# Patent

## Title
Antibodies that are capable of specifically binding tissue factor pathway inhibitor

## Abstract

The invention relates to antibodies that are capable of specifically binding tissue factor pathway inhibitor (TFPI), neutralizing free TFPI and reducing the clotting time of blood. Furthermore, the invention relates to polynucleotides that encode such antibodies and to cells that comprise the polynucleotides or that express the antibodies of the invention. Such antibodies have utility in the treatment of subjects with a coagulopathy, alone as well as in combination with a second agent.

## Background
CROSS-REFERENCE TO RELATED APPLICATIONS
This application is a continuation-in-part of U.S. application Ser. No. 13/805,900, filed Feb. 22, 2013, which is a 35 U.S.C. §371 National Stage application of PCT/EP2011/060980 filed Jun. 30, 2011 which claimed priority of European Patent Application 10167911.6, filed Jun. 30, 2010 and European Patent Application 11160763.6, filed Apr. 1, 2011; this application also claims priority under 35 U.S.C. §119(e) of U.S. Provisional application 61/362,108, filed Jul. 7, 2010 and U.S. Provisional application 61/475,895, filed Apr. 15, 2011; the contents of all above-named applications are incorporated herein by reference.


FIELD OF THE INVENTION
The present invention relates to antibodies that are capable of specifically binding the C-terminal of tissue factor pathway inhibitor (TFPI) and which are thus capable of neutralising the free pool of TFPI. The invention also relates to uses for such antibodies, such as therapeutic and pharmaceutical uses.
BACKGROUND OF THE INVENTION
In subjects with a coagulopathy, such as in human beings with haemophilia A and B, various steps of the coagulation cascade are rendered dysfunctional due to, for example, the absence or insufficient presence of a coagulation factor. Such dysfunction of one part of the coagulation cascade results in insufficient blood coagulation and potentially life-threatening bleeding, or damage to internal organs, such as the joints. Subjects such as human beings with haemophilia A and B may receive coagulation factor replacement therapy such as exogenous Factor VIII or Factor IX, respectively. However, such patients are at risk of developing “inhibitors” (antibodies) to such exogenous factors, rendering formerly efficient therapy ineffective. Furthermore, exogenous coagulation factors may only be administered intravenously, which is of considerable inconvenience and discomfort to patients. For example, infants and toddlers may have to have intravenous catheters surgically inserted into a chest vein, in order for venous access to be guaranteed. This leaves them at great risk of developing bacterial infections and thrombotic complications. Subjects with a coagulopathy may only receive therapy after a bleed has commenced, rather than as a precautionary measure, which often impinges upon their general quality of life. Thus, there are still many unmet medical needs in the haemophilia community, in particular, and in subjects with coagulopathies, in general.
The coagulation cascade is normally set into motion upon vessel wall injury, which exposes sub-endothelial tissue factor (TF) to the components of circulating blood. In brief, TF forms a complex with Factor VII/Factor VIIa (FVII/FVIIa) on the surface of TF-expressing cells. This complex activates Factor X (FX) to Factor Xa (FXa) which, with Factor Va (FVa) as cofactor, leads to the generation of a limited amount of thrombin (FIIa). Small amounts of thrombin activate platelets, which results in surface exposure of phospholipids that support the binding of the tenase complex, Factor VIIIa/Factor IXa (FVIIIa/FIXa). The tenase complex activates large amounts of FX to FXa, which subsequently results in the generation of a large amount of thrombin. A full thrombin burst is needed for the formation of a mechanically strong fibrin structure and stabilization of the haemostatic plug.
In individuals with haemophilia, FVIII or FIX is present at low levels, or may be entirely absent. Due to the lack of tenase activity, the capacity to generate FXa is low and insufficient to support the propagation phase of coagulation. In contrast, the TF-mediated initiation phase of coagulation is not dependent on the formation of the tenase complex. Initiation of coagulation via the TF-pathway will, however, be blocked by plasma inhibitors shortly after the initial FXa generation. One such inhibitor is tissue factor pathway inhibitor (TFPI), which inhibits both FXa and TF/FVIIa and plays a key role as a feed-back inhibitor of on-going coagulation. TFPI is a strong inhibitor of the TF-FVIIa complex only in the presence of FXa. Thus, efficient inhibition of TF/FVIIa requires generation of FXa, formation of the FXa/TFPI complex, and a subsequent formation of the ternary TF/FVIIa/FXa/TFPI complex.
Several pools of TFPI exist in vivo. A major fraction is bound to the vascular endothelium, a minor fraction is associated with lipoproteins in the blood, a small fraction is present in platelets and, finally, a small amount exists as free, circulating TFPI. Furthermore, TFPI exists as TFPIalpha, TFPIbeta and TFPIgamma forms. Neutralization of the inhibitory activity of certain fractions of TFPI may prove efficient in treatment of undesired bleedings.
Antibodies that are capable of binding TFPI are known in the art. Several documents disclose antibodies that are capable of binding to the K3 domain of TFPI, namely:

    
    
        J. Biochem, 1995, 118 (1): 178-182.
        Blood Coagul. Fibrinolyis, 1999, 10 (6): 309-19.
        JP6153981A.
    
    


These references do not disclose TFPI antibodies for the treatment of subjects with a coagulopathy.
There is still a need in the art of medicine for pharmaceuticals which may be used to enhance coagulation. There is a need for pharmaceuticals which may be administered not only intravenously but also by other routes of administration, such as subcutaneously. Thus, there is a need for pharmaceuticals, such as antibodies, which are pro-coagulant even when administered in low doses and/or which have a high bioavailability. Furthermore, there is a need for pharmaceuticals, such as antibodies, which are suitable for the prophylactic treatment of individuals with a congenital or acquired coagulopathy such as haemophilia A, haemophilia B, haemophilia A with inhibitors or haemophilia B with inhibitors. More specifically, there is a need for pharmaceuticals, such as antibodies, that lower the threshold for FVIII or FIX activity in individuals with haemophilia A and haemophilia B, respectively. Within the particular realm of antibodies that are capable of binding TFPI, there is a need for antibodies which do not bind to all pools of TFPI, such as antibodies which do not affect the function of endothelial cell-bound TFPI, such as the GPI-anchored pool of TFPI. More specifically, there is a need for TFPI antibodies that demonstrate dose linearity with respect to their half-life in plasma.
Disclosed herein are antibodies which are suitable for use as pharmaceuticals. Such antibodies may have a substantial impact upon the quality of life of—not least—individuals with haemophilia A or B, with or without inhibitors.
SUMMARY OF THE INVENTION
The inventors have developed monoclonal antibodies that are capable of specifically binding to the C-terminal of full length tissue factor pathway inhibitor (TFPI), wherein “C-terminal” is herein defined as that portion of TFPI which is, or which corresponds to, amino acid residues 186-276 of full length human TFPI (SEQ ID NO:1). The present invention relates to these antibodies and to other antibodies that are derived from these antibodies and/or that have similar binding properties and that are capable of modulating the activity of free TFPI.
Antibodies of the invention may be capable of specifically binding residues selected from the group consisting of P186, S187, L190, P192, A193, D194, R195, G196, L197, C198, R199, A200, N201, E202, N203, R204, F205, Y206, Y207, N208, K213, R215, P216, F217, K218, Y219, S220, N225, E226, N227, N228, T230, S231, K232, Q233, E234, L236, R237, K240, K241, G242, F243, I244, Q245, R246, I247, S248, K249, G250, G251, L252, I253, K254, T255, K256, R257, K258, R259, K260, K261, Q262, R263, V264, K265, I266, A267, Y268, E269, E270, I271, F272, V273, K274, N275 and M276 of SEQ ID NO: 1.
Antibodies of the invention may be capable of specifically binding residues selected from the group consisting of P186, S187, L190, P192, A193, D194, R195, G196, L197, C198, R199, A200, N201, E202, N203, R204, F205, Y206, Y207, N208, K213, R215, P216, F217, K218, Y219, S220, N225, E226, N227, N228, T230, S231, K232, Q233, E234, L236 and R237 of SEQ ID NO: 1.
Antibodies of the invention may be capable of specifically binding residues selected from the group consisting of K240, K241, G242, F243, I244, Q245, R246, I247, S248, K249, G250, G251, L252, I253, K254, T255, K256, R257, K258, R259, K260, K261, Q262, R263, V264, K265, I266, A267, Y268, E269, E270, I271, F272, V273, K274, N275 and M276 of SEQ ID NO: 1.
One particular antibody comprises the heavy chain variable region of SEQ ID NO: 7 and the light chain variable region of SEQ ID NO: 5. Another particular antibody comprises the heavy chain variable region of SEQ ID NO: 9 and the light chain variable region of SEQ ID NO: 11. A third particular antibody comprises the heavy chain variable region of SEQ ID NO: 13 and the light chain variable region of SEQ ID NO: 15.
The invention also provides polynucleotides which encode an antibody of the invention, such as polynucleotides which encode an antibody light chain and/or an antibody heavy chain of the invention.
The invention also provides pharmaceutical compositions comprising an antibody or polynucleotide of the invention and a pharmaceutically acceptable carrier or diluent.
The antibodies, polynucleotides and compositions of the invention are also provided for use in the treatment or prevention of a coagulopathy or the stimulation of blood clotting. That is, the invention provides a method for the treatment or prevention of a coagulopathy, or the stimulation of blood clotting, said method comprising administering to a patient in need thereof a therapeutically or prophylactically effective amount of an antibody, polynucleotide or composition of the invention.
BRIEF DESCRIPTION OF THE SEQUENCE LISTING
SEQ ID NO: 1 provides the amino acid sequence of full length human TFPI (signal peptide sequence omitted).
SEQ ID NO: 2 provides the amino acid sequence of truncated TFPI (1-239).
SEQ ID NO: 3 provides the amino acid sequence of truncated TFPI (1-245).
SEQ ID NO: 4 provides the nucleic acid sequence (signal peptide sequence omitted) of the variable heavy (VH) domain of anti-TFPI4F110 (also designated mAb 4F110).
SEQ ID NO: 5 provides the amino acid sequence (signal peptide sequence omitted) of the variable heavy (VH) domain of anti-TFPI4F110.
SEQ ID NO: 6 provides the nucleic acid sequence (signal peptide sequence omitted) of the variable light (VL) domain of anti-TFPI4F110.
SEQ ID NO: 7 provides the amino acid sequence (signal peptide sequence omitted) of the variable light (VL) domain of anti-TFPI4F110.
SEQ ID NO: 8 provides the nucleic acid sequence (signal peptide sequence omitted) of the variable heavy (VH) domain of anti-TFPI22F66.
SEQ ID NO: 9 provides the amino acid sequence (signal peptide sequence omitted) of the variable heavy (VH) domain of anti-TFPI22F66.
SEQ ID NO: 10 provides the nucleic acid sequence (signal peptide sequence omitted) of the variable light (VL) domain of anti-TFPI22F66.
SEQ ID NO: 11 provides the amino acid sequence (signal peptide sequence omitted) of the variable light (VL) domain of anti-TFPI22F66.
SEQ ID NO: 12 provides the nucleic acid sequence (signal peptide sequence omitted) of the variable heavy (VH) domain of anti-TFPI22F71.
SEQ ID NO: 13 provides the amino acid sequence (signal peptide sequence omitted) of the variable heavy (VH) domain of anti-TFPI22F71.
SEQ ID NO: 14 provides the nucleic acid sequence (signal peptide sequence omitted) of the variable light (VL) domain of anti-TFPI22F71.
SEQ ID NO: 15 provides the amino acid sequence (signal peptide sequence omitted) of the variable light (VL) domain of anti-TFPI22F71.
SEQ ID NO: 16 provides the nucleic acid sequence of the reverse primer that was used for HC (VH domain) amplification.
SEQ ID NO: 17 provides the nucleic acid sequence of the reverse primer that was used for TFPI22F66 and TFPI22F71 LC (VL domain) amplification.
SEQ ID NO: 18 provides the nucleic acid sequence of the reverse primer that was used for TFPI4F110 LC amplification.
SEQ ID NO: 19 provides the amino acid sequence of Factor VII/Factor VIIa.
SEQ ID NO: 20 provides the amino acid sequence of Factor VIII.
SEQ ID NO: 21 provides the amino acid sequence of Factor IX.
SEQ ID NO: 22 provides the amino acid sequence of truncated TFPI (1-240).
SEQ ID NO: 23 provides the amino acid sequence of truncated TFPI (1-241).
SEQ ID NO: 24 provides the amino acid sequence of truncated TFPI (1-242).
SEQ ID NO: 25 provides the amino acid sequence of truncated TFPI (1-243).
SEQ ID NO: 26 provides the amino acid sequence of truncated TFPI (1-244).
SEQ ID NO: 27 provides the amino acid sequence of soluble TFPI Kunitz domain 3.
SEQ ID NO: 28 provides the amino acid sequence of the heavy chain Fab portion of mAb 0001, derived from anti-TFPI4F110.
SEQ ID NO: 29 provides the amino acid sequence of the light chain of mAb 0001, derived from anti-TFPI4F110.



DESCRIPTION OF THE DRAWINGS
FIG. 1 shows the effect of the 4F110 TFPI antibody on TF-induced clot formation. Clotting time was measured with a dilute PT assay at various fixed concentrations of TF (Innovin® diluted 1:7,500; 1:15,000; 1:30,000) and antibody (0.005-1 nM).
FIG. 2 shows the effect of 4F110 anti-TFPI on TF-induced thrombin generation in FVIII-depleted plasma. Clotting was initiated by calcification and addition of Innovin® (TF source) to citrated FVIII-depleted plasma supplemented with 10 μM PS/PC in the absence and presence of 10 nM 4F110.
FIG. 3 shows the effect of 4F110 anti-TFPI on TF-induced thrombin generation in FVIII-depleted plasma replenished with various levels of rFVIII. Clotting was initiated by calcification and addition of Innovin® (TF source) to citrated FVIII-depleted plasma supplemented with 10 μM PS/PC in the absence and presence of 10 nM 4F110. Bars show the corresponding lag times calculated based on a thrombin threshold level of 1 nM (means±SD, n=x).
FIG. 4 shows the effect of 4F110 anti-TFPI and rFVIII on TF-induced clot formation in FVIII-depleted plasma supplemented with 150,000 platelets/μl measured by thromboelastography (TEG) analysis. A. TEG curves show the effect of adding 0.005, 0.05 and 1.0 U/ml rFVIII to FVIII-depleted plasma in the absence of anti-TFPI. B. TEG curves show the effect of adding 0.005, 0.05 and 1.0 U/ml rFVIII to FVIII depleted plasma in the presence of 10 nM 4F110 anti-TFPI C. R values (clot times) for the curves without AB shown in A (open bars) and with AB shown in B (closed bars). D. K (speed of clot kinetics) values for the curves without AB shown in A (open bars) and with AB shown in B (closed bars). E. Angle values for the curves without AB shown in A (open bars) and with AB shown in B (closed bars). F. MA (maximal amplitude) values for the curves without AB shown in A (open bars) and with AB shown in B (closed bars).
FIG. 5 shows the fluorescence-activated cell sorter (FACS) analysis of a TFPI-expressing cell line. As also illustrated in FIG. 6, the two C-terminal monoclonal antibodies were not able to bind to TFPI on a cellular surface.
FIG. 6 shows that the C-terminal TFPI antibodies named 4F110, 22F66, 22F71, 22F74, 22F79 and 22F132 do not bind or bind very poorly to truncated TFPI(1-239) (middle five bars).
FIG. 7 shows that six TFPI antibodies (4F110, 22F66, 22F71, 22F132, 22F79, 22F74) bind to different truncated forms of TFPI, listed at the right. Binding is relative to the binding to wild type (wt) TFPI (1.0).
FIG. 8 shows the neutralization of TFPI inhibition of FVIIa/TF/FXa activity in the presence of phospholipid (PS/PC) vesicles. Open circle: 4F110; filled circle 22F66; square: 22F71; grey triangle: 22F79; open triangle: 22F74; grey rhombus: 22F132.
FIG. 9 is a cartoon of the structure of TFPI and the various pools of TFPI.



DESCRIPTION OF THE INVENTION
The invention relates to antibodies that are capable of specifically binding full-length tissue factor pathway inhibitor (TFPI), such as antibodies that bind to the “C-terminal” of TFPI. Antibodies that specifically bind to the “C-terminal” of TFPI, or portion thereof, may bind exclusively to the “C-terminal” of TFPI, or portion thereof, or may be capable of binding to a limited number of homologous antigens, or portions thereof. Such antibodies may specifically bind the C-terminal domain and/or the Kunitz 3 (K3) domain of TFPI; that is, they may bind to the “C-terminal” but may not bind to the Kunitz 1 (K1) domain of TFPI, the Kunitz 2 (K2) domain of TFPI, or to other similar molecules. Antibodies of the invention may not bind to a TFPI molecule that comprise the K1 and/or K2 domain but that lack that portion of TFPI which is C-terminal to the K2 domain. Antibodies of the invention may be incapable of binding truncated TFPI, such as C-terminal truncated TFPI. Truncated forms of TFPI that may not be bound by the antibodies of the invention include the polypeptide of SEQ ID NO: 2 and a polypeptide having the sequence of amino acids 1 to 161 of SEQ ID NO: 1. Alternatively, the antibodies may bind the K1 domain of TFPI, the K2 domain of TFPI, or other molecules such as truncated TFPI molecules with a low affinity compared to that with which they bind the C-terminal of TFPI.
The term “TFPI”, as used herein, encompasses any naturally occurring form of TFPI which may be derived from any suitable organism. For example, TFPI for use as described herein may be vertebrate TFPI, such as mammalian TFPI, such as TFPI from a primate (such as a human); a rodent (such as a mouse or a rat), a lagomorph (such as a rabbit), or an artiodactyl (such a cow, sheep, pig or camel). Preferably, the TFPI is human TFPI. The TFPI may be a mature form of TFPI such as a TFPI protein that has undergone post-translational processing within a suitable cell. Such a mature TFPI protein may, for example, be glycosylated. The TFPI may be a full length TFPI protein. The term TFPI also encompasses variants, isoforms and other homologs of such TFPI molecules. Variant TFPI molecules may have the same type of activity as naturally occurring TFPI, such as the ability to neutralize the catalytic activity of FXa, or the ability to inhibit a complex of TF-FVIIa/FXa.
The term “C-terminal”, as used herein, refers to any part of TFPI that is C-terminal to the amino acid residue which corresponds to amino acid 185 of human TFPI (SEQ ID NO: 1). The term “C-terminal” specifically excludes the Kunitz 1 (K1) and Kunitz 2 (K2) domains of TFPI. On the other hand, the term “C-terminal” includes parts of TFPI that are within the Kunitz 3 (K3) domain of TFPI (amino acids 185-238) and/or parts of TFPI that include amino acids 240-276.
“Free TFPI” is the in vivo pool of TFPI that contains an available “C-terminal”. The term “free TFPI” refers to the soluble pool of TFPI in plasma. Other pools of TFPI, that are not “free TFPI”, are GPI-anchored TFPI and lipoprotein bound TFPI. In contrast to free TFPI, these pools of TFPI do not have a C-terminal that is available for binding to, eg., an antibody. Antibodies of the invention may be capable of specifically binding free TFPI, but may not be capable of specifically binding GPI-anchored TFPI. Antibodies of the invention may be capable of specifically binding free TFPI, but may not be capable of specifically binding lipoprotein bound TFPI.
Thus, the invention relates to antibodies that may be capable of modulating the activity of free TFPI, only. Such antibodies may possess the ability to shorten clotting time. For example, an antibody of the invention may have the ability to shorten clotting time in human FVIII-deficient plasma or human FIX-deficient plasma, or to reduce time to clot as measured in a thromboelastography (TEG) analysis of human whole blood.
Antibodies of the invention may be monoclonal antibodies in the sense that they are made by identical immune cells that are all clones of the same parent cell. Antibodies of the invention may be produced, screened and purified using the methods described in the Examples. Antibodies of the invention may also be produced by means of other methods known to the person skilled in the art, such as a phage display or a yeast display. Once produced, antibodies may be screened for binding to, for example, full length TFPI, truncated TFPI (1-161), truncated TFPI (1-239), truncated TFPI (1-240), truncated TFPI (1-241), truncated TFPI (1-242), truncated TFPI (1-243), truncated TFPI (1-244), truncated TFPI (1-245) and truncated TFPI (1-246) using the methods described in the Examples.
The term “antibody” herein refers to a protein, derived from a germline immunoglobulin sequence that is capable of specifically binding to an antigen or a portion thereof. The term includes full length antibodies of any isotype (that is, IgA, IgE, IgG, IgM and/or IgY) and any single chain thereof.
The term “antibody”, as referred to herein, includes whole antibodies and any antigen binding fragment (i.e., “antigen-binding portion”) or single chains thereof. An antibody refers to a glycoprotein comprising at least two heavy chains (HC) and two light chains (LC) that are interconnected by disulfide bonds; or an antigen binding portion thereof. Each heavy chain is comprised of a heavy chain variable region (VH) and a heavy chain constant region (CH). Each light chain is comprised of a light chain variable region (VL) and a light chain constant region (CL). The variable regions of the heavy and light chains contain a binding domain that interacts with an antigen. The VH and VL regions can be further subdivided into regions of hypervariability, termed complementarity determining regions (CDR), interspersed with regions that are more conserved, termed framework regions (FR). The constant regions of the antibodies may mediate the binding of the immunoglobulin to host tissues or factors, including various cells of the immune system (e.g., effector cells) and the first component (Clq) of the classical complement system.
Examples of antigen-binding fragments of the invention include Fab, Fab′, F(ab)2, F(ab′)2, F(ab)S, Fv (typically the VL and VH domains of a single arm of an antibody), single-chain Fv (scFv; see e.g. Bird et al., Science 1988; 242:42S-426; and Huston et al. PNAS 1988; 85:5879-5883), dsFv, Fd (typically the VH and CHI domain), and dAb (typically a VH domain) fragments; VH, VL, VhH, and V-NAR domains; monovalent molecules comprising a single VH and a single VL chain; minibodies, diabodies, triabodies, tetrabodies, and kappa bodies (see, e.g., Ill et al. Protein Eng 1997; 10:949-57); camel IgG; IgNAR; as well as one or more isolated CDRs or a functional paratope, where the isolated CDRs or antigen-binding residues or polypeptides can be associated or linked together so as to form a functional antibody fragment. Various types of antibody fragments have been described or reviewed in, e.g., Holliger and Hudson, Nat Biotechnol 2005; 2S:1126-1136; WO2005040219, and published U.S. Patent Applications 20050238646 and 20020161201.
“Fab fragments”, including “Fab” and “Fab(ab′)2” fragments, of an antibody are derived from said antibody by cleavage of the heavy chain in the hinge region on the N-terminal or C-terminal side the hinge cysteine residues connecting the heavy chains of the antibody. A “Fab” fragment includes the variable and constant domains of the light chain and the variable domain and the first constant domain (CH1) of the heavy chain. “F(ab′)2” fragments comprise a pair of “Fab” fragments that are generally covalently linked by their hinge cysteines. A Fab′ is formally derived from a F(ab′)2 fragment by cleavage of the hinge disulfide bonds connecting the heavy chains in the F(ab′)2. Other chemical couplings than disulfide linkages of antibody fragments are also known in the art. A Fab fragment retains the ability of the parent antibody to bind to its antigen, potentially with a lower affinity. F(ab′)2 fragments are capable of divalent binding, whereas Fab and Fab′ fragments can bind monovalently. Generally, Fab fragments lack the constant CH2 and CH3 domains, i.e. the Fc part, where interaction with the Fc receptors would occur. Thus, Fab fragments are in general devoid of effector functions. Fab fragments may be produced by methods known in the art, either by enzymatic cleavage of an antibody, e.g. using papain to obtain the Fab or pepsin to obtain the F(ab′)2, or Fab fragments may be produced recombinantly using techniques that are well known to the person skilled in the art.
An “Fv” fragment is an antibody fragment that contains a complete antigen recognition and binding site, and generally comprises a dimer of one heavy and one light chain variable domain in association that can be covalent in nature, for example in a single chain variable domain fragment (scFv). It is in this configuration that the three hypervariable regions of each variable domain interact to define an antigen-binding site on the surface of the VH-VL dimer. Collectively, the six hypervariable regions or a subset thereof confer antigen binding specificity to the antibody. However, even a single variable domain comprising only three hypervariable regions specific for an antigen has the ability to recognize and bind antigen, although usually at a lower affinity than the entire binding site (Cai & Garen, Proc. Natl. Acad. Sci. USA, 93: 6280-6285, 1996). For example, naturally occurring camelid antibodies that only have a heavy chain variable domain (VHH) can bind antigen (Desmyter et al., J. Biol. Chem., 277: 23645-23650, 2002; Bond et al., J. Mol. Biol. 2003; 332: 643-655).
“Single-chain Fv” or “scFv” antibody fragments comprise the VH and VL domains of antibody, where these domains are present in a single polypeptide chain. Generally, the Fv polypeptide further comprises a polypeptide linker between the VH and VL domains that enables the scFv to form the desired structure for antigen binding. For a review of scFv, see Pluckthun, 1994, In: The Pharmacology of Monoclonal Antibodies, Vol. 113, Rosenburg and Moore eds. Springer-Verlag, New York, pp. 269-315.
The term “diabodies” refers to small antibody fragments with two antigen-binding sites, in which fragments comprise a heavy chain variable domain (VH) connected to a light chain variable domain (VL) in the same polypeptide chain (VH and VL). By using a linker that is too short to allow pairing between the two variable domains on the same chain, the variable domains are forced to pair with complementary domains of another chain, creating two antigen-binding sites. Diabodies are described more fully, for example, in EP 404,097; WO 93/11161; and Hollinger et al., 1993, Proc. Natl. Acad. Sci. USA, 90:6444-6448.
The expression “linear antibodies” refers to antibodies as described in Zapata et al., 1995, Protein Eng., 8(10):1057-1062. Briefly, these antibodies contain a pair of tandem Fd segments (VH-CH1-VH-CH1) that, together with complementary light chain polypeptides, form a pair of antigen binding regions. Linear antibodies can be bispecific or monospecific.
The term “monobody” as used herein, refers to an antigen binding molecule with a heavy chain variable domain and no light chain variable domain. A monobody can bind to an antigen in the absence of light chains and typically has three hypervariable regions, for example CDRs designated CDRH1, CDRH2, and CDRH3. A heavy chain IgG monobody has two heavy chain antigen binding molecules connected by a disulfide bond. The heavy chain variable domain comprises one or more hypervariable regions, preferably a CDRH3 or HVL-H3 region.
Antibody fragments may be obtained using conventional recombinant or protein engineering techniques, and the fragments may be screened for binding to full length TFPI, truncated TFPI (1-161), truncated TFPI (1-239), truncated TFPI (1-240), truncated TFPI (1-241), truncated TFPI (1-242), truncated TFPI (1-243), truncated TFPI (1-244), truncated TFPI (1-245) and truncated TFPI (1-246) in the same manner as intact antibodies.
Antibody fragments of the invention may be made by truncation, e.g. by removal of one or more amino acids from the N and/or C-terminal ends of a polypeptide. Fragments may also be generated by one or more internal deletions.
An antibody of the invention may be, or may comprise, a fragment of the MuTFPI4F110 antibody, the MuTFPI22F66 antibody, the MuTFPI22F71 antibody, the MuTFPI 22F74 antibody, the MuTFPI 22F79 antibody, the MuTFPI 22F132 antibody, or a variant of any one of these antibodies. An antibody of the invention may be, or may comprise, an antigen binding portion of one of these antibodies, or variants thereof. For example, the antibody of the invention may be a Fab fragment of one of these antibodies or variants thereof, or it may be a single chain antibody derived from one of these antibodies, or a variant thereof.
The MuTFPI4F110 antibody has a variable heavy chain sequence as shown in SEQ ID NO: 5 and a variable light chain sequence as shown in SEQ ID NO: 7. An antibody of the invention may comprise this variable heavy chain sequence and/or this variable light chain sequence. The MuTFPI4F110 antibody has the CDR sequences shown at amino acid residues 31 to 35, 50 to 66 and 99 to 107 of SEQ ID NO: 5 and amino acid residues 24 to 34, 50 to 56 and 89 to 97 of SEQ ID NO: 7. An antibody of the invention may comprise 1, 2, 3, 4, 5 or all 6 of these CDR sequences. An antibody of the invention may comprise amino acid residues 99 to 107 of SEQ ID NO: 5.
The MuTFPI22F66 antibody has a variable heavy chain sequence as shown in SEQ ID NO: 9 and a variable light chain sequence as shown in SEQ ID NO: 11. An antibody of the invention may comprise this variable heavy chain sequence and/or this variable light chain sequence. The MuTFPI22F66 antibody has the CDR sequences shown at amino acid residues 31 to 35, 50 to 66 and 99 to 106 of SEQ ID NO: 9 and amino acid residues 24 to 33, 49 to 55 and 88 to 96 of SEQ ID NO: 11. An antibody of the invention may comprise 1, 2, 3, 4, 5 or all 6 of these CDR sequences. An antibody of the invention may comprise amino acid residues 99 to 106 of SEQ ID NO: 9.
The MuTFPI22F71 antibody has a variable heavy chain sequence as shown in SEQ ID NO: 13 and a variable light chain sequence as shown in SEQ ID NO: 15. An antibody of the invention may comprise this variable heavy chain sequence and/or this variable light chain sequence. The MuTFPI22F71 antibody has the CDR sequences shown at amino acid residues 31 to 35, 50 to 66 and 99 to 111 of SEQ ID NO: 13 and amino acid residues 24 to 38, 54 to 60 and 93 to 101 of SEQ ID NO: 15. An antibody of the invention may comprise 1, 2, 3, 4, 5 or all 6 of these CDR sequences. An antibody of the invention may comprise amino acid residues 99 to 111 of SEQ ID NO: 13.
Antibodies of the current invention may be isolated. The term “isolated antibody” refers to an antibody that has been separated and/or recovered from another/other component(s) of its natural environment and/or purified from a mixture of components in its natural environment.
An antibody of the invention may be a human antibody or a humanized antibody. The term “human antibody”, as used herein, is intended to include antibodies having variable regions in which both the framework and CDR regions are derived from human germline immunoglobulin sequences. Furthermore, if the antibody contains a constant region, the constant region also is derived from human germline immunoglobulin sequences. The human antibodies of the invention may include amino acid residues not encoded by human germline immunoglobulin sequences (e.g., mutations introduced by random or site-specific mutagenesis in vitro or by somatic mutation in vivo). However, the term “human antibody”, as used herein, is not intended to include antibodies in which CDR sequences derived from the germline of another mammalian species, such as a mouse, have been grafted onto human framework sequences.
Such a human antibody may be a human monoclonal antibody. Such a human monoclonal antibody may be produced by a hybridoma which includes a B cell obtained from a transgenic nonhuman animal, e.g., a transgenic mouse, rat or rabbit, having a genome comprising a human heavy chain transgene and a light chain transgene fused to an immortalized cell.
Human antibodies may be isolated from sequence libraries built on selections of human germline sequences, further diversified with natural and synthetic sequence diversity.
Human antibodies may be prepared by in vitro immunisation of human lymphocytes followed by transformation of the lymphocytes with Epstein-Barr virus.
The term “human antibody derivatives” refers to any modified form of the human antibody, e.g., a conjugate of the antibody and another agent or antibody.
The term “humanized antibody” is intended to refer to a human/non-human chimeric antibody that contains a minimal sequence (CDR regions) derived from non-human immunoglobulin. Humanized antibodies are thus human immunoglobulins (recipient antibody) in which residues from a hyper-variable region of the recipient are replaced by residues from a hypervariable region of a non-human species (donor antibody) such as from a mouse, rat, rabbit, or non-human primate, having the desired specificity, affinity, and capacity. In some instances, FR residues of the human immunoglobulin are replaced by corresponding non-human residues. An example of such a modification is the introduction of one or more so-called back-mutations.
The term “humanized antibody derivative” refers to any modified form of the humanized antibody, such as a conjugate of the antibody and another agent or antibody.
Furthermore, humanized antibodies may comprise residues that are not found in the recipient antibody or in the donor antibody. These modifications are made to further refine antibody performance. In general, a humanized antibody will comprise substantially all of at least one, and typically two, variable domains, in which all or substantially all of the hypervariable loops correspond to those of a non-human immunoglobulin and all or substantially all of the FR residues are those of a human immunoglobulin sequence. The humanized antibody can optionally also comprise at least a portion of an immunoglobulin constant region (Fc), typically that of a human immunoglobulin.
The “fragment crystallizable” region (“Fc region”/“Fc domain”) of an antibody is the N-terminal region of an antibody, which comprises the constant CH2 and CH3 domains. The Fc domain may interact with cell surface receptors called Fc receptors, as well as some proteins of the complement system. The Fc region enables antibodies to interact with the immune system. In one aspect of the invention, antibodies may be engineered to include modifications within the Fc region, typically to alter one or more of its functional properties, such as serum half-life, complement fixation, Fc-receptor binding, protein stability and/or antigen-dependent cellular cytotoxicity, or lack thereof, among others. Furthermore, an antibody of the invention may be chemically modified (e.g., one or more chemical moieties can be attached to the antibody) or be modified to alter its glycosylation, again to alter one or more functional properties of the antibody. Preferably, a modified Fc domain comprises one or more, and perhaps all of the following mutations that will result in decreased affinity to certain Fc receptors (L234A, L235E, and G237A) and in reduced C1q-mediated complement fixation (A3305 and P3315), respectively (residue numbering according to the EU index).
In one aspect, antibodies of the invention may be engineered to include modifications within the Fc region, typically to alter one or more functional properties of the antibody, such as serum half-life, complement fixation, Fc receptor binding, protein stability and/or antigen-dependent cellular cytotoxicity, or lack thereof. Furthermore, an antibody of the invention may be chemically modified (e.g., one or more chemical moieties can be attached to the antibody) or be modified to alter its glycosylation, again to alter one or more functional properties of the antibody.
The isotype of an antibody of the invention may be IgG, such as IgG1, such as IgG2, such as IgG4. If desired, the class of an antibody may be “switched” by known techniques. For example, an antibody that was originally produced as an IgM molecule may be class switched to an IgG antibody. Class switching techniques also may be used to convert one IgG subclass to another, for example: from IgG1 to IgG2 or IgG4; from IgG2 to IgG1 or IgG4; or from IgG4 to IgG1 or IgG2. Engineering of antibodies to generate constant region chimeric molecules, by combination of regions from different IgG subclasses, can also be performed.
In one embodiment, the hinge region of CHI is modified such that the number of cysteine residues in the hinge region is altered, e.g., increased or decreased. This approach is described further for instance in U.S. Pat. No. 5,677,425 by Bodmer et al.
The constant region may further be modified to stabilize the antibody, e.g., to reduce the risk of a bivalent antibody separating into two monovalent VH-VL fragments. For example, in an IgG4 constant region, residue S241 may be mutated to a proline (P) residue to allow complete disulphide bridge formation at the hinge (see, e.g., Angal et al., Mol. Immunol. 199S; 30:105-8).
An antibody of the invention will have the ability to bind to TFPI. An antibody of the invention is, preferably, capable of specifically binding the C-terminal of TFPI. That is, it is capable of binding the C-terminal of TFPI with a greater binding affinity than that with which it binds to the K1 domain of TFPI, the K2 domain of TFPI, or another molecule.
The target molecule of an antibody of the invention may be any TFPI molecule as described herein, such as a naturally occurring TFPI molecule, a fully mature TFPI molecule or a full-length TFPI molecule. The TFPI molecule may be in a form that is present in vivo. The target molecule may be TFPI in a form that is present in plasma in vivo. The antibody of the invention may be able to discriminate between the various naturally occurring forms of TFPI, binding to some but not to others. For example, antibodies of the invention may not be capable of binding naturally occurring, truncated forms of TFPI that do not comprise a K3 domain and/or a carboxy terminal domain. However, the target molecule may be a truncated TFPI molecule that comprises a K3 domain and/or a carboxy terminal. The target molecule may be a variant or a fragment of a TFPI molecule. The target molecule may consist of, or may comprise, the amino acid sequence of SEQ ID NO: 1, or a fragment or other variant thereof. Target molecules comprise a suitable epitope for antibody binding, such as the epitope described herein.
The target molecule may comprise five or more, ten or more, fifteen or more, twenty or more, twenty five or more, or thirty or more surface accessible residues of TFPI or of a particular region of TFPI, such as the K3 domain or the C-terminal of TFPI. A surface accessible residue is a residue having more than 40% relative accessibility.
Methods of measuring surface accessibility are well known in the art, having first been described by Lee & Richards in 1971 [Lee and F. M. Richards, “The Interpretation of Protein Structures: Estimation of Static Accessibility” J. Mol. Biol. 55, 379-400 (1971)]. Surface accessibilities may be calculated using the computer program Quanta 2005, from Accelrys Inc., using the atomic coordinates originating from, for example, X-ray structures or homology built structures.
The term “binding affinity” is herein used as a measure of the strength of a non-covalent interaction between two molecules, e.g. an antibody, or fragment thereof, and an antigen. The term “binding affinity” is used to describe monovalent interactions (intrinsic activity).
Binding affinity between two molecules, e.g. an antibody, or fragment thereof, and an antigen, through a monovalent interaction may be quantified by determining the dissociation, or binding, constant (KD). In turn, KD can be determined by measurement of the kinetics of complex formation and dissociation, e.g. by the SPR method (Biacore). The rate constants corresponding to the association and the dissociation of a monovalent complex are referred to as the association rate constant ka (or kon) and dissociation rate constant kd (or koff), respectively. KD is related to ka and kd through the equation KD=kd/ka.
Following the above definition, binding affinities associated with different molecular interactions, e.g. comparison of the binding affinity of different antibodies for a given antigen, may be compared by comparison of the KD values for the individual antibody/antigen complexes.
An antibody according to the current invention may be able to compete with another molecule for binding to the “C-terminal” of TFPI, such as the portion of TFPI represented by SEQ ID NO: 27. Therefore, an antibody according to the current invention may be able to bind the “C-terminal” of TFPI with a greater affinity that that of another molecule also capable of binding the “C-terminal” of TFPI. The ability of an antibody to compete with another molecule for binding to the “C-terminal” of TFPI may be assessed by determining and comparing the KD value for the interactions of interest, such as a specific interaction between an antibody and an antigen, with that of the KD value of an interaction not of interest.
Typically, the KD for the antibody with respect to the target will be 2-fold, preferably 5-fold, more preferably 10-fold less than KD with respect to the other, non-target molecule such as unrelated material or accompanying material in the environment. More preferably, the KD will be 50-fold less, such as 100-fold less, or 200-fold less; even more preferably 500-fold less, such as 1,000-fold less, or 10,000-fold less.
The value of this binding constant can be determined directly by well-known methods, and can be computed even for complex mixtures by methods such as those, for example, set forth in Caceci et al. (Byte 9:340-362, 1984). For example, the KD may be established using a double-filter nitrocellulose filter binding assay such as that disclosed by Wong & Lohman (Proc. Natl. Acad. Sci. USA 90, 5428-5432, 1993). Other standard assays to evaluate the binding ability of ligands such as antibodies towards targets are known in the art, including for example, ELISAs, Western blots, RIAs, and flow cytometry analysis. The binding kinetics and binding affinity of the antibody also can be assessed by standard assays known in the art, such as Surface Plasmon Resonance (SPR), e.g. by using a BiacoreTM system.
A competitive binding assay can be conducted in which the binding of the antibody to the target is compared to the binding of the target by another ligand of that target, such as another antibody. The concentration at which 50% inhibition occurs is known as the Ki. Under ideal conditions, the Ki is equivalent to KD. The Ki value will never be less than the KD, so measurement of Ki can conveniently be substituted to provide an upper limit for KD.
An antibody of the invention may have a KD for its target of 1×10−7M or less, 1×10−8M or less, or 1×10−9M or less, or 1×10−19M or less, 1×10−11M or less, or 1×10−12M or less. The KD of an antibody of the current invention may be less than 0.8 nM, such as less than 0.7 nM, such as less than 0.6 nM, such as less than 0.5 nM, such as less than 0.4 nM, such as less than 0.3 nM, such as less than 0.2 nM, such as less than 0.1 nM, such as less than 0.05 nM, such as less than 0.025 nM, such as less than 0.015 nM, such as less than 0.10 nM.
An antibody that specifically binds its target may bind its target with a high affinity, that is, exhibiting a low KD as discussed above, and may bind to other, non-target molecules with a lower affinity. For example, the antibody may bind to non-target molecules with a KD of 1×10−6M or more, more preferably 1×10−5 M or more, more preferably 1×10−4 M or more, more preferably 1×10−3 M or more, even more preferably 1×10−2 M or more. An antibody of the invention is preferably capable of binding to its target with an affinity that is at least two-fold, 10-fold, 50-fold, 100-fold 200-fold, 500-fold, 1,000-fold or 10,000-fold or greater than its affinity for binding to another non-target molecule.
The antibody of the current invention may be capable of neutralising TFPI inhibition of the FVIIa/TF/FX complex.
The antibody of the current invention may be capable of binding TFPI such that the percentage of free TFPI in a subject is reduced to less than 50%, such as less than 30%, such as less than 29%, such as less than 28%, such as less than 27%, such as less than 26%, such as less than 25%, such as less than 24%, such as less than 23%, such as less than 22%, such as less than 21%, such as less than 20%, such as less than 19%, such as less than 18%, such as less than 17%, such as less than 16%, such as less than 15%, such as less than 14%, such as less than 13%, such as less than 12%, such as less than 11%, such as less than 10%, such as less than 9%, such as less than 8%, such as less than 7%, such as less than 6%, such as less than 5%, such as less than 4%, such as less than 3%, such as less than 2%, such as less than 1%, such as between 1% and 0%.
The term “complementarity-determining region” (“CDR”) or “hypervariable region”, when used herein, refers to the amino acid residues of an antibody that are responsible for antigen binding. The CDRs are generally comprised of amino acid residues 24-34 (L1), 50-56 (L2) and 89-97 (L3) in the light-chain variable domain and 31-35 (H1), 50-65 (H2) and 95-102 (H3) in the heavy-chain variable domain; (Kabat et al. (1991) Sequences of Proteins of Immunological Interest, Fifth Edition, U.S. Department of Health and Human Services, NIH Publication No. 91-3242) and/or those residues from a “hypervariable loop” (residues 26-32 (L1), 50-52 (L2) and 91-96 (L3) in the light-chain variable domain and 26-32 (H1), 53-55 (H2) and 96-101 (H3) in the heavy-chain variable domain; Chothia and Lesk, J. Mol. Biol. 1987; 196:901-917). Typically, the numbering of amino acid residues in this region is performed by the method described in Kabat et al., supra. Phrases such as “Kabat position”, “Kabat residue”, and “according to Kabat” herein refer to this numbering system for heavy chain variable domains or light chain variable domains. Using the Kabat numbering system, the actual linear amino acid sequence of a peptide may contain fewer or additional amino acids corresponding to a shortening of, or insertion into, a framework (FR) or CDR of the variable domain. For example, a heavy chain variable domain may include amino acid insertions (residue 52a, 52b and 52c according to Kabat) after residue 52 of CDR H2 and inserted residues (e.g. residues 82a, 82b, and 82c, etc. according to Kabat) after heavy chain FR residue 82. The Kabat numbering of residues may be determined for a given antibody by alignment at regions of homology of the sequence of the antibody with a “standard” Kabat numbered sequence.
The term “framework region” or “FR” residues refer to those VH or VL amino acid residues that are not within the CDRs, as defined herein.
An antibody of the invention may comprise a CDR region from one or more of the specific antibodies disclosed herein, such as a CDR region from within SEQ ID NOs: 5, 7, 9, 11, 13 or 15. The CDR sequences within the light chain of an antibody of the invention may be identified at: amino acids 24 to 34, 50 to 56 and 89 to 97 of SEQ ID NO: 7; amino acids 24 to 33, 49 to 55 and 88 to 96 of SEQ ID NO: 11; amino acids 24 to 38, 54 to 60 and 93 to 101 of SEQ ID NOs: 15. The CDR sequences within the heavy chain of an antibody of the invention may be identified at: amino acids 31 to 35, 50 to 66 and 99 to 107 of SEQ ID NO: 5; at amino acids 31 to 35, 50 to 66 and 99-106 of SEQ ID NO: 9; amino acids 31 to 35, 50 to 66 and 99-106 of SEQ ID NO: 9; at amino acids 31 to 35, 50 to 66 and 99-111 of SEQ ID NO: 13.
An antibody of the invention may comprise any one or more of these CDR sequences. An antibody of the invention may comprise the CDR3 heavy chain sequence of one of the antibodies described herein, e.g. amino acids 99 to 107 of SEQ ID NO: 5, 99 to 106 of SEQ ID NO: 9 or 99 to 111 of SEQ ID NO: 13. An antibody of the invention may comprise all six CDRs from one of the specific antibodies described herein such as the CDR amino acids indicated above from SEQ ID NO: 5 and SEQ ID NO: 7, the CDR amino acids indicated above from SEQ ID NO: 9 and SEQ ID NO: 11 or the CDR amino acids indicated above from SEQ ID NO: 13 and SEQ ID NO: 15.
The term “epitope”, as used herein, is defined in the context of a molecular interaction between an “antigen binding polypeptide” (Ab) and its corresponding “antigen” (Ag). The term antigen (Ag) refers to the molecular entity used for immunization of an immunocompetent vertebrate to produce the antibody (Ab) that recognizes the Ag. Herein, Ag is termed more broadly and is generally intended to include target molecules that are specifically recognized by the Ab, thus including fragments or mimics of the molecule used in the immunization process for raising the Ab. Thus, for Abs that bind to the C-terminal of TFPI, both full-length TFPI, truncated TFPI and other variants of TFPI that comprise the C-terminal portion of TFPI are referred to as an Ag.
Generally, the term “epitope” refers to the area or region on an Ag to which an Ab specifically binds, i.e. the area or region in physical contact with the Ab. A protein epitope may comprise amino acid residues in the Ag that are directly involved in binding to a Ab (also called the immunodominant component of the epitope) and other amino acid residues, which are not directly involved in the binding, such as amino acid residues of the Ag which are effectively blocked by the Ab (in other words, the amino acid residue is within the “solvent-excluded surface” and/or the “footprint” of the Ab). The term epitope herein includes both types of binding sites in any particular region of the K3 domain or the C-terminal domain of TFPI that specifically binds to an anti-TFPI antibody, or another “C-terminal”-specific agent according to the invention, unless otherwise stated (e.g., in some contexts the invention relates to antibodies that bind directly to particular amino acid residues). The “C-terminal” may comprise a number of different epitopes, which may include, without limitation, (1) linear peptide antigenic determinants, (2) conformational antigenic determinants which consist of one or more non-contiguous amino acids located near each other in the mature C-terminal conformation; and (3) post-translational antigenic determinants which consist, either in whole or part, of molecular structures covalently attached to the “C-terminal”, such as carbohydrate groups.
The epitope for a given antibody (Ab)/antigen (Ag) pair can be defined and characterized at different levels of detail using a variety of experimental and computational epitope mapping methods. The experimental methods include mutagenesis, X-ray crystallography, Nuclear Magnetic Resonance (NMR) spectroscopy, Hydroged deuterium eXchange Mass Spectrometry (HX-MS) and various competition binding methods. As each method relies on a unique principle the description of an epitope is intimately linked to the method by which it has been determined. Thus, the epitope for a given Ab/Ag pair will be defined differently depending on the epitope mapping method employed.
At its most detailed level, the epitope for the interaction between the Ag and the Ab can be defined by the spatial coordinates defining the atomic contacts present in the Ag-Ab interaction, as well as information about their relative contributions to the binding thermodynamics. At a less detailed level the epitope can be characterized by the spatial coordinates defining the atomic contacts between the Ag and Ab. At a further less detailed level the epitope can be characterized by the amino acid residues that it comprises as defined by a specific criterium, e.g. distance between atoms in the Ab and the Ag. At a further, less detailed, level the epitope can be characterized through function, e.g. by competition binding with other Abs. The epitope can also be defined more generically as comprising amino acid residues for which substitution by another amino acid will alter the characteristics of the interaction between the Ab and Ag.
In the context of an X-ray derived crystal structure defined by spatial coordinates of a complex between an Ab, e.g. a Fab fragment, and its Ag, the term epitope is herein, unless otherwise specified or contradicted by context, specifically defined as K3 or C-terminal residues characterized by having a heavy atom (i.e. a non-hydrogen atom) within a distance of 2-6 Å, such as 3 Å, such as 4 Å, such as 5 Å from a heavy atom in the Ab.
From the fact that descriptions and definitions of epitopes, dependent on the epitope mapping method used, are obtained at different levels of detail, it follows that comparison of epitopes for different Abs on the same Ag can similarly be conducted at different levels of detail.
Epitopes described at the amino acid residue level, e.g. determined from an X-ray structure, are said to be identical if they contain the same set of amino acid residues. Epitopes are said to overlap if at least one amino acid residue is shared by the epitopes. Epitopes are said to be separate (unique) if no amino acid residue are shared by the epitopes.
Epitopes characterized by competition binding are said to be overlapping if the binding of corresponding Ab's are mutually exclusive, i.e. if the binding of one Ab excludes simultaneous binding of the other Ab. The epitopes are said to be separate (unique) if the Ag is able to accommodate binding of both corresponding Ab's simultaneously.
The definition of the term “paratope” is derived from the above definition of “epitope” by reversing the perspective. Thus, the term “paratope” refers to the area or region on the Ab to which an Ag specifically binds, i.e. to which it makes physical contact to the Ag.
In the context of an X-ray derived crystal structure defined by spatial coordinates of a complex between an Ab, e.g. a Fab fragment, and its Ag, the term paratope is herein, unless otherwise specified or contradicted by context, specifically defined as Ag residues characterized by having a heavy atom (i.e. a non-hydrogen atom) within a distance of 2-6 Å, such as 3 Å, such as 4 Å, such as 5 Å from a heavy atom in the C-terminal domain.
The epitope and paratope for a given antibody (Ab)/antigen (Ag) pair may be identified by routine methods. For example, the general location of an epitope may be determined by assessing the ability of an antibody to bind to different fragments or variant TFPI polypeptides. The specific amino acids within TFPI that make contact with an antibody (epitope) and the specific amino acids in an antibody that make contact with TFPI (paratope) may also be determined using routine methods, such as those described in the examples. For example, the antibody and target molecule may be combined and the Ab/Ag complex may be crystallised. The crystal structure of the complex may be determined and used to identify specific sites of interaction between the antibody and its target.
An antibody according to the current invention may bind to the same epitope, domain or portion of TFPI as the antibodies of the invention that are specifically disclosed herein. For example, other yet unidentified antibodies of the invention may be identified by comparing their binding to TFPI with that of the monoclonal antibodies, MuTFPI4F110, MuTFPI22F66 and MuTFPI22F71; or by comparing the function of yet unidentified antibodies with that of MuTFPI4F110, MuTFPI22F66 and MuTFPI22F71. Analyses and assays that may be used for the purpose of such identification include TFPI neutralizing assays such as: a FXa inhibition assay; an ELISA and binding interaction analyses, such as those described in the examples.
An antibody of the invention may bind an epitope comprising one or more amino acid residues, such as 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46 or 47 amino acid residues, such as 6-10 amino acid residues or 16-21 amino acid residues within the C terminal of full length TFPI, wherein said one or more amino acids have a relative accessibility of more than 40% when measured as described in the Examples. Thus, an antibody of the invention may bind an epitope comprising 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46 or 47 amino acid residues, such as 6-10 amino acid residues or 16-21 amino acid residues selected from the group consisting of amino acid residues 186-187, 190, 192-208, 213, 215-220, 225-228, 230-234, 236-237 and 240-276 of SEQ ID NO: 1.
An antibody of the invention may bind to an epitope that comprises 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46 or 47 amino acid residues, such as 6-10 amino acid residues or 16-21 amino acid residues, selected from the group consisting of P186, S187, L190, P192, A193, D194, R195, G196, L197, C198, R199, A200, N201, E202, N203, R204, F205, Y206, Y207, N208, K213, R215, P216, F217, K218, Y219, S220, N225, E226, N227, N228, T230, S231, K232, Q233, E234, L236, R237, K240, K241, G242, F243, I244, Q245, R246, I247, S248, K249, G250, G251, L252, I253, K254, T255, K256, R257, K258, R259, K260, K261, Q262, R263, V264, K265, I266, A267, Y268, E269, E270, I271, F272, V273, K274, N275 and M276 of SEQ ID NO: 1. For example, the antibody may bind to an epitope comprising 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25 or 26 amino acid residues, selected from the group consisting of P186, S187, L190, P192, A193, D194, R195, G196, L197, C198, R199, A200, N201, E202, N203, R204, F205, Y206, Y207, N208, K213, R215, P216, F217, K218, Y219, S220, N225, E226, N227, N228, T230, S231, K232, Q233, E234, L236 and R237 of SEQ ID NO: 1. The antibody may bind to an epitope comprising 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25 or 26 amino acid residues, such as 4-15 amino acid residues, such as 6-10 amino acid residues, selected from the group consisting of K240, K241, G242, F243, I244, Q245, R246, I247, S248, K249, G250, G251, L252, I253, K254, T255, K256, R257, K258, R259, K260, K261, Q262, R263, V264, K265, I266, A267, Y268, E269, E270, I271, F272, V273, K274, N275 and M276 of SEQ ID NO: 1.
An antibody of the invention may bind to an epitope comprising one, two, three, four, five, six, seven, eight, nine, ten, eleven or all of the amino acids selected from the group consisting of Tyr23, Asn24, Ser25, Val26, Ile27, Gly28, Lys29, Arg31, Lys48, Gln49, Leu52 and Lys56 of SEQ ID NO: 27.
The heavy chain of an antibody according to the invention may comprise:

    
    
        a Ser in the position corresponding to position 31 and/or
        a Tyr in the position corresponding to position 33 and/or
        a Tyr in the position corresponding to position 35 and/or
        a Glu in the position corresponding to position 50 and/or
        an Asn in the position corresponding to position 59 and/or
        a Trp in the position corresponding to position 99 and/or
        an Arg in the position corresponding to position 101 and/or
        a Phe in the position corresponding to position 102

of SEQ ID NO: 28.

    
    


The light chain of an antibody according to the invention may comprise:

    
    
        an Asn in the position corresponding to position 28 and/or
        an Asp in the position corresponding to position 30 and/or
        an Asp in the position corresponding to position 32 and/or
        a Glu in the position corresponding to position 50 and/or
        a Ser in the position corresponding to position 91 and/or
        an Asp in the position corresponding to position 92 and/or
        a Leu in the position corresponding to position 94 and/or
        a Tyr in the position corresponding to position 96

of SEQ ID NO: 29.

    
    


The heavy chain of an antibody of the invention may have a paratope comprising:

    
    
        a Tyr in the position corresponding to position 33,
        a Glu in the position corresponding to position 50 and
        a Trp in the position corresponding to position 99

of SEQ ID NO: 28.

    
    


The light chain of an antibody of the invention may have a paratope comprising:

    
    
        a Glu in the position corresponding to position 50,
        a Ser in the position corresponding to position 91,
        an Asp in the position corresponding to position 92 and
        a Tyr in the position corresponding to position 96

of SEQ ID NO: 29.

    
    


The heavy chain of an antibody of the invention may have a paratope comprising:

    
    
        a Ser or a conservative amino acid substitution thereof in the position corresponding to position 31 of CDR1,
        a Tyr in the position corresponding to position 33 of CDR1,
        a Tyr or a conservative amino acid substitution thereof in the position corresponding to position 35 of CDR1,
        a Glu in the position corresponding to position 50 of CDR2,
        an Asn or a conservative amino acid substitution thereof in the position corresponding to position 58 of CDR2,
        a Trp in the position corresponding to position 95 of CDR3,
        an Arg or a conservative amino acid substitution thereof in the position corresponding to position 97 of CDR3 and
        a Phe or a conservative amino acid substitution thereof in the position corresponding to position 98 of CDR3

as defined using Kabat numbering.

    
    


The light chain of an antibody of the invention may have a paratope comprising:

    
    
        an Asn or a conservative amino acid substitution thereof in the position corresponding to position 28 of CDR1,
        an Asp or a conservative amino acid substitution thereof in the position corresponding to position 30 of CDR1,
        an Asp or a conservative amino acid substitution thereof in the position corresponding to position 32 of CDR1,
        a Glu in the position corresponding to position 50 of CDR2,
        a Ser in the position corresponding to position 91 of CDR3,
        an Asp in the position corresponding to position 92 of CDR3,
        a Leu or a conservative amino acid substitution thereof in the position corresponding to position 94 of CDR3 and
        a Tyr in the position corresponding to position 96 of CDR3

as defined using Kabat numbering.

    
    


Mutation of certain residues of the above-mentioned paratope is likely to give rise to reduced binding of an antibody of the invention to TFPI; in other words, the KD will increase when certain important residues are mutated. On the other hand, other residues may be mutated without the mutation resulting in a worsening of the antibody-antigen binding constant (for example, a conservative amino acid substitution). For the purposes of clarity, the term “conservative amino acid substitution” refers to a substitution of amino acids having side chains with similar biochemical properties (i.e., non-polar and aliphatic, aromatic, acidic, basic, and polar, uncharged). Whether or not mutation of any particular amino acid residue would give rise to reduced binding of the invented antibody can be estimated from a detailed 3-dimensional description of the interaction.
Hence, in a preferred embodiment, the heavy chain of an antibody of the invention has a paratope comprising:

    
    
        a Tyr in the position corresponding to position 33 of CDR1,
        a Glu in the position corresponding to position 50 of CDR2 and
        a Trp in the position corresponding to position 95 of CDR3

as defined using Kabat numbering.

    
    


In a preferred embodiment, the light chain of an antibody of the invention has a paratope comprising:

    
    
        a Glu in the position corresponding to position 50 of CDR2,
        a Ser in the position corresponding to position 91 of CDR3,
        an Asp in the position corresponding to position 92 of CDR3 and
        a Tyr in the position corresponding to position 96 of CDR3

as defined using Kabat numbering.

    
    


An antibody of the invention may have the ability to compete with another antibody of the invention for binding to TFPI or another appropriate target as described herein. For example, an antibody of the invention may cross-compete with the antibodies identified as MuTFPI4F110, MuTFPI22F66 and MuTFPI22F71, described herein, for binding to TFPI, or to a suitable fragment or variant of TFPI that is bound by MuTFPI4F110, MuTFPI22F66 and MuTFPI22F71 antibodies. Such cross-competing antibodies can be identified based on their ability to cross-compete with a known antibody of the invention in standard binding assays. For example, SPR e.g. by using a BiacoreTM system, ELISA assays or flow cytometry may be used to demonstrate cross-competition. Such cross-competition may suggest that the two antibodies bind to identical, overlapping or similar epitopes.
“Epitope binning” refers to the use of competitive binding assays to identify pairs of antibodies that are, or are not, capable of binding an antigen, such as TFPI, simultaneously, thereby identifying antibodies that bind to the same, or overlapping epitopes of TFPI. Families of antibodies (or bins) that have the same, or overlapping, binding specificity can then be used to help define specific epitopes on TFPI. Epitope binning experiments provide evidence that antigenically distinct epitopes are present. However, by themselves, they do not identify, or “map” the epitope to a specific amino acid sequence or location on TFPI. Competition for binding can be evaluated for any pair of antibodies or fragments. Favourable properties of a family (or bin) of antibodies can be correlated with binding to a specific epitope defined in terms of the antibody bin.
As explained above, TFPI downregulates blood coagulation. It does this by inhibiting the activity of FXa and by inhibiting the TF-FVIIa complex in the presence of FXa. The activity of TFPI that is inhibited by an antibody of the invention may be any of these activities or any downstream effect thereof. For example, an antibody of the invention may lead to an increase in blood coagulation, an increase in the presence or levels of FXa or an increased activity of TF-FVIIa. Preferably, an antibody of the invention reduces clotting time when contacted with (a) human FVIII deficient plasma or (b) human whole blood.
The measurement of TFPI activity may comprise assessing the activity of free TFPI in inhibiting coagulation or reducing clotting time in a blood sample. For example, such a method may comprise contacting TFPI with a sample of blood, or a blood product such as plasma or serum that comprises blood coagulation factors, under conditions in which coagulation should occur, and determining whether coagulation of the blood is inhibited or clotting time is reduced by the presence of the TFPI. The level of blood coagulation or clotting time in such a sample may then be compared to that in an equivalent sample in which a test antibody is also present. If the level of coagulation is increased or clotting time is reduced in the antibody sample, this suggests that the antibody is inhibiting the activity of TFPI in the sample.
Blood coagulation may be detected by looking for coagulation of the blood itself, of plasma, or for one or more characteristics of the coagulation cascade that lie downstream to the point of action of TFPI. For example, the method may assess levels of FXa or activation of TF-FVIIa in the sample.
Various other methods for assessing blood coagulation and clotting time are well known in the art. For example, any effect of an antibody on blood clotting time may be assessed using a dilute prothrombin time analysis (dPT analysis) as described in the examples. Briefly, human plasma is contacted with human thromboplastin. The time taken for the plasma to clot is measured in the presence and absence of the test antibody. A positive control may be used in such an analysis, such as addition of FVIIa (NovoSeven®), which would be expected to reduce clotting time. An antibody of the invention should be capable of reducing clotting time in such a method. Preferably, an antibody of the invention should be capable of reducing clotting time in a dose-dependent manner.
Thromboelastography (TEG) may be used to assess the kinetics of clot formation and fibrinolysis in samples of whole blood, such as in FVIII-deficient whole blood. The ability of an antibody to reduce clotting time or to stimulate blood coagulation may thus be similarly assessed in a whole blood sample by comparing the time taken for clot formation in the presence and absence of the antibody.
Methods to assess the functional effects of an antibody of the invention may thus be carried out in vitro. Such methods are preferably carried out on samples of human blood or plasma. Such samples may be normal human blood or plasma or may be deficient in, or supplemented with, one or more factors involved in blood coagulation. For example, these methods may be carried out using normal human whole blood, normal human plasma or FVIII-deficient plasma or whole blood. FVIII-deficient blood or plasma may be generated by contacting a suitable blood or plasma sample with neutralising anti-FVIII antibody. Such in vitro methods may be binding interaction analyses or TFPI neutralisation analyses, such as those described in the examples.
Once a suitable antibody has been identified and selected, the amino acid sequence of the antibody may be identified by methods known in the art. The genes encoding the antibody can be cloned using specific and/or degenerate primers. The antibody may be recombinantly produced by routine methods.
The invention also relates to polynucleotides that encode antibodies of the invention. Thus, a polynucleotide of the invention may encode any antibody as described herein. The terms “nucleic acid molecule” and “polynucleotide” are used interchangeably herein and refer to a polymeric form of nucleotides of any length, either deoxyribonucleotides or ribonucleotides, or analogs thereof. Non-limiting examples of polynucleotides include a gene, a gene fragment, messenger RNA (mRNA), cDNA, recombinant polynucleotides, plasmids, vectors, isolated DNA of any sequence, isolated RNA of any sequence, nucleic acid probes, and primers. A polynucleotide of the invention may be provided in isolated or purified form.
A nucleic acid sequence which “encodes” a selected polypeptide is a nucleic acid molecule which is transcribed (in the case of DNA) and translated (in the case of mRNA) into a polypeptide in vivo when placed under the control of appropriate regulatory sequences. The boundaries of the coding sequence are determined by a start codon at the 5′ (amino) terminus and a translation stop codon at the 3′ (carboxy) terminus. For the purposes of the invention, such nucleic acid sequences can include, but are not limited to, cDNA from viral, prokaryotic or eukaryotic mRNA, genomic sequences from viral or prokaryotic DNA or RNA, and even synthetic DNA sequences. A transcription termination sequence may be located 3′ to the coding sequence.
A polynucleotide of the invention may comprise a sequence which encodes a VH or VL amino acid sequence as described above. For example, a polynucleotide of the invention may encode a polypeptide comprising any one or more of the sequences selected from the group consisting of: SEQ ID NOs: 5, 7, 9, 11, 13 and 15; or variants or fragments thereof.
Polynucleotides of the invention may be synthesised according to methods well known in the art, as described by way of example in Sambrook et al (1989, Molecular Cloning—a laboratory manual; Cold Spring Harbor Press).
The nucleic acid molecules of the present invention may be provided in the form of an expression cassette which includes control sequences, signal peptide sequences operably linked to the inserted sequence, thus allowing for expression of the antibody of the invention in vivo. These expression cassettes, in turn, are typically provided within vectors (e.g., plasmids or recombinant viral vectors). Such an expression cassette may be administered directly to a host subject. Alternatively, a vector comprising a polynucleotide of the invention may be administered to a host subject. Preferably the polynucleotide is prepared and/or administered using a genetic vector. A suitable vector may be any vector which is capable of carrying a sufficient amount of genetic information, and allowing expression of a polypeptide of the invention.
The present invention thus includes expression vectors that comprise such polynucleotide sequences. Such expression vectors are routinely constructed in the art of molecular biology and may for example involve the use of plasmid DNA and appropriate initiators, promoters, enhancers, signal peptide sequences and other elements, such as for example polyadenylation signals which may be necessary, and which are positioned in the correct orientation, in order to allow for expression of a peptide of the invention. Other suitable vectors would be apparent to persons skilled in the art. By way of further example in this regard we refer to Sambrook et al.
The invention also includes cells that have been modified to express an antibody of the invention. Such cells include transient, or preferably stable higher eukaryotic cell lines, such as mammalian cells or insect cells, lower eukaryotic cells, such as yeast or prokaryotic cells such as bacterial cells. Particular examples of cells which may be modified by insertion of vectors or expression cassettes encoding for an antibody of the invention include mammalian HEK293, CHO, BHK, NSO and human retina cells. Preferably the cell line selected will be one which is not only stable, but also allows for mature glycosylation and cell surface expression of a polypeptide.
In another aspect, the present invention provides compositions and formulations comprising molecules of the invention, such as the antibodies, polynucleotides, vectors and cells described herein. For example, the invention provides a pharmaceutical composition that comprises one or more antibodies of the invention, formulated together with a pharmaceutically acceptable carrier.
Accordingly, one object of the invention is to provide a pharmaceutical formulation comprising such an antibody which is present in a concentration from 1 mg/ml to 200 mg/ml, and wherein said formulation has a pH from 2.0 to 10.0. The formulation may further comprise a buffer system, preservative(s), tonicity agent(s), chelating agent(s), stabilizers and surfactants. The use of preservatives, isotonic agents, chelating agents, stabilizers and surfactants in pharmaceutical compositions is well-known to the skilled person. Reference may be made to Remington: The Science and Practice of Pharmacy, 19th edition, 1995.
In one embodiment, the pharmaceutical formulation is an aqueous formulation. Such a formulation is typically a solution or a suspension. The terms “aqueous formulation” is defined as a formulation comprising at least 50% w/w water. Likewise, the term “aqueous solution” is defined as a solution comprising at least 50% w/w water, and the term “aqueous suspension” is defined as a suspension comprising at least 50% w/w water.
In another embodiment, the pharmaceutical formulation is a freeze-dried formulation, to which the physician or the patient adds solvents and/or diluents prior to use.
In a further aspect, the pharmaceutical formulation comprises an aqueous solution of such an antibody, and a buffer, wherein the antibody is present in a concentration of 1-200 mg/ml, and wherein said formulation has a pH from about 2.0 to about 10.0.
An antibody or a pharmaceutical formulation of the invention may be used to treat a subject with a coagulopathy.
As used herein, the term “subject” includes any human patient, or non-human vertebrate, with a coagulopathy.
The term “treatment”, as used herein, refers to the medical therapy of any human or other vertebrate subject in need thereof. Said subject is expected to have undergone physical examination by a medical practitioner or a veterinary medical practitioner, who has given a tentative or definitive diagnosis which would indicate that the use of said specific treatment is beneficial to the health of said human or other vertebrate. The timing and purpose of said treatment may vary from one individual to another, according to the status quo of the subject's health. Thus, said treatment may be prophylactic, palliative, symptomatic and/or curative. In terms of the present invention, prophylactic, palliative, symptomatic and/or curative treatments may represent separate aspects of the invention.
The term “coagulopathy”, as used herein, refers to an increased haemorrhagic tendency which may be caused by any qualitative or quantitative deficiency of any pro-coagulative component of the normal coagulation cascade, or any upregulation of fibrinolysis. Such coagulopathies may be congenital and/or acquired and/or iatrogenic and are identified by a person skilled in the art.
Non-limiting examples of congenital hypocoagulopathies are haemophilia A, haemophilia B, Factor VII deficiency, Factor XI deficiency, von Willebrand's disease and thrombocytopenias such as Glanzmann's thombasthenia and Bernard-Soulier syndrome. Haemophilia A with “inhibitors” (that is, allo-antibodies against factor VIII) and haemophilia B with “inhibitors” (that is, allo-antibodies against factor IX) are non-limiting examples of coagulopathies that are partly congenital and partly acquired.
A non-limiting example of an acquired coagulopathy is serine protease deficiency caused by vitamin K deficiency; such vitamin K-deficiency may be caused by administration of a vitamin K antagonist, such as warfarin. Acquired coagulopathy may also occur following extensive trauma. In this case otherwise known as the “bloody vicious cycle”, it is characterised by haemodilution (dilutional thrombocytopaenia and dilution of clotting factors), hypothermia, consumption of clotting factors and metabolic derangements (acidosis). Fluid therapy and increased fibrinolysis may exacerbate this situation. Said haemorrhage may be from any part of the body.
A non-limiting example of an iatrogenic coagulopathy is an overdosage of anticoagulant medication—such as heparin, aspirin, warfarin and other platelet aggregation inhibitors—that may be prescribed to treat thromboembolic disease. A second, non-limiting example of iatrogenic coagulopathy is that which is induced by excessive and/or inappropriate fluid therapy, such as that which may be induced by a blood transfusion.
In one embodiment of the current invention, haemorrhage is associated with haemophilia A or B. In another embodiment, haemorrhage is associated with haemophilia A or B with acquired inhibitors. In another embodiment, haemorrhage is associated with thrombocytopenia. In another embodiment, haemorrhage is associated with von Willebrand's disease. In another embodiment, haemorrhage is associated with severe tissue damage. In another embodiment, haemorrhage is associated with severe trauma. In another embodiment, haemorrhage is associated with surgery. In another embodiment, haemorrhage is associated with haemorrhagic gastritis and/or enteritis. In another embodiment, the haemorrhage is profuse uterine bleeding, such as in placental abruption. In another embodiment, haemorrhage occurs in organs with a limited possibility for mechanical haemostasis, such as intracranially, intraaurally or intraocularly. In another embodiment, haemorrhage is associated with anticoagulant therapy.
The use of an antibody or formulation of the invention may significantly reduce blood loss in subjects in need thereof. The use of said antibody or formulation may significantly reduce bleeding time. Thus, the invention is also the use of an antibody that is capable of binding the C-terminal of TFPI, for the treatment of a subject with a coagulopathy. Furthermore, the invention is a method of treating a subject in need thereof with a monoclonal antibody that is capable of binding to the C-terminal of TFPI. Use of said monoclonal antibody of the invention will, preferably, reduce in vivo clotting time without causing transient thrombocytopaenia.
An antibody of the invention may be administered parenterally, such as intravenously, such as intramuscularly, such as subcutaneously. Alternatively, an antibody of the invention may be administered via a non-parenteral route, such as perorally or topically. An antibody of the invention may be administered prophylactically. An antibody of the invention may be administered therapeutically (on demand).
A suitable dosage of an antibody of the invention may be determined by a skilled medical or veterinary medical practitioner. A suitable dose of an antibody of the invention may be in the range of from about 0.1 μg/kg to about 100 mg/kg body weight of the patient to be treated.
Furthermore, antibodies of the invention may be co-administered with one or more other therapeutic agents or formulations. The other agent may be an agent that enhances haemostasis, such as a Factor VIIa polypeptide, a Factor VIII polypeptide or a Factor IX polypeptide. The other agent may be intended to treat other symptoms or conditions of the patient. For example, the other agent may be an analgesic, an immunosuppressant or an anti-inflammatory agent. The other agent may be a monoclonal antibody, such as one of those disclosed in international patent application WO2010072691.
Co-administration of an antibody of the invention and said one or more other agents may be achieved in a number of different ways. In one embodiment, an antibody of the invention and the other agent may be administered together in a single composition. In another embodiment, an antibody of the invention and the other agent may be administered separately but as part of a combined therapy. For example, an antibody of the invention may be administered before, after, or concurrently with the other agent. In its broadest sense, co-administration according to the current invention refers to an antibody of the invention and the other agent being present in human blood at the same time, irrespective of the time when the two or more agents were administered. Thus, an antibody of the invention may be present in the blood at the same time as an exogenous FVIIa polypeptide, FVIII polypeptide or FIX polypeptide.
The term “Factor VII(a)” herein encompasses the uncloven zymogen, Factor VII (FVII), as well as the cloven and thus activated protease, Factor VIIa (FVIIa). “Factor VII(a)” includes natural allelic variants of FVII(a) that may exist and occur from one individual to another. A wild type human Factor VIIa sequence is provided in SEQ ID NO: 19, as well as in Proc Natl Acad Sci USA 1986; 83:2412-2416.








Wild type human coagulation Factor VII(a) (SEQ ID NO. 19):



ANAFLγγLRPGSLγRγCKγγQCSFγγARγIFKDAγRTKLFWISYSDGDQCASSPCQNGGSCK-


 


DQLQSYICFCLPAFEGRNCETHKDDQLICVNENGGCEQYCSDHTGTKRSCRCHE-


 


GYSLLADGVSCTPTVEYPCGKIPILEKR-


 


NASKPQGRIVGGKVCPKGECPWQVLLLVNGAQLCGGTLINTIWVVSAAHCFD-


 


KIKNWRNLIAVLGEHDLSEHDGDEQSRRVAQVIIPSTYVPGTTNHDIALLRLHQPVVLT-


 


DHVVPLCLPERTFSERTLAFVRFSLVSGWGQLLDRGA-


 


TALELMVLNVPRLMTQDCLQQSRKVGDSPNITEYMFCAGYSDGSKDSCKGDSGGPHATHYR-


 


GTWYLTGIVSWGQGCATVGHFGVYTRVSQYIEWLQKLMRSEPRPGVLLRAPFP






Wild type FVII consists of 406 amino acid residues and is composed of four domains as defined by homology. There is an N-terminal Gla domain followed by two epidermal growth factor (EGF)-like domains and a C-terminal serine protease domain. FVII circulates in plasma as a single-chain molecule. Upon activation to activated FVII (FVIIa), the molecule is cloven between residues Arg152 and Ile153, resulting in a two-chain protein held together by a disulphide bond. The light chain contains the Gla and EGF-like domains, whereas the heavy chain is the protease domain. FVIIa requires binding to its cell-surface co-factor tissue factor (TF) to become biologically active.
Factor VII(a) may be plasma-derived or recombinantly produced, using well known methods of production and purification. The degree and location of glycosylation, gamma-carboxylation and other post-translational modifications may vary depending on the chosen host cell and its growth conditions. In SEQ ID NO. 19, “γ” (gamma) represents gamma-carboxylated Glu (‘E’) remains. The term “Factor VII(a) polypeptide” herein refers to wild type Factor VIIa molecules as well as FVII(a) variants, FVII(a) derivatives and FVII(a) conjugates. Such variants, derivatives and conjugates may exhibit substantially the same, or improved, biological activity relative to wild-type human Factor VIIa.
The term “FVII(a) variant”, as used herein, is intended to designate Factor FVII having the sequence of SEQ ID NO: 19, wherein one or more amino acids of the parent protein have been substituted by another amino acid and/or wherein one or more amino acids of the parent protein have been deleted and/or wherein one or more amino acids have been inserted in protein and/or wherein one or more amino acids have been added to the parent protein. Such addition can take place either at the N-terminal end or at the C-terminal end of the parent protein or both. The “analogue” or “analogues” within this definition still have FVII activity in its activated form. In one embodiment a variant is at least 90% identical with the sequence of SEQ ID NO: 19. In another embodiment a variant is at least 95% identical with the sequence of SEQ ID NO: 19. As used herein, any reference to a specific position refers to the corresponding position in SEQ ID NO: 19.
Non-limiting examples of FVII(a) variants that have substantially the same or increased proteolytic activity compared to recombinant wild type human Factor VII(a) include those disclosed in WO 01/83725, WO 02/22776, WO 02/077218, WO 03/027147, WO 03/037932, WO 04/029090, WO 05/024006, and EP 05108713.8, U.S. Pat. No. 7,173,000 B2; and JP4451514 B2.
The term “Factor VII(a) derivative” as used herein, is intended to designate a FVII polypeptide that exhibits substantially the same or improved biological activity relative to wild-type Factor VIIa, in which one or more of the amino acids of the parent peptide have been genetically and/or chemically and/or enzymatically modified, such as by alkylation, glycosylation, PEGylation, acylation, ester formation, disulfide bond formation, or amide formation.
The term “PEGylated human Factor VII(a)” refers to a human Factor VII(a) polypeptide, to which a PEG molecule has been conjugated. Such a PEG molecule may be attached to any part of the Factor VIIa polypeptide, including any amino acid residue or carbohydrate moiety of the Factor VIIa polypeptide. This includes but is not limited to PEGylated human Factor VIIa, cysteine-PEGylated human Factor VIIa and variants thereof. Non-limiting examples of Factor VII derivatives includes glycoPEGylated FVII(a) derivatives as disclosed in WO 03/031464 and WO 04/099231 and WO 02/077218,
The term “cysteine-PEGylated human Factor VII(a)” refers to a Factor VII(a) polypeptide in which a PEG molecule is conjugated to a sulfhydryl group of a cysteine that has been introduced into said human Factor VIIa.
The term “improved biological activity” refers to FVII(a) polypeptides that exhibit i) substantially the same or increased proteolytic activity compared to recombinant wild type human Factor VIIa in the presence and/or absence of tissue factor or ii) to FVII(a) polypeptides with substantially the same or increased TF affinity compared to recombinant wild type human Factor VIIa or iii) to FVII(a) polypeptides with substantially the same or increased half life in plasma compared to recombinant wild type human Factor VIIa, or iv) to FVII(a) polypeptides with substantially the same or increased affinity for the activated platelet. The activity of FVIIa polypeptides may be tested using, for example, the in vitro hydrolysis assay or the in vitro proteolysis assay, as described in the examples.
“Factor VIII” or “FVIII” herein refers to a human plasma glycoprotein that is a member of the intrinsic coagulation pathway and is essential to blood coagulation. “Native FVIII” is the human FVIII molecule derived from the full length sequence as shown in SEQ ID NO: 20 (amino acid 1-2332). The terms “Factor VIII(a)” and “FVIII(a)” herein include both FVIII and FVIIIa. “FVIII(a)” includes natural allelic variants of FVIII(a) that may exist and occur from one individual to another. FVIII(a) may be plasma-derived or recombinantly produced, using well known methods of production and purification. The degree and location of glycosylation, tyrosine sulfation and other post-translation modifications may vary, depending on the chosen host cell and its growth conditions.
Factor VIII (FVIII) is a large, complex glycoprotein that is primarily produced by hepatocytes. FVIII consists of 2351 amino acids, including a signal peptide, and contains several distinct domains as defined by homology. There are three A-domains, a unique B-domain, and two C-domains. The domain order can be listed as NH2-A1-A2-B-A3-C1-C2-COOH. FVIII circulates in plasma as two chains, separated at the B-A3 border. The chains are connected by bivalent metal ion-bindings. The A1-A2-B chain is termed the heavy chain (HC) while the A3-C1-C2 is termed the light chain (LC). Small acidic regions C-terminal of the A1 (the a1 region) and A2 (the a2 region) and N-terminal of the A3 domain (the a3 region) play important roles in its interaction with other coagulation proteins, including thrombin and von Willebrand factor (vWF or VWF), the carrier protein for FVIII.
Endogenous FVIII molecules circulate in vivo as a pool of molecules with B domains of various sizes, the shortest having C-terminal at position 740, i.e. at the C-terminal of A2-a2. These FVIII molecules with B-domains of different length all have full procoagulant activity. Upon activation with thrombin, FVIII is cloven C-terminal of A1-a1 at position 372, C-terminal of A2-a2 at position 740, and between a3 and A3 at position 1689, the latter cleavage releasing the a3 region with concomitant loss of affinity for VWF. The activated FVIII molecule is termed FVIIIa. The activation allows interaction of FVIIIa with phospholipid surfaces like activated platelets and activated factor IX (FIXa), i.e. the tenase complex is formed, allowing efficient activation of factor X (FX).
FVIII molecules/variants may be B domain-truncated FVIII molecules wherein the remaining domains correspond closely to the sequences as set forth in amino acid numbers 1-740 and 1649-2332 of SEQ ID NO: 20. In such variants, as well as in FVIII derived from the full-length sequence, mutations may be introduced in order to, for example, reduce vWF binding capacity. Amino acid modifications, such as substitutions and deletions, may be introduced into the molecule in order to modify the binding capacity of FVIII with various other components such as LRP, various receptors, other coagulation factors, cell surfaces, introduction and/or abolishment of glycosylation sites, etc. Other mutations that do not abolish FVIII activity may also be accommodated in a FVIII molecule/variant according to the present invention.
FVIII molecules that are administered according to the present invention are capable of functioning in the coagulation cascade in a manner that is functionally similar, or equivalent, to FVIII, inducing the formation of FXa via interaction with FIXa on an activated platelet and supporting the formation of a blood clot. FVIII activity can be assessed in vitro using techniques well known in the art. Clot analyses, FX activation assays (often termed chromogenic assays), thrombin generation assays and whole blood thromboelastography are examples of such in vitro techniques. FVIII molecules according to the present invention have FVIII activity that is at least about 10%, at least about 20%, at least about 30%, at least about 40%, at least about 50%, at least about 60%, at least about 70%, at least about 80%, at least about 90%, 100% or even more than 100% of that of native human FVIII.
The B domain in FVIII spans amino acids 741-1648 of SEQ ID NO: 20. The B domain is cloven at several different sites, generating large heterogeneity in circulating plasma FVIII molecules. The exact function of the heavily glycosylated B domain is unknown. What is known is that the B domain is dispensable for FVIII activity in the coagulation cascade. Recombinant FVIII is thus frequently produced in the form of B domain-deleted/truncated variants.
Endogenous full length FVIII is synthesized as a single-chain precursor molecule. Prior to secretion, the precursor is cloven into the heavy chain and the light chain. Recombinant B domain-deleted FVIII can be produced by means of two different strategies. Either the heavy chain without the B-domain and the light chain are synthesized individually as two different polypeptide chains (two-chain strategy) or the B domain-deleted FVIII is synthesized as a single precursor polypeptide chain (single-chain strategy) that is cloven into the heavy and light chains in the same way as the full-length FVIII precursor.
In a B domain-deleted FVIII precursor polypeptide, produced by the single-chain strategy, the heavy and light chain moieties are often separated by a linker. To minimize the risk of introducing immunogenic epitopes in the B domain-deleted FVIII, the sequence of the linker is preferably derived from the FVIII B-domain. As a minimum, the linker must comprise a recognition site for the protease that cleaves the B domain-deleted FVIII precursor polypeptide into the heavy and light chain. In the B domain of full length FVIII, amino acid 1644-1648 constitutes this recognition site. The thrombin cleavage site leading to removal of the linker on activation of B domain-deleted FVIII is located in the heavy chain. Thus, the size and amino acid sequence of the linker is unlikely to influence its removal from the remaining FVIII molecule by thrombin activation. Deletion/truncation of the B domain is an advantage for production of FVIII. Nevertheless, parts of the B domain can be included in the linker without reducing the productivity. The negative effect of the B domain on productivity has not been attributed to any specific size or sequence of the B domain.
Factor IXa (FIXa) is a trypsin-like serine protease that serves a key role in haemostasis by generating, as part of the tenase complex, most of the factor Xa required to support proper thrombin formation during coagulation (reviewed in (Hoffman and Monroe, III 2001)).
Factor IX (FIX) is a vitamin K-dependent coagulation factor with structural similarities to factor VII, prothrombin, factor X, and protein C. The circulating zymogen form consists of 415 amino acids divided into four distinct domains comprising an N-terminal γ-carboxyglutamic acid-rich (Gla) domain, two EGF domains and a C-terminal trypsin-like serine protease domain. Activation of FIX occurs by limited proteolysis at Arg145-Ala146 and Arg180-Val181 releasing a 35-aa fragment, the so-called activation peptide (Schmidt and Bajaj 2003). The activation peptide is heavily glycosylated, containing two N-linked and up to four O-linked glycans.
“Factor IX” or “FIX”, as used herein, refers to a human plasma Factor IX glycoprotein that is a member of the intrinsic coagulation pathway and is essential to blood coagulation. “Factor IX(a)” includes natural allelic variants of FIX(a) that may exist and occur from one individual to another. Factor IX(a) may be plasma-derived or recombinantly produced using well known methods of production and purification. The degree and location of glycosylation, gamma-carboxylation and other post-translation modifications may vary depending on the chosen host cell and its growth conditions. Unless otherwise specified or indicated, Factor IX means any functional human Factor IX protein molecule in its normal role in coagulation, including any fragment, analogue and derivative thereof.
One example of a “wild type FIX” is the full length human FIX molecule, as shown in SEQ ID NO: 21.








Wild type human coagulation Factor IX (SEQ ID NO: 21):



YNSGKLγγFVQGNLγRγCMγγKCSFγγARγVFγNTγRTTγFWKQYVDGDQCESNPCLNGGSCKDDINSYE


 


TγFWKQYVDGDQCESNPCLNGGSCKDDINSYE-


 


CWCPFGFEGKNCELDVTCNIKNGRCEQFCKNSADNKVVCSCTEGYRLAENQKSCPAV-


 


PFPCGRVSVSQTSKLTRAEAVFPDVDYV-


 


NSTEAETILDNITQSTQSFNDFTRVVGGEDAKPGQFPWQVVLNGKVDAFCGG-


 


SIVNEKWIVTAAHCVETGVKITVVAGEHNIEETEHTEQKRNVIRIIPHHNYNAAINKYNHDI-


 


ALLELDEPLVLNSYVTPICIADKEYTNIFLKFGSGYVSGWGRVFHKGRSALVLQYL-


 


RVPLVDRATCLRSTKFTIYNNMFCAGFHEGGRDSCQGDSGGPHVTEVEGTSFLT-


 


GIISWGEECAMKGKYGIYTKVSRYVNWIKEKTKLT






In SEQ ID NO: 21, “γ” represents gamma-carboxylated Glu (‘E’) remains. In fully gamma-carboxylated FIX, the first 12 Glu residues are gamma-carboxylated, but there are variants, especially in the case of recombinant FIX, in which less gamma-carboxylation takes place. Note, also, that a dimorphism occurs in FIX at position 148, which can be either Ala or Thr (see McGraw et al. (1985) PNAS, 82:2847). Both are “wild type” FIX.
The terms “FIX analogue”, as used herein, is intended to designate Factor FIX having the sequence of SEQ ID NO: 21, wherein one or more amino acids of the parent protein have been substituted by another amino acid and/or wherein one or more amino acids of the parent protein have been deleted and/or wherein one or more amino acids have been inserted in protein and/or wherein one or more amino acids have been added to the parent protein. Such addition can take place either at the N-terminal end or at the C-terminal end of the parent protein or both. The “analogue” or “analogues” within this definition still have FIX activity in its activated form. In one embodiment a variant is at least 90% identical with the sequence of SEQ ID NO: 21. In a further embodiment a variant is at least 95% identical with the sequence of SEQ ID NO: 21. As used herein any reference to a specific positions refers to the corresponding position in SEQ ID NO: 21.
Unless otherwise specified, factor IX domains include the following amino acid residues: Gla domain being the region from reside Tyr1 to residue Lys43; EGF1 being the region from residue Gln44 to residue Leu84; EGF2 being the region from residue Asp85 to residue Arg145; the Activation Peptide being the region from residue Ala146 to residue Arg180; and the Protease Domain being the region from residue Val181 to Thr414. The light chain refers to the region encompassing the Gla domain, EGF1 and EGF2, while the heavy chain refers to the Protease Domain.
The clotting activity of procoagulant agents such as FVIIa polypeptide, a FVIII polypeptide or a Factor IX polypeptide may be determined using clotting assays that are known to the person skilled in the art, such as those described in the Examples.
The time at which antibodies of the invention are to be co-administered with a second agent, such as a Factor VIIa polypeptide, a Factor VIII polypeptide or a Factor IX polypeptide, may be determined by the skilled medical or veterinary medical practitioner.
Following is a non-limiting list of embodiments of the present invention:
Embodiment 1
An antibody that is capable of specifically binding the C-terminal of full length TFPI.
Embodiment 2
The antibody according to embodiment 1, wherein said C-terminal is amino acids 186-276 of human TFPI (SEQ ID NO: 1).
Embodiment 3
The antibody according to any one of embodiments 1 or 2, which is a monoclonal antibody.
Embodiment 4
The antibody according to any one of embodiments 1-3, wherein the epitope of said antibody comprises one or more amino acid residues selected from the group consisting of P186, S187, L190, P192, A193, D194, R195, G196, L197, C198, R199, A200, N201, E202, N203, R204, F205, Y206, Y207, N208, K213, R215, P216, F217, K218, Y219, S220, N225, E226, N227, N228, T230, S231, K232, Q233, E234, L236, R237, K240, K241, G242, F243, I244, Q245, R246, I247, S248, K249, G250, G251, L252, I253, K254, T255, K256, R257, K258, R259, K260, K261, Q262, R263, V264, K265, I266, A267, Y268, E269, E270, I271, F272, V273, K274, N275 and M276 of SEQ ID NO: 1.
Embodiment 5
The antibody according to any one of embodiments 1-3, wherein the epitope of said antibody comprises one or more amino acid residues selected from the group consisting of P186, S187, L190, P192, A193, D194, R195, G196, L197, C198, R199, A200, N201, E202, N203, R204, F205, Y206, Y207, N208, K213, R215, P216, F217, K218, Y219, S220, N225, E226, N227, N228, T230, S231, K232, Q233, E234, L236, R237, K240, K241, G242 and F243 of SEQ ID NO: 1.
Embodiment 6
The antibody according to any one of embodiments 1-3, wherein the epitope of said antibody comprises one or more amino acid residues selected from the group consisting of P186, S187, L190, P192, A193, D194, R195, G196, L197, C198, R199, A200, N201, E202, N203, R204, F205, Y206, Y207, N208, K213, R215, P216, F217, K218, Y219, S220, N225, E226, N227, N228, T230, S231, K232, Q233, E234, L236 and R237 of SEQ ID NO: 1.
Embodiment 7
The antibody according to any one of embodiments 1-3, wherein the epitope of said antibody comprises one or more amino acid residues selected from the group consisting of K240, K241, G242, F243, I244, Q245, R246, I247, S248, K249, G250, G251, L252, I253, K254, T255, K256, R257, K258, R259, K260, K261, Q262, R263, V264, K265, I266, A267, Y268, E269, E270, I271, F272, V273, K274, N275 and M276 of SEQ ID NO: 1.
Embodiment 8
The antibody according to any one of embodiments 1-3, wherein said epitope comprises an amino acid residue selected from the group consisting of Tyr23, Asn24, Ser25, Val26, Ile27, Gly28, Lys29, Arg31, Lys48, Gln49, Leu52 and Lys56 of SEQ ID NO: 27.
Embodiment 9
The antibody according to embodiment 8, wherein said epitope comprises the amino acid residues corresponding to the Ile27, Lys29 and Arg31 of SEQ ID NO: 27.
Embodiment 10
The antibody according to any one of embodiments 8-9, wherein said epitope comprises Tyr23 of SEQ ID NO: 27.
Embodiment 11
The antibody according to any one of embodiments 8-10, wherein said epitope comprises Asn24 of SEQ ID NO: 27.
Embodiment 12
The antibody according to any one of embodiments 8-11, wherein said epitope comprises Ser25 of SEQ ID NO: 27.
Embodiment 13
The antibody according to any one of embodiments 8-12, wherein said epitope comprises Val26 of SEQ ID NO: 27.
Embodiment 14
The antibody according to any one of embodiments 8-13, wherein said epitope comprises Gly28 of SEQ ID NO: 27.
Embodiment 15
The antibody according to any one of embodiments 8-14, wherein said epitope comprises Lys48 of SEQ ID NO: 27.
Embodiment 16
The antibody according to any one of embodiments 8-15, wherein said epitope comprises Leu52 of SEQ ID NO: 27.
Embodiment 17
The antibody according to any one of embodiments 8-16, wherein said epitope comprises Lys56 of SEQ ID NO: 27.
Embodiment 18
The antibody according to any one of embodiments 8-17, wherein said epitope comprises Gln49 of SEQ ID NO: 27.
Embodiment 19
The antibody according to any one of embodiments 8-18, wherein said epitope comprises Tyr23, Asn24, Ser25, Val26, Gly28, Lys48, Leu52 and Lys56 of SEQ ID NO: 27.
Embodiment 20
The antibody according to any one of embodiments 8-19, wherein the heavy chain of said antibody comprises:

    
    
        a Ser in the position corresponding to position 31 and/or
        a Tyr in the position corresponding to position 33 and/or
        a Tyr in the position corresponding to position 35 and/or
        a Glu in the position corresponding to position 50 and/or
        an Asn in the position corresponding to position 59 and/or
        a Trp in the position corresponding to position 99 and/or
        an Arg in the position corresponding to position 101 and/or
        a Phe in the position corresponding to position 102

of SEQ ID NO: 28.

    
    


Embodiment 21
The antibody according to embodiment 20, wherein the heavy chain of said antibody comprises:

    
    
        a Ser in the position corresponding to position 31,
        a Tyr in the position corresponding to position 33,
        a Tyr in the position corresponding to position 35,
        a Glu in the position corresponding to position 50,
        an Asn in the position corresponding to position 59,
        a Trp in the position corresponding to position 99,
        an Arg in the position corresponding to position 101 and
        a Phe in the position corresponding to position 102

of SEQ ID NO: 28.

    
    


Embodiment 22
The antibody according to any one of embodiments 8-21, wherein the light chain of said antibody comprises:

    
    
        an Asn in the position corresponding to position 28 and/or
        an Asp in the position corresponding to position 30 and/or
        an Asp in the position corresponding to position 32 and/or
        a Glu in the position corresponding to position 50 and/or
        a Ser in the position corresponding to position 91 and/or
        an Asp in the position corresponding to position 92 and/or
        a Leu in the position corresponding to position 94 and/or
        a Tyr in the position corresponding to position 96

of SEQ ID NO: 29.

    
    


Embodiment 23
The antibody according to embodiment 22, wherein the light chain of said antibody comprises:

    
    
        an Asn in the position corresponding to position 28,
        an Asp in the position corresponding to position 30,
        an Asp in the position corresponding to position 32,
        a Glu in the position corresponding to position 50,
        a Ser in the position corresponding to position 91,
        an Asp in the position corresponding to position 92,
        a Leu in the position corresponding to position 94 and
        a Tyr in the position corresponding to position 96

of SEQ ID NO: 29.

    
    


Embodiment 24
The antibody according to any one of embodiments 20-23, wherein the heavy chain of said antibody comprises:

    
    
        a Ser in the position corresponding to position 31,
        a Tyr in the position corresponding to position 33,
        a Tyr in the position corresponding to position 35,
        a Glu in the position corresponding to position 50,
        an Asn in the position corresponding to position 59,
        a Trp in the position corresponding to position 99,
        an Arg in the position corresponding to position 101 and
        a Phe in the position corresponding to position 102

of SEQ ID NO: 28; and wherein the light chain of said antibody comprises:

        an Asn in the position corresponding to position 28,
        an Asp in the position corresponding to position 30,
        an Asp in the position corresponding to position 32,
        a Glu in the position corresponding to position 50,
        a Ser in the position corresponding to position 91,
        an Asp in the position corresponding to position 92,
        a Leu in the position corresponding to position 94 and
        a Tyr in the position corresponding to position 96 of SEQ ID NO: 29.
    
    


Embodiment 25
The antibody according to any one of embodiments 1-24, wherein the heavy chain of said antibody comprises a CDR1 sequence of amino acids 31 to 35 (SYYMY) of SEQ ID NO: 5, wherein one of these amino acids may be substituted by a different amino acid.
Embodiment 26
The antibody according to any one of embodiments 1-25, wherein the heavy chain of said antibody comprises a CDR2 sequence of amino acids 50-66 (EINPSNGDTNLNEKFKS) of SEQ ID NO: 5, wherein one, two or three of these amino acids may be substituted by a different amino acid.
Embodiment 27
The antibody according to any one of embodiments 1-26, wherein the heavy chain of said antibody comprises a CDR3 sequence of amino acids 99-107 (WDRFDGFVY) of SEQ ID NO: 5, wherein one or two of these amino acids may be substituted by a different amino acid.
Embodiment 28
The antibody according to any one of embodiments 1-24, wherein the heavy chain of said antibody comprises a CDR1 sequence of amino acids 31-35 (GYPMN) of SEQ ID NO: 9, wherein one of these amino acids may be substituted by a different amino acid.
Embodiment 29
The antibody according to any one of embodiments 1-24 and 28, wherein the heavy chain of said antibody comprises a CDR2 sequence of amino acids 50-66 (LINPYNGDTTFNQKFKG) of SEQ ID NO: 9, wherein one, two or three of these amino acids may be substituted by a different amino acid.
Embodiment 30
The antibody according to any one of embodiments 1-24 and 28-29, wherein the heavy chain of said antibody comprises a CDR3 sequence of amino acids 99-106 (GTYEYVDY) of SEQ ID NO: 9, wherein one or two of these amino acids may be substituted by a different amino acid.
Embodiment 31
The antibody according to any one of embodiments 1-24, wherein the heavy chain of said antibody comprises a CDR1 sequence of amino acids 31-35 (TYWIH) of SEQ ID NO: 13, wherein one of these amino acids may be substituted by a different amino acid.
Embodiment 32
The antibody according to any one of embodiments 1-24 and 31, wherein the heavy chain of said antibody comprises a CDR2 sequence of amino acids 50-66 (AIDPGNSDATYSQKFKD) of SEQ ID NO: 13, wherein one, two or three of these amino acids may be substituted by a different amino acid.
Embodiment 33
The antibody according to any one of embodiments 1-24 and 31-32, wherein the heavy chain of said antibody comprises a CDR3 sequence of amino acids 99-111 (EVYYGYDGDYFDY) of SEQ ID NO: 13, wherein one, two or three of these amino acids may be substituted by a different amino acid.
Embodiment 34
The antibody according to any one of embodiments 1-27, wherein the light chain of said antibody comprises a CDR1 sequence of amino acids 24-34 (IISTNIDDDIN) of SEQ ID NO: 7, wherein one, two or three of these amino acids may be substituted with a different amino acid.
Embodiment 35
The antibody according to any one of embodiments 1-27 and 34, wherein the light chain of said antibody comprises a CDR2 sequence of amino acids 50-56 (EGNTLRP) of SEQ ID NO: 7, wherein one of these amino acids may be substituted with a different amino acid.
Embodiment 36
The antibody according to any one of embodiments 1-27 and 34-35, wherein the light chain of said antibody comprises a CDR3 sequence of amino acids 89-97 (LQSDDLPYT) of SEQ ID NO: 7, wherein one or two of these amino acids may be substituted with a different amino acid.
Embodiment 37
The antibody according to any one of embodiments 1-24 and 28-30, wherein the light chain of said antibody comprises a CDR1 sequence of amino acids 24-33 (SASSSVFYMH) of SEQ ID NO: 11, wherein one, two or three of these amino acids may be substituted with a different amino acid.
Embodiment 38
The antibody according to any one of embodiments 1-24, 28-30 and 37, wherein the light chain of said antibody comprises a CDR2 sequence of amino acids 49-55 (DTSILSS) of SEQ ID NO: 11, wherein one of these amino acids may be substituted with a different amino acid.
Embodiment 39
The antibody according to any one of embodiments 1-24, 28-30 and 37-38, wherein the light chain of said antibody comprises a CDR3 sequence of amino acids 88-96 (QQWSSYPLT) of SEQ ID NO: 11, wherein one or two of these amino acids may be substituted with a different amino acid.
Embodiment 40
The antibody according to any one of embodiments 1-24 and 31-33, wherein the light chain of said antibody comprises a CDR1 sequence of amino acids 24-38 (RASESVSVHGTHLMH) of SEQ ID NO: 15, wherein one, two or three of these amino acids may be substituted with a different amino acid.
Embodiment 41
The antibody according to any one of embodiments 1-24, 31-33 and 40, wherein the light chain of said antibody comprises a CDR2 sequence of amino acids 54-60 (AASKLES) of SEQ ID NO: 15, wherein one of these amino acids may be substituted with a different amino acid.
Embodiment 42
The antibody according to any one of embodiments 1-24, 31-33 and 40-41, wherein the light chain of said antibody comprises a CDR3 sequence of amino acids 93-101 (QQSIGDPWT) of SEQ ID NO: 15, wherein one or two of these amino acids may be substituted with a different amino acid.
Embodiment 43
The antibody according to any one of embodiments 1-24, wherein the heavy chain of said antibody comprises:

    
    
        a CDR1 sequence of amino acids 31 to 35 (SYYMY) of SEQ ID NO: 5, wherein one of these amino acids may be substituted by a different amino acid; and/or
        a CDR2 sequence of amino acids 50-66 (EINPSNGDTNLNEKFKS) of SEQ ID NO: 5, wherein one, two or three of these amino acids may be substituted by a different amino acid; and/or
        a CDR3 sequence of amino acids 99-107 (WDRFDGFVY) of SEQ ID NO: 5, wherein one or two of these amino acids may be substituted by a different amino acid.
    
    


Embodiment 44
The antibody according to any one of embodiments 1-24, wherein the heavy chain of said antibody comprises:

    
    
        a CDR1 sequence of amino acids 31-35 (GYPMN) of SEQ ID NO: 9, wherein one of these amino acids may be substituted by a different amino acid; and/or
        a CDR2 sequence of amino acids 50-66 (LINPYNGDTTFNQKFKG) of SEQ ID NO: 9, wherein one, two or three of these amino acids may be substituted by a different amino acid; and/or
        a CDR3 sequence of amino acids 99-106 (GTYEYVDY) of SEQ ID NO: 9, wherein one or two of these amino acids may be substituted by a different amino acid.
    
    


Embodiment 45
The antibody according to any one of embodiments 1-24, wherein the heavy chain of said antibody comprises:

    
    
        a CDR1 sequence of amino acids 31-35 (TYWIH) of SEQ ID NO: 13, wherein one of these amino acids may be substituted by a different amino acid; and/or
        a CDR2 sequence of amino acids 50-66 (AIDPGNSDATYSQKFKD) of SEQ ID NO: 13, wherein one, two or three of these amino acids may be substituted by a different amino acid; and/or
        a CDR3 sequence of amino acids 99-111 (EVYYGYDGDYFDY) of SEQ ID NO: 13, wherein one or two of these amino acids may be substituted by a different amino acid.
    
    


Embodiment 46
The antibody according to any one of embodiments 1-24, wherein the light chain of said antibody comprises:

    
    
        a CDR1 sequence of amino acids 24-34 (IISTNIDDDIN) of SEQ ID NO: 7, wherein one, two or three of these amino acids may be substituted with a different amino acid; and/or
        a CDR2 sequence of amino acids 50-56 (EGNTLRP) of SEQ ID NO: 7, wherein one or two of these amino acids may be substituted with a different amino acid; and/or
        a CDR3 sequence of amino acids 89-97 (LQSDDLPYT) of SEQ ID NO: 7, wherein one or two of these amino acids may be substituted with a different amino acid.
    
    


Embodiment 47
The antibody according to any one of embodiments 1-24, wherein the light chain of said antibody comprises:

    
    
        a CDR1 sequence of amino acids 24-33 (SASSSVFYMH) of SEQ ID NO: 11, wherein one, two or three of these amino acids may be substituted with a different amino acid; and/or
        a CDR2 sequence of amino acids 49-55 (DTSILSS) of SEQ ID NO: 11, wherein one or two of these amino acids may be substituted with a different amino acid; and/or
        a CDR3 sequence of amino acids 88-96 (QQWSSYPLT) of SEQ ID NO: 11, wherein one or two of these amino acids may be substituted with a different amino acid.
    
    


Embodiment 48
The antibody according to any one of embodiments 1-24, wherein the light chain of said antibody comprises:

    
    
        a CDR1 sequence of amino acids 24-38 (RASESVSVHGTHLMH) of SEQ ID NO: 15, wherein one, two or three of these amino acids may be substituted with a different amino acid; and/or
        a CDR2 sequence of amino acids 54-60 (AASKLES) of SEQ ID NO: 15, wherein one or two of these amino acids may be substituted with a different amino acid; and/or
        a CDR3 sequence of amino acids 93-101 (QQSIGDPWT) of SEQ ID NO: 15, wherein one or two of these amino acids may be substituted with a different amino acid.
    
    


Embodiment 49
The antibody according to any one of embodiments 1-24, wherein the heavy chain of said antibody comprises:

    
    
        a CDR1 sequence of amino acids 31 to 35 (SYYMY) of SEQ ID NO: 5, wherein one of these amino acids may be substituted by a different amino acid; and/or
        a CDR2 sequence of amino acids 50-66 (EINPSNGDTNLNEKFKS) of SEQ ID NO: 5, wherein one, two or three of these amino acids may be substituted by a different amino acid; and/or
        a CDR3 sequence of amino acids 99-107 (WDRFDGFVY) of SEQ ID NO: 5, wherein one or two of these amino acids may be substituted by a different amino acid.
    
    


and wherein the light chain of said antibody comprises:

    
    
        a CDR1 sequence of amino acids 24-34 (IISTNIDDDIN) of SEQ ID NO: 7, wherein one, two or three of these amino acids may be substituted with a different amino acid; and/or
        a CDR2 sequence of amino acids 50-56 (EGNTLRP) of SEQ ID NO: 7, wherein one or two of these amino acids may be substituted with a different amino acid; and/or
        a CDR3 sequence of amino acids 89-97 (LQSDDLPYT) of SEQ ID NO: 7, wherein one or two of these amino acids may be substituted with a different amino acid.
    
    


Embodiment 50
The antibody according to any one of embodiments 1-24, wherein the heavy chain of said antibody comprises:

    
    
        a CDR1 sequence of amino acids 31-35 (GYPMN) of SEQ ID NO: 9, wherein one of these amino acids may be substituted by a different amino acid; and/or
        a CDR2 sequence of amino acids 50-66 (LINPYNGDTTFNQKFKG) of SEQ ID NO: 9, wherein one, two or three of these amino acids may be substituted by a different amino acid; and/or
        a CDR3 sequence of amino acids 99-106 (GTYEYVDY) of SEQ ID NO: 9, wherein one or two of these amino acids may be substituted by a different amino acid.
    
    


and wherein the light chain of said antibody comprises:

    
    
        a CDR1 sequence of amino acids 24-33 (SASSSVFYMH) of SEQ ID NO: 11, wherein one, two or three of these amino acids may be substituted with a different amino acid; and/or
        a CDR2 sequence of amino acids 49-55 (DTSILSS) of SEQ ID NO: 11, wherein one or two of these amino acids may be substituted with a different amino acid; and/or
        a CDR3 sequence of amino acids 88-96 (QQWSSYPLT) of SEQ ID NO: 11, wherein one or two of these amino acids may be substituted with a different amino acid.
    
    


Embodiment 51
The antibody according to any one of embodiments 1-24, wherein the heavy chain of said antibody comprises:

    
    
        a CDR1 sequence of amino acids 31-35 (TYWIH) of SEQ ID NO: 13, wherein one of these amino acids may be substituted by a different amino acid; and/or
        a CDR2 sequence of amino acids 50-66 (AIDPGNSDATYSQKFKD) of SEQ ID NO: 13, wherein one, two or three of these amino acids may be substituted by a different amino acid; and/or
        a CDR3 sequence of amino acids 99-111 (EVYYGYDGDYFDY) of SEQ ID NO: 13, wherein one or two of these amino acids may be substituted by a different amino acid.
    
    


and wherein the light chain of said antibody comprises:

    
    
        a CDR1 sequence of amino acids 24-38 (RASESVSVHGTHLMH) of SEQ ID NO: 15, wherein one, two or three of these amino acids may be substituted with a different amino acid; and/or
        a CDR2 sequence of amino acids 54-60 (AASKLES) of SEQ ID NO: 15, wherein one or two of these amino acids may be substituted with a different amino acid; and/or
        a CDR3 sequence of amino acids 93-101 (QQSIGDPWT) of SEQ ID NO: 15, wherein one or two of these amino acids may be substituted with a different amino acid.
    
    


Embodiment 52
The antibody according to any one of embodiments 25-51, wherein said amino acid substitution is a conservative substitution.
Embodiment 53
The antibody according to any one of embodiments 1-24, wherein the heavy chain comprises:

    
    
        a CDR1 sequence of amino acids 31 to 35 (SYYMY) of SEQ ID NO: 5 and/or
        a CDR2 sequence of amino acids 50-66 (EINPSNGDTNLNEKFKS) of SEQ ID NO: 5 and/or
        a CDR3 sequence of amino acids 99-107 (WDRFDGFVY) of SEQ ID NO: 5;

and wherein the light chain of said antibody comprises:

        a CDR1 sequence of amino acids 24-34 (IISTNIDDDIN) of SEQ ID NO: 7 and/or
        a CDR2 sequence of amino acids 50-56 (EGNTLRP) of SEQ ID NO: 7 and/or
        a CDR3 sequence of amino acids 89-97 (LQSDDLPYT) of SEQ ID NO: 7.
    
    


Embodiment 54
The antibody according to any one of embodiments 1-24, wherein the heavy chain comprises:

    
    
        a CDR1 sequence of amino acids 31-35 (GYPMN) of SEQ ID NO: 9,
        a CDR2 sequence of amino acids 50-66 (LINPYNGDTTFNQKFKG) of SEQ ID NO: 9 and
        a CDR3 sequence of amino acids 99-106 (GTYEYVDY) of SEQ ID NO: 9;
    
    


and wherein the light chain comprises:

    
    
        a CDR1 sequence of amino acids 24-33 (SASSSVFYMH) of SEQ ID NO: 11,
        a CDR2 sequence of amino acids 49-55 (DTSILSS) of SEQ ID NO: 11 and
        a CDR3 sequence of amino acids 88-96 (QQWSSYPLT) of SEQ ID NO: 11.
    
    


Embodiment 55
The antibody according to any one of embodiments 1-24, wherein the heavy chain comprises:

    
    
        a CDR1 sequence of amino acids 31-35 (TYWIH) of SEQ ID NO: 13,
        a CDR2 sequence of amino acids 50-66 (AIDPGNSDATYSQKFKD) of SEQ ID NO: 13 and
        a CDR3 sequence of amino acids 99-111 (EVYYGYDGDYFDY) of SEQ ID NO: 13;
    
    


and wherein the light chain comprises:

    
    
        a CDR1 sequence of amino acids 24-38 (RASESVSVHGTHLMH) of SEQ ID NO: 15,
        a CDR2 sequence of amino acids 54-60 (AASKLES) of SEQ ID NO: 15 and
        a CDR3 sequence of amino acids 93-101 (QQSIGDPWT) of SEQ ID NO: 15.
    
    


Embodiment 56
The antibody according to any one of embodiments 1-24, wherein the heavy chain of said antibody comprises SEQ ID NO: 5.
Embodiment 57
The antibody according to any one of embodiments 1-24 and 56, wherein the light chain of said antibody comprises SEQ ID NO: 7.
Embodiment 58
The antibody according to any one of embodiments 1-24, wherein the heavy chain of said antibody comprises SEQ ID NO: 9.
Embodiment 59
The antibody according to any one of embodiments 1-24 and 58, wherein the light chain of said antibody comprises SEQ ID NO: 11.
Embodiment 60
The antibody according to any one of embodiments 1-24, wherein the heavy chain of said antibody comprises SEQ ID NO: 13.
Embodiment 61
The antibody according to any one of embodiments 1-24 and 60, wherein the light chain of said antibody comprises SEQ ID NO: 15.
Embodiment 62
The antibody according to any one of embodiments 1-24, wherein said antibody comprises SEQ ID NO: 5 and SEQ ID NO: 7.
Embodiment 63
The antibody according to any one of embodiments 1-24, wherein said antibody comprises SEQ ID NO: 9 and SEQ ID NO: 11.
Embodiment 64
The antibody according to any one of embodiments 1-24, wherein said antibody comprises SEQ ID NO: 13 and SEQ ID NO: 15.
Embodiment 65
The antibody according to any one of the embodiments 1-64, which is a humanized antibody.
Embodiment 66
The antibody according to any one of the embodiments 1-65, wherein the isotype of said antibody is IgG.
Embodiment 67
The antibody according to embodiment 66, wherein said isotype is IgG1, IgG2 or IgG4.
Embodiment 68
The antibody according to embodiment 67, wherein the isotype of said antibody is IgG4.
Embodiment 69
The antibody, according to any one of embodiments 1-68, wherein the KD of said antibody is less than 4.0 nM, such as less than 3.0 nM, such as less than 2.0 nM, such as less than 1.0 nM, such as less than 0.8 nM, such as less than 0.7 nM, such as less than 0.6 nM, such as less than 0.5 nM, such as less than 0.4 nM, such as less than 0.3 nM, such as less than 0.2 nM, such as less than 0.1 nM, such as less than 0.05 nM, such as less than 0.02 nM, such as less than 0.01 nM.
Embodiment 70
The antibody according to any one of embodiments 1-69, which is not capable of binding truncated TFPI (1-185).
Embodiment 71
The antibody according to any one of embodiments 1-69, which is not capable of binding truncated TFPI (1-239).
Embodiment 72
The antibody according to any one of embodiments 1-71, which is not capable of binding the K1 or the K2 domain of TFPI.
Embodiment 73
The antibody according to any one of embodiments 1-72, which is not capable of binding GPI-anchored TFPI and/or lipoprotein bound TFPI.
Embodiment 74
The antibody according to any one of embodiments 1-73, which is capable of neutralizing TFPI inhibition of TF/FVIIa/FXa in the presence of phospholipid.
Embodiment 75
The antibody according to any one of embodiments 1-74, which is capable of binding the C-terminal of TFPI such that the percentage of free TFPI in a subject is reduced to less than 50%, such as less than 40%, such as less than 30%, such as less than 20%, such as less than 10%.
Embodiment 76
The antibody according to any one of embodiments 1-75, which is capable of competing with MuTFPI4F110 for binding to TFPI.
Embodiment 77
The antibody according to any one of embodiments 1-75, which is not capable of competing with MuTFPI4F110 for binding to TFPI.
Embodiment 78
The antibody according to any one of embodiments 1-76, which reduces in vivo clotting time without significantly reducing the platelet count.
Embodiment 79
The antibody, according to embodiment 78, wherein said platelet count is not reduced to approximately 80%, such as approximately 75%, such as approximately 70%, such as approximately 65%, such as approximately 60%, such as approximately 55%, such as approximately 50%, such as approximately 45%, such as approximately 40%, such as approximately 35%, such as approximately 30%, such as approximately 25% of the original platelet count.
Embodiment 80
The antibody according to any one of embodiments 1-79, which reduces in vivo clotting time without causing transient thrombocytopaenia.
Embodiment 81
A pharmaceutical formulation comprising the antibody according to any one of embodiments 1-80.
Embodiment 82
A pharmaceutical formulation comprising the antibody according to any one of embodiments 1-80 and a Factor VIIa, Factor VIII or Factor IX polypeptide.
Embodiment 83
The pharmaceutical formulation according to embodiment 81, which is suitable for parenteral use.
Embodiment 84
The pharmaceutical formulation according to embodiment 83, which is suitable for intravenous use.
Embodiment 85
The pharmaceutical formulation according to embodiment 83, which is suitable for subcutaneous use.
Embodiment 86
The antibody according to any one of embodiments 1-80, or the pharmaceutical formulation according to any one of embodiments 80-85, for the treatment of a subject with a coagulopathy.
Embodiment 87
The antibody according to any one of embodiments 1-80, or the pharmaceutical formulation according to any one of embodiments 80-85, for the treatment of any congenital, acquired and/or iatrogenic coagulopathy, such as may be selected from the group consisting of haemophilia A, with or without inhibitors, and haemophilia B, with or without inhibitors.
Embodiment 88
The antibody according to any one of claims 1-29 and second coagulation agent, selected from the list consisting of a FVIIa polypeptide, a FVIII polypeptide or a FIX polypeptide, for the treatment of a subject with a coagulopathy.
Embodiment 89
The antibody according to any one of embodiments 1-80 and a FVIII polypeptide for the treatment of haemophilia A.
Embodiment 90
The antibody according to any one of embodiments 1-80 and a FIX polypeptide for the treatment of haemophilia B.
Embodiment 91
The antibody according to any one of embodiments 1-80 and a FVIIa polypeptide for the treatment of haemophilia A or B with inhibitors.
Embodiment 92
A method of treating a subject with a coagulopathy, comprising administering to said subject the antibody according to any one of embodiments 1-80.
Embodiment 93
A method of treating a subject with haemophilia A comprising administering to said subject the antibody according to any one of embodiments 1-80 and a FVIII polypeptide.
Embodiment 94
A method of treating a subject with haemophilia B comprising administering to said subject the antibody according to any one of embodiments 1-80 and a FIX polypeptide.
Embodiment 95
A method of treating a subject with FVII deficiency comprising administering to said subject the antibody according to any one of embodiments 1-80 and a FVII polypeptide.
Embodiment 96
A method of treating a subject with haemophilia A with inhibitors, comprising administering to said subject the antibody according to any one of embodiments 1-80 and a FVII polypeptide.
Embodiment 97
A method of treating a subject with haemophilia B with inhibitors, comprising administering to said subject the antibody according to any one of embodiments 1-80 and a FVII polypeptide.
Embodiment 98
The method according to embodiment 84, wherein said coagulopathy is any congenital, acquired and/or iatrogenic coagulopathy, such as may be selected from the group consisting of haemophilia A, with or without inhibitors, and haemophilia B, with or without inhibitors.
Embodiment 99
A polynucleotide that encodes the antibody according to any one of embodiments 1-80.
Embodiment 100
A polynucleotide according to embodiment 99, which comprises at least one sequence selected from the group consisting of SEQ ID NOs: 4, 6, 8, 10, 12 and 14.
Embodiment 101
A eukaryotic cell which comprises the polynucleotide according to any one of embodiments 99-101.
Embodiment 102
A eukaryotic cell which expresses the antibody, or fragment thereof, according to any one of embodiments 1-80.
Embodiment 102
The eukaryotic cell according to embodiment 102, which is a mammalian cell.
Embodiment 103
The mammalian cell according to embodiment 102, which is selected from the group consisting of HEK293, CHO, BHK, NSO and human retina cells.
Embodiment 104
The antibody according to any one of embodiments 8-19, wherein the heavy chain of said antibody comprises at least one of:

    
    
        a Ser in the position corresponding to position 31 of CDR1,
        a Tyr in the position corresponding to position 33 of CDR1,
        a Tyr in the position corresponding to position 35 of CDR1,
        a Glu in the position corresponding to position 50 of CDR2,
        an Asn in the position corresponding to position 58 of CDR2,
        a Trp in the position corresponding to position 95 of CDR3,
        an Arg in the position corresponding to position 97 of CDR3 and
        a Phe in the position corresponding to position 98 of CDR3,
    
    


as defined using Kabat numbering.
Embodiment 105
The antibody according to embodiment 104, wherein the heavy chain of said antibody comprises:

    
    
        a Tyr in the position corresponding to position 33 of CDR1,
        a Glu in the position corresponding to position 50 of CDR2 and
        a Trp in the position corresponding to position 95 of CDR3

as defined using Kabat numbering.

    
    


Embodiment 106
The antibody according to embodiment 105, wherein the heavy chain of said antibody comprises:

    
    
        a Ser or a conservative amino acid substitution thereof in the position corresponding to position 31 of CDR1,
        a Tyr in the position corresponding to position 33 of CDR1,
        a Tyr or a conservative amino acid substitution thereof in the position corresponding to position 35 of CDR1,
        a Glu in the position corresponding to position 50 of CDR2,
        an Asn or a conservative amino acid substitution thereof in the position corresponding to position 58 of CDR2,
        a Trp in the position corresponding to position 95 of CDR3,
        an Arg or a conservative amino acid substitution thereof in the position corresponding to position 97 of CDR3 and
        a Phe or a conservative amino acid substitution thereof in the position corresponding to position 98 of CDR3

as defined using Kabat numbering.

    
    


Embodiment 107
The antibody according to any one of embodiments 8-19 or 104, wherein the light chain of said antibody comprises at least one of:

    
    
        an Asn in the position corresponding to position 28 of CDR1,
        an Asp in the position corresponding to position 30 of CDR1,
        an Asp in the position corresponding to position 32 of CDR1,
        a Glu in the position corresponding to position 50 of CDR2,
        a Ser in the position corresponding to position 91 of CDR3,
        an Asp in the position corresponding to position 92 of CDR3,
        a Leu in the position corresponding to position 94 of CDR3 and
        a Tyr in the position corresponding to position 96 of CDR3

as defined using Kabat numbering.

    
    


Embodiment 108
The antibody according to embodiment 107, wherein the light chain of said antibody comprises:

    
    
        a Glu in the position corresponding to position 50 of CDR2,
        a Ser in the position corresponding to position 91 of CDR3,
        an Asp in the position corresponding to position 92 of CDR3 and
        a Tyr in the position corresponding to position 96 of CDR3
    
    


as defined using Kabat numbering.
Embodiment 109
The antibody according to embodiment 108, wherein the light chain of said antibody comprises:

    
    
        an Asn or a conservative amino acid substitution thereof in the position corresponding to position 28 of CDR1,
        an Asp or a conservative amino acid substitution thereof in the position corresponding to position 30 of CDR1,
        an Asp or a conservative amino acid substitution thereof in the position corresponding to position 32 of CDR1,
        a Glu in the position corresponding to position 50 of CDR2,
        a Ser in the position corresponding to position 91 of CDR3,
        an Asp in the position corresponding to position 92 of CDR3,
        a Leu or a conservative amino acid substitution thereof in the position corresponding to position 94 of CDR3 and
        a Tyr in the position corresponding to position 96 of CDR3

as defined using Kabat numbering.

    
    


The present invention is further illustrated by the following examples which should not be construed as further limiting. The contents of all figures and all references, patents and published patent applications cited throughout this application are expressly incorporated herein by reference.
EXAMPLES
Example 1
Immunisation and Fusion
Mice were immunized with full length TFPI (SEQ ID NO: 1).
RBF mice were used for immunizations and production of mouse monoclonal antibodies. Injections were made subcutaneously in the back of the mice. 20 μg TFPI was mixed with complete Freund's adjuvant for the first injection. In the subsequent immunizations, incomplete Freund's adjuvant was used with same concentration of the antigen. Ten days after the last immunization, eye-blood from mice was screened, using ELISA, for TFPI specific antibodies. Mice with positive serum titres were boosted with 10 μg of TFPI by intravenous injection, and sacrificed after three days. The spleens were removed aseptically and dispersed to a single cell suspension. Fusion of spleen cells and myeloma cells was done by the PEG-method or by electrofusion.
Screening Procedure


    
    
        Screening for binding to full length TFPI and no binding to TFPI(1-161)
        Cellular assays with endothelial cell lines or TF & TFPI transfected cells
        TFPI neutralizing activity in plasma (dilute prothrombin time)
        Clot dynamics measured in human plasma (Endogenous thrombin potential; ETP) and in human whole blood (thrombelastography; TEG)
        Identification of the specific inhibitory epitopes on full length soluble TFPI involved in binding of the monoclonal antibodies with the above characteristics

Purification of mAbs

    
    


Monoclonal antibodies were purified by means of protein A affinity chromatography.
Example 2
Cloning and Sequencing of Mouse Anti-TFPI K3/C-Terminal Specific mAbs
This example describes cloning and sequencing of the murine heavy chain and light chain sequences of anti-TFPI antibodies MuTFPI4F110, MuTFPI22F66 and MuTFPI22F71.
Total RNA was extracted from hybridoma cells using the RNeasy-Mini Kit from Qiagen and used as template for cDNA synthesis. cDNA was synthesized in a 5′-RACE reaction using the SMARTTM RACE cDNA amplification kit from Clontech. Subsequent target amplification of HC and LC sequences was performed by PCR using Phusion Hot Start polymerase (Finnzymes) and the universal primer mix (UPM) included in the SMARTTM RACE kit as forward primer. The sequence of the reverse primer used for HC (VH domain) amplification is given in SEQ ID NO: 16. The sequence of the reverse primer used for MuTFPI22F66 and MuTFPI22F71 LC (VL domain) amplification is given in SEQ ID NO: 17. The sequence of the reverse primer used for MuTFPI4F110 LC amplification is given in SEQ ID NO: 18.
PCR products were separated by gel electrophoresis, extracted using the GFX PCR DNA & Gel Band Purification Kit from GE Healthcare Bio-Sciences and cloned for sequencing using a Zero Blunt TOPO PCR Cloning Kit and chemically competent TOP10 E. coli (Invitrogen). Colony PCR was performed on selected colonies using an AmpliTaq Gold Master Mix from Applied Biosystems and M13uni/M13rev primers. Colony PCR clean-up was performed using the ExoSAP-IT enzyme mix (USB). Sequencing was performed at MWG Biotech, Martinsried Germany using M13uni(−21)/M13rev(−29) sequencing primers. Sequences were analyzed and annotated using the VectorNTI program. All kits and reagents were used according to the manufacturer's instructions.
A single unique murine kappa type LC and a single unique murine HC, subclass IgG1 was identified for each of the hybridomas: MuTFPI4F110, MuTFPI22F66 and MuTFPI22F71. Nucleic acid and amino acid sequences are as shown in the sequence listing; leader peptide sequences are not included.
Example 3
Dilute Prothrombin Time (dPT)
A dilute prothrombin (PT) analysis with human plasma in combination with diluted human thromboplastin. Clot time in the plasma was measured upon addition of increasing protein A purified TFPI monoclonal antibody concentrations to look for dose dependent reduction of clotting time with the mAbs of interest.
120 μl citrate-stabilized FVIII-depleted plasma (Helena) was mixed with 5 μl MuTFPI4F110 at various final concentrations (0.0-1.0 nM) and incubated for 15 min at room temperature. Clotting was measured by ACL300 analysis at 37° C. Coagulation was initiated by mixing 75 μl plasma with 75 μl reagent containing 0.02 M CaCl2 and 1:3,750; 1:7,500; or 1:15,000 dilution of lipidated tissue factor (TF) (Innovin®) in 20 mM Hepes, 150 mM NaCl, pH 7.4. As shown in FIG. 1, MuTFPI4F110 shortened the clotting time in a concentration dependent manner at all three TF concentrations.
Only a fraction of TFPI present in plasma contains an intact C-terminal. This data suggests that binding of an antibody to this full length TFPI fraction efficiently promotes TF-induced clotting in FVIII-depleted plasma.
Example 4
Endogenous Thrombin Formation
Thrombin activity was assessed continuously following the conversion of the fluorogenic substrate Z-Gly-Gly-Arg-AMC.HCl (I-1140), from Bachem (Bubendorf, Switzerland). Fluorescence was measured in a microtiterplate Fluorskan Ascent fluorometer (Thermo Labsystems, Helsinki, Finland) with excitation and emission wavelengths set at 368 and 460 nm, respectively. A calibrator was used to allow calculation of the amount of thrombin formed and correction of the obtained relative fluorescence units for inner-filter effects and fluorogenic substrate consumption. In addition, the contribution to substrate conversion by thrombin-α2-macroglobulin complexes was subtracted (9). These corrections were performed automatically by means of the calibrated automated thrombogram (CAT) computer software provided by Synapse BV (Maastricht, the Netherlands). Finally, the first derivative of the data was taken that yielded the thrombin generation curve, allowing calculation of the total area under the curve, the endogenous thrombin potential (ETP).
The effect of MuTFPI4F110 on thrombin generation in FVIII-depleted plasma supplemented with 10 μM PS/PC is studied in FIG. 2. Triggering of coagulation by re-calcification and addition of Innovin® to a final dilution of 1/50,000 did not induce a measurable thrombin generation in the absence of anti-TFPI. In contrast, thrombin generation occurred in the presence of 10 nM MuTFPI4F110. After an initial increase the thrombin concentration reached a steady-state level of about 2 nM.
MuTFPI4F110 was studied in the presence of sub-normal levels of FVIII, typical for severe and moderate hemophilia A, to see if it is capable of improving or normalising the thrombin generation. The results in FIG. 3 show the effect on TF-induced thrombin generation of replenishing FVIII-depleted plasma with 0-2 IU/ml rFVIII (REFacto®) in absence and presence of 10 nM MuTFPI4F110. Thrombin generation was below the detection level in the absence of added rFVIII and was measurable only when rFVIII was added to a level higher than  ̃0.3 IU/ml rFVIII. Supplementation with higher levels of rFVIII resulted in a dose-dependent increase in the thrombin activity peak and shortened the lag time to thrombin generation. Thrombin generation experiments in the presence of 10 nM MuTFPI4F110 showed that neutralization of TFPI in FVIII-depleted plasma resulted in enhancement of thrombin generation, as illustrated in FIG. 2, at a higher resolution. After a lag time of about 13 min the thrombin concentration increased and reached a steady-state level of about 2 nM. Addition of rFVIII to levels higher than about 0.05 IU/ml changed this pattern and induced an additional transient thrombin peak on top of the basal steady-state level induced by MuTFPI4F110 alone. The results showed that MuTFPI4F110 directed towards the C-terminal of TFPI alone promotes initiation of coagulation, and, in combination with sub-optimal levels of FVIII, it also enhances the generation of a thrombin burst.
Example 5
Thrombelastography (TEG) Measurements
Citrate-stabilized FVIII-depleted plasma (Helena) was supplemented with (final concentrations): 0.12 pM TF (Innovin®, 1:50,000), 150,000 washed platelets/μl and various concentrations (0.0; 0.005; 0.05; 0.01 and 1.0 U/ml) of recombinant FVIII (ReFacto®). Clotting in the absence or presence of 10 nM MuTFPI4F110 was initiated when 320 μl of this premix was transferred to a thrombelastograph cup containing 20 μl 0.2 M CaCl2. The TEG trace was followed continuously for up to 120 min (5000 series TEG analyzer, Haemoscope Corporation, Niles, Ill., USA). The following TEG variables were recorded: R time (clotting time i.e. the time from initiation of coagulation until an amplitude of 2 mm was obtained), α-angle (clot development measured as the angle between the R value and the inflection point of the TEG trace), K (speed of clot kinetics to reach a certain level of clot strength, amplitude=20 mm), and MA (maximal amplitude of the TEG trace reflecting the maximal mechanical strength of the clot).
The results showed that MuTFPI4F110 enhanced the TF-induced clot formation i.e. shortened the clotting time (R value) and enhanced the rate of clot development (angle value) both in the absence of rFVIII and at low concentrations of rFVIII, corresponding to severe and moderate hemophilia.
Example 6
FACS Analysis
The TFPI-positive human endothelial-like immortalised cell line EAHy926WT (derived from umbilical vein endothelial cells) were used as a positive control for binding of membrane bound TFPI. The aerolysin-resistant EAHy926AR cells do not express TFPI on their surface and were used as a negative control.
Staining with anti TFPI antibodies and the corresponding isotype control antibody hzATNP were done as follows: Washed cell-line preparations (50000 cells pr well) were added to 96 well plates (Greiner, cat no. 65021) together with 50 μl of diluted TFPI antibody or isotype control in titration giving final concentrations 5 μg/ml. Cell preparations were then incubated at 4 degrees Celsius for 1 hour. After incubation and wash (PBS buffer with 5% Fetal calf serum, centrifuge for 5 minutes at 200 g) the secondary RPE-labelled anti-human antibody (diluted in PBS buffer 1:200) was added and incubated for another 1 hour at 4 degrees of Celsius. Finally, cells were washed and fixed by paraformaldehyde (1% weight in volume (w/v) paraformaldehyde) and analysed in the flow cytometer within 36 hours.
In FIG. 5, the binding of C-terminal specific anti TFPI antibodies (4F100 and 4F110) and the isotype control antibody hzATNP (0.5 μg/ml) to EAHy926WT and EAHy926AR is shown.
It is here clear that anti-TFPI antibodies directed against the C-terminal of TFPI do not bind TFPI anchored via GPI expressed by endothelial cell line EAHy926WT, whereas antibodies to Kunitz 2 bind selectively to the EAHy926WT and not to the aerolysin resistant TFPI negative cell line EAHy926AR.
Example 7
ELISA
The effect of truncating the C-terminal tail of TFPI on TFPI's binding affinity to MuTFPI22F66, MuTFPI22F71, MuTFPI22F74, MuTFPI22F79 and MuTFPI22F132 was analyzed by means of ELISA, or real-time binding analysis, using the ForteBio platform. The TFPI variants, which were either wild type (wt) TFPI (SEQ ID NO: 1) or truncated TFPI mutants encompassing amino acids 1-239 (SEQ ID NO: 2), 1-240 (SEQ ID NO: 22), 1-241 (SEQ ID NO: 23), 1-242 (SEQ ID NO: 24), 1-243 (SEQ ID NO: 25), 1-244 (SEQ ID NO: 26) or 1-245 (SEQ ID NO: 3), were expressed in HEK293-F cells. The ELISAs, or the real-time binding analyses, were carried out using the conditioned medium from the cell cultures.
The concentrations of wt TFPI and truncated TFPI mutants in the conditioned medium were estimated by means of an ELISA that binds TFPI K1-K2 (Goat anti-TFPI, in-house) and K2 (MAb4F36, in-house). The binding to these antibodies is not affected by the truncations. Alternatively, biotin-labelled MAb4F36 was captured on streptavidin coated BioSensor tips (ForteBio) and used for concentration estimations.
In the ELISA setting, the effect of the mutations on TFPI's ability to bind to MuTFPI22F66, MuTFPI22F71, MuTFPI22F74, MuTFPI22F79 or MuTFPI22F132 was analyzed using each of the listed MAbs as capturing antibody and using MAb4F36 for detection. Direct binding of TFPI variants to biotin-labelled MuTFPI22F66, MuTFPI22F71, MuTFPI22F74, MuTFPI22F79, and MuTFPI22F132, captured on streptavidin coated BioSensor tips (ForteBio), was measured using the ForteBio platform.
FIG. 7 reflects the effect of the truncations calculated, relative to the expression level and relative to wt. It was demonstrated that mAb 4F110 binding to the three truncated forms 1-243, 1-244 and 1-245 was not affected, compared to their binding to full length TFPI, whereas binding of mAb 22F74 to all of the truncated TFPI forms was strongly reduced. The rest of the tested antibodies lay within this range.
Example 8
Neutralizing TFPI Inhibition of FVIIa/TF/FXa Activity in the Presence of PS/PC Vesicles
Materials used were BSA buffer (50 mM Hepes; 0.1 M NaCl, 5 mM CaCl2, 0.1 mg/ml BSA, pH 7.4) EDTA: 50 mM and the reagents listed in the tables below.





















Working




Sample ID

conc
conc
solution
Dilution



mAB
Batch
mg/ml
nM
nM
factor





















1
TFPI-22F66
BA002-2
2.2
14667
400
36.7


2
TFPI-22F71
BA002-3
0.5
3333
400
8.3


3
TFPI-22F74
BA002-5
0.6
4000
400
10


4
TFPI-22F79
BA002-6
4.8
32000
400
80


5
TFPI-22F132
BA002-7
5.2
34667
400
86.7


6
TFPI-4F110
OP001
3.5
23333
400
58.3

























Final conc


Reagent
Batch - lot no.
Conc
in well


















EDTA
MERCK 8418
0.5M



mAb


nM





50





12.5





3.13





0.78





0.2





0.05





0.01





0












FVIIa
LASa 13200-008
27
μM
10
pM



frozen in aliquots



storage −80° C.


vesicles
HTI Phospholipids vesicles
2.0
mM
12.5
μM



cat#PCPS-02 #W1115-



75% PC - 25% PS



(0.02% azid added)


S-2765
Chromogenix 82 1413 39
35
mM
0.5
mM



lot#N0574120 2010-50


FX
Enzyme Research HXF 3064
34
μM
160
nM



A2L dissolved in 50%



Glycerol 08 Dec. 2009



frozen in aliquots



storage −80° C.


TFPI Fl.
0172-0000-0001-6A
21.9
μM
1
nM



aliqouts storage −20° C.


TF
Dade Behring#B4212-50#
6
nM
10
pM


(Innovin)
vial diss. in



10 ml H2O 08 Dec. 2009,



frozen in aliquots



storage −20° C.









All of the components, in final concentrations as indicated in the table above, were added together. 25 μl FX and 25 μl TFPI mAb were added in varying concentrations to 25 μl human TFPI, 25 μl FVIIa-TF (innovin) and PS/PC vesicles in microtiter wells. Mixtures were incubated for 15 min at room temperature. 50 μl EDTA was added, followed by 50 μl S-2765. Plates were mixed and read for 15 min at 405 nm in Spectramax. 100% activity was the activity of FVIIa/TF/FX obtained with no TFPI present.
The six C-terminal TFPI mAbs listed in the table above were capable of neutralising TFPI inhibition of the complex FVIIa/TF/FX in the presence of PS/PC vesicles. The antibodies also neutralised TFPI in the absence of PS/PC.
Example 9
Binding Interaction Analysis
Binding interaction analysis was obtained by Surface Plasmon Resonance in a Biacore 3000. Capture of the relevant monoclonal antibody at a fixed concentration was obtained with immobilised mouse anti-IgG. Different concentrations of TFPI were tested. Determination of binding constants (kon, koff, KD) was obtained assuming a 1:1 interaction of TFPI and the antibody of interest.














TFPI binding constant nM















Human
Human
Rabbit
Rabbit



mAB ID
TFPI
TFPI161
TFPI
TFPI161

















MuTFPI22F66
0.6
—
3.76
—



MuTFPI22F71
0.8
—
0.18
—



MuTFPI22F74
nd
—
2.73
—



MuTFPI22F132
nd
—
0.1
—



MuTFPI4F110
0.002
—
—
—










Competition of the different mAbs for binding to TFPI when bound to mAb 4F110 was obtained by immobilisation of mAb 4F110 at a CM5 chip followed by binding of 50 nM TFPI followed by varying concentrations the mAbs (22F66, 22F71, 22F74, 22F79, 22F132, 22F158, 22F174, 4F110) to be tested for competition. Results are shown in the table below. Regeneration of the chip was obtained by 10 mM Glycine, pH 1.7.















Competition with mAB 4F110



mAb ID
for binding to TFPI









TFPI-22F66
YES



TFPI-22F71
YES



TFPI-22F74
NO



TFPI-22F79
NO



TFPI-22F132
NO



TFPI-22F158
YES



TFPI-22F174
YES



TFPI-4F110
YES










The C-terminal mAbs fall into two groups with respect to competition with mAb 4F110. Antibodies in both groups display TFPI neutralizing activity.

Example 10a
Epitope Determination by Means of Comparative Modelling
Epitope models were generated by means of the commercially available computer program, Modeller [N. Eswar, M. A. Marti-Renom, B. Webb, M. S. Madhusudhan, D. Eramian, M. Shen, U. Pieper, A. Sali. Comparative Protein Structure Modeling With MODELLER. Current Protocols in Bioinformatics, John Wiley & Sons, Inc., Supplement 15, 5.6.1-5.6.30, 2006] based on published x-ray crystallographic structures of TFPI1-2. For the TFPI1-3, residues with a relative accessibility larger than 40% were found to be: 186-187, 190, 192-208, 213, 215-220, 225-228, 230-234 and 236-237. For the C-terminal, residues 240-276 had a relative accessability that was larger than 40%.
Example 10b
Crystal Structure of Soluble TFPI Kunitz Domain 3 in Complex with Anti-TFPI4F110 Fab
Throughout this example, all sequence residue numbers relating to Kunitz domain 3 should have 184 added to them to obtain the corresponding residue number in full length human TFPI sequence as in SEQ ID NO: 1. For example residue Gly 1 in this example is equivalent to residue Gly 185 in SEQ ID NO: 1. Soluble TFPI Kunitz domain 3 (SEQ ID NO: 27) in complex with a Fab fragment of the human anti-TFPI4F110 monoclonal antibody, was solved and refined to 2.1 Å resolution using X-ray crystallography. The results demonstrate that the antibody is capable of binding the Kunitz domain 3 of TFPI.
Materials and Methods
Soluble TFPI Kunitz domain 3 (SEQ ID NO: 27) and Fab 0001 (also referred to as anti-TFPI4F110 Fab, which consists of a light chain corresponding to SEQ ID NO: 29 and a heavy chain fragment corresponding to SEQ ID NO: 28) were mixed with a slight molar excess of TFPI Kunitz domain 3 and the complex was purified using size exclusion chromatography using a PBS elution buffer (4 tablets in 2 liters of water, GIBCO Cat. No. 18912-014 Invitrogen Corporation). The complex was then concentrated to about 5.70 mg/ml using an Amicon Ultra-15 centrifugal filter with a 10,000 molecular weight cut-off. Crystals were grown by the hanging drop-technique using a 24 wells VDX-plate and 1.00 ml precipitant solution per well. The precipitant solution contained 18% PEG 4000, 26% Propanol, 100 mM Sodium Citrate, pH 5.5, and was mixed in a ratio of 1:1 with the protein solution. Total drop size was 2.0 μl and crystals appeared after a few days. A crystal was prepared for cryo-freezing by transferring 6 μl of a cryo-solution containing 75% of the precipitant solution and 25% glycerol to the drop containing the crystal, and soaking was allowed for about 15 seconds. The crystal was then fished, flash frozen in liquid N2 and kept at a temperature of 100 K by a cryogenic N2 gas stream during data collection. Crystallographic data were collected, to 2.1 Å at beam-line BL911-3 at MAX-lab, Lund, Sweden. Space group determination, integration and scaling of the data were made by the XDS software package [Kabsch, W., J. Appl. Crystallogr., (1993), Vol. 26, pages 795-800] and further checked by the Pointless software [Evans, P., Acta crystallographica. Section D, Biological crystallography, (2006), Vol. 62, pages 72-82]. The space group was determined to be P21 and the cell parameters for the synchrotron data were determined to be 69.29, 65.77, 125.55 Å with a β angle of 97.50°, respectively. The R-sym to 2.10 Å resolution was 12.3% and completeness 98.2%.
Molecular replacement (MR) was used for structure determination using the coordinates of a Fab molecule with accession code 3QPQ (unpublished) of the Protein Data Bank (PDB) [Berman, H. M. et al, Nucleic Acids Res., (2000), Vol. 28, pages 235-242]. The Fab molecule was divided into two domains, the variable and the constant domains, which each were used as search models in the molecular replacement calculations. However, despite the asymmetric unit of the crystal should contain two crystallographically independent Fab/K3 complexes only one of the Fab molecules could be found using the PHASER software [Mccoy, A. J. et al, J. Appl. Crystallogr., (2007), Vol. 40, pages 658-674], in either the PHENIX [Adams, P. D. et al, Acta Cryst. D, (2010), Vol. 66, pages 213-221] or CCP4 [Collaborative Computational Project, N., Acta crystallographica. Section D, Biological crystallography, (1994), Vol. 50, pages 760-763] software packages, or with the MOLREP software [Vagin, A. et al, J. Appl. Crystallogr., (1997), Vol. 30, pages 1022-1025] of the CCP4 package. It was, however, possible to rebuild and refine that Fab model according to the 4F110-Fab sequence using the computer graphics software COOT [Emsley, P. et al, Acta Crystallogr. Sect. D-Biol. Crystallogr., (2010), Vol. 66, pages 486-501] and crystallographic refinement software PHE-NIX.REFINE [Afonine, P. V. et al, Acta Crystallogr. Sect. D-Biol. Crystallogr., (2012), Vol. 68, pages 352-367]. To be able to find the missing molecules a data set was integrated in space-group P1 which PHASER, of the PHENIX package, could use to find the expected 4 Fab molecules. It had no success in finding any K3 domain molecule though using the coordinates of the PDB accession code 1IRH [Mine, S. et al, Biochemistry, (2002), Vol. 41, pages 78-85]. The four independent molecules in space group P1 were subsequently refined in PHENIX.REFINE [Afonine, P. V. et al, Acta Crystallogr. Sect. D-Biol. Crystallogr., (2012), Vol. 68, pages 352-367]. It was hereafter possible to choose two of the Fab molecules from the P1 solution and use that as a search model in subsequent PHASER runs using the P21 symmetry data again, but it was still not possible to find the positions of the K3 domain molecules using MR. The difference electron density map indicated, however, the approximate positions of the K3 domain molecules at this stage and after electron density improvements by the DM software rounds of automated model building and phase improvements using the ARP-wARP [Langer, G. et al, Nat Protoc, (2008), Vol. 3, pages 1171-1179][Murshudov, G. N. et al, Acta Crystallographica Section D Biological Crystallography, (2011), Vol. 67, pages 355-367] software gave partial K3 domain structure models. The newly obtained phases could subsequently be used successfully in direct space maps search by the MOLREP software using SCULPTOR [Bunkóczi, G. et al, Acta crystallographica. Section D, Biological crystallography, (2011), Vol. 67, pages 303-312] treated PDB:1IRH models as a single model in MOLREP. The structure model was then subject to simulated annealing refinements using the Cartesian refinement protocol by the PHENIX.REFINE software. A procedure of computer graphics inspection of the electron density maps, model corrections and building using the COOT software program [Emsley, P. et al, Acta Crystallogr. Sect. D-Biol. Crystallogr., (2004), Vol. 60, pages 2126-2132] followed by crystallographic refinements, using the software programs REFMAC5 [Murshudov, G. N. et al, Acta Crystallogr. Sect. D-Biol. Crystallogr., (1997), Vol. 53, pages 240-255] of the CCP4 software package and PHENIX.REFINE [Afonine, P. V. et al, Acta Crystallogr. Sect. D-Biol. Crystallogr., (2012), Vol. 68, pages 352-367] of the PHENIX software package [Adams, P. D. et al, Acta Cryst. D, (2010), Vol. 66, pages 213-221] was entered. The procedure was cycled until no further significant improvements could be made to the model. Final R- and R-free for all data were 0.208 and 0.246, respectively. For more refinement statistics see Table 1. For analyses of the structure, the coordinates were finally transferred back to the CCP4 package.
Results
Calculation of the areas excluded in pair-wise interactions by the software program Areaimol [Lee, B. et al, J Mol Biol, (1971), Vol. 55, pages 379-400][Saff, E. B. et al, Math Intell, (1997), Vol. 19, pages 5-11] of the CCP4 program suite [Collaborative Computational Project, N., Acta crystallographica. Section D, Biological crystallography, (1994), Vol. 50, pages 760-763] gave for the soluble TFPI Kunitz domain 3/anti-TFPI4F110 Fab molecular complex of the crystal structure 680 and 669 for TFPI Kunitz domain 3 and 532 and 536 Å2 for anti-TFPI4F110 and the two crystallographic independent molecular complexes, respectively.
The direct contacts between the TFPI Kunitz domain 3 and anti-TFPI4F110 Fab were identified by running the CONTACTS software of the CCP4 program suite [Bailey, S., Acta Crystallogr. Sect. D-Biol. Crystallogr., (1994), Vol. 50, pages 760-763] using a cut-off distance of 4.0 Å between the anti-TFPI4F110 Fab and the TFPI Kunitz domain 3 molecules. The results from the soluble TFPI Kunitz domain 3/anti-TFPI4F110 Fab complex crystal structure are shown in Table 2 and 3, respectively. The resulting TFPI Kunitz domain 3 epitope for anti-TFPI4F110 was found to comprise the following residues of TFPI Kunitz domain 3 (SEQ ID NO: 27): Tyr 23, Asn 24, Ser 25, Val 26, Ile 27, Gly 28, Lys 29, Arg 31, Lys 48, Gln 49, Leu 52 and Lys 56 for molecular complex nr. 1 and Tyr 23, Asn 24, Ser 25, Val 26, Ile 27, Gly 28, Lys 29, Arg 31, Lys 48, Leu 52 and Lys 56 for molecular complex 2. Evaluated from distances, charge-charge interactions, hydrogen bonds, polar and hydrophobic interactions and low solvent accessibility the following residues seems to be particularly important residues of the epitope: 1) Lys 29, 2) Arg 31 and 3) Ile 27.
Thus, the anti-TFPI4F110 TFPI Kunitz domain 3 epitope comprise residues in the loop between β-strands 1 and 2, residues in the start of β-strand 2 and residues on one side of the C-terminal α-helix of Kunitz domain 3. Many of the epitope residues are located, and part of, a cluster of residues forming a surface area with positive electrostatic potential on the K3 domain.
The anti-TFPI4F110 paratope for TFPI Kunitz domain 3 included, for molecular complex 1, residues Asn 28, Asp 30, Asp 32, Glu 50, Ser 91, Asp 92, Leu 94 and Tyr 96 of the light (L) chain (SEQ ID NO: 29, Table 2), and residues Ser 31, Tyr 33, Tyr 35, Glu 50, Asn 59, Trp 99, Arg 101 and Phe 102 of the heavy (H) chain (SEQ ID NO: 28, Table 2). The anti-TFPI4F110 paratope for TFPI Kunitz domain 3 included, for molecular complex 2, residues Asn 28, Asp 30, Asp 32, Glu 50, Ser 91, Asp 92, Leu 94 and Tyr 96 of the light (L) chain (SEQ ID NO: 29, Table 2), and residues Ser 31, Tyr 33, Tyr 35, Glu 50, Trp 99, Arg 101 and Phe 102 of the heavy (H) chain (SEQ ID NO: 28, Table 3). Alternatively, the paratope residues can be listed using their positions in each of the CDR loops using Kabat numbering. For example, according to Kabat numbering, the light chain paratope includes an Asn at positions 28 and an Asp at positions 30 and 32 in CDR1; a Glu at position 50 in CDR2; and a Ser at position 91, an Asp at position 92, a Leu at position 94, and a Tyr at position 96 of CDR3. Similarly, the heavy chain paratope, according to Kabat numbering, has a Ser at position 31, a Tyr at position 33 and a Tyr at position 35 in CDR1; a Glu at position 50 and an Asn at position 58 in CDR2; and a Trp at position 95, an Arg at position 97 and a Phe at position 98 in CDR3.







TABLE 1





Results from the X-ray model refinement to the observed data of the TFPI Kunitz domain 3/anti-


TFPI4F110 Fab complex by the software program PHENIX.REFINE [Afonine, P. V. et al, Acta


Crystallogr. Sect. D-Biol. Crystallogr., (2012), Vol. 68, pages 352-367] of the PHENIX


program software package [Adams, P. D. et al, Acta Cryst. D, (2010), Vol. 66, pages 213-221].

















REMARK
3
REFINEMENT.


REMARK
3
PROGRAM: PHENIX (phenix.refine: dev_1180)


REMARK
3
AUTHORS: Adams, Afonine, Chen, Davis, Echols, Gildea, Gopal,


REMARK
3
  : Grosse-Kunstleve, Headd, Hung, Immormino, Ioerger, McCoy,


REMARK
3
  : McKee, Moriarty, Pai, Read, Richardson, Richardson, Romo,


REMARK
3
  : Sacchettini, Sauter, Smith, Storoni, Terwilliger, Zwart


REMARK
3


REMARK
3
REFINEMENT TARGET: ML


REMARK
3


REMARK
3
DATA USED IN REFINEMENT.


REMARK
3
RESOLUTION RANGE HIGH (ANGSTROMS): 2.100


REMARK
3
RESOLUTION RANGE LOW (ANGSTROMS): 28.815


REMARK
3
MIN(FOBS/SIGMA_FOBS): 1.99


REMARK
3
COMPLETENESS FOR RANGE (%): 98.24


REMARK
3
NUMBER OF REFLECTIONS: 64495


REMARK
3
NUMBER OF REFLECTIONS (NON-ANOMALOUS): 64495


REMARK
3


REMARK
3
FIT TO DATA USED IN REFINEMENT.


REMARK
3
R VALUE (WORKING + TEST SET): 0.2095


REMARK
3
R VALUE (WORKING SET): 0.2076


REMARK
3
FREE R VALUE: 0.2459


REMARK
3
FREE R VALUE TEST SET SIZE (%): 5.02


REMARK
3
FREE R VALUE TEST SET COUNT: 3237


REMARK
3


REMARK
3
FIT TO DATA USED IN REFINEMENT (IN BINS).















REMARK
3
BIN
RESOLUTION RANGE
COMPL.
NWORK
NFREE
RWORK
RFREE


REMARK
3
1
28.8180-5.9552 
0.99
2800
146
0.1988
0.1959


REMARK
3
2
5.9552-4.7336
0.99
2733
147
0.1658
0.1766


REMARK
3
3
4.7336-4.1373
0.99
2708
137
0.1557
0.1975


REMARK
3
4
4.1373-3.7599
0.99
2706
152
0.1723
0.2292


REMARK
3
5
3.7599-3.4909
0.99
2688
137
0.1833
0.2470


REMARK
3
6
3.4909-3.2854
0.99
2676
142
0.1921
0.2403


REMARK
3
7
3.2854-3.1210
0.99
2685
148
0.2047
0.2395


REMARK
3
8
3.1210-2.9853
0.99
2675
133
0.2157
0.2580


REMARK
3
9
2.9853-2.8705
0.99
2687
146
0.2197
0.2583


REMARK
3
10
2.8705-2.7715
0.98
2655
140
0.2214
0.2600


REMARK
3
11
2.7715-2.6849
0.98
2649
144
0.2258
0.2773


REMARK
3
12
2.6849-2.6082
0.99
2683
136
0.2277
0.2616


REMARK
3
13
2.6082-2.5396
0.99
2654
137
0.2336
0.2801


REMARK
3
14
2.5396-2.4777
0.97
2606
152
0.2353
0.2576


REMARK
3
15
2.4777-2.4214
0.99
2671
142
0.2315
0.2866


REMARK
3
16
2.4214-2.3699
0.98
2647
127
0.2415
0.2597


REMARK
3
17
2.3699-2.3225
0.98
2596
130
0.2434
0.2799


REMARK
3
18
2.3225-2.2787
0.98
2656
141
0.2448
0.2855


REMARK
3
19
2.2787-2.2380
0.97
2637
140
0.2583
0.3413


REMARK
3
20
2.2380-2.2001
0.97
2607
150
0.2583
0.3013


REMARK
3
21
2.2001-2.1646
0.97
2587
133
0.2620
0.3038


REMARK
3
22
2.1646-2.1313
0.97
2645
136
0.2769
0.2695


REMARK
3
23
2.1313-2.1000
0.97
2607
141
0.2926
0.3764









REMARK
3



REMARK
3
BULK SOLVENT MODELLING.


REMARK
3
METHOD USED: FLAT BULK SOLVENT MODEL


REMARK
3
SOLVENT RADIUS: 1.11


REMARK
3
SHRINKAGE RADIUS: 0.90


REMARK
3
GRID STEP FACTOR: 4.00


REMARK
3


REMARK
3
ERROR ESTIMATES.


REMARK
3
COORDINATE ERROR (MAXIMUM-LIKELIHOOD BASED): 0.29


REMARK
3
PHASE ERROR (DEGREES, MAXIMUM-LIKELIHOOD BASED): 26.14


REMARK
3


REMARK
3
STRUCTURE FACTORS CALCULATION ALGORITHM: FFT


REMARK
3


REMARK
3
DEVIATIONS FROM IDEAL VALUES.













REMARK
3

RMSD
MAX
COUNT



REMARK
3
BOND:
0.002
0.020
7743


REMARK
3
ANGLE:
0.641
6.498
10511


REMARK
3
CHIRALITY:
0.040
0.185
1173


REMARK
3
PLANARITY:
0.002
0.044
1350


REMARK
3
DIHEDRAL:
11.904
89.640
2838









REMARK
3
MIN NONBONDED DISTANCE: 1.960


REMARK
3


REMARK
3
MOLPROBITY STATISTICS.


REMARK
3
ALL-ATOM CLASHSCORE: 7.34


REMARK
3
RAMACHANDRAN PLOT:


REMARK
3
OUTLIERS: 0.31%


REMARK
3
ALLOWED: 4.22%


REMARK
3
FAVORED: 95.47%


REMARK
3
ROTAMER OUTLIERS: 1.61%


REMARK
3
CBETA DEVIATIONS: 0


REMARK
3


REMARK
3
ATOMIC DISPLACEMENT PARAMETERS.


REMARK
3
WILSON B: 23.25


REMARK
3
RMS(B_ISO_OR_EQUIVALENT_BONDED): 3.94


REMARK
3
ATOMS NUMBER OF ATOMS














REMARK
3

ISO.
ANISO.





REMARK
3
ALL:
15622
7520


REMARK
3
ALL (NO H):
8264
7520


REMARK
3
SOLVENT:
720
0


REMARK
3
NON-SOLVENT:
7544
7520


REMARK
3
HYDROGENS:
7358
0









REMARK
3



REMARK
3
TLS DETAILS.


REMARK
3
NUMBER OF TLS GROUPS: 31


REMARK
3
ORIGIN: CENTER OF MASS


REMARK
3
TLS GROUP: 1


REMARK
3
SELECTION: chain ‘L’ and (resid 1 through 25)


REMARK
3
ORIGIN FOR THE GROUP (A): −30.0248 −32.0314 −59.6109


REMARK
3
T TENSOR














REMARK
3
T11:
0.1980
T22:
0.1134




REMARK
3
T33:
0.3225
T12:
0.0076


REMARK
3
T13:
−0.0699
T23:
−0.0820









REMARK
3
L TENSOR














REMARK
3
L11:
3.4996
L22:
6.2661




REMARK
3
L33:
6.8502
L12:
2.9258


REMARK
3
L13:
−3.8513
L23:
−6.3910









REMARK
3
S TENSOR














REMARK
3
S11:
−0.0478
S12:
0.1332
S13:
−0.1844


REMARK
3
S21:
−0.1742
S22:
0.1059
S23:
−0.0314


REMARK
3
S31:
0.2287
S32:
−0.0376
S33:
−0.0594









REMARK
3
TLS GROUP: 2


REMARK
3
SELECTION: chain ‘L’ and (resid 26 through 48)


REMARK
3
ORIGIN FOR THE GROUP (A): −31.3592 −22.7824 −52.5801


REMARK
3
T TENSOR














REMARK
3
T11:
0.1917
T22:
0.0925




REMARK
3
T33:
0.2428
T12:
0.0141


REMARK
3
T13:
−0.0381
T23:
0.0034









REMARK
3
L TENSOR














REMARK
3
L11:
4.4922
L22:
0.6519




REMARK
3
L33:
2.8198
L12:
−0.0173


REMARK
3
L13:
−0.5205
L23:
0.3506









REMARK
3
S TENSOR














REMARK
3
S11:
0.0218
S12:
0.0392
S13:
0.1431


REMARK
3
S21:
−0.0520
S22:
0.0887
S23:
0.1131


REMARK
3
S31:
−0.0528
S32:
0.1046
S33:
−0.1271









REMARK
3
TLS GROUP: 3


REMARK
3
SELECTION: chain ‘L’ and (resid 49 through 101)


REMARK
3
ORIGIN FOR THE GROUP (A): −33.4133 −24.0165 −56.5431


REMARK
3
T TENSOR














REMARK
3
T11:
0.1590
T22:
0.1009




REMARK
3
T33:
0.2558
T12:
−0.0003


REMARK
3
T13:
−0.0362
T23:
0.0123









REMARK
3
L TENSOR














REMARK
3
L11:
2.4001
L22:
0.8819




REMARK
3
L33:
2.3017
L12:
0.3202


REMARK
3
L13:
−1.2126
L23:
−0.2700









REMARK
3
S TENSOR














REMARK
3
S11:
−0.0407
S12:
0.3644
S13:
−0.0521


REMARK
3
S21:
0.0642
S22:
0.0554
S23:
0.0022


REMARK
3
S31:
−0.0304
S32:
−0.2729
S33:
−0.0037









REMARK
3
TLS GROUP: 4


REMARK
3
SELECTION: chain ‘L’ and (resid 102 through 113)


REMARK
3
ORIGIN FOR THE GROUP (A): −17.6845 −26.2284 −72.0192


REMARK
3
T TENSOR














REMARK
3
T11:
0.2414
T22:
0.1888




REMARK
3
T33:
0.2589
T12:
0.0119


REMARK
3
T13:
−0.0492
T23
−0.0445









REMARK
3
L TENSOR














REMARK
3
L11:
8.4779
L22:
0.7830




REMARK
3
L33:
5.9280
L12:
2.5630


REMARK
3
L13:
−7.0932
L23:
−2.1454









REMARK
3
S TENSOR














REMARK
3
S11:
−0.1678
S12:
0.4840
S13:
−0.5853


REMARK
3
S21:
−0.1130
S22:
−0.0252
S23:
0.0300


REMARK
3
S31:
0.3078
S32:
−0.1435
S33:
0.1824









REMARK
3
TLS GROUP: 5


REMARK
3
SELECTION: chain ‘L’ and (resid 114 through 128)


REMARK
3
ORIGIN FOR THE GROUP (A): 10.2163 −14.6842 −66.3332


REMARK
3
T TENSOR














REMARK
3
T11:
0.1636
T22:
0.2258




REMARK
3
T33:
0.3178
T12:
−0.0113


REMARK
3
T13:
0.0600
T23:
−0.0297









REMARK
3
L TENSOR














REMARK
3
L11:
8.1430
L22:
5.5811




REMARK
3
L33:
7.8584
L12:
0.6732


REMARK
3
L13:
6.2496
L23:
0.9988









REMARK
3
S TENSOR














REMARK
3
S11:
−0.2533
S12:
−0.1889
S13:
1.0053


REMARK
3
S21:
0.0313
S22:
−0.0801
S23:
−0.3330


REMARK
3
S31:
−0.5756
S32:
0.1833
S33:
0.3275









REMARK
3
TLS GROUP: 6


REMARK
3
SELECTION: chain ‘L’ and (resid 129 through 150)


REMARK
3
ORIGIN FOR THE GROUP (A): −0.6078 −25.1278 −70.4951


REMARK
3
T TENSOR














REMARK
3
T11:
0.2082
T22:
0.1450




REMARK
3
T33:
0.1854
T12:
−0.0118


REMARK
3
T13:
0.0362
T23:
0.0089









REMARK
3
L TENSOR














REMARK
3
L11:
8.3715
L22:
1.2960




REMARK
3
L33:
2.8683
L12:
0.4681


REMARK
3
L13:
4.6127
L23:
−0.0275









REMARK
3
S TENSOR














REMARK
3
S11:
0.2092
S12:
−0.3626
S13:
0.1293


REMARK
3
S21:
−0.0290
S22:
−0.2284
S23:
0.0575


REMARK
3
S31:
0.2166
S32:
−0.2785
S33:
0.0202









REMARK
3
TLS GROUP: 7


REMARK
3
SELECTION: chain ‘L’ and (resid 151 through 174)


REMARK
3
ORIGIN FOR THE GROUP (A): −3.2125 −24.8282 −68.0754


REMARK
3
T TENSOR














REMARK
3
T11:
0.1973
T22:
0.0929




REMARK
3
T33:
0.2334
T12:
−0.0221


REMARK
3
T13:
−0.0261
T23:
−0.0120









REMARK
3
L TENSOR














REMARK
3
L11:
6.9016
L22:
0.0481




REMARK
3
L33:
1.6497
L12:
−0.2519


REMARK
3
L13:
0.9617
L23:
−0.1933









REMARK
3
S TENSOR














REMARK
3
S11:
−0.1015
S12:
−0.0242
S13:
0.2678


REMARK
3
S21:
−0.0261
S22:
0.1077
S23:
−0.1516


REMARK
3
S31:
0.1161
S32:
−0.1871
S33:
−0.0021









REMARK
3
TLS GROUP: 8


REMARK
3
SELECTION: chain ‘L’ and (resid 175 through 204)


REMARK
3
ORIGIN FOR THE GROUP (A): 8.6598 −25.0498 −71.3558


REMARK
3
T TENSOR














REMARK
3
T11:
0.2014
T22:
0.0899




REMARK
3
T33:
0.3269
T12:
0.0401


REMARK
3
T13:
−0.0040
T23:
0.0341









REMARK
3
L TENSOR














REMARK
3
L11:
6.4644
L22:
0.9332




REMARK
3
L33:
3.1999
L12:
0.1834


REMARK
3
L13:
1.9789
L23:
0.6303









REMARK
3
S TENSOR














REMARK
3
S11:
0.1672
S12:
0.1910
S13:
−0.4434


REMARK
3
S21:
−0.0555
S22:
0.0585
S23:
−0.1791


REMARK
3
S31:
0.1990
S32:
0.2704
S33:
−0.2285









REMARK
3
TLS GROUP: 9


REMARK
3
SELECTION: chain ‘L’ and (resid 205 through 214)


REMARK
3
ORIGIN FOR THE GROUP (A): 12.1567 −19.0597 −76.4507


REMARK
3
T TENSOR














REMARK
3
T11:
0.2582
T22:
0.2844




REMARK
3
T33:
0.4308
T12:
−0.0428


REMARK
3
T13:
0.0597
T23:
0.0679









REMARK
3
L TENSOR














REMARK
3
L11:
1.9322
L22:
4.7885




REMARK
3
L33:
6.3684
L12:
2.3575


REMARK
3
L13:
2.6636
L23:
0.9973









REMARK
3
S TENSOR














REMARK
3
S11:
−0.4942
S12:
0.6205
S13:
0.8722


REMARK
3
S21:
−0.4615
S22:
0.1826
S23:
−0.0466


REMARK
3
S31:
−0.9241
S32:
0.7998
S33:
0.2916









REMARK
3
TLS GROUP: 10


REMARK
3
SELECTION: chain ‘H’ and (resid 1 through 124)


REMARK
3
ORIGIN FOR THE GROUP (A): −20.1235 −17.7708 −39.1885


REMARK
3
T TENSOR














REMARK
3
T11:
0.2028
T22:
0.1342




REMARK
3
T33:
0.2048
T12:
−0.0194


REMARK
3
T13:
−0.0368
T23:
0.0021









REMARK
3
L TENSOR














REMARK
3
L11:
4.2431
L22:
0.5591




REMARK
3
L33:
1.4260
L12:
0.0593


REMARK
3
L13:
−0.7911
L23:
0.1539









REMARK
3
S TENSOR














REMARK
3
S11:
0.0324
S12:
−0.4225
S13:
−0.0778


REMARK
3
S21:
0.0484
S22:
−0.0351
S23:
−0.0010


REMARK
3
S31:
−0.0715
S32:
0.1057
S33:
0.0092









REMARK
3
TLS GROUP: 11


REMARK
3
SELECTION: chain ‘H’ and (resid 125 through 218)


REMARK
3
ORIGIN FOR THE GROUP (A): −0.1394 −10.0312 −62.1715


REMARK
3
T TENSOR














REMARK
3
T11:
0.1342
T22:
0.1077




REMARK
3
T33:
0.2399
T12:
−0.0154


REMARK
3
T13:
0.0040
T23:
−0.0037









REMARK
3
L TENSOR














REMARK
3
L11:
1.9173
L22:
3.5357




REMARK
3
L33:
5.0063
L12:
−0.5673


REMARK
3
L13:
1.3153
L23:
−2.4652









REMARK
3
S TENSOR














REMARK
3
S11:
0.0526
S12:
0.0949
S13:
0.0946


REMARK
3
S21:
−0.0985
S22:
−0.1156
S23:
−0.1105


REMARK
3
S31:
−0.1031
S32:
0.1748
S33:
0.0519









REMARK
3
TLS GROUP: 12


REMARK
3
SELECTION: chain ‘K’ and (resid 1 through 6)


REMARK
3
ORIGIN FOR THE GROUP (A): −50.8687 −16.3040 −32.7837


REMARK
3
T TENSOR














REMARK
3
T11:
0.1952
T22:
0.5983




REMARK
3
T33:
0.3054
T12:
−0.0006


REMARK
3
T13:
−0.0201
T23:
−0.0437









REMARK
3
L TENSOR














REMARK
3
L11:
9.1595
L22:
6.5291




REMARK
3
L33:
7.1338
L12:
−3.8015


REMARK
3
L13:
3.8260
L23:
3.0977









REMARK
3
S TENSOR














REMARK
3
S11:
0.1281
S12:
−0.8677
S13:
−0.7604


REMARK
3
S21:
−0.1736
S22:
0.1312
S23:
0.4309


REMARK
3
S31:
−0.0703
S32:
−0.2640
S33:
−0.1691









REMARK
3
TLS GROUP: 13


REMARK
3
SELECTION: chain ‘K’ and (resid 7 through 17)


REMARK
3
ORIGIN FOR THE GROUP (A): −43.4669 −25.3927 −19.6578


REMARK
3
T TENSOR














REMARK
3
T11:
0.6647
T22:
1.1051




REMARK
3
T33:
0.5836
T12:
−0.0449


REMARK
3
T13:
0.0430
T23:
0.2389









REMARK
3
L TENSOR














REMARK
3
L11:
5.8648
L22:
3.5501




REMARK
3
L33:
4.1747
L12:
−1.1974


REMARK
3
L13:
1.5166
L23:
0.3987









REMARK
3
S TENSOR














REMARK
3
S11:
−0.0713
S12:
−1.9990
S13:
−1.3647


REMARK
3
S21:
1.7622
S22:
0.0052
S23:
0.1790


REMARK
3
S31:
0.4397
S32:
0.0126
S33:
0.0409









REMARK
3
TLS GROUP: 14


REMARK
3
SELECTION: chain ‘K’ and (resid 18 through 47)


REMARK
3
ORIGIN FOR THE GROUP (A): −44.4100 −25.4731 −29.9202


REMARK
3
T TENSOR














REMARK
3
T11:
0.2670
T22:
0.4571




REMARK
3
T33:
0.3423
T12:
−0.0104


REMARK
3
T13:
0.0144
T23:
0.1032









REMARK
3
L TENSOR














REMARK
3
L11:
3.9034
L22:
5.3903




REMARK
3
L33:
8.2294
L12:
0.7341


REMARK
3
L13:
−2.6912
L23:
−0.0062









REMARK
3
S TENSOR














REMARK
3
S11:
−0.2495
S12:
−1.0597
S13:
−0.6877


REMARK
3
S21:
0.2501
S22:
−0.0651
S23:
0.0266


REMARK
3
S31:
0.9551
S32:
−0.2297
S33:
0.3067









REMARK
3
TLS GROUP: 15


REMARK
3
SELECTION: chain ‘K’ and (resid 48 through 57)


REMARK
3
ORIGIN FOR THE GROUP (A): −49.3374 −25.3148 −39.7262


REMARK
3
T TENSOR














REMARK
3
T11:
0.3545
T22:
0.4883




REMARK
3
T33:
0.5013
T12:
−0.1196


REMARK
3
T13:
−0.0149
T23:
−0.1004









REMARK
3
L TENSOR














REMARK
3
L11:
3.5333
L22:
3.1795




REMARK
3
L33:
7.0522
L12:
2.1089


REMARK
3
L13:
−4.2722
L23:
−0.6878









REMARK
3
S TENSOR














REMARK
3
S11:
−0.1646
S12:
0.3659
S13:
−0.5209


REMARK
3
S21:
−0.6341
S22:
−0.2112
S23:
1.3377


REMARK
3
S31:
1.0094
S32:
−1.5656
S33:
0.3624









REMARK
3
TLS GROUP: 16


REMARK
3
SELECTION: chain ‘A’ and (resid 1 through 25)


REMARK
3
ORIGIN FOR THE GROUP (A): −2.2098 12.4899 −9.3446


REMARK
3
T TENSOR














REMARK
3
T11:
0.8177
T22:
1.2633




REMARK
3
T33:
0.8580
T12:
−0.2185


REMARK
3
T13:
0.2999
T23:
−0.6861









REMARK
3
L TENSOR














REMARK
3
L11:
0.4680
L22:
0.4916




REMARK
3
L33:
0.8073
L12:
0.2185


REMARK
3
L13:
0.2583
L23:
0.0444









REMARK
3
S TENSOR














REMARK
3
S11:
0.2316
S12:
−0.1170
S13:
0.0901


REMARK
3
S21:
0.2636
S22:
−0.2774
S23:
0.5277


REMARK
3
S31:
−0.2864
S32:
−0.0462
S33:
0.1020









REMARK
3
TLS GROUP: 17


REMARK
3
SELECTION: chain ‘A’ and (resid 26 through 101)


REMARK
3
ORIGIN FOR THE GROUP (A): −1.3082 10.5321 −19.0290


REMARK
3
T TENSOR














REMARK
3
T11:
0.5069
T22:
1.0407




REMARK
3
T33:
0.6710
T12:
−0.0419


REMARK
3
T13:
0.2628
T23:
−0.7494









REMARK
3
L TENSOR














REMARK
3
L11:
1.2120
L22:
0.2809




REMARK
3
L33:
1.6432
L12:
0.2353


REMARK
3
L13:
−0.4909
L23:
−0.2781









REMARK
3
S TENSOR














REMARK
3
S11:
0.2388
S12:
−0.6782
S13:
0.9143


REMARK
3
S21:
0.2081
S22:
−0.4593
S23:
0.4729


REMARK
3
S31:
−0.8546
S32:
0.0710
S33:
−0.5705









REMARK
3
TLS GROUP: 18


REMARK
3
SELECTION: chain ‘A’ and (resid 102 through 137)


REMARK
3
ORIGIN FOR THE GROUP (A): −23.9349 −11.2494 −3.9773


REMARK
3
T TENSOR














REMARK
3
T11:
0.3068
T22:
1.4215




REMARK
3
T33:
0.4477
T12:
−0.0607


REMARK
3
T13:
0.1020
T23:
0.0489









REMARK
3
L TENSOR














REMARK
3
L11:
2.8293
L22:
1.4864




REMARK
3
L33:
1.6857
L12:
1.3011


REMARK
3
L13:
−1.6393
L23:
−0.6772









REMARK
3
S TENSOR














REMARK
3
S11:
0.1539
S12:
−1.0774
S13:
0.0285


REMARK
3
S21:
−0.0767
S22:
0.0757
S23:
−0.1736


REMARK
3
S31:
0.0644
S32:
−0.2265
S33:
0.0076









REMARK
3
TLS GROUP: 19


REMARK
3
SELECTION: chain ‘A’ and (resid 138 through 163)


REMARK
3
ORIGIN FOR THE GROUP (A): −21.8598 −9.5472 5.0477


REMARK
3
T TENSOR














REMARK
3
T11:
0.5904
T22:
1.7811




REMARK
3
T33:
0.4216
T12:
−0.1110


REMARK
3
T13:
−0.0549
T23:
−0.1608









REMARK
3
L TENSOR














REMARK
3
L11:
0.2396
L22:
2.0873




REMARK
3
L33:
3.2551
L12:
−0.0541


REMARK
3
L13:
−0.4041
L23:
−2.2289









REMARK
3
S TENSOR














REMARK
3
S11:
0.0753
S12:
−0.7657
S13:
0.0217


REMARK
3
S21:
0.7399
S22:
−0.0751
S23:
−0.0725


REMARK
3
S31:
−0.4048
S32:
−0.0924
S33:
0.0265









REMARK
3
TLS GROUP: 20


REMARK
3
SELECTION: chain ‘A’ and (resid 164 through 188)


REMARK
3
ORIGIN FOR THE GROUP (A): −21.9271 −12.7297 −2.3891


REMARK
3
T TENSOR














REMARK
3
T11:
0.3618
T22:
1.3496




REMARK
3
T33:
0.5308
T12:
−0.0971


REMARK
3
T13:
0.0790
T23:
0.0052









REMARK
3
L TENSOR














REMARK
3
L11:
3.1100
L22:
4.4691




REMARK
3
L33:
4.3539
L12:
1.3406


REMARK
3
L13:
−2.1991
L23:
−2.2876









REMARK
3
S TENSOR














REMARK
3
S11:
0.1127
S12:
−1.4377
S13:
−0.3115


REMARK
3
S21:
0.1430
S22:
−0.0851
S23:
−0.2952


REMARK
3
S31:
−0.0640
S32:
0.2676
S33:
0.0325









REMARK
3
TLS GROUP: 21


REMARK
3
SELECTION: chain ‘A’ and (resid 189 through 214)


REMARK
3
ORIGIN FOR THE GROUP (A): −31.3188 −13.0623 5.6606


REMARK
3
T TENSOR














REMARK
3
T11:
0.5197
T22:
1.7990




REMARK
3
T33:
0.5517
T12:
0.0917


REMARK
3
T13:
0.0726
T23:
0.2046









REMARK
3
L TENSOR














REMARK
3
L11:
3.6465
L22:
6.2220




REMARK
3
L33:
4.4267
L12:
3.5423


REMARK
3
L13:
−2.9477
L23:
−3.5778









REMARK
3
S TENSOR














REMARK
3
S11:
0.0304
S12:
−1.2892
S13:
−0.2462


REMARK
3
S21:
0.7992
S22:
−0.0574
S23:
0.1950


REMARK
3
S31:
−0.0634
S32:
−0.0081
S33:
0.0112









REMARK
3
TLS GROUP: 22


REMARK
3
SELECTION: chain ‘B’ and (resid 1 through 32)


REMARK
3
ORIGIN FOR THE GROUP (A): 3.1665 −12.2756 −27.8305


REMARK
3
T TENSOR














REMARK
3
T11:
0.2021
T22:
0.6826




REMARK
3
T33:
0.3091
T12:
0.0391


REMARK
3
T13:
−0.0122
T23:
0.0632









REMARK
3
L TENSOR














REMARK
3
L11:
1.1995
L22:
2.3617




REMARK
3
L33:
4.8040
L12:
−0.2421


REMARK
3
L13:
0.3960
L23:
−1.3153









REMARK
3
S TENSOR














REMARK
3
S11:
−0.0006
S12:
−0.8640
S13:
−0.3774


REMARK
3
S21:
−0.0563
S22:
0.1131
S23:
0.1240


REMARK
3
S31:
0.0150
S32:
−0.4573
S33:
−0.1523









REMARK
3
TLS GROUP: 23


REMARK
3
SELECTION: chain ‘B’ and (resid 33 through 57)


REMARK
3
ORIGIN FOR THE GROUP (A): 8.5488 −4.4531 −21.8330


REMARK
3
T TENSOR














REMARK
3
T11:
0.2395
T22:
0.8508




REMARK
3
T33:
0.2819
T12:
−0.0752


REMARK
3
T13:
−0.0078
T23:
−0.0983









REMARK
3
L TENSOR














REMARK
3
L11:
0.1821
L22:
3.1190




REMARK
3
L33:
0.5456
L12:
−0.7455


REMARK
3
L13:
−0.3109
L23:
1.3036









REMARK
3
S TENSOR














REMARK
3
S11:
0.0362
S12:
−1.1833
S13:
0.0514


REMARK
3
S21:
0.2177
S22:
−0.1428
S23:
0.1297


REMARK
3
S31:
−0.1631
S32:
0.0000
S33:
0.0099









REMARK
3
TLS GROUP: 24


REMARK
3
SELECTION: chain ‘B’ and (resid 58 through 76)


REMARK
3
ORIGIN FOR THE GROUP (A): 14.3993 −9.5115 −22.6979


REMARK
3
T TENSOR














REMARK
3
T11:
0.2840
T22:
0.9534




REMARK
3
T33:
0.3306
T12:
−0.0730


REMARK
3
T13:
−0.0323
T23:
−0.0273









REMARK
3
L TENSOR














REMARK
3
L11:
0.5840
L22:
2.0750




REMARK
3
L33:
5.7507
L12:
0.2344


REMARK
3
L13:
1.8099
L23:
1.1082









REMARK
3
S TENSOR














REMARK
3
S11:
0.0439
S12:
−0.9348
S13:
0.0336


REMARK
3
S21:
0.3233
S22:
−0.0066
S23:
−0.2044


REMARK
3
S31:
−0.2650
S32:
0.2799
S33:
−0.0443









REMARK
3
TLS GROUP: 25


REMARK
3
SELECTION: chain ‘B’ and (resid 77 through 124)


REMARK
3
ORIGIN FOR THE GROUP (A): 3.0000 −10.0249 −20.6917


REMARK
3
T TENSOR














REMARK
3
T11:
0.2287
T22:
0.9606




REMARK
3
T33:
0.3648
T12:
−0.0219


REMARK
3
T13:
0.0268
T23:
0.0657









REMARK
3
L TENSOR














REMARK
3
L11:
1.2322
L22:
0.4469




REMARK
3
L33:
0.9204
L12:
−0.3092


REMARK
3
L13:
0.1327
L23:
0.5248









REMARK
3
S TENSOR














REMARK
3
S11:
0.0571
S12:
−1.1687
S13:
−0.1853


REMARK
3
S21:
0.1238
S22:
−0.1175
S23:
−0.0697


REMARK
3
S31:
−0.0996
S32:
0.1073
S33:
−0.0027









REMARK
3
TLS GROUP: 26


REMARK
3
SELECTION: chain ‘B’ and (resid 125 through 180)


REMARK
3
ORIGIN FOR THE GROUP (A): −20.5939 −17.1677 −11.3423


REMARK
3
T TENSOR














REMARK
3
T11:
0.3309
T22:
1.2172




REMARK
3
T33:
0.4123
T12:
−0.0332


REMARK
3
T13:
0.0314
T23:
0.1985









REMARK
3
L TENSOR














REMARK
3
L11:
0.0689
L22:
0.9313




REMARK
3
L33:
0.6900
L12:
0.1493


REMARK
3
L13:
0.1010
L23:
−0.2964









REMARK
3
S TENSOR














REMARK
3
S11:
−0.0545
S12:
−1.3751
S13:
−0.4830


REMARK
3
S21:
0.2556
S22:
−0.0512
S23:
0.1333


REMARK
3
S31:
−0.0002
S32:
0.0839
S33:
0.0091









REMARK
3
TLS GROUP: 27


REMARK
3
SELECTION: chain ‘B’ and (resid 181 through 208)


REMARK
3
ORIGIN FOR THE GROUP (A): −25.3297 −17.0492 −16.0220


REMARK
3
T TENSOR














REMARK
3
T11:
0.2104
T22:
1.1943




REMARK
3
T33:
0.4043
T12:
−0.0865


REMARK
3
T13:
−0.0231
T23:
0.1583









REMARK
3
L TENSOR














REMARK
3
L11:
3.0337
L22:
4.0068




REMARK
3
L33:
0.5339
L12:
−1.7626


REMARK
3
L13:
0.8687
L23:
0.3718









REMARK
3
S TENSOR














REMARK
3
S11:
0.0430
S12:
−0.6449
S13:
−0.3411


REMARK
3
S21:
0.0141
S22:
−0.1562
S23:
0.4243


REMARK
3
S31:
−0.0515
S32:
−0.1681
S33:
0.1151









REMARK
3
TLS GROUP: 28


REMARK
3
SELECTION: chain ‘B’ and (resid 209 through 218)


REMARK
3
ORIGIN FOR THE GROUP (A): −24.3577 −24.0870 −18.2162


REMARK
3
T TENSOR














REMARK
3
T11:
0.4717
T22:
0.9525




REMARK
3
T33:
0.4298
T12:
−0.2429


REMARK
3
T13:
−0.0324
T23:
0.2651









REMARK
3
L TENSOR














REMARK
3
L11:
0.9346
L22:
6.9929




REMARK
3
L33:
2.4082
L12:
−1.5837


REMARK
3
L13:
0.4443
L23:
2.3237









REMARK
3
S TENSOR














REMARK
3
S11:
−0.7136
S12:
−0.0804
S13:
−1.0971


REMARK
3
S21:
0.4731
S22:
0.1025
S23:
0.4142


REMARK
3
S31:
0.6166
S32:
−0.8413
S33:
0.6128









REMARK
3
TLS GROUP: 29


REMARK
3
SELECTION: chain ‘Q’ and (resid 2 through 17)


REMARK
3
ORIGIN FOR THE GROUP (A): 29.3065 7.5801 −33.3024


REMARK
3
T TENSOR














REMARK
3
T11:
0.6480
T22:
0.5090




REMARK
3
T33:
0.3886
T12:
−0.2202


REMARK
3
T13:
−0.0450
T23:
−0.0244









REMARK
3
L TENSOR














REMARK
3
L11:
7.0684
L22:
7.9998




REMARK
3
L33:
5.9595
L12:
−4.6106


REMARK
3
L13:
0.4214
L23:
−1.3317









REMARK
3
S TENSOR














REMARK
3
S11:
−0.7795
S12:
−0.3434
S13:
0.7311


REMARK
3
S21:
0.3985
S22:
0.2759
S23:
−1.0140


REMARK
3
S31:
−1.1207
S32:
1.0928
S33:
0.5007









REMARK
3
TLS GROUP: 30


REMARK
3
SELECTION: chain ‘Q’ and (resid 18 through 35)


REMARK
3
ORIGIN FOR THE GROUP (A): 22.3932 8.1108 −27.6298


REMARK
3
T TENSOR














REMARK
3
T11:
0.5075
T22:
0.7391




REMARK
3
T33:
0.2506
T12:
−0.1911


REMARK
3
T13:
−0.0300
T23:
−0.1137









REMARK
3
L TENSOR














REMARK
3
L11:
3.6620
L22:
4.2298




REMARK
3
L33:
1.6042
L12:
−0.6350


REMARK
3
L13:
−1.0309
L23:
0.1780









REMARK
3
S TENSOR














REMARK
3
S11:
−0.4499
S12:
−0.8605
S13:
0.4427


REMARK
3
S21:
0.3936
S22:
−0.2248
S23:
−0.2021


REMARK
3
S31:
−0.5435
S32:
0.7612
S33:
0.5940









REMARK
3
TLS GROUP: 31


REMARK
3
SELECTION: chain ‘Q’ and (resid 36 through 56)


REMARK
3
ORIGIN FOR THE GROUP (A): 24.3479 14.6260 −29.5531


REMARK
3
T TENSOR














REMARK
3
T11:
0.6547
T22:
0.6959




REMARK
3
T33:
0.4255
T12:
−0.2907


REMARK
3
T13:
−0.0267
T23:
−0.1541









REMARK
3
L TENSOR














REMARK
3
L11:
4.6970
L22:
4.9551




REMARK
3
L33:
5.1377
L12:
−2.4341


REMARK
3
L13:
1.2588
L23:
−0.0990









REMARK
3
S TENSOR














REMARK
3
S11:
−0.3449
S12:
−0.8524
S13:
1.1570


REMARK
3
S21:
0.4104
S22:
0.1544
S23:
−0.5618


REMARK
3
S31:
−0.8961
S32:
0.5452
S33:
0.1991


REMARK
3
















CRYST1
69.290
65.770
125.550
90.00
97.50
90.00
P 1 21 1













SCALE1
0.014432
0.000000
0.001900
0.00000



SCALE2
0.000000
0.015205
0.000000
0.00000



SCALE3
0.000000
0.000000
0.008034
0.00000

















TABLE 2







TFPI Kunitz domain 3, chain K, (SEQ ID NO: 27) interactions with the


heavy chain (chain H) of anti-TFPI4F110 (SEQ ID NO: 28) and light


chain (chain L) of anti-TFPI4F110 Fab (SEQ ID NO: 29) for the first


crystallographic independent complex. A distance cut-off of 4.0 Å


was used. The contacts were identified by the CONTACT computer


software program of the CCP4 suite [Collaborative Computational


Project, N., Acta crystallographica.Section D, Biological crystallography,


(1994), Vol. 50, pages 760-763]. In the last column “***” indicates


a strong possibility for a hydrogen bond at this contact (distance <3.3 Å)


as calculated by CONTACT, “*” indicates a weak possibility


(distance >3.3 Å). Blank indicates that the program considered there to be


no possibility of a hydrogen bond. Hydrogen-bonds are specific between


a donor and an acceptor, are typically strong, and are easily identifiable.









TFPI (K3)
4F110 aTFPI
















Res. #


Res. #





Res.
and
Atom
Res.
and
Atom
Distance
Possibly


Type
Chain
name
Type
Chain
name
[Å]
H-bond

















Tyr
23K
OH
Phe
102H
CE1
3.56






Phe
102H
CZ
3.58


Asn
24K
CG
Tyr
 33H
OH
3.86


Asn
24K
OD1
Tyr
 33H
OH
3.87
*


Asn
24K
ND2
Tyr
 33H
OH
2.99
***





Tyr
 33H
CZ
3.76


Ser
25K
O
Arg
101H
CD
3.09





Arg
101H
NE
3.53
*





Arg
101H
CZ
3.58





Arg
101H
NH1
3.16
***


Val
26K
CA
Arg
101H
NH1
3.87


Val
26K
CB
Tyr
 33H
CE1
3.89


Val
26K
CG1
Ser
 31H
O
3.76





Tyr
 33H
CD1
3.71





Tyr
 33H
CE1
3.51


Val
26K
C
Arg
101H
NH1
3.68


Val
26K
O
Arg
101H
CD
3.71





Arg
101H
CB
3.61





Arg
101H
NH1
2.99
***


Ile
27K
CA
Trp
 99H
CD1
3.95


Ile
27K
CB
Trp
 99H
CD1
3.74


Ile
27K
CG2
Trp
 99H
CD1
3.98





Tyr
 35H
OH
3.85





Tyr
 33H
CE2
3.94





Tyr
 33H
CD2
3.48





Tyr
 33H
CB
3.79





Tyr
 33H
CG
3.40





Tyr
 33H
CD1
3.79


Ile
27K
C
Arg
101H
CD
3.99





Trp
 99H
NE1
4.00





Arg
101H
CB
3.89





Arg
101H
CG
3.61


Ile
27K
O
Trp
 99H
NE1
3.04
***





Arg
101H
CA
3.62





Trp
 99H
CD1
3.62





Arg
101H
CB
3.84





Arg
101H
CG
3.65


Gly
28K
N
Arg
101H
CD
3.62





Arg
101H
CG
3.62


Gly
28K
CA
Phe
102H
CE1
3.88





Arg
101H
CD
3.79





Arg
101H
CG
3.68


Lys
29K
CD
Ser
 91L
O
3.58


Lys
29K
CE
Ser
 91L
OG
3.69





Ser
 91L
O
3.20





Glu
 50L
OE2
3.26





Trp
 99H
CZ2
3.54


Lys
29K
NZ
Asp
 32L
CB
3.99





Ser
 91L
OG
2.88
***





Ser
 91L
C
3.79





Asp
 92L
OD1
3.17
***





Ser
 91L
O
3.22
***





Glu
 50L
CD
3.94





Glu
 50L
OE2
2.82
***





Trp
 99H
CZ2
3.93





Ser
 91L
CB
3.72


Arg
31K
CZ
Leu
 94L
CD2
3.91





Tyr
 96L
OH
3.96





Glu
 50H
OE1
3.58





Glu
 50H
OE2
3.86


Arg
31K
NH1
Leu
 94L
CD1
3.99





Glu
 50H
OE1
3.46
*





Glu
 50H
CD
3.66





Glu
 50H
OE2
3.05
***





Asn
 59H
ND2
3.72
*


Arg
31K
NH2
Leu
 94L
CD2
3.82





Tyr
 96L
CE1
3.90





Tyr
 96L
CZ
3.61





Tyr
 96L
OH
2.82
***





Glu
 50H
OE1
2.81
***





Glu
 50H
CD
3.64





Glu
 50H
OE2
3.78
*


Lys
48K
CE
Asp
 92L
OD2
3.30


Lys
48K
NZ
Asn
 28L
O
3.08
***





Asp
 92L
CB
3.54





Asp
 92L
CG
3.57





Asp
 92L
OD2
2.78
***


Gln
49K
OE1
Asp
 30L
OD1
3.89
*





Asp
 30L
OD2
3.69
*


Gln
49K
NE2
Asn
 28L
ND2
3.36
*





Asp
 30L
OD1
3.33
*





Asp
 30L
CG
3.87





Asp
 30L
OD2
3.68
*


Leu
52K
CD1
Asp
 30L
OD2
3.60


Lys
56K
CE
Glu
 50L
OE1
3.59





Phe
102H
CD1
3.93





Phe
102H
CE1
3.96


Lys
56K
NZ
Asp
 32L
CG
3.57





Asp
 32L
OD2
3.22
***





Asp
 32L
OD1
3.46
*





Glu
 50L
OE1
2.97
***





Glu
 50L
CD
3.54





Glu
 50L
OE2
3.48
*
















TABLE 3







TFPI Kunitz domain 3, chain Q, (SEQ ID NO: 27) interactions with the


heavy chain (chain B) of anti-TFPI4F110 (SEQ ID NO: 28) and light


chain (chain A) of anti-TFPI4F110 Fab (SEQ ID NO: 29) for the second


crystallographic independent complex. A distance cut-off of 4.0 Å was


used. The contacts were identified by the CONTACT computer software


program of the CCP4 suite [Collaborative Computational Project, N.,


Acta crystallographica.Section D, Biological crystallography, (1994), Vol.


50, pages 760-763]. In the last column “***” indicates a strong


possibility for a hydrogen bond at this contact (distance <3.3 Å) as


calculated by CONTACT, “*” indicates a weak possibility


(distance >3.3 Å). Blank indicates that the program considered there to be


no possibility of a hydrogen bond. Hydrogen-bonds are specific between


a donor and an acceptor, are typically strong, and are easily identifiable.









TFPI (K3)
4F110 aTFPI
















Res.


Res.





Res.
# and
Atom
Res.
# and
Atom
Distance
Possibly


Type
Chain
name
Type
Chain
name
[Å]
H-bond

















Tyr
23Q
OH
Phe
102B
CE1
3.53






Phe
102B
CZ
3.30


Asn
24Q
OD1
Tyr
 33B
OH
3.96
*


Asn
24Q
ND2
Tyr
 33B
CZ
3.89





Tyr
 33B
OH
3.31
*





Tyr
 33B
CE2
3.82


Ser
25Q
O
Arg
101B
CD
2.99





Arg
101B
NE
3.71
*





Arg
101B
CZ
3.73





Arg
101B
NH1
3.03
***


Val
26Q
CA
Arg
101B
NH1
3.97


Val
26Q
CG1
Ser
 31B
O
3.85





Tyr
 33B
CD1
3.76





Tyr
 33B
CE1
3.65


Val
26Q
C
Arg
101B
CD
3.95


Val
26Q
O
Arg
101B
CD
3.49





Arg
101B
NH1
3.45
*





Arg
101B
CB
3.59





Arg
101B
CG
3.86


Ile
27Q
CA
Trp
 99B
CD1
3.98


Ile
27Q
CB
Trp
 99B
CD1
3.80


Ile
27Q
CD1
Glu
 50B
OE1
3.99


Ile
27Q
CG2
Tyr
 33B
CB
3.76





Tyr
 33B
CG
3.41





Tyr
 33B
CD1
3.99





Tyr
 33B
CD2
3.33





Tyr
 35B
OH
3.82





Tyr
 33B
CE2
3.84


Ile
27Q
C
Trp
 99B
NE1
3.97





Arg
101B
CG
3.63


Ile
27Q
O
Arg
101B
CA
3.79





Trp
 99B
CD1
3.65





Trp
 99B
NE1
3.02
***





Arg
101B
CG
3.72


Gly
28Q
N
Arg
101B
CD
3.84





Arg
101B
CG
3.65


Gly
28Q
CA
Arg
101B
CG
3.80





Phe
102B
CE1
3.73


Lys
29Q
CD
Ser
 91A
O
3.47


Lys
29Q
CE
Ser
 91A
OG
3.34





Ser
 91A
O
3.18





Trp
 99B
CZ2
3.58





Glu
 50A
OE2
3.29


Lys
29Q
NZ
Ser
 91A
OG
2.68
***





Ser
 91A
O
3.20
***





Ser
 91A
CB
3.70





Ser
 91A
C
3.67





Glu
 50A
OE2
2.94
***





Asp
 92A
OD1
3.18
***


Arg
31Q
CD
Leu
 94A
CD1
3.92


Arg
31Q
NE
Leu
 94A
CD1
3.96


Arg
31Q
CZ
Tyr
 96A
OH
4.00





Glu
 50B
OE1
3.55





Glu
 50B
OE2
3.91





Leu
 94A
CD2
3.94


Arg
31Q
NH1
Glu
 50B
CD
3.60





Glu
 50B
OE1
3.34
*





Glu
 50B
OE2
3.06
***





Leu
 94A
CD1
3.97


Arg
31Q
NH2
Tyr
 96A
CZ
3.60





Tyr
 96A
OH
2.82
***





Tyr
 96A
CE1
3.90





Glu
 50B
CD
3.73





Glu
 50B
OE1
2.88
***





Glu
 50B
OE2
3.91
*





Leu
 94A
CD2
3.87


Lys
48Q
CE
Asn
 28A
O
3.82


Lys
48Q
NZ
Asp
 92A
OD2
3.24
***





Asp
 92A
CB
3.91





Asn
 28A
C
3.89





Asn
 28A
O
2.77
***


Leu
52Q
CG
Asp
 30A
OD2
3.97


Leu
52Q
CD1
Asp
 30A
OD2
3.13


Leu
52Q
CD2
Asp
 30A
OD2
3.73


Lys
56Q
CE
Phe
102B
CD1
3.77





Phe
102B
CE1
3.76





Glu
 50A
OE1
3.63


Lys
56Q
NZ
Glu
 50A
CD
3.57





Asp
 32A
CG
3.77





Asp
 32A
OD1
3.68
*





Asp
 32A
OD2
3.44
*





Glu
 50A
OE1
2.98
***





Glu
 50A
OE2
3.51
*









These results indicate that anti-TFPI4F110 Fab specifically binds to TFPI Kunitz domain 3.

Example 11
Factor VIIa Variant Activity Assay (In Vitro Hydrolysis Assay)
Native (wild-type) Factor VIIa and Factor VIIa variant (both hereafter referred to as “Factor VIIa”) are assayed in parallel to directly compare their specific activities. The assay is carried out in a microtiter plate (MaxiSorp, Nunc, Denmark). The chromogenic substrate D-Ile-Pro-Arg-p-nitroanilide (S-2288, Chromogenix, Sweden), final concentration 1 mM, is added to Factor VIIa (final concentration 100 nM) in 50 mM Hepes, pH 7.4, containing 0.1 M NaCl, 5 mM CaCl2 and 1 mg/ml bovine serum albumin. The absorbance at 405 nm is measured continuously in a Spectra-MaxTM340 plate reader (Molecular Devices, USA). The absorbance developed during a 20-minute incubation, after subtraction of the absorbance in a blank well containing no enzyme, is used to calculate the ratio between the activities of variant and wild-type Factor VIIa:

Ratio=(A405 nm Factor VIIa variant)/(A405 nm Factor VIIa wild-type).

Example 12
Factor VIIa Variant Activity Assay (In Vitro Proteolysis Assay)
Native (wild-type) Factor VIIa and Factor VIIa variant (both hereafter referred to as “Factor VIIa”) are assayed in parallel to directly compare their specific activities. The assay is carried out in a microtiter plate (MaxiSorp, Nunc, Denmark). Factor VIIa (10 nM) and Factor X (0.8 microM) in 100 microL 50 mM Hepes, pH 7.4, containing 0.1 M NaCl, 5 mM CaCl2 and 1 mg/ml bovine serum albumin, are incubated for 15 min. Factor X cleavage is then stopped by the addition of 50 microL 50 mM Hepes, pH 7.4, containing 0.1 M NaCl, 20 mM EDTA and 1 mg/ml bovine serum albumin. The amount of Factor Xa generated is measured by addition of the chromogenic substrate Z-D-Arg-Gly-Arg-p-nitroanilide (S-2765, Chromogenix, Sweden), final concentration 0.5 mM. The absorbance at 405 nm is measured continuously in a SpectraMaxTM 340 plate reader (Molecular Devices, USA). The absorbance developed during 10 minutes, after subtraction of the absorbance in a blank well containing no FVIIa, is used to calculate the ratio between the proteolytic activities of variant and wild-type Factor VIIa:

Ratio=(A405 nm Factor VIIa variant)/(A405 nm Factor VIIa wild-type).

Example 13
Factor VIII Activity Assay (Chromogenic Assay)
The FVIII activity (FVIII:C) of the rFVIII compound is evaluated in a chromogenic FVIII assay using Coatest SP reagents (Chromogenix) as follows: rFVIII samples and a FVIII standard (e.g. purified wild-type rFVIII calibrated against the 7th international FVIII standard from NIBSC) are diluted in Coatest assay buffer (50 mM Tris, 150 mM NaCl, 1% BSA, pH 7.3, with preservative). Fifty μl of samples, standards, and buffer negative control are added to 96-well microtiter plates (Nunc) in duplicates. The factor IXa/factor X reagent, the phospholipid reagent and CaCl2 from the Coatest SP kit are mixed 5:1:3 (vol:vol:vol) and 75 μl of this added to the wells. After 15 min incubation at room temperature, 50 μl of the factor Xa substrate 5-2765/thrombin inhibitor I-2581 mix is added and the reagents incubated for 10 minutes at room temperature before 25 μl 1 M citric acid, pH 3, is added. The absorbance at 415 nm is measured on a Spectramax microtiter plate reader (Molecular Devices) with absorbance at 620 nm used as reference wavelength. The value for the negative control is subtracted from all samples and a calibration curve prepared by linear regression of the absorbance values plotted vs. FVIII concentration. Specific activity is calculated by dividing the activity of the samples with the protein concentration determined by HPLC. The concentration of the sample is determined by integrating the area under the peak in the chromatogram corresponding to the light chain and compare with the area of the same peak in a parallel analysis of a wild-type unmodified rFVIII, where the concentration is determined by amino acid analyses.
Example 14
Factor VIII Activity Assay (One-Stage Clot Assay)
FVIII activity (FVIII:C) of the rFVIII compounds is further evaluated in a one-stage FVIII clot assay as follows: rFVIII samples and a FVIII standard (e.g. purified wild-type rFVIII calibrated against the 7th international FVIII standard from NIBSC) are diluted in HBS/BSA buffer (20 mM hepes, 150 mM NaCl, pH 7.4 with 1% BSA) to approximately 10 U/ml, followed by 10-fold dilution in FVIII-deficient plasma containing VWF (Dade Behring). Samples are subsequently diluted in HBS/BSA buffer. The APTT clot time is measured using an ACL300R or an ACL5000 instrument (Instrumentation Laboratory) using the single factor program. FVIII-deficient plasma with VWF (Dade Behring) is used as assay plasma and SynthASil, (HemosILTM, Instrumentation Laboratory) as aPTT reagent. In the clot instrument, the diluted sample or standard is mixed with FVIII-deficient plasma and aPTT reagents at 37° C. Calcium chloride is added and time until clot formation is determined by measuring turbidity. The FVIII:C in the sample is calculated based on a standard curve of the clot formation times of the dilutions of the FVIII standard.
All references, including publications, patent applications, and patents, cited herein are hereby incorporated by reference in their entirety and to the same extent as if each reference were individually and specifically indicated to be incorporated by reference and were set forth in its entirety herein (to the maximum extent permitted by law).
All headings and sub-headings are used herein for convenience only and should not be construed as limiting the invention in any way.
The use of any and all examples, or exemplary language (e.g., “such as”) provided herein, is intended merely to better illuminate the invention and does not pose a limitation on the scope of the invention unless otherwise claimed. No language in the specification should be construed as indicating any non-claimed element as essential to the practice of the invention.
The citation and incorporation of patent documents herein is done for convenience only and does not reflect any view of the validity, patentability, and/or enforceability of such patent documents.
This invention includes all modifications and equivalents of the subject matter recited in the claims appended hereto as permitted by applicable law.

## Claims

1. An antibody that specifically binds to an epitope on the C-terminal of full length TFPI (tissue factor pathway inhibitor), wherein said epitope comprises Tyr23, Asn24, Ser25, Val26, Ile27, Gly28, Lys29, Arg31, Lys48, Leu52 and Lys56 of SEQ ID NO: 27.

2. The antibody of claim 1, wherein said epitope further comprises Gln49 of SEQ ID NO: 27.

3. An antibody that specifically binds to an epitope on the C-terminal of full length TFPI, wherein said epitope comprises Tyr23, Asn24, Ser25, Val26, Gly28, Lys48, Leu52 and Lys56 of SEQ ID NO: 27.