSIVHQQVFPT(SEQ ID NO:32))、Dpagtlv213L(EAGQSLVISASIIVFNLLELEGDYR(SEQ ID NO:33))由Biomatik合成。PEG-PLA购买自AdvancedPolymer Materials Inc.(Montreal,QC,Canada)。其他溶剂或试剂购买自Sigma-Aldrich或Fisher Scientific Inc.。
B.甲基丙烯酸酯单体的合成
在使用前,将单体AMA-MA在异丙醇和乙酸乙酯(3∶7)中重结晶两次。遵循先前的出版物(Zhou等,2011;2012)合成单体,包括甲基丙烯酸2-(乙基丙基氨基)乙酯(EPA-MA)、甲基丙烯酸2-(二丙基氨基)乙酯(DPA-MA)、甲基丙烯酸2-(二丁基氨基)乙酯(DBA-MA)和甲基丙烯酸2-(二戊基氨基)乙酯(D5A-MA)、甲基丙烯酸2-(五亚甲基亚氨基)乙酯(C6A-MA)、甲基丙烯酸2-(六亚甲基亚氨基)乙酯(C7A-MA)。遵循先前发表的程序(Zhou等,2011;2012)合成新单体,包括甲基丙烯酸2-(七亚甲基亚氨基)乙酯(C8A-MA)、甲基丙烯酸2-(4-甲基亚哌啶基亚氨基)乙酯(C6S1A-MA)、甲基丙烯酸2-(3,5-二甲基亚哌啶基亚氨基)乙酯(C6S2A-MA)。以下是所述新单体的化学表征:
甲基丙烯酸2-(七亚甲基亚氨基)乙酯(C8A-MA):
1H NMR(TMS,CDCl3,ppm):6.10(br,1H,CHH=C(CH3)-),5.54(br,1H,CHH=C(CH3)-),4.19(t,J=6.1Hz,2H,-OCH2CH2N-),2.77(t,J=6.1Hz,2H,-OCH2CH2N-),2.60(td,4H,-N(CH2CH2CH2)2CH2),1.94(m,3H,CH2=C(CH3)-),1.61(tdd,2H,-N(CH2CH2CH2)2CH2),1.54(td,8H,-N(CH2CH2CH2)2CH2).
甲基丙烯酸2-(4-甲基亚哌啶基亚氨基)乙酯(C6S1A-MA):
1H NMR(TMS,CDCl3,ppm):6.07(br,1H,CHH=C(CH3)-),5.53(br,1H,CHH=C(CH3)-),4.26(m,2H,-OCH2CH2N-),2.88(m,2H,-OCH2CH2N-),2.65(m,2H,-N(CHHCH2)2CHCH3),2.04(tt,2H,-N(CHHCH2)2CHCH3),1.92(m,3H,CH2=C(CH3)-),1.59(m,2H,-N(CH2CHH)2CHCH3),1.31(m,lH,-CHCH3),1.21(m,2H,-N(CH2CHH)2CHCH3),0.89(d,3H,-CHCH3).
甲基丙烯酸2-(3,5-二甲基亚哌啶基亚氨基)乙酯(C6S2A-MA):
1H NMR(TMS,CDCl3,ppm):6.09(br,1H,CHH=C(CH3)-),5.55(br,1H,CHH=C(CH3)-),4.28(t,2H,-OCH2CH2N-),2.85(ddt,2H,-OCH2CH2N-),2.66(t,2H,-N(CHHCHCH3)2CH2),1.94(m,3H,CH2=C(CH3)-),1.68(m,3H,-N(CH2CHCH3)2CHH),1.57(t,2H,-N(CH2CHCH3)2CH2),0.93(d,1H,-N(CH2CHCH3)2CHH),0.84(d,3H,-N(CH2CHCH3)2CH2).
C.PEG-b-PR嵌段共聚物的合成
遵循先前报道的类似操作(Tsavrevsky等,2007),通过原子转移自由基聚合(ATRP)合成PEG-b-PR共聚物。无染料共聚物用于聚合物表征。以PEG-b-PDPA为例举例说明该操作。首先,将DPA-MA(1.48g,7mmol),PMDETA(21μL,0.1mmol)和MeO-PEG114-Br(0.5g,0.1mmol)添加到聚合管中。然后添加2-丙醇(2mL)和DMF(2mL)的混合物以溶解单体和引发剂。在冷冻-泵-解冻三次循环以除去氧气后,在氮气氛下将CuBr(14mg,0.1mmol)添加到聚合管中,并将该管在真空中密封。在40℃下进行聚合持续10小时。聚合后,将反应混合物用10mL THF稀释,并通过中性Al2O3柱以除去催化剂。通过旋转蒸发除去THF溶剂。将剩余物在蒸馏水中透析并冻干以得到白色粉末。合成后,通过1H NMR和凝胶渗透色谱(GPC)表征聚合物。
D.PEG-b-(PR-r-染料)嵌段共聚物的合成
将AMA-MA引入到PEG-b-PR共聚物中用于染料的缀合。遵循上述操作合成PEG-b-(PR-r-AMA)共聚物(Zhou等,2011;2012)。通过控制AMA-MA单体与引发剂的进料比(比值=1)将一个伯氨基引入到每个聚合物链中。合成后,将PEG-b-(PR-r-AMA)(10mg)溶解在2mLDMF中。然后添加NHS-酯(1.5当量的染料-NHS)。在过夜反应后,通过制备型凝胶渗透色谱法(PLarian Prep 10m 10E3柱,Varian,THF作为洗脱剂,5mL/min)纯化共聚物,以除去游离染料分子。将生成的PEG-b-(PR-r-染料)共聚物冻干并保持在-20℃下储存。
E.胶束纳米粒的制备
遵循先前公开的溶剂蒸发方法(Zhou等人,2012)制备胶束。在PEG-b-PC7A的实例中,首先将10mg共聚物溶解在1mL甲醇中,并随后在超声处理下将其逐滴添加到4mL蒸馏水中。使用微超滤系统(MW=100KD)将混合物过滤4次以除去THF。然后添加蒸馏水以将聚合物浓度调节至10mg/mL作为储备溶液。在胶束形成后,通过动态光散射(DLS,Malvern MicroV型,氦-氖激光,λ=632nm)表征纳米粒的流体动力学直径(Dh)。
F.OVA-PC7A亲和力测定
设计FRET实验以研究在不同比例下的聚合物和蛋白质相互作用。在典型的操作中,将Cy3.5缀合的PC7A(100μg/mL)与Alexa Fluor 647标记的OVA(20μg/mL)在PBS缓冲液(pH 7.4)中孵育。孵育0.5小时后,使用Hitachi荧光计(F-7500型)获得荧光发射光谱。样品在590nm处激发,并且在600至750nm收集发射光谱。
G淋巴结成像
为了研究NP是否可在引流淋巴结中积累,本发明人用吲哚菁绿(ICG,ex/em=800/820nm)标记PC7A共聚物。将ICG编码的PC7A NP(每只小鼠30μg)皮下注射到C57BL/6小鼠的尾基部。使用临床摄相机对NP分布进行成像。在注射NP之后24小时处死动物,切除主要器官和腹股沟和腋窝的LN并成像。
H.通过二硫键将肽引入NP
为了将肽引入到PC7A NP的核心中,在烧瓶中将PEG-b-P(C7A-r-AMA)和(丙酸3-(2-吡啶基二硫代)琥珀酰亚胺基酯)(SPDP,是PC7A的-NH2的1.5倍)用DMF溶解。将混合物在室温下搅拌24小时。将混合物用甲醇稀释并过滤4次以除去未反应的SDPD和副产物。然后将SH-肽溶解在PBS(pH 7.4)中并添加到聚合物溶液中。孵育6小时后,将混合物过滤4次以除去未反应的肽和副产物。将肽-PC7A缀合物冻干并保持在-80℃下储存。胶束溶液的制备使用先前描述的方案。对于NP表面上的肽缀合,使用相同的操作,只是用哌啶预处理Fmoc-PC7A以脱保护。
I.动物和细胞
所有动物操作伦理合规并且在德克萨斯州西南医学中心的动物管理和使用委员会(the Institutional Animal Care and Use Committee)的批准下进行。从UT西南繁育中心获得雌性C57BL/6小鼠(6-8周)。INF-α/βR-/-小鼠由David Farrar博士(UTSouthwestern)友情提供。STINGgt/gt小鼠、MyD88-/-小鼠、TRIF-/-小鼠、C57BL/6-Tg(TcraTcrb)1100Mjb/J(CD45.2,H-2b)(OT-I)小鼠、C57BL/6-CD45.1小鼠购买自Jackson实验室。MyD88-/-/TRIF-/-小鼠在我们的实验室中杂交。如前所述4产生cGas-/-小鼠。所有这些品系都在C57BL/6J背景上培养。对于每个实验,由不知情的研究者将小鼠随机分配到每组。STINGgt/gt和cGAS-/-BMDM来源于相应的敲除小鼠,并随后将其在含有M-CSF的培养基中培养6至7天。THP-1细胞购买自ATCC,并且发明人建立了稳定表达靶向hSTING和hcGAS的shRNA的THP-1细胞系,如前所述(Collins等,2015),这些THP-1细胞系在补充有10%FBS、0.05%-巯基乙醇(Sigma)和Pen/strep的混悬RPMI培养基(Gibco)中培养。B16-OVA细胞由MDAnderson Cancer Center的Patrick Hwu博士友情提供,TC-1细胞由John Hopkins大学的T.C.Wu博士友情提供,MC38细胞由Yangxin Fu博士(UT Southwestern)友情提供。使用支原体污染试剂盒(R&D)对所有细胞系进行常规检测。在37℃、5%CO2和正常水平的O2下在完全培养基(DMEM,10%胎牛血清,100U/mL青霉素G钠和100μg/mL链霉素(Pen/Strep)、MEM非必需氨基酸(均来自Invitrogen)和20μM β-巯基乙醇(β-ME))中培养细胞。
J.体内细胞毒性杀伤测定
在C57BL/6小鼠的尾基部对C57BL/6小鼠组进行皮下注射(OVA 10μg加30μg的纳米粒或具有相同剂量的其他佐剂)。按制造商推荐的体积比使用imject Alum(每只小鼠4mg,与抗原溶液50μl∶50μl混合)。一周后,处死初始C57BL/6小鼠并收集脾细胞。在37℃下将一半的脾细胞用OVA257-263或E749-57肽在完全培养基中脉冲2小时。未经脉冲和肽脉冲的细胞分别用0.5或0.05μM羧基荧光素琥珀酰亚胺酯(carboxyfluorescein succinimidyl ester,CFSE)在无血清培养基中标记15分钟。将相等数量(1×107个)的CFSE低(OVA脉冲细胞)和CFSE高(未脉冲细胞)混合在一起并静脉内注射到经免疫接种小鼠中。16小时后,收集来自经处理小鼠的血液并进行流式细胞术分析。确定CFSE高和CFSE低的数量并用于计算OVA肽脉冲的靶细胞杀伤的百分比。比杀伤(specific killing)定义为比裂解(specific lysis)的百分比=[1-非转移对照比例/实验比例]×100。
K.ELISA测定
对于抗体检测,在第0天和第14天用不同疫苗免疫接种C57BL/6小鼠组。在第21天,从尾静脉抽取50μL血液并通过ELISA测量血清中的抗原特异性IgG1和IgG2c。对于ELISA测定,在4℃下将平底96孔板(Nunc,Rochester,NY)用50mM碳酸盐缓冲液(pH 9.6)中浓度为0.5μg蛋白质/孔的OVA蛋白预涂覆过夜,然后将其用5%甘氨酸封闭。将从经免疫接种动物获得的抗血清在PBS-0.05%Tween(PBS-T)(pH 7.4)中从102至106连续稀释,并将其添加至孔并在37℃下孵育1小时。使用在PBS-T-1%BSA中稀释度为1∶10,000的山羊抗小鼠IgG1和IgG2c(HRP)(Abcam,Cambridge,MA)用于标记。在添加HRP底物后,在ELISA平板读数器(Bio-Rad,Hercules,CA)中在450nm的波长下测定光密度。
L.体内细胞摄取测定
对于抗原递送测定,用单独的PBS、OVA-AF647或纳米粒加OVA-AF647处理在C57BL/6小鼠的尾基部进行皮下注射。在注射之后24小时,处死小鼠并取出腹股沟淋巴结,用26号针取出并随后通过70-μm的细胞过滤器(BD)以回收细胞悬液。用PI和抗CD11c-FITC、抗CD11b-太平洋蓝、抗-B220-APC-Cy7、抗-CD8a-PE-Cy7对淋巴结细胞悬液进行染色。对四个主要的APC群体(CD8α+DC细胞(CD11c+CD11b-B220-CD8α+)、CD8α-DC细胞(CD11c+CD8α-)、巨噬细胞(CD11b+CDl1c-B220-)、B细胞(B220+CD11c-))的OVA-AF647阳性细胞进行分析。通过用抗CD86-PE染色测量APC成熟。
对于纳米粒摄取和STING激活测定,用单独的PBS或PC7A-Cy5(30μg)处理进行C57BL/6小鼠尾基部的皮下注射。在注射之后24小时,处死小鼠,取出腹股沟淋巴结和皮下组织,并在37℃下在胶原酶IV(Sigma-Aldrich)溶液中消化25分钟。然后使组织通过70-μm的细胞过滤器(BD)以回收细胞悬液。用PI和抗CD11c-FITC、抗MHCII-BV605和抗-CD45.2-Apc-Cy7对所有细胞悬液进行染色。对于细胞内pIRF3染色,通过固定/渗透稳定试剂盒(BDCat#554714)使细胞透化。在用小鼠血清封闭后,用pIRF3抗体(Cell Signaling,Cat#4947)对细胞进行染色,并随后用抗兔IgG-PE二抗(Biolegend)染色。对经染色的细胞悬液进行流式细胞术(LSRII,BD),并用软件(Tree Star Inc.Ashland,OR)进行分析。
M.体外摄取和交叉呈递测定
通过在DC培养基中培养从C57BL/6J小鼠的股骨冲洗的骨髓细胞产生骨髓来源的树突细胞,该DC培养基是补充有10%FBS、pen/strep、丙酮酸钠和20ng/mL GM-CSF的DMEM。每2天更换一半培养基;在第6天收集非贴壁和松散黏附的未成熟树突细胞(DC),并通过测定CD11c(通常为60-80%CD11c+)的表达进行表型分型。将OVA-AF647(2μg/mL)或OVA-AF647与不同纳米粒(50μg/mL)的混合物与鼠骨髓来源的树突细胞(BMDC)在37℃下孵育4小时,并通过FACS使用细胞的平均荧光强度(MFI)进行定量。对于交叉呈递测定,将BMDC与单独的OVA或OVA与不同纳米粒的混合物在37℃下孵育18至20小时,然后通过单克隆抗体25mAb-D1.16(特异性识别与H-2Kb结合之OVA肽SIINFEKL的抗体)检测呈递在细胞表面上MHC-I上的OVA257-267。
N.体外和体内CD8+T细胞致敏测定
为了评估OVA-NP脉冲的BMDC的抗原呈递,将致敏的OT-IT细胞的IFN-γ分泌用于定量CD8+T细胞激活。简言之,将BMDC与单独的OVA(3μg/mL)或OVA与不同纳米粒(50μg/mL)的混合物在37℃下孵育18小时。根据制造商的指示通过磁分离(MACS系统;MiltenyiBiotec,Bergisch Gladbach,Germany)选择来自OT-I小鼠的CD8+T淋巴细胞。CD8+T淋巴细胞的纯度为>95%。将CD8+T细胞以2×105个细胞/孔接种在96孔板(Costar;Coming,Inc.,Coming,NY)中含有10%FCS的RPMI培养基中,并添加2×105个未脉冲或抗原脉冲的BMDC 24小时。收集细胞培养物上清液并使用小鼠TH1/TH29-Plex Ultra-sensitive试剂盒(MesoScale Discovery)分析细胞因子含量。样品一式三份地运行。
从B6CD45.2+OT-I小鼠中收获脾,在MACS柱上通过磁珠分离对来自细胞悬液的CD8+T细胞进行分离。将5×104个OT-1CD8+T细胞通过静脉内(i.v.)注射转移到B6CD45.1+小鼠中,并在免疫接种前使其适应1天。1天后,用单独的PBS、OVA(10μg)或纳米粒(30μg)加OVA在尾基部对CD45.1+小鼠组进行皮下免疫接种。一周后,收获脾并将其分散成单细胞悬液,用抗CD8-PE-cy7、APC-缀合的H-2Kb/OVA(SIINFEKL)四聚体(NIH)染色用于流式细胞术分析。
O.溶血测定
如先前所述(Wilson等,2013)通过红细胞溶血测定评估聚合物促进脂质双层膜的pH依赖性破坏的能力。在内体加工途径的pH范围内(7.4、7.2、7.0、6.8、6.6和6.4),在100mM磷酸钠缓冲液(补充有150mM NaCl)中小鼠红细胞(20μg/mL)的存在下,将聚合物在37℃孵育1小时。通过测量释放的血红蛋白的量(A541nm)通过分光光度法测定细胞裂解的程度(即,溶血活性)。将溶血活性标准化为100%裂解对照(1%Triton X-100处理的红细胞)。样品一式三份地运行。
P.流式细胞术
抗体购买自Biolegend。使用以下一抗:抗CD16/CD32(Biolegend,Cat#:101301,克隆:93)、抗CD8-PE-cy7(Biolegend,Cat#:100721,克隆:53-6.7)、抗CD11c-FITC(Biolegend,Cat#:117305,克隆:N418)和抗CD11b-Pacif blue(Biolegend,Cat#:101223,克隆:M1/70)、抗B220-APC-cy7(Biolegend,Cat#:103223、克隆:RA3-6B2)、抗CD86-PE(Biolegend,Cat#:105007,克隆:GL-1)、与SIINFEKL-APC结合的抗-H-2Kb(Biolegend,Cat#:141605,克隆:25-D1.16)、抗CD45.2-APC(Biolegend,Cat#:109814,克隆:104)、抗CD45.2-APCcy7(Biolegend,Cat#:109823,克隆:104)、抗PD-L1-PE(Biolegend,Cat#:124307,克隆:1OF.9G2)、同种型对照-PE(Biolegend,Cat#:400607,克隆:RTK4530)、抗-F4/80-PE/cy7(Biolegend,Cat#:123113,克隆:BM8)、抗Gr-1-FITC(Biolegend,Cat#:108419,克隆:RB608C5)、抗MHCII-BV605(Biolegend,Cat#:107639,克隆:M5/114.15.2)、抗兔IgG-PE(Biolegend,Cat#:406421,克隆:聚4064)。在BDTM LSR II流式细胞仪上获取流数据并使用软件进行分析。
Q.RT-PCR
在注射OVA-PC7A NP(OVA 10μg,PC7A 150μg)或相同剂量的不同佐剂后,在指定的时间点采集皮下组织。为获得BMDM,在含有10%FBS、抗生素和来自L929细胞培养物的条件培养基的DMEM中培养约1×107个骨髓细胞。6至7天后,收获成熟的巨噬细胞并在12孔板上培养用于实验(Collins等,2015)。根据制造商的说明,通过TRIzol(Invitrogen)从细胞或组织中提取总RNA。如先前所述(Li等,2013;Collins等,2015)进行q-RT-PCR。样品一式三份地运行。以下引物用于q-RT-PCR。
mIRF7:ATGCACAGATCTTCAAGGCCTGGGC(SEQ ID NO:16);
GTGCTGTGGAGTGCACAGCGGAAGT(SEQ ID NO:17);
mCXCL10:GCCGTCATTTTCTGCCTCA(SEQ ID NO:18);
CGTCCTTGCGAGAGGGATC(SEQ ID NO:19);
mRPL19:AAATCGCCAATGCCAACTC(SEQ ID NO:20);
TCTTCCCTATGCCCATATGC(SEQ ID NO:21);
hCXCLl0:TGGCATTCAAGGAGTACCTC(SEQ ID NO:22);
TTGTAGCAATGATCTCAACACG(SEQ ID NO:23);
hGAPDH:ATGACATCAAGAAGGTGGTG(SEQ ID NO:24);
CATACCAGGAAATGAGCTTG(SEQ ID NO:25).
R.免疫和肿瘤治疗实验。
用B16-OVA或B16F10黑素瘤细胞(1.5×105个)或TC-1细胞(1.5×105个)、MC38细胞(5×105个)皮下注射至6至8周龄小鼠(每组n=10)的小鼠右胁部。如在正文中所述,用在尾基部皮下注射抗原-聚合物NP(每种抗原肽0.5μg,PC7A NP 30μg)或相同剂量的不同佐剂来免疫接种动物。或者在第3天、第6天、第9天和第12天,用200μg检查点抑制剂(抗mPD-1、BioXcell、BE0146)i.p.注射一些组用于比较或协同作用评价。随后由不知情的研究者使用数字卡尺每周测量肿瘤生长两次并计算为0.5×长度×宽度2。当肿瘤表面积达到1500mm3时处死小鼠,肿瘤检测的终点是对照组最长存活时间(longest survival time,LST)的2倍,因此对于黑素瘤肿瘤模型为约40天,且对于TC-1和MC38肿瘤模型为约60天。
对于PD-L1表达分析,将肿瘤组织用1mg/mL胶原酶IV(Sigma-Aldrich)和0.2mg/mLDNA酶I(Sigma-Aldrich)在37℃消化45分钟。然后用针对PD-L1、CD11b、Gr-1、F4/80、CD11c和CD45的抗体(Biolegend)对细胞进行染色。
S.统计分析
基于试验性免疫接种和肿瘤治疗研究,本发明人使用3至6只动物/组的组大小进行免疫原性测量,且使用10只动物/组进行肿瘤治疗实验。使用Microsoft Excel和Prism5.0(GraphPad)进行统计分析。数据表示为平均值±s.e.m.。通过t检验分析数据。在t检验之前进行方差相似性检验(f-检验)。所有t检验均为单尾和未配对的,并且如果p<0.05(*,p<0.05;**,p<0.01;***,p<0.001,除非另有说明),则认为是统计学显著的。使用对数秩检验分析两组的存活率,并且如果p<0.05则认为是统计学显著的。
T.聚合物纳米疫苗
使用原子转移自由基聚合方法合成具有70个重复单元的PR链段的PEG-b-PR的pH敏感性聚合物库(library)。通过使PEG-b-PR(NH2)与N,N-二甲基甲酰胺中的NHS-染料反应合成染料缀合的聚合物。PC7A纳米疫苗是通过使PC7A纳米粒与蛋白质或肽抗原在水中物理混合而新鲜制备的。
U.免疫接种
用100μL PBS溶液中的纳米疫苗在尾基部皮下注射免疫接种C57BL/6小鼠(雌性,6-8周龄,校园中的繁育中心)。所有动物操作均由德克萨斯大学西南医学中心的动物管理和使用委员会批准。
V.DNA酶I转染
根据制造商的说明,通过转染试剂DOTAP(Roche)用5μg DNA酶I(Roche)转染BMDM。在用DOTAP-DNA酶I或单独的DOTAP孵育细胞1小时后,洗涤细胞以除去过量的转染试剂和酶,并随后将其与400μg/ml的PC7A孵育9小时。通过RT-PCR测量CXCL10。
W.STING拉下测定
为了研究STING与PC7A共聚物的相互作用,本发明人用生物素标记了PC7A共聚物(每个聚合物链2-3个生物素)。对于THP-1细胞拉下测定,将PC7A-生物素(200μg/ml)与THP-1细胞一起孵育8小时,并随后收集细胞并在RIPA缓冲液(Sigma R0278)中裂解。用链霉亲和素修饰的dynabead(BD 557812)沉淀裂解物。通过兔抗-STING抗体(Cell Signaling,Cat#13647)使用SDS-PAGE和Western印迹分析样品。对于STING蛋白拉下测定,先前已经描述了人STING CTD(139-379)的表达和纯化7,将PC7A-生物素(50μg/mL)与STING CTD(1μg/ml)在PBS(pH=6.8)中孵育3小时,具有相同浓度的PBS(pH=6.8)中PEPA-生物素和PBS(pH=4.4)中PD5A-生物素用作对照组,并随后用链霉亲和素修饰的dynabead沉淀。使用SDS-PAGE和Western印迹分析样品。
X.等温滴定量热法(ITC)
使用VP-ITC微量热计(GE Healthcare)用ITC测量STING CTD和PC7A聚合物或cGAMP之间的结合亲和力,PC7A-牛血清白蛋白(BSA)的ITC用作阴性对照。在含有25mMHEPES(pH6.8)、150mM NaCl的缓冲液中在20℃下进行滴定。以4分钟的间隔时间进行32次进样。滴定曲线由NITPIC整合,且随后曲线由SEDFIT拟合(Zhang等,2013)。图形使用GUSSI(biophysics.swmed.edu/MBR/software.html)制备。
Y.组织中的IDO酶活性测定
使用无内毒素的试剂盒(Qiagen)制备细菌pDNA(pEGFPN1,Clontech)。用30μgpDNA与体内jetPEI(Polyplus-转染,N∶P=8)混合静脉内注射小鼠,或用NP(150μg,疫苗剂量的5倍)s.c.注射小鼠。如先前报道中所述(Huang等,2012;Hoshi等人,2010)测量IDO活性。简言之,在免疫接种之后24小时取出组织,并在1.5体积的冰冷的0.14M KCl-20mM磷酸钾缓冲液(pH 7)中进行匀浆。在4℃下将匀浆物样品以7000×g离心10分钟。然后将50μl上清液与50μl底物溶液混合。底物溶液的组成为100mM磷酸钾缓冲液(pH 6.5)、50μM亚甲基蓝、20μg过氧化氢酶、50mM抗坏血酸盐和0.4mM L-TRP。在37℃下孵育反应混合物后,用3%高氯酸酸化样品,并在4℃下以7000×g离心10分钟。通过HPLC测量产物的浓度。酶活性表示为每克组织蛋白质每小时的产物含量。
Z.OVA加载和稳定性研究
通过超滤法测量胶束纳米粒内的OVA加载效率。简言之,将来自不同聚合物的胶束纳米粒(300μg/mL)与AF647标记的OVA(100μg/mL)混合30分钟。加载OVA后,通过截留分子量为100kD的超滤管从加载OVA的纳米粒中除去游离的OVA。用激发波长为640nm的Hitachi荧光计(F-7500型)测量游离OVA的浓度。使用以下等式计算加载效率:
为了评价加载稳定性,将加载有OVA的PC7A纳米粒在含有5%胎牛血清的PBS缓冲液(pH 7.4)中孵育不同的时间。如上所述分离和测定游离OVA。
进一步设计FRET实验以研究聚合物和OVA相互作用。在典型的操作中,将Cy3.5-缀合的PC7A(100μg/mL)与AF647标记的OVA(20μg/mL)在PBS缓冲液(pH=7.4)中孵育。孵育30分钟之后,用Hitachi荧光计(F-7500型)获得荧光发射光谱。样品在590nm处激发,并且在600至750nm收集发射光谱。
通过用1μg H1N1 PR8(甲型流感病毒A/PR/8/1934(H1N1)血凝素(HA)抗原)与PC7A[200μg PC7A/小鼠]、明矾[1∶1vol/vol比]或无内毒素H2O一起i.m.疫苗接种来致敏8周龄雌性B6 WT小鼠。初次致敏之后10天,用0.5μg H1N1 PR8 HA与200μg PC7A/小鼠、明矾[1∶1vol/vol比]或无内毒素H2O一起对小鼠进行加强。在第17天(加强之后一周)从经疫苗接种小鼠中收获血清。
对于ELISA,将板用H1N1 HA PR8抗原(PBS中5μg/mL)在4℃下包被过夜。用TBS-3%(wt/vol)牛血清白蛋白(BSA)封闭平板。将样品以1∶10000稀释度添加至平板。洗涤平板后,以1∶5000稀释度添加HRP-缀合的山羊抗小鼠IgG(H+L)。对于IgG1和IgG2b检测,以1∶5000的稀释度添加HRP缀合的山羊抗小鼠IgG1或IgG2b抗体。用3,3’,5,5’-四甲基联苯胺底物对板进行显色并测量450nm下的OD。
对于流感攻击,将流感A/PR/8/34(H1N1)病毒在无菌PBS中稀释至10×(700pfu/小鼠)MLD50。腹膜内(i.p.)使用氯胺酮(30mg/ml)/赛拉嗪(4mg/ml)使小鼠镇静,并且以40μL的总体积鼻内施用病毒,在鼻孔之间均匀分开。病毒攻击后,小鼠i.p.接受阿替美唑(0.63mg/ml),并随后监测体重减轻和死亡率持续14天。当体重减轻超过30%时,小鼠被人道地处死。
实施例2-数据和讨论
肿瘤特异性CD8T细胞应答的成功产生需要空间-时间控制肿瘤抗原转运至次级淋巴器官,抗原呈递细胞(APC)中的胞质递送和交叉呈递与固有刺激相协调。使用纳米粒的免疫治疗是一个新兴领域,其中最近的进展聚焦于病毒纳米粒的免疫原性优势(Lizotte等,2016)。尽管非病毒纳米粒(直径<50nm)可在淋巴结内选择性地积累(Reddy等,2007;Liu等,2014),但很少有研究显示它们能够同时促进抗原呈递和刺激固有免疫应答而不引入佐剂(例如,CpG、聚(I∶C))。最近,本发明人的实验室已经建立了超pH敏感性(ultra-pHsensitive,UPS)纳米粒(直径20-50nm)的库,其可在广泛的生理pH范围内(4-7.4)进行微调(Ma等,2014))。一旦通过巨胞饮作用(macropinocytosis)被细胞摄取,这些UPS纳米粒可在特定的pH值下缓冲内吞细胞器的腔内pH值(Wang等,2015)。受到胞质递送生物制剂的“质子海绵”聚合物(Boussif等,1995)和用于LN靶向的小纳米粒尺寸的启发,本发明人对UPS纳米粒进行体内筛选以评价其产生细胞毒性T淋巴细胞(CTL)应答的能力。UPS库由含有具有直链或环状侧链的叔胺的共聚物组成(图1A和图5A),其中每种组分在相应的pKa下呈现出明显的pH缓冲(图5B-C)。使用卵清蛋白(OVA)作为模型抗原。在不同的聚合物纳米粒上测量的OVA加载效率为>75%(图6A)。
通过已建立的体内细胞毒性测定定量OVA特异性CTL应答(图1A)(Barber等,2015)。简言之,首先将OVA-聚合物NP皮下注射到C57BL/6小鼠的尾基部。7天后,通过测量CFSE标记的靶细胞的杀伤率来确定OVA表位(SIINFEKL)特异性CTL效应。流式细胞术数据显示,与其他环胺(例如,PC6A、经取代的PC6A和PC8A)以及直链叔胺相比,PC7A NP允许最高的OVA特异性脾细胞杀伤(82%)(图1B)。与具有相当的pKa(6.9-7.0)的PC6S1A和PEPA NP相比,PC7A NP产生大约两倍强的CTL应答。在直链系列中,与其他共聚物相比,PEPA具有最高的CTL应答。这些数据表明,UPS共聚物的pH转变(即,靶向早期内体pH的6.9)和聚合物结构(即,环状七元环)对于诱导强CTL应答是重要的。常规的PEG-b-聚(D,L-乳酸)(PEG-PLA)胶束具有弱CTL应答(4.2%)(Maldonado等,2015)。OVA-PC7A NP诱导比OVA-明矾(4.3%)或刺激TLR4通路的OVA-LPS(3.7%)高约20倍(Poltorak等,1998),并且比刺激TLR9途径的OVA-CpG(23%)高3.6倍(Hemmi等,2000)的CTL应答。此外,来自加强之后7天收集的经免疫接种小鼠血清的OVA特异性抗体应答显示,用PC7A NP进行疫苗接种的小鼠产生与用明矾或LPS的那些相当的OVA特异性IgG1应答的相似滴度(图1C)。与用OVA加CpG或LPS免疫接种的那些相比,PC7A NP还产生OVA特异性IgG2c抗体的相似滴度(图1D)。总而言之,本发明人得出结论,PC7A NP能够诱导稳健的抗原特异性CTL、Th1和Th2应答,具有与数种已建立的佐剂相当或更好的效力。
为了研究PC7A NP的APC靶向能力,本发明人首先用吲哚菁绿(λex/λem=800/820nm)标记PC7A共聚物并在尾基部皮下注射后使用临床摄相机(SPY)对纳米粒转运到引流淋巴结(dLN)中进行成像。结果显示,在24小时时外周淋巴结中PC7A NP(直径29nm)的高效积累(图7A)。其他器官未显示出显著的积累。为了研究PC7A NP用于抗原递送的能力,本发明人首先证实OVA可通过强FRET效应包封在PC7A胶束中(图6C-E),并且该包封在5%血清中相对稳定超过24小时(图6B)。然后,他们使用具有和不具有PC7A胶束包封的Alexa Fluor 647标记的OVA,并在皮下注射之后24小时收获dLN。进行流式细胞术以定量CD8α+和CD8α-树突细胞(DC)和巨噬细胞中OVA阳性细胞的百分比。所有三个亚群显示,相对于单独的OVA,通过PC7A介导的递送显示出显著更高的OVA积累(图2A)。已知LN驻留的CD8α+DC细胞对于诱导CTL应答是重要的(Hildner等,2008;Sancho等,2008)。相对于仅OVA的对照,OVA-PC7A NP组中OVA阳性CD8α+DC的量提高了29倍。
本发明人使用数种体外细胞培养测定研究了PC7A NP对抗原的胞质递送和交叉呈递的能力(Heath等,2004)(图2B)。OVA-PC7A NP与骨髓来源的树突细胞(BMDC)的孵育显示出抗原摄取与OVA-PD5A NP相比相似,且小于仅OVA的组(图2C)。相反,如通过mAb25-D1.16检测的OVA肽(SIINFEKL)-MHC-1复合物示出了相对于两个对照组3倍的抗原交叉呈递(图2D)。使用体外OT-I CD8+T细胞致敏测定,用OVA-PC7A NP处理的BMDC相对于其他对照组显著提高了从OT-I小鼠分离的CD8+T细胞的IFN-γ分泌(图2E)。该结果得到了体内CD8+T细胞致敏测定的进一步支持,其中OVA-PC7A NP组中的OVA表位(SIINFEKL)特异性CD8+T细胞显示相对于仅OVA的组提高了15倍(图2F-G)。通过在不同pH值下的红细胞(RBC)中的溶血测定示出了关于胞质递送的内体破坏的进一步证据(Wilson等,2013)。结果显示,PC7A NP在胶束状态下在pH 7.4下没有溶血作用,但在胶束解离后在pH低于7.0时显示出强溶血活性(约90%)。PD5A NP在相同的pH范围内未显示任何可观察到的RBC溶血(图8A-B)。
共刺激信号(例如,CD80/86)和细胞因子也是诱导强肿瘤特异性CTL应答所必需的(Liechtenstein等,2012)。在先前的实验中,在用OVA-PC7A NP免疫接种之后24小时,本发明人发现与单独的OVA相比,腹股沟LN的尺寸看来提高(图7B)。来自OVA-PC7A NP处理的小鼠的腹股沟LN中的总细胞数相对于OVA-PD5A或单独OVA的对照提高大于2倍(图7C)。流式细胞术分析显示,在OVA-PC7A NP处理的小鼠的APC的不同亚组中CD86的表达显著高于其他三个对照组(图3A和图7D)。已显示I型IFN加强了CD8+T细胞应答的有效性(Zitvogel等,2015;Fuertes等,2013)。本发明人在皮下注射PC7A NP之后随时间检查了IFN刺激基因(IFN-stimulated gene,ISG)在局部组织中的表达(Trinchieri等,2010)。使用聚(I∶C)作为阳性对照(Alexopoulou等,2001)。结果显示聚(I∶C)能够在2至8小时的早期时间点内在IRF7和CXCL10表达中引起比PC7A NP更高的应答。在24小时时,PC7A NP产生比聚(I∶C)和PD5ANP组二者更强的应答(图3B-C)。
为了证实IFN途径对CTL应答的影响,本发明人测量了IFN受体(IFN-α/βR-/-)敲除小鼠中的OVA特异性CTL和Th1应答。数据显示与野生型对照相比,在IFN-α/βR-/-小鼠中大部分CTL/Th1应答被消除(图3D-F,n=5),这与ISG表达数据一致。已知Toll样受体(TLR)MAVS和STING激活I型干扰素途径(Zitvogel等,2015;Baccala等,2007)。
为了进一步阐明该机制,本发明人分析了MyD88-/-/TRIF-/-、MAVS-/-和STINGgt/gt小鼠中的免疫应答。结果显示PC7A NP诱导的T细胞应答不依赖于TLR和MAVS途径,而STINGgt/gt小鼠几乎概括了IFN-α/βR-/-小鼠的结果(图3D-F)。环GMP-AMP合酶(cGAS)可感知胞质DNA并产生环GMP-AMP(cGAMP),其随后激活STING,引起I型IFN的诱导(Sun等,2013)。cGAS-/-小鼠的另外的研究显示CTL应答部分依赖于cGAS。通过使用骨髓来源的巨噬细胞和人单核细胞THP-1细胞的体外细胞培养结果进一步证实了STING和cGAS在ISG诱导中的作用(图9A-B)。为了进一步评价胞质DNA在该过程中的作用,本发明人在PC7A处理之前将DNA酶I转染到BMDM中(Carroll等,2016),并发现WT BMDM中PC7A诱导的ISG水平降低至几乎与cGAS-/-BMDM中相同的水平(图9C)。该结果表明胞质DNA部分地负责cGAS依赖性STING激活。对于cGAS非依赖性STING激活,本发明人使用与THP-1细胞一起孵育的生物素缀合的PC7A NP进行STING拉下测定。通过链霉亲和素修饰的dynabead的细胞裂解和蛋白质拉下显示,仅PC7A-生物素能够保留STING,而PD5A-生物素和仅PC7A(不含生物素)的对照不能(图9D)。使用STING的经纯化C末端结构域(CTD,139-397 AA)的进一步研究显示在不存在其他蛋白质的情况下的STING CTD拉下(图9E),表明STING与PC7A之间的直接结合。这得到了等温量热法(ITC)实验的进一步支持,其中STING在HEPES缓冲液中的PC7A滴定显示解离常数(Kd)为1.3μM(图9F-G)。该相互作用与cGAMP-STING复合物(Kd=9.6nM)相比更弱。相反,在阴性对照中PC7A与牛血清白蛋白之间发现可忽略的结合。尽管本发明人可检测PC7A与STING之间的特定相互作用,但是需要进一步的结构和功能研究来确定PC7A是否可通过直接结合激活STING。
接下来,本发明人试图确定负责纳米粒摄取和STING激活的主要细胞群。使用Cy5标记的PC7A聚合物用于定量细胞中的NP摄取,且磷酸化的IRF3(pIRF3)用于检测STING-I型IFN途径的激活(Woo等,2014)。在皮下注射Cy5-PC7A NP之后一天,他们在注射部位收集腹股沟LN和皮下组织并制备单细胞悬液。流式细胞术分析显示,在LN中,NP+细胞相对于PBS对照中的NP-细胞和CD45+白细胞具有显著升高的pIRF3表达(图10A)。进一步的分析显示87%的NP+细胞表达DC细胞标志物(CD11c+),其进一步通过MHC-II+表达证实(图10B)。对来自注射部位的细胞悬液进行相同的分析(图10C)。数据显示CD45+白细胞内化PC7A NP的量显著高于CD45-细胞。在CD45-细胞群中,本发明人没有观察到pIRF3水平的任何显著提高。在CD45+细胞群中,相对于NP-细胞,在NP+细胞中发现显著升高的pIRF3水平。对CD45+NP+细胞的进一步分析显示95%的细胞群具有CD11c+标志物(图10D中的下图)。基于这些数据,本发明人得出结论,在注射部位和引流LN二者中,APC(尤其是DC)是摄取PC7A NP并随后激活STING-I型IFN途径的主要细胞群。
已经报道了STING-I型IFN激活诱导免疫调节应答,其中IDO-1表达被鉴定为该调节途径中的主要免疫检查点(Lemos等,2014;Huang等,2012)。在该研究中,本发明人首先在用不同聚合物处理的小鼠中进行体内IDO酶活性测定。用PC7A、PD5A或PEPA共聚物(150μg,疫苗剂量的5倍)皮下注射来处理小鼠显示出脾中的IDO活性相对于PBS对照提高了33-51%,低于静脉注射PEI-DNA的阳性对照。在由PC7A、PD5A或PEPA共聚物诱导的IDO活性中未检测到统计学显著差异(图9H)。体内动物数据得到了THP-1和BMDM细胞中细胞培养数据的进一步支持。在该研究中,本发明人比较了用整组纳米粒处理的IDO-1和CXCL 10表达谱。结果显示,除了PC7A NP之外的纳米粒缺乏CTL活性不是IDO-1表达升高的结果,而是由于缺乏STING激活(图9I-J)和DC上的低效抗原递送和呈递(例如,参见图2D中的PD5A的代表性数据)。
基于上述特征(图4A),本发明人研究了PC7A纳米疫苗在数种肿瘤模型中的抗肿瘤效力。在B16-OVA黑素瘤模型中,配制抗原肽(OVA257-280,0.5μg)与PC7A NP(30μg)的物理混合物。在肿瘤接种之后5天对不同的纳米疫苗组进行皮下注射,随后在5天后进行加强注射(图4B)。在PBS对照组中,所有动物在20天内死亡。相对于PBS对照,单独的OVA257-280、单独的PC7A NP或OVA257-280-PD5A NP组没有提供任何显著的肿瘤生长抑制或存活益处(图11A-B)。OVA257-280-CpG和OVA257-280-聚(I∶C)组提供较小程度的免疫保护(图4B-C)。然而,所有动物在第40天之前死亡。相反,OVA257-280-PC7A NP达到最大治疗效力,其中50%的动物存活超过40天。在B16-F10黑素瘤中,本发明人使用在PC7A NP(每种肽0.5μg,30μg聚合物)中的肿瘤相关抗原(Gp10021-41、Trp1214-237、Trp2173-196)或新抗原(Obsl1T1764M、Kif18bK739N、Def8R255G)(Kreiter等,2015)的混合物。相对于仅抗原、仅PC7A和未处理对照,PC7A疫苗接种显著减缓了B16F10肿瘤的生长(两个研究中P<0.001,n=10,图4d和图11C)。在结肠癌MC38模型中,他们选择了具有经验证免疫原性新表位的三种肿瘤新抗原(Reps1P45A、AdpgkR304M、Dpagt1V213L)(Yadav等,2014)。数据还显示显著改善的肿瘤生长抑制(图4E)。最后,本发明人使用人乳头瘤病毒(HPV)E6/7TC-1肿瘤(Sun等,2015;Liu等,2016)。使用E7来源的肽E743-62,当用E743-62-PC7A NP处理时,50%的小鼠在60天内无肿瘤(图4F-G和图12E)。PC7A纳米疫苗与抗PD-1抗体的组合在B16-OVA黑素瘤和TC-1肿瘤模型二者中显示出协同作用(图4G和图12A-F)。在TC-1模型中,100%的动物存活超过60天,并且这些动物中的90%无肿瘤(图12E)。B16OVA和TC-1肿瘤模型二者均显示肿瘤细胞上的轻度PD-L1表达,而骨髓细胞的某些亚型具有相对于同种型对照的高PD-L1表达(图12D和12F)。这些数据支持纳米疫苗与抗PD1治疗的协同作用。同时,如其他组所报道的,单独的抗PD-1治疗并未引起任何一种模型中抗肿瘤效果的显著改善(Rice等,2015;Holmgaard等,2013)。肿瘤接种之后82天,用1×106个TC-1肿瘤细胞再次攻击无肿瘤小鼠。数据显示,先前治疗的无肿瘤小鼠对新移植的肿瘤具有抗性持续超过60天,而此类肿瘤在初始小鼠和手术治愈的小鼠中稳健地生长(图12E)。这些结果表明纳米疫苗诱导的长期抗肿瘤应答可能激活记忆T细胞。与聚(I∶C)对照相比,用PC7A NP(150μg,疫苗剂量的5倍)处理的小鼠的全身细胞因子/趋化因子的分析显示出更少的全身性炎症(图13)。在用重复注射PC7A纳米疫苗(150μg,疫苗剂量的5倍,图14)处理的小鼠中的主要器官(例如,肝、脾、肾、心脏)的组织学分析未显示任何可观察到的毒性。这些数据示出了PC7A纳米疫苗在小抗原剂量(0.5μg)下安全且有效的抗肿瘤免疫力,以及其与检查点抑制剂的显著协同作用。
该研究的结果建立了简单的纳米粒PC7A NP,其可与多种肿瘤抗原物理混合以产生稳健的癌症特异性T细胞应答。我们最初的尝试是筛选允许针对肿瘤之T细胞免疫的超pH敏感向聚合物组合物的库。在PC7A NP中,本发明人偶然发现了符合T细胞激活的所有空间-时间标准的单一聚合物组合物。机械地,PC7A NP允许在小尺寸限制内(<50nm)促进抗原递送至淋巴结的稳定的抗原加载。同等重要的是,PC7A NP实现了肿瘤抗原的高效胞质递送和STING激活。PC7A NP中的7元环胺侧链结构呈现相对高的转变pH(即6.9),在早期内体pH(6.5-7.0)下提供pH特异性质子海绵效应,并且质子化单体的刚性构型用于膜破坏(图8A-B)。常规的pH不敏感纳米粒PEG-b-PLA胶束也包括在CTL筛选中,但未显示任何可观察到的CTL效应(图1B)。肿瘤抗原的早期内体释放到胞质中避免了溶酶体降解,引起细胞表面上的抗原交叉呈递提高。这种独特的膜破坏能力也可以是将痕量DNA引入细胞质的原因,其随后激活胞质的cGAS-STING通路用于固有刺激21。同时,STING拉下测定和ITC实验揭示了PC7A与STING的直接结合。PC7A-STING相互作用看来是特异性的,如得到了缺乏PEPA和PD5A共聚物的STING CTD拉下(特别地,PEPA具有与PC7A相同的转变pH但缺乏环结构)、以及通过ITC实验的PC7A与PC7A之间的可忽略之结合的支持。
总之,本发明人发现合成纳米粒不仅增强抗原递送而且刺激STING途径以加强抗肿瘤免疫,提供了癌症免疫治疗中的新方法。简单(simplicity)、稳健的T细胞应答和与检查点抑制的协同作用使PC7A纳米疫苗成为临床开发的有吸引力的候选物。该纳米疫苗平台可被迅速采用以并入许多现有的肿瘤相关抗原以及越来越多的肿瘤新抗原(Schumacher和Schreiber,2015;Sharma和Allison,2015)。PC7A NP的独特特征还使其能够将微生物抗原包装为预防和治疗感染性疾病的疫苗。
实施例3-纳米疫苗和放射治疗的组合
将2×105个TC-1细胞皮下注射到C57BL/6小鼠的背部(n=8/组)。14天后当肿瘤达到约200mm3的尺寸时以20Gy辐射肿瘤。对于疫苗接种处理,在电离辐射的同一天,将纳米疫苗(30μgPC7A+0.5μg肽E743-62(GQAEPDRAHYNIVTFCCKCD,SEQ ID NO:26)皮下注射到尾基部的小鼠背部。六天后用相同剂量的纳米疫苗的另一次注射对小鼠进行加强。随后由不知情的研究者使用数字卡尺每周测量肿瘤生长两次并计算为0.5×长×宽2。当肿瘤尺寸达到1500mm3时处死小鼠。如图18中所示,组合的纳米疫苗和放射治疗显示出相对于用单独的放射或纳米疫苗处理显著改善的治疗协同作用。
***
根据本公开内容,本文中所公开和要求保护的所有方法无需过度实验而操作和实施。尽管已经根据一些优选实施方案描述了本公开内容的组合物和方法,但是对于本领域技术人员将显而易见的是,可对本文中所述方法和步骤或所述方法的步骤顺序进行改变而不脱离本公开内容的概念、精神和范围。更具体地,明显的是,在获得相同或相似结果的同时,化学和生理学相关的某些试剂可代替本文中所述的试剂。对于本领域技术人员明显的是,如所附权利要求限定的,所有这些类似的替代和修改被认为是在本公开内容的精神、范围和概念内。
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<120> 用于免疫治疗的激活STING的纳米疫苗
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Claims (65)
1.组合物,其包含:
(A)抗原;
(B)pH敏感性二嵌段共聚物;
其中所述抗原被所述共聚物包封。
2.权利要求1所述的组合物,其中所述抗原是抗癌抗原。
3.权利要求2所述的组合物,其中所述抗原是肿瘤相关抗原或肿瘤新抗原。
4.权利要求3所述的组合物,其中所述肿瘤相关抗原是人乳头瘤病毒E6蛋白、E7蛋白或其片段。
5.权利要求3所述的组合物,其中所述肿瘤相关抗原是间皮素或其片段。
6.权利要求3所述的组合物,其中所述抗癌抗原是黑素瘤肿瘤相关抗原或新抗原。
7.权利要求3所述的组合物,其中所述抗癌抗原是膀胱癌、血癌、骨癌、脑癌、乳腺癌、中枢神经系统癌症、宫颈癌、结肠癌、子宫内膜癌、食管癌、胆囊癌、胃肠道癌、外生殖器癌、泌尿生殖道癌、头癌、肾癌、喉癌、肝癌、肺癌、肌肉组织癌症、颈癌、口腔或鼻黏膜癌、卵巢癌、胰腺癌、前列腺癌、皮肤癌、脾癌、小肠癌、大肠癌、胃癌、睾丸癌或甲状腺癌的抗原。
8.权利要求1所述的组合物,其中所述抗原是病毒抗原。
9.权利要求8所述的组合物,其中所述病毒抗原是乙型肝炎病毒抗原、流感病毒抗原、西尼罗病毒抗原、登革病毒抗原、埃博拉病毒抗原或HIV抗原。
10.权利要求1所述的组合物,其中所述抗原是细菌抗原。
11.权利要求10所述的组合物,其中所述抗原是结核分枝杆菌(mycobacteriumtuberculosis,Mtb)抗原。
12.权利要求1所述的组合物,其中所述抗原是疟疾抗原。
13.根据权利要求1至12中任一项所述的组合物,其中如通过pH滴定所计算的,所述二嵌段共聚物在水中的pKa为约6至约7.5。
14.根据权利要求1至12中任一项所述的组合物,其中由所述二嵌段共聚物形成的纳米粒在低于pKa的pH下解离。
15.根据权利要求1至12中任一项所述的组合物,其中所述二嵌段共聚物包含亲水性嵌段和疏水性嵌段。
16.权利要求15所述的组合物,其中所述亲水性嵌段是PEG聚合物、PVP聚合物或MPC聚合物。
17.根据权利要求1至16中任一项所述的组合物,其中所述二嵌段共聚物进一步由下式限定:
其中:
R1是氢、烷基(C≤12)、环烷基(C≤12)、经取代的烷基(C≤12)、经取代的环烷基(C≤12);
n是1至500的整数;
R2和R2’各自独立地选自氢、烷基(C≤12)、环烷基(C≤12)、经取代的烷基(C≤12)或经取代的环烷基(C≤12);
R3是下式的基团:
其中:
nx是1至10;
X1、X2和X3各自独立地选自氢、烷基(C≤12)、环烷基(C≤12)、经取代的烷基(C≤12)或经取代的环烷基(C≤12);并且
X4和X5各自独立地选自烷基(C≤12)、环烷基(C≤12)或这些基团中任一种的经取代形式,或者X4和X5合在一起并且是烷二基(C≤12)、烷氧二基(C≤12)、烷氨二基(C≤12)或这些基团中任一种的经取代形式;
x是1至150的整数;
R4是下式的基团:
其中:
ny是1-10;
X1’、X2’和X3’各自独立地选自氢、烷基(C≤12)、环烷基(C≤12)、经取代的烷基(C≤12)或经取代的环烷基(C≤12);并且
X4’和X5’各自独立地选自氢、烷基(C≤12)、环烷基(C≤12)、酰基(C≤12)、经取代的烷基(C≤12)、经取代的环烷基(C≤12)、经取代的酰基(C≤12)、染料或荧光猝灭剂,或者X4’和X5’合在一起并且是烷二基(C≤12)、烷氧二基(C≤12)、烷氨二基(C≤12)或这些基团中任一种的经取代形式;
y是1到150的整数;
R5是氢、卤素、羟基、烷基(C≤12)或经取代的烷基(C≤12),
其中R3和R4可以在所述聚合物内以任意顺序出现,前提是R3和R4不是相同基团。
18.权利要求17所述的组合物,其进一步限定为:
其中:
R1是氢、烷基(C≤12)、环烷基(C≤12)、经取代的烷基(C≤12)、经取代的环烷基(C≤12);
n是1至500的整数;
R2和R2’各自独立地选自氢、烷基(C≤12)、环烷基(C≤12)、经取代的烷基(C≤12)或经取代的环烷基(C≤12);
R3是下式的基团:
其中:
X4和X5各自独立地选自烷基(C≤12)、环烷基(C≤12)或这些基团中任一种的经取代形式,或者X4和X5合在一起并且是烷二基(C≤12)、烷氧二基(C≤12)、烷氨二基(C≤12)或这些基团中任一种的经取代形式;
x是1至150的整数;
R4是下式的基团:
其中:
X4’和X5’各自独立地选自氢、烷基(C≤12)、环烷基(C≤12)、酰基(C≤12)、经取代的烷基(C≤12)、经取代的环烷基(C≤12)、经取代的酰基(C≤12)、染料或荧光猝灭剂,或者X4’和X5’合在一起并且是烷二基(C≤12)、烷氧二基(C≤12)、烷氨二基(C≤12)或这些基团中任一种的经取代形式;
y是0到150的整数;
R5是氢、卤素、羟基、烷基(C≤12)或经取代的烷基(C≤12),
其中R3和R4可以在所述聚合物内以任意顺序出现,前提是R3和R4不是相同基团。
19.权利要求18所述的组合物,其进一步限定为:
其中:
R1是氢、烷基(C≤12)、环烷基(C≤12)、经取代的烷基(C≤12)、经取代的环烷基(C≤12);
n是1至500的整数;
R3是下式的基团:
其中:
X4和X5各自独立地选自烷基(C≤12)、环烷基(C≤12)或这些基团中任一种的经取代形式,或者X4和X5合在一起并且是烷二基(C≤12)、烷氧二基(C≤12)、烷氨二基(C≤12)或这些基团中任一种的经取代形式;
x是1至150的整数;
R5是氢、卤素、羟基、烷基(C≤12)或经取代的烷基(C≤12)。
20.根据权利要求17至19中任一项所述的组合物,其中R1是烷基(C≤12)。
21.根据权利要求17至20中任一项所述的组合物,其中n为50至200。
22.根据权利要求17至21中任一项所述的组合物,其中X4是烷基(C≤12)或环烷基(C≤12)。
23.根据权利要求17至22中任一项所述的组合物,其中X5是烷基(C≤12)或环烷基(C≤12)。
24.根据权利要求17至23中任一项所述的组合物,其中X4和X5合在一起并且是烷二基(C≤12)、烷氧二基(C≤12)、烷氨二基(C≤12)或这些基团中任一种的经取代形式。
25.权利要求24所述的组合物,其中X4和X5合在一起并且是烷二基(C≤12)或经取代的烷二基(C≤12)。
26.权利要求25所述的组合物,其中X4和X5合在一起并且是-CH2CH2CH2CH2CH2-、-CH2CH2CH2CH2CH2CH2-、-CH2CH2CH2CH2CH2CH2CH2-、-CH2CH2CH(CH3)CH2CH2-或-CH2CH(CH3)CH2CH(CH3)CH2-。
27.根据权利要求17至26中任一项所述的组合物,其中x是50至120。
28.根据权利要求17至27中任一项所述的组合物,其中y是0。
29.根据权利要求17至28中任一项所述的组合物,其中X4’和X5’合在一起并且是烷二基(C≤12)。
30.根据权利要求17至29中任一项所述的组合物,其中所述二嵌段共聚物是PEG114-b-PDEA70、PEG114-b-PEPA70、PEG114-b-PDPA70、PEG114-b-PDBA70、PEG114-b-PD5A70、PEG114-b-PC6A70、PEG114-b-PC7A70、PEG114-b-PC8A70、PEG114-b-PC6S1A70或PEG114-b-PC6S2A70。
31.权利要求30所述的组合物,其中所述二嵌段共聚物是PEGl14-b-PEPA70、PEG114-b-PC6A70、PEG114-b-PC7A70、PEG114-b-PC6S1A70或PEG114-b-PC6S2A70。
32.根据权利要求1至31中任一项所述的组合物,其还包含溶剂。
33.权利要求32所述的组合物,其中所述溶剂是水或水性缓冲液。
34.包含佐剂和抗原的组合物,所述抗原激活STING途径,并且所述佐剂形成纳米粒。
35.包含佐剂和抗原的组合物,所述抗原激活一种或更多种干扰素受体蛋白,并且所述佐剂形成纳米粒。
36.组合物,其包含:
(A)佐剂;以及
(B)抗原;
其中所述组合物是粒度小于50nm、在所述佐剂上包含多个杂环烷基的纳米粒,其中所述杂环烷基中的至少一个杂原子是氮原子,并且pH转变点为约6.5至7.4。
37.权利要求36所述的组合物,其中所述粒度为5nm至50nm。
38.权利要求36所述的组合物,其中所述多个杂环烷基为10至200个杂环烷基。
39.权利要求36所述的组合物,其中所述杂环烷基是氮杂环庚烷。
40.权利要求36所述的组合物,其中所述pH转变点为6.5至7.2。
41.药物组合物,其包含:
(A)根据权利要求1至40中任一项所述的组合物;以及
(B)赋形剂。
42.权利要求41所述的药物组合物,其中所述药物组合物配制成用于注射。
43.权利要求42所述的药物组合物,其中所述药物组合物配制成用于静脉内、肌内、腹膜内或皮下注射。
44.根据权利要求41至43中任一项所述的药物组合物,其中所述药物组合物配制成单位剂量。
45.根据权利要求41至44中任一项所述的药物组合物,其中药物组合物还包含第二活性剂。
46.权利要求45所述的药物组合物,其中所述第二活性剂是检查点抑制剂。
47.在有此需要的患者中治疗疾病或病症的方法,其包括向所述患者施用治疗有效量的根据权利要求1至46中任一项所述的组合物。
48.权利要求47所述的方法,其中所述疾病或病症是癌症。
49.权利要求48所述的方法,其中所述癌症是上皮癌、肉瘤、淋巴瘤、白血病、黑素瘤、间皮瘤、多发性骨髓瘤或精原细胞瘤。
50.权利要求48所述的方法,其中所述癌症是膀胱癌、血癌、骨癌、脑癌、乳腺癌、中枢神经系统癌症、宫颈癌、结肠癌、子宫内膜癌、食管癌、胆囊癌、胃肠道癌、外生殖器癌、泌尿生殖道癌、头癌、肾癌、喉癌、肝癌、肺癌、肌肉组织癌症、颈癌、口腔或鼻黏膜癌、卵巢癌、胰腺癌、前列腺癌、皮肤癌、脾癌、小肠癌、大肠癌、胃癌、睾丸癌或甲状腺癌。
51.根据权利要求47至50中任一项所述的方法,其中所述方法还包括第二抗癌治疗。
52.权利要求51所述的方法,其中所述第二抗癌治疗是手术、化学治疗、放射治疗、基因治疗或第二免疫治疗。
53.权利要求52所述的方法,其中所述第二抗癌治疗是第二免疫治疗。
54.权利要求53所述的方法,其中所述第二免疫治疗是检查点治疗。
55.权利要求52所述的方法,其中所述第二抗癌治疗是放射治疗。
56.权利要求55所述的方法,其中所述放射治疗施用两次或更多次,所述组合物施用两次或更多次,或者这二者施用两次或更多次。
57.权利要求47所述的方法,其中所述疾病或病症是感染性疾病。
58.权利要求57所述的方法,其中所述疾病或病症是病毒感染。
59.权利要求57所述的方法,其中所述疾病或病症是细菌感染。
60.根据权利要求47至59中任一项所述的方法,其中所述患者是哺乳动物。
61.权利要求60所述的方法,其中所述患者是人。
62.根据权利要求47至61中任一项所述的方法,其中所述方法包括施用所述组合物一次。
63.根据权利要求47至61中任一项所述的方法,其中所述方法包括施用所述组合物两次或更多次。
64.在患者中激活STING途径的方法,其包括向有此需要的患者施用包含抗原和佐剂的组合物,其中所述佐剂形成纳米粒。
65.权利要求64所述的方法,其中所述佐剂是合成聚合物。
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CN114269387A (zh) * | 2019-06-22 | 2022-04-01 | 德克萨斯大学系统董事会 | 生物可降解性超ph敏感性聚合物 |
CN111184738A (zh) * | 2020-03-04 | 2020-05-22 | 北京大学 | 一种二嵌段共聚物或其药学上可接受的盐在制备抗病毒药物中的应用、药物组合物 |
CN111184738B (zh) * | 2020-03-04 | 2021-05-28 | 北京大学 | 一种二嵌段共聚物或其药学上可接受的盐在制备抗病毒药物中的应用、药物组合物 |
CN114456331A (zh) * | 2022-02-16 | 2022-05-10 | 北京大学 | 能够与膜结合的聚合物及其制备方法和用途 |
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KR20180114946A (ko) | 2018-10-19 |
AU2017225769A1 (en) | 2018-09-20 |
JP2019511483A (ja) | 2019-04-25 |
CA3016457A1 (en) | 2017-09-08 |
MX2018010586A (es) | 2019-03-28 |
US20190060446A1 (en) | 2019-02-28 |
EP3423044A1 (en) | 2019-01-09 |
WO2017151922A1 (en) | 2017-09-08 |
AU2017225769B2 (en) | 2023-01-05 |
EP3423044A4 (en) | 2019-11-20 |
US11376324B2 (en) | 2022-07-05 |
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