Methods of treating chronic inflammatory diseases using a gm-csf antagonist
一种GM-CSF、慢性炎症的技术,应用在使用GM-CSF拮抗剂治疗慢性炎症疾病领域,能够解决TNF抑制剂治疗益处消失、TNF抑制剂不能达到足够的反应等问题
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Embodiment 1
[0145] The humanized antibody (humaneered antibodies) of embodiment 1 exemplary GM-CSF
[0146] A panel of humanized Fab' molecules with c19 / 2 specificity was prepared from an epitope-focused human V-segment library as described in US Patent Application 20060134098.
[0147] Fab' fragments were expressed from E. coli cells grown in 2xYT medium to an OD600 of 0.6. Expression was induced using IPTG for 3 hours at 33°C. Assembled Fab' was obtained from the periplasmic fraction and purified by affinity chromatography using streptococcal protein G (HiTrap protein G HP column; GE Healthcare) according to standard methods. Fab' were eluted in pH 2.0 buffer, then adjusted to pH 7.0 and dialyzed against PBS pH 7.4.
[0148] Binding kinetics were analyzed by Biacore 3000 surface plasmon resonance (SPR). Recombinant human GM-CSF antigen was biotinylated and immobilized on a streptavidin CM5 sensor chip. Fab samples were diluted to a starting concentration of 3 nM and serial 3-fold di...
Embodiment 2
[0152] EXAMPLE 2 EXEMPLARY CLINICAL PROTOCOL FOR DELIVERY OF ANTI-GM-CSF ANTIBODIES
[0153] Anti-GM-CSF antibody was stored at 10 mg / ml in sterile isotonic saline solution for injection at 4°C and diluted in 100 ml or 200 ml of 0.9% sodium chloride for injection before administration to patients. Antibodies are administered to RA patients at doses of 0.2 to 10 mg / kg by one hour intravenous infusion.
[0154] Patients included in this treatment regimen were selected based on the following criteria: patients exhibited signs of active RA; patients were receiving methotrexate, where patients had received stable doses of DMARDs for at least 6 weeks. In addition, patients included in this study exhibited the following symptoms: a swollen joint count of at least 6 (using a 66-joint count) and a tender joint count of at least 6 (using a 68-joint count). At least two of the following criteria were also included in the inclusion criteria: ESR ≥ 20 mm / hr, CRP ≥ 15 mg / l, morning stiffne...
Embodiment 3
[0158] Example 3 Treatment of Patients with Methotrexate and Anti-GM-CSF Antibodies
[0159] Patients with active RA were treated with methotrexate and anti-GM-CSF antibodies following the clinical protocol described in Example 2. Patients received 0.2 mg / kg of anti-GM-CSF antibody. The patient also received 25mg / week methotrexate treatment.
[0160] Blood counts, measured by standard methods, also include hemoglobin (HGB), total white blood cell count (WBCC), platelets (PLT), neutrophils (Neut; also called absolute neutrophil count ANC), lymphocytes (LYMPH ), monocytes (MONO), eosinophils (EOSIN), basophils (BASO), hematocrit (HCT) values. In addition, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were also measured. Blood counts, ESR and CRP before treatment, during treatment and up to 2 weeks after treatment are shown in Table 2. As can be seen, after 2 weeks, the ESR dropped from an abnormal value of 40 to 18, which is within the normal range for an...
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