# Patent

## Title
Ron inhibitors for use in preventing and treating bone loss

## Abstract

Provided herein are methods for inhibiting osteolysis or treating osteoporosis in a subject in need thereof, the method including administering to the subject at least one RON inhibitor. The osteolysis may be caused by a condition selected from the group consisting of cancer, inflammation, and cyst. The condition may include a bone tumor or a tumor located in bone. The subject may have been diagnosed with bone cancer. The inhibitor may be ASLAN002. The inhibitor may be OSI-296. The inhibitor may be selective or specific for RON. The inhibitor may not depend on the function of RANKL or TGFβ.

## Background
CROSS-REFERENCE TO RELATED APPLICATIONS
This is a U.S. national stage entry of International Patent Application No. PCT/US2015/020479, filed on Mar. 13, 2015, which claims priority to U.S. Provisional Patent Application No. 61/953,309, filed on Mar. 14, 2014, the entire contents of all of which are fully incorporated herein by reference.


STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH
This invention was made with government support under Grant Numbers W81XWH-08-1-0109 and W81XWH-10-1-0366 awarded by ARMY/MRMC—Medical Research and Materiel Command. The government has certain rights in the invention.


BRIEF DESCRIPTION OF SEQUENCE LISTING
The instant application contains a Sequence Listing which has been submitted in ASCII format via EFS-Web and is hereby incorporated by reference in its entirety. Said ASCII copy, created on Aug. 22, 2016, is named U-5628-026389-9117-US01-SEQ-LIST-08-29-16.txt, and is 38,980 bytes in size.
FIELD
This disclosure relates to compositions and methods for inhibiting osteolysis or treating osteoporosis.
INTRODUCTION
Over 70% of patients with metastatic breast cancer have bone metastases. These metastases cause a number of complications including severe pain, nerve compression, hypercalcemia, and debilitating bone fractures. The development and growth of bone metastases depend on the interactions between tumor cells and cells within the bone microenvironment. Bone homeostasis is normally maintained by balanced osteoclast and osteoblast activities, and it is the ability of tumor cells to disrupt this delicate balance that results in bone destruction and metastatic tumor growth. The “vicious cycle” hypothesis describes the complex interactions that result in bone destruction and subsequent metastatic tumor growth. As active osteoclasts resorb bone, growth factors such as TGFβ are released from the bone matrix into the bone-tumor microenvironment. Such growth factors not only increase survival and proliferation of the metastatic tumor cells, but also lead to production of factors such as parathyroid hormone-related peptide and interleukin 11. These factors indirectly lead to further osteoclast differentiation and activation by stimulating secretion of receptor activator of nuclear factor-kB ligand (RANKL) from osteoblasts. RANKL is a key mediator of osteoclastogenesis and osteoclast activity, thus completing the cycle of bone resorption and metastatic tumor growth. Although several molecular contributors of bone metastasis have been identified, of which RANKL is key, identification of other targetable pathways may lead to additional therapies and/or more effective therapeutic combinations.
SUMMARY
In an aspect, the disclosure relates to methods for inhibiting osteolysis or for treating osteoporosis in a subject in need thereof. The methods may include administering to the subject at least one RON inhibitor.
The disclosure provides for other aspects and embodiments that will be apparent in light of the following detailed description and accompanying Figures.



BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 shows that MSP increases tumor-driven osteolysis through host Ron activity. FIG. 1A is a series of microcomputed tomography (μCT) scans of bone lesions in the tibias of both wild-type (WT) mice, and mice in which the tyrosine kinase domain of RON had been deleted from the genome (RonTK−/−), 21 days post tumor cell injection. FIG. 1B is a bar chart showing the osteolytic area in tibias from WT and RonTK−/− mice ex vivo using high resolution X-ray analysis. FIG. 1C is a graph of tumor volume in tibias, determined by caliper measurements, as a function of time. FIG. 1D is a bar chart showing the proliferation rate of PyMT control expressed as the percent of cells staining positive for phospho-H3 in various experimental groups. FIG. 1E is a series of images showing sections of tumor-bearing bones from various experimental groups. FIG. 1F is a bar chart of TRAP+ osteoclasts in various experimental groups.
FIG. 2 shows that RON is required for tumor-driven osteolysis of human breast cancer. FIG. 2A is a pair of representative X-ray images of DU4475 bone lesions in NOD.SCID/WT or NOD.SCID/Ron TK−/− mice. FIG. 2B is a bar chart showing osteolytic area from tibial bone lesions. FIG. 2C is a pair of images of TRAP staining on sections of tumor-bearing bones from various experimental groups. FIG. 2D is a bar chart showing the number of TRAP+ osteoclasts per field in various experimental groups. FIG. 2E is a bar chart showing the proliferation rate of DU4475 tumor cells in the bone, expressed as the percentage of Ki67 positive cells.
FIG. 3 shows that RON inhibition reduces MSP tumor-induced osteolysis in prophylactic and adjuvant settings. FIG. 3A is a series of X-ray images of PyMT-MSP bone lesions from mice treated with OSI-296. FIG. 3B is a pair of X-ray images of PyMT-MSP bone lesions from mice treated with ASLAN002. FIG. 3C is a bar chart showing osteolytic area in PyMT-MSP bone lesions from mice treated with OSI-296. FIG. 3D is a bar chart showing the osteolytic area in PyMT-MSP bone lesions from mice treated with ASLAN002. FIG. 3E is a pair of representative X-ray images of DU4475-induced bone lesions from mice treated with ASLAN002. FIG. 3F is a bar chart showing the osteolytic area in DU4475 bone lesions from mice in various experimental groups. FIG. 3G is a bar chart showing serum RANKL concentration from mice in various experimental groups.
FIG. 4 shows that MSP tumor-induced osteolysis is not dependent on RANKL or TGFβ signaling. FIG. 4A is a series of representative X-ray images of PyMT-MSP bone lesions from mice treated with muRANK-Fc. FIG. 4B is a bar chart of the osteolytic area in bone lesions from mice in each experimental group. FIG. 4C is a series of images of TRAP stained tumor-bearing bones from various experimental groups. FIG. 4D is a series of X-ray images of PyMT bone lesions arising from tumors in the presence or absence of TGβRII. FIG. 4E is a bar chart showing the osteolytic area in bone lesions from mice in various experimental groups.
FIG. 5 shows that expression of MSP in human breast cancer increases tumor-induced osteolysis and overrides dependence on RANKL signaling. FIG. 5A is a Western blot showing MSP protein levels secreted into the media of parental, control, and MSP-overexpressing MDA-MB-231 cells. FIG. 5B is a series of X-ray images of bone lesions from NOD.SCID mice treated with muRANK-Fc or OSI-296 3 days post tumor cell injection. FIG. 5C is a bar chart showing the osteolytic area from bone lesions in mice from various experimental groups.
FIG. 6 shows that MSP promotes osteoclast activity and survival through activation of Src and Akt signaling pathways. FIG. 6A is a bar chart showing the resorption area from various experimental groups. FIG. 6B is a bar chart showing the resorption area arising from WT and Ron TK−/− bone marrow precursor cells differentiated in the presence of M-CSF and RANKL for 9 days. FIG. 6C is a bar chart showing the resorption area for WT bone marrow precursor cells seeded on osteologic slides and differentiated in the presence of M-CSF and RANKL for 9 days. FIG. 6D is a bar chart showing the number of TRAP+ osteoclasts per well from various experimental groups. FIG. 6E is a pair of Western blots of osteoclast lysates from WT cells treated with MSP, muRANK-Fc, and/or ASLAN002. FIG. 6F is an illustration showing MSP/Ron function in the bone microenvironment.
FIG. 7 shows that loss of RON activity protects from osteoporotic bone loss. FIG. 7A is a series of μCT scans of the proximal tibia (axial view of the metaphyseal region) from WT and Ron TK−/− mice following ovariectomy (OVX) or sham operation. FIG. 7B is a bar chart showing the bone mineral density in the metaphyseal region of the tibia determined by bone histomorphometry analysis. FIG. 7C is a bar chart showing trabecular bone volume in the tibia expressed at percent per total volume and determined by bone histomorphometry analysis. FIG. 7D is a bar chart showing trabecular separation in the tibia. FIG. 7E is a series of images showing representative sections of the stained tibia from various experimental groups.
FIG. 8A is a bar chart showing TRAP+ osteoclasts from normal, uninjected WT and Ron TK−/− mice. FIG. 8B is a series of images of bone formation as observed by calcein and Alizarin double labeling. FIG. 8C is a bar chart showing mineral apposition rate determined by bone histomorphometric analysis in WT and RonTK−/− mice. FIG. 8D is a bar chart showing bone formation rate per total bone surface in WT and RonTK−/− mice. FIG. 8E is a graph of mineral apposition rate in WT and STK−/− mice. FIG. 8F is a bar chart showing bone formation rate per total bone surface in WT and STK−/− mice. FIG. 8G is a pair of images of tissue sections stained for RON in normal, uninjected WT, and STK−/− mice. FIG. 8H is a Western analysis for RON and phospho-Ron in the MCF10A-Ron and MC3T3-E1 cell lines.
FIG. 9A is a bar chart showing mRNA expression levels of MSP, RON, and matriptase in a panel of human breast cancer cell lines. FIG. 9B is a pair of images of TRAP stained normal, uninjected NOD.SCID:WT, and NOD.SCID:Ron TK−/− bones. FIG. 9C is a bar chart showing TRAP+ osteoclasts from normal, uninjected bones. FIG. 9D is a series of X-ray images of bone lesions from various experimental groups. FIG. 9E is a bar chart showing the osteolytic area of bone lesions in mice from various experimental groups. FIG. 9F is a pair of graphs showing growth curves of PyMT-MSP bone lesions from various experimental groups. FIG. 9G is a pair of images of TRAP stained bone tumors from various experimental groups. FIG. 9H is a bar chart showing TRAP+ osteoclasts from PyMT-MSP bone tumors of various experimental groups.
FIG. 10A is a pair of X-ray images of PyMT control bone lesions treated with OSI-296. FIG. 10B is a bar chart showing the osteolytic area in mice with bone lesions treated with OSI 296. FIG. 10C is a bar chart showing the proliferation rate for PyMT control tumors indicated as percent cells staining positive for phospho-H3. FIG. 10D is a graph showing the tumor growth curve for PyMT-MSP bone lesions treated with OSI-296. FIG. 10E is a graph showing the tumor growth curve for PyMT-MSP bone lesions treated with ASLAN002. FIG. 10F is a bar chart showing the proliferation rate of PyMT-MSP tumors treated with OSI-296. FIG. 10G is a graph showing the tumor growth curve for DU4475 bone lesions from experimental groups treated with ASLAN002.
FIG. 11A is a series of images of TRAP stained PyMT-MSP bone tumors from mice treated with OSI-296 either 3 days post tumor cell injection for pre-osteolysis or 3 weeks post injection for post osteolysis treatment. FIG. 11B is a bar chart showing TRAP+ osteoclasts from bone tumors in various experimental groups. FIG. 11C is a pair of images showing bone formation as observed by calcein and Alizarin double labeling. FIG. 11D is a bar chart showing mineral apposition rate in normal, uninjected animals treated with ASLAN002. FIG. 11E is a bar chart showing bone formation rate per total bone surface in animals treated with ASLAN002.
FIG. 12A is a graph showing the growth curve from bone lesions treated with muRANK-Fc in each experimental group. FIG. 12B is a pair of images of RON and NFATc1 stained tissue sections from PyMT-MSP tumor bearing bones treated with muRANK-Fc. FIG. 12C is a graph showing a growth curve from bone lesions in mice from each experimental group.
FIG. 13A is a series of representative images of resorption pits from WT and RonTK−/− osteoclasts in the presence and absence of MSP. FIG. 13B is a bar chart showing the resorption area in various experimental groups. FIG. 13C is a timeline describing the addition of MSP during differentiation. FIG. 13D is a bar chart showing TRAP+ osteoclasts in various experimental groups. FIG. 13E is a bar chart showing the number of TRAP+ osteoclasts per well for various experimental groups. FIG. 13F is a bar chart showing the resorption area in various experimental groups. FIG. 13G is a timeline describing the addition of MSP and removal of RANKL to determine osteoclast survival. FIG. 13H is an illustration of signaling pathways activated downstream of RON activation in osteoclasts.
FIG. 14A is a chart of the expression of MSP in normal plasma cells versus myeloma cells. FIG. 14B is a chart of the expression of MSP in lung carcinomas.
FIG. 15A is a graph of the percent change in plasma CTX levels compared to baseline prior to drug treatment for patients receiving ASLAN002 in a Phase I clinical trial. FIG. 15B is a graph of the percent change in BSAP levels (compared to baseline) in blood plasma of patients receiving ASLAN002.
FIG. 16 is a graph of resorption area from Ron TK−/− bone marrow precursor cells transduced with WT, constitutively active (CA), or kinase dead (KD) Src in the presence or absence of MSP, with WT osteoclasts as control (n=3 per group).
FIG. 17A is graph of the number of TRAP+ osteoclasts per well of WT bone marrow precursor cells differentiated in the presence of M-CSF and RANKL, with M-CSF and RANKL then washed out, and 100 pg/mL of MSP and/or 10 μM of the Src inhibitor AZD0530 added daily. FIG. 17B is a graph of the number of TRAP+ osteoclasts per well in the presence or absence of MSP. FIG. 17C is a graph of TRAP+ osteoclasts in WT bone marrow precursor cells differentiated in the presence of M-CSF and RANKL, with or without MSP added daily.



DETAILED DESCRIPTION
The present disclosure relates to the discovery that the RON ligand, macrophage-stimulating protein (MSP), is an important mediator of tumor-driven osteolysis. Macrophage-stimulating protein (MSP, also known as human MST1 or mouse (hepatocyte growth factor like) HGFL) is a plasminogen-related growth factor that was originally identified as a serum protein that caused macrophage chemotaxis and activation. MSP is secreted as an inactive single-chain precursor (pro-MSP), which becomes active after proteolytic cleavage, forming a disulfide-linked heterodimer. The first protease identified to activate pro-MSP under biological conditions was membrane-type serine protease 1 (MT-SP1, also known as ST14 or matriptase). However, there are other proteases capable of pro-MSP maturation such as hepsin, human airway trypsin-like protease (HAT), and hepatocyte growth factor activator (HGFA). MSP exerts several biological effects depending on the cell type in which its receptor, macrophage-stimulating-1 receptor (MST1R, or RON), becomes activated. MSP is the only known ligand for RON, and RON is one of only two members of a distinct receptor tyrosine kinase family that also includes Met. RON is expressed in many tissues during development; however, in adults its expression is restricted to certain epithelial-derived cells (such as keratinocytes), nociceptive neurons, resident tissue macrophages, and osteoclasts. MSP can promote migration and survival of epithelial cell lines and can promote an epithelial-to-mesenchymal transition in immortalized canine kidney cells in vitro.
In addition to the effects the MSP/RON pathway has in a normal cellular context, the MSP/RON pathway may have a role in cancer. RON is expressed at high levels in many different epithelial cancers as well as malignancies of brain and bone. MSP and RON are coordinately overexpressed in over 20% of human breast cancers, and their overexpression along with matriptase has been shown to be an independent prognostic indicator for metastasis and poor survival. Overexpression of RON in breast epithelial cells leads to the transformation of cell lines and metastatic tumor development in mice. Overexpression of MSP in tumor cells driven by the polyomavirus middle T antigen under the control of the mouse mammary tumor virus promoter (MMTV-PyMT) led to spontaneous metastasis to bone and a significant increase in metastasis to other organs. MSP is sufficient to promote spontaneous metastasis to bone, yet spontaneous bone metastasis had been previously very difficult to achieve in genetically engineered mouse models. The bone metastases that developed in this model were osteolytic, replicating what is most commonly seen in human breast cancer patients. Interestingly, the overexpression of RON in mammary tumors did not lead to an increase in bone metastasis, suggesting a non-cell autonomous mechanism where tumor-host interactions may play a key role in MSP-driven bone metastasis.
Despite evidence supporting an oncogenic and bone metastatic role in breast cancer, the role of the RON receptor tyrosine kinase pathway in the bone microenvironment during metastasis has remained unknown. As disclosed herein, the inventors discovered that the RON ligand, macrophage-stimulating protein (MSP), is an important mediator of tumor-driven osteolysis. MSP overexpression leads to a significant increase in the ability of tumor cells to destroy bone and this ability requires RON activity in host osteoclasts. MSP-driven osteoclast activation does not require RANKL or TGFβ signaling and, importantly, pharmacological inhibition of RON can prevent both the development of osteolysis and the progression of existing osteolysis. In addition, the MSP/RON pathway is pertinent to other cases of pathogenic osteoclast activation; this pathway also functions in bone loss due to osteoporosis. These findings elucidate an important role for the MSP/RON pathway in osteoclast activation, providing rationale for the use of RON inhibitors for treatment of bone destruction in the setting of metastatic cancer or osteoporosis.
1. DEFINITIONS
The terms “comprise(s),” “include(s),” “having,” “has,” “can,” “contain(s),” and variants thereof, as used herein, are intended to be open-ended (i.e., meaning “including but not limited to”) transitional phrases, terms, or words that do not preclude the possibility of additional acts or structures unless otherwise noted. The use of the terms “a” and “an” and “the” and similar referents in the context of describing the invention are to be construed to cover both the singular and the plural, unless otherwise indicated herein or clearly contradicted by context. The present disclosure also contemplates other embodiments “comprising,” “consisting of” and “consisting essentially of,” the embodiments or elements presented herein, whether explicitly set forth or not.
For the recitation of numeric ranges herein, each intervening number there between with the same degree of precision is explicitly contemplated. For example, for the range of 6-9, the numbers 7 and 8 are contemplated in addition to 6 and 9, and for the range 6.0-7.0, the number 6.0, 6.1, 6.2, 6.3, 6.4, 6.5, 6.6, 6.7, 6.8, 6.9, and 7.0 are explicitly contemplated.
The term “about” as used herein as applied to one or more values of interest, refers to a value that is similar to a stated reference value. In certain aspects, the term “about” refers to a range of values that fall within 20%, 19%, 18%, 17%, 16%, 15%, 14%, 13%, 12%, 11%, 10%, 9%, 8%, 7%, 6%, 5%, 4%, 3%, 2%, 1%, or less in either direction (greater than or less than) of the stated reference value unless otherwise stated or otherwise evident from the context (except where such number would exceed 100% of a possible value).
“Administration” or “administering” refers to delivery of an inhibitor by any appropriate route to achieve the desired effect. Administration may include, but is not limited to, oral, sublingual, intramuscular, subcutaneous, intravenous, transdermal, topical, parenteral, buccal, rectal, and via injection, inhalation, and implants.
As used herein “cancer” refers to abnormal cell growth. A cancer cell may have the potential to invade or spread to other parts of the body. Cancer may include a malignant tumor or malignant neoplasm. Cancer is a subset of neoplasms, wherein a neoplasm is a group of cells that have undergone unregulated growth, and will often form a mass or lump, but may be distributed diffusely. “Metastasis” or “metastatic disease” refers to the spread of a cancer or disease from one organ or part to another not directly connected with it. The new occurrences of cancer thus generated are referred to as “metastases,” a “secondary tumor,” or “metastatic tumor.” Cancer may include, for example, cancer of the skin, breast, prostate, lung, pancreas, colon, bone, bladder, rectum, stomach, esophagus, trachea, throat, head, neck, liver, kidney, brain, thyroid, heart, testicle, ovary, and cervix. Cancer may include carcinoma (derived from epithelial cells), sarcoma (derived from connective tissue), lymphoma (derived from hematopoietic cells), leukemia (derived from hematopoietic cells), blastoma (derived from immature “precursor” cells or embryonic tissue), or germ cell tumor (derived from pluripotent cells). In some embodiments, cancer includes bone cancer. In some embodiments, cancer includes a bone tumor or a tumor located in bone.
As used herein, an “effective amount” or “an amount sufficient to” achieve a particular result in a subject refers to an amount of a therapeutic agent (e.g., a RON inhibitor) that is effective to produce a desired effect, which is optionally a therapeutic effect (i.e., by administration of a therapeutically effective amount). In some aspects, such particular result is a reduction in osteolysis in a patient in need thereof. In some aspects, such particular result is a reduction in osteoporosis in a patient in need thereof. The progression from normal cells to cells that can form a discernible mass to outright cancer involves multiple steps known as malignant progression.
“Inhibitor” refers to an agent that inhibits the activity of one or more proteins. For example, an inhibitor may indirectly inhibit the activity of a protein by inhibiting the expression of the protein. An another example, an inhibitor may indirectly or directly bind and inhibit the activity of the protein, including catalytic activity or binding activity such as the ability of the protein to mediate binding to its target. An inhibitor is said to competitively inhibit binding of a protein if it preferentially binds to that protein to the extent that it blocks, to some degree, activity of the protein. Competitive inhibition can be determined by any method known in the art, for example, competition ELISA assays, competition binding assays, activity assays over a range of concentrations, or behavioral assays. An inhibitor can be said to inhibit a protein by at least 95%, at least 90%, at least 85%, at least 80%, at least 75%, at least 70%, at least 65%, at least 60%, at least 55%, at least 50%, at least 45%, at least 40%, at least 35%, at least 30%, at least 25%, or at least 20%.
“Selective inhibitor” as used herein refers to an inhibitor whose activity on, for example, a protein, is greater relative to its activity on another protein under selected conditions. An inhibitor is said to be “selective” for a protein, for example, when it inhibits the activity of that protein more effectively than it would inhibit the activity of a random, unrelated protein, or even a similar or related protein having analogous but distinct function. The relative inhibition of a protein may be quantified by, for example, IC50, EC50, or Kd values, among others. IC50 values may be determined, for example, using Invitrogen Omnia (Waltham, Mass.). The terms “specific” and “selective” may be used interchangeably herein.
“Physiological conditions” refers to conditions of an assay or reaction that may occur in nature for that organism or cell system. Physiological conditions may include a temperature of between about 20-40° C. and a pH of between about 6-8. For example, physiological conditions may include an aqueous buffered solution at a pH of 7.2-7.6 and a temperature of about 37° C.
“Menopause” or “menopausal subject” refers to a condition in a woman when her menstrual periods stop and she is no longer able to have children. “Premenopause” or “premenopausal subject” refers to the years leading up to the last period, when the levels of reproductive hormones are already becoming more variable and lower, and the effects of hormone withdrawal are present. “Postmenopause” or “postmenopausal subject” refers to a condition in a woman who has not experienced any menstrual flow for a minimum of 12 months, assuming that she does still have a uterus, and is not pregnant or lactating. In women without a uterus, menopause or postmenopause can be identified by a blood test showing a very high FSH level. Thus postmenopause is all of the time in a woman's life that takes place after her last period, or more accurately, all of the time that follows the point when her ovaries become inactive.
“Osteoporosis” as used herein is a progressive bone disease that is characterized by a decrease in bone mass and density. Osteoporosis can lead to an increased risk of fracture. Osteoporosis includes primary type 1, primary type 2, and secondary osteoporosis. As used herein, “treating osteoporosis” includes preventing osteoporosis, reducing the progression of osteoporosis, inhibiting osteolysis, or inhibiting osteoclasts, or a combination thereof.
“Osteolysis” refers to an active resorption of bone matrix by osteoclasts. Osteolysis can occur during the natural formation of healthy bones. Osteolysis often occurs in the proximity of a prosthesis and can cause an immunological response or changes in the bone's structural load. Osteolysis may be caused by a condition including, but not limited to, tumor, inflammation, hormone changes such as menopause, or cyst, or a combination thereof. In some embodiments, the tumor comprises metastatic cancer. In some embodiments, the tumor comprises a bone tumor and/or a tumor located in bone.
“Subject” or “patient” as used herein can mean any subject, particularly a mammalian subject, that wants to or is in need of being treated with the herein described therapeutic composition. A subject can be an animal, a vertebrate animal, a mammal, a rodent (e.g. a guinea pig, a hamster, a rat, a mouse), murine (e.g. a mouse), canine (e.g. a dog), feline (e.g. a cat), equine (e.g. a horse), a primate, simian (e.g. a monkey or ape), a monkey (e.g. marmoset, baboon), an ape (e.g. gorilla, chimpanzee, orangutan, gibbon), or a human. In some embodiments, the subject is a mammal. In further embodiments, the mammal is a human. In further embodiments, the mammal is a female human. In some embodiments, the subject is diagnosed with cancer. In some embodiments, the subject is diagnosed with bone cancer. In some embodiments, the subject is diagnosed with osteoporosis.
As used herein the terms “treat,” “treatment,” or “treatment of” in the context of treating a condition, pertains generally to treatment and therapy, whether of a human or an animal (e.g. in veterinary applications), in which a desired therapeutic effect is achieved. “Treatment” or “treating” means preventing, inhibiting the progress (e.g., reduce the rate of progress or halt the rate of progress), suppressing, repressing, ameliorating, or completely eliminating the disease. Preventing the disease involves administering a composition of the present invention to an animal prior to onset of the disease. Suppressing the disease involves administering a composition of the present invention to an animal after induction of the disease but before its clinical appearance. Repressing or ameliorating the disease involves administering a composition of the present invention to an animal after clinical appearance of the disease.
Unless otherwise defined, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art. In case of conflict, the present document, including definitions, will control. Preferred methods and materials are described below, although methods and materials similar or equivalent to those described herein can be used in practice or testing of the present invention. All publications, patent applications, patents and other references mentioned herein are incorporated by reference in their entirety. The materials, methods, and examples disclosed herein are illustrative only and not intended to be limiting.
2. RON
Recepteur d'origine nantais (RON or Ron) belongs to a subfamily of receptor tyrosine kinases. RON is encoded by the MST1R gene. RON is also known as macrophage-stimulating protein receptor. RON is activated by a serum-derived growth factor macrophage stimulating protein (MSP). RON gene transcription is essential for embryonic development and critical in regulating certain physiological processes. Activation of RON leads to the activation of common receptor tyrosine kinase downstream-signaling pathways, such as activation of MAPK, PI3K, RAS-ERK, and beta-catenin. Furthermore, Ron participates in crosstalk with other signaling pathways such as Insulin-like growth factor 1 (IGF1R) and EGF receptor (EGFR) that are common tumorigenic mechanisms. In some embodiments, RON may comprise an amino acid sequence consisting of SEQ ID NO: 1, which is encoded by a polynucleotide sequence of SEQ ID NO: 2.
3. MET
Met, also called c-Met and MET and hepatocyte growth factor receptor (HGFR), is a receptor tyrosine kinase. Met possesses tyrosine kinase activity and is a membrane receptor protein. The primary single chain precursor protein is post-translationally cleaved to produce the alpha and beta subunits, which are disulfide linked to form the mature receptor. Hepatocyte growth factor (HGF) is the only known ligand of Met. Met is normally expressed by cells of epithelial origin, while HGF is expressed in cells of mesenchymal origin or in transformed cells such as tumors. Upon HGF stimulation, Met induces several biological responses that collectively give rise to a program known as invasive growth. Met is also important for embryonic development and wound healing. In some embodiments, Met may comprise an amino acid sequence consisting of SEQ ID NO: 3, which is encoded by a polynucleotide sequence of SEQ ID NO: 4.
4. RON INHIBITOR
Provided herein are RON inhibitors and compositions comprising the same. RON inhibitors encompass agents that inhibit the activity of RON under physiological conditions. A RON inhibitor may also inhibit the activity of members of the RON pathway including, for example, MSP, MBD4, Src, and PI3K. The amount or the activity of the protein may be reduced or inhibited using a variety of techniques known in the art. For example, an inhibitor may indirectly or directly bind and inhibit the activity of the protein, including binding activity or catalytic activity. An inhibitor may inhibit the ability of the protein to interact with cellular and extracellular components. An inhibitor may prevent or reduce expression of the protein. For example, a therapeutic composition adapted to reduce the amount or the activity of the protein may comprise a small molecule inhibitor of the protein itself or of a binding partner, an antibody specific for the protein, or a siRNA. In some embodiments, the therapeutic composition may comprise a siRNA adapted to reduce the expression of the protein. RON inhibitors may include, but are not limited to, OSI-296 (Steinig et al. Bioorg. Med. Chem. 2013, 23, 4381-4387), ASLAN002 (also known as BMS-777607; Schroeder et al. J. Med. Chem. 2009, 52, 1251-1254), LCRF-0004, Ron8, golvatinib (Molife et al. Clin. Cancer Res. 2014, 20, 6284-6294), LY2801653 (Kawada et al. Cancer Res. 2014, 74, 844-895), PF-04254644 (Cui et al. J. Med. Chem. 2013, 56, 6651-6665), SU11274 (Gao et al. Med. Oncol. 2013, 30, 546), foretinib (GSK1363089; Shah et al. PLoS One 2013, 8, e54014), MK-8033 (Northrup et al. J. Med. Chem. 2013, 56, 2294-2310), 3,5-disubstituted and 3,5,7-trisubstituted quinolines (Wang et al. J. Med. Chem. 2011, 54, 2127-2142), Compound I (Zhang et al. Cancer Res. 2008, 68, 6680-6687), NPS-1034 (Rho et al. Cancer Res. 2014, 74, 253-262), crizotinib (Yasuda et al. J. Thorac. Oncol. 2012, 7, 1086-1090), and any other agents that inhibit the activity of or reduce the amount of RON.
In some embodiments, the inhibitor is OSI-296, shown below:




In some embodiments, the inhibitor is ASLAN002, shown below:




In some embodiments, the inhibitor may act independently of the RANKL and/or TGFβ pathways. The inhibitor may not affect the function of RANKL and/or TGFβ. The inhibitor may not depend on the function of RANKL and/or TGFβ.
a. RON-Selective Inhibitor
The RON inhibitor may be selective or specific for RON. As used herein, a RON-selective inhibitor inhibits the activity of RON greater than it inhibits the activity of another protein, such as, for example, another receptor tyrosine kinase, under physiological conditions. Receptor tyrosine kinases other than RON include, for example, Met and Axl. For example, a RON-selective inhibitor may inhibit RON greater than it inhibits Met under physiological conditions. For example, a RON-selective inhibitor may inhibit RON greater than it inhibits Axl under physiological conditions.
In some embodiments, a RON-selective inhibitor may inhibit the activity of RON at least about 2 times, at least about 3 times, at least about 4 times, at least about 5 times, at least about 10 times, at least about 15 times, at least about 20 times, at least about 25 times, at least about 50 times, or at least about 100 times more than it inhibits the activity of another receptor tyrosine kinase, such as Met. In some embodiments, a RON-selective inhibitor may have an IC50 for another receptor tyrosine kinase that is at least about 2 times, at least about 3 times, at least about 4 times, at least about 5 times, at least about 10 times, at least about 15 times, at least about 20 times, at least about 25 times, at least about 50 times, or at least about 100 times greater than the IC50 for RON. In some embodiments, the RON-selective inhibitor comprises ASLAN002.
5. METHODS OF USING THE RON INHIBITORS
RON inhibitors may be used to inhibit osteolysis or treat osteoporosis. The method includes administering to the subject at least one RON inhibitor. In some embodiments, the inhibitor is a RON-selective inhibitor.
A RON inhibitor may be administered to a subject by any convenient route of administration, whether systemically/peripherally or at the site of desired action, including but not limited to, oral (e.g. by ingestion); topical (including e.g. transdermal, intranasal, ocular, buccal, and sublingual); pulmonary (e.g. by inhalation or insufflation therapy using, e.g. an aerosol, e.g. through mouth or nose); rectal; vaginal; parenteral, for example, by injection, including subcutaneous, intradermal, intramuscular, intravenous, intraarterial, intracardiac, intrathecal, intraspinal, intracapsular, subcapsular, intraorbital, intraperitoneal, intratracheal, subcuticular, intraarticular, subarachnoid, and intrasternal; by implant of a depot, for example, subcutaneously or intramuscularly.
a. Methods for Inhibiting Osteolysis
Provided herein are methods for inhibiting osteolysis in a subject in need thereof. The method includes administering to the subject at least one RON inhibitor. In some embodiments, the inhibitor is a RON-selective inhibitor. Inhibiting osteolysis may include reducing bone turnover, reducing the progression of bone loss, inhibiting osteoclasts, or a combination thereof. In some embodiments, the subject has been diagnosed with a condition selected from inflammation, cyst, cancer, cancer with bone metastasis, and cancer-mediated bone destruction.
b. Methods for Treating Osteoporosis
Provided herein are methods for treating osteoporosis in a subject in need thereof. Treating osteoporosis may include preventing osteoporosis, reducing the progression of osteoporosis, or a combination thereof. The method includes administering to the subject at least one RON inhibitor. In some embodiments, the inhibitor is a RON-selective inhibitor.
All methods described herein can be performed in any suitable order unless otherwise indicated herein or otherwise clearly contradicted by context. The use of any and all examples, or exemplary language (e.g., “such as”) provided herein, is intended merely to illustrate aspects and embodiments of the disclosure and does not limit the scope of the claims.
6. EXAMPLES
Example 1
Experimental Procedures
Tumor Injections and X-Ray Analysis.
All procedures involving mice and experimental protocols were approved by the Institutional Animal Care and Use Committee (IACUC) of the University of Utah. The RonTK−/− mice which reside on the FVB background, were crossed with NOD.SCID mice for an immune-compromised mouse model. As a control, wild-type FVB mice were also crossed with NOD.SCID mice. The STK−/− mice, which are on a C57BL/6 background, were compared to wild-type C57BL/6 mice as controls. Mice for all experiments were 6 to 8 weeks of age. For intratibial injections, 1×105 (PyMTor DU4475) or 3×105 (MDA-MB-231) tumor cells were resuspended in 10 μL matrigel and injected into the right tibia of anesthetized female FVB (PyMT) or NOD.SCID mice carrying various alleles of RON. Osteolysis was assessed by X-ray radiography. Dissected hindlimbs from mice sacrificed at the final time point in each experiment were placed in the Kodak In-vivo Multispectral Imaging System FX and exposed to X-ray radiography at 35 kV for 100 sec. Excess tumor tissue was removed from the bones prior to X-ray. Osteolytic lesions were quantified using Image J software (NCBI). All images were compared to the contralateral leg as an internal control.
Micro-Computed Tomography Imaging and Bone Mineral Density Measurements.
Representative samples were imaged by micro-computed tomography (μCT, Skyscan) with volume rendering snapshots of the tibia. For the osteoporosis study, representative samples were imaged and presented as volume rendering snapshots of the axial view of the tibial metaphysis region. For bone mineral density (BMD) measurements, the right tibia was removed and fixed in 10% NBF overnight. The tibia were then scanned by dual-energy X-ray absorptiometry (DXA) using a Norland pDEXA densitometer (Norland Medical Systems, White Plains, N.Y.). A region including the primary and secondary spongiosa was used to determine the BMD of the tibia.
Tissue Processing and Immunohistochemical Staining.
Hindlimb bones were excised from mice at the time of sacrifice and bones were fixed in 10% neutral-buffered formalin, decalcified in Formical-2000 (Decal Corporation, Tallman, N.Y.) for 8 days and embedded in paraffin for hematoxylin and eosin (H & E) or immunohistochemical staining. Osteoclast number was assessed as TRAP+ multinucleated cells containing 4 or more nuclei and reported as TRAP+ cells per field. Three sections per mouse and 5 fields per section were used for quantification with fields representing the entire length of the tibia. Tumor proliferation rate was reported as the number of cells which were positive for phospho-H3 staining compared to the number of unstained cells per field expressed as a percent. Three sections per mouse and 5 fields per section were used for quantification with analysis being restricted to within the bone marrow cavity. Immunohistochemical analysis was performed with heat-induced antigen retrieval in sodium-citrate buffer (Dako, Denmark). Primary antibodies used were anti-TRAP at 1:50 (Santa Cruz, sc-30833, Dallas, Tex.), anti-Ki67 at 1:100 (Santa Cruz, sc-12202S, Dallas, Tex.), anti-phosphoH3 at 1:100 (Cell Signaling, #9701, Beverly, Mass.), anti-NFATc1 at 1:50 (Santa Cruz, sc-13033, Dallas, Tex.), and anti-RON at 1:250 (Santa Cruz, sc-322, Dallas, Tex.). Bones from mice lacking RON were used as a negative control. Biotinylated secondary antibody was used with the EnVision+ system HRP kit (Dako, Denmark) and nuclei counterstained with hematoxylin.
Recombinant MSP Production and Purification.
Briefly, human MSP was expressed in 293T cells following transduction with pMSCV-hMSP-Thrombin-His-V5 lentivirus, which also contained a hygromycin selection cassette. Secreted MSP was collected from serum-free supernatants, concentrated, and activated by incubation with kallikrein (Sigma, St. Louis, Mo.; K2638). The activated MSP was purified over a His-Talon column (Clontech, Mountain View, Calif.; 635651), washed, and concentrated using Amicon Ultra-15 Centrifugal Filter Devices. MSP protein concentration was quantified using a human MSP DuoSet ELISA kit (R&D Systems; DY352) on a custom MULTI-ARRAY MSD 96-well microplate platform (MesoScale Discovery, Rockville, Md.; L15XA-3) and read with the SECTOR Imager 2400. MSP specific activity was confirmed by quantifying the ability of MSP to cause phosphorylation of Ron expressed in MCF10A cells.
Plasmids and Retroviral Transduction of Osteoclast Precursors.
Wild-type Src was subcloned out of the pM5McSrc vector (Addgene plasmid 17685) by PCR and inserted into the pMSCV-puro vector (Clontech, Mountain View, Calif.) using the BgIII 5′ and EcoRI 3′ restriction sites. The constitutively active Src mutant (Y529F) and the kinase dead Src mutant (Y529F+K297M) were generated using standard PCR techniques. A total of 5 ug of the pMSCV retroviral vectors were transfected into the 293T cell line using X-tremeGENE 9 transfection reagent (Roche Applied Science, Indianapolis, Ind.). Virus was collected 48 hours after post transfection. Ron TK−/− bone marrow precursor cells were infected with virus for 24 hours in the presence of 100 ng/mL M-CSF and 4 ug/mL Polybrene (Sigma, St. Louis, Mo.). Cells were selected in the presence of M-CSF and 1 ug/mL puromycin for 3 days prior to use as osteoclast precursors.
Osteoclast Resorption Assay.
Bone marrow osteoclasts were generated from 6 to 8 week old WT and RonTK−/− mice. Briefly, bone marrow was isolated from hindlimb bones and plated in α-MEM media containing 10% heat-inactivated fetal bovine serum (FBS, Sigma, St. Louis, Mo.), 100 units/mL penicillin-streptomycin (Hyclone), and 33 ng/mL human macrophage colony-stimulating factor (hM-CSF) (PeproTech, Rocky Hill, N.J.) for 24 hours. Non-adherent cells were collected and frozen for later use. To assess resorption activity, bone marrow precursor cells were thawed and seeded at a density of 1×105 cells per well in BioCoat Osteologic slides (BD Biosciences, San Jose, Calif.) in α-MEM media containing 10% FBS and antibiotics. After adhering overnight, media was removed and media containing 33 ng/mL hM-CSF and 9 ng/mL muRANKL (R & D systems, Minneapolis, Minn.) was added. The medium was changed every 3 days depending on acidification, and the assay was terminated as indicated. Recombinant human MSP was prepared and added daily as indicated. Cells were removed with 6% bleach and slides were viewed microscopically using phase-contrast with 20× magnification. Osteolytic resorption area within 5 representative fields was determined using Image J software, experiments were performed in triplicate. Recombinant MSP was prepared as follows (to be described in detail elsewhere): Concentrated, serum-free media from an MCF7 cell line engineered to overexpress MSP was cleaved with kallikrein (Invitrogen, Waltham, Mass.; 4 ng of kallikrein/1 μg of supernatant protein at 37° C. for 2.5 hours). The reaction was diluted to 20 mL with 10 mM sodium phosphate, pH 7.4 and loaded onto a 5 mL HiTrap heparin column (Millipore, Billerica, Mass.) equilibrated with 20 mL of 10 mM sodium phosphate, pH 7.4, at a rate of 1 mL/min. The column was washed with 10 mL of 10 mM sodium phosphate, pH 7.4, at a rate of 1 mL/min. The bound protein was eluted with 7 mL of serial concentrations of NaCl in 10 mM sodium phosphate, pH 7.4: 0.1 M, 0.15 M, 0.2 M, 0.25 M, 0.3 M, 0.35 M, 0.4 M, 0.45 M, and 2 M. Each fraction was collected and concentrated/desalted on a spin column. Each fraction was run for MSP western analysis and ELISA analysis to determine purity and concentration.
Osteoclast Survival Assay.
Bone marrow precursor cells were thawed and seeded at a density of 2×105 cells per well in a 24-well plate containing glass coverslips in α-MEM media containing 10% FBS and antibiotics. After adhering overnight, media was removed and media containing 33 ng/mL hM-CSF and 9 ng/mL muRANKL was added. Cells were allowed to differentiate for 7 days with media changed every 3 days. Coverslips were then imaged microscopically using phase contrast to determine osteoclast number in each well. To test survival, factor-containing media was removed and α-MEM media containing 10% FBS was added as well as MSP as indicated. Cells were cultured for an additional 48 hours, fixed with 10% NBF for 10 minutes and washed with 1×PBS. For TRAP fluorescent staining, the leukocyte acid phosphatase kit (Sigma, St. Louis, Mo.) was used according to the manufacturer's instructions, with the substitution of 200 μM ELF97 (Invitrogen, Waltham, Mass.) as a phosphatase substrate. Coverslips were incubated in TRAP solution for 15 minutes at 37 degrees, washed with 1×PBS and counterstained with DAPI. The number of multinucleated TRAP+ cells (containing 4 or more nuclei) within 5 representative fields were included for quantification. Experiments were performed in triplicate.
Murine RANKL ELISA.
Quantitative levels of murine RANKL in serum isolated from mice at the end-point of experiments were determined in triplicate by ELISA according to the manufacturer's protocol (Quantikine immunoassay kit, R & D systems, Minneapolis, Minn.).
Pharmacological Inhibition In Vitro and In Vivo.
For in vitro experiments, OSI-296 (OSI pharmaceuticals, Melville, N.Y.) and ASLAN002 (BMS-777607; Selleck, Houston, Tex.) were dissolved in DMSO. Inhibitors were added to in vitro osteoclast assays at a final concentration of 10 μM daily for 3 days beginning on day 9 of the experiment. muRANK-Fc (Amgen, Thousand Oaks, Calif.) was provided as a stock of 4.1 mg/mL in PBS and was added to in vitro assays at a final concentration of 10 μg/mL daily as indicated.
For in vivo experiments, the OSI-296 inhibitor was dissolved in 40% Trappsol with 0.01 M HCl, and mice were treated at a concentration of 200 mg/kg daily by oral gavage. Treatment began either 3 days after tumor cell injection for prophylactic experiments, or 3 weeks after tumor cell injection for therapeutic experiments. ASLAN002 was dissolved in 70% PEG400 with 1×PBS and mice were treated at a concentration of 50 mg/kg daily by oral gavage. muRANK-Fc was given at a concentration of 10 mg/kg every three days by intra-peritoneal injection. For the osteoporosis study, mice were treated beginning on the day after ovary removal. The treatment regimen for OSI-296 was 200 mg/kg every other day by oral gavage. ASLAN002 was administered at 50 mg/kg every other day by oral gavage. Treatment continued until the time of sacrifice at 28 days.
Cell Culture.
The DU4475 cell line (ATCC) was maintained in RPMI (Hyclone, GE Healthcare, Little Chalfont, UK) with 10% FBS and antibiotics. The MDA-MB-231 cell line (ATCC) was maintained in RPMI with 10% FBS, antibiotics, and HEPES (Sigma, St. Louis, Mo.). MC3T3-E1 subclone 4 cells (ATCC) were maintained in α-MEM with 10% FBS and antibiotics. PyMT tumors were isolated and transduced as previously described and frozen for later use (Welm, et al. Proc. Natl. Acad. Sci. USA 2005, 102, 4324-9; Welm, et al. Proc. Natl. Acad. Sci. USA 2007, 104, 7570-7575). Cells were thawed and grown for 2 to 3 days in DMEM/F12 with 10% FBS, antibiotics, insulin (Gibco, Life Technologies, Thermo Fisher, Waltham, Mass.), hydrocortisone, and epidermal growth factor prior to injections. MDA-MB-231 cells were transduced with replication-defective retroviruses containing the expression vector pMSCVpuro or MSCVpuro-MSP, and infected cells were selected with puromycin.
Western Blot Analyses.
Cells were serum starved (0.5% FBS) for 3 hours prior to lysate collection. Inhibitors were added 1 hour prior to lysis and MSP was added 15 min prior to lysis when indicated. Cells were washed with 1×PBS and harvested in lysis buffer (25 mM Tris-HCl, pH 7.5, 0.42 M NaCl, 1.5 mM MgCl2, 0.5 mM EDTA, 1 mM DTT, 25% sucrose, and 0.1% Triton X-100) plus 100× protease arrest (Bioscience, Bozeman, Mont.) and 100× orthovanadate. Primary antibodies used for immunoblotting include: anti-MSP (Santa Cruz, sc-6090, Dallas, Tex.) at a 1:250 dilution, anti-pan Akt (Cell Signaling, #4691S, Beverly, Mass.) at a 1:1000 dilution, anti-pan Erk (Cell Signaling, #4695, Beverly, Mass.) at a 1:1000 dilution, anti-phospho Akt (Cell Signaling, #9271 L, Beverly, Mass.) at a 1:500 dilution, anti-phospho Erk (Cell Signaling, #4370S, Beverly, Mass.) at a 1:500 dilution, anti-Src (Cell Signaling, #2110, Beverly, Mass.) at a 1:500 dilution, and anti-phospho Src (Y416) (Cell Signaling, #2113, Beverly, Mass.) at a 1:500 dilution. The secondary antibodies used were HRP-conjugated anti-goat IgG (Santa Cruz, Dallas, Tex.) and anti-rabbit IgG (Santa Cruz, Dallas, Tex.). Chemiluminescent signals were detected using Immun-Star HRP (BioRad, Hercules, Calif.).
In Vivo Bone Labeling and Histomophometry.
To label bones, mice were intraperitoneally injected with 20 mg/kg of calcein (Sigma-Aldrich, St. Louis, Mo.) or 30 mg/kg of Alizarin Complexone (Sigma-Aldrich, St. Louis, Mo.) in a 2% sodium bicarbonate solution. Mice 6 to 8 months of age were labeled 8 days and 2 days prior to euthanasia, respectively. Tibia were fixed in 70% ethanol, embedded in methylmethacrylate and sectioned. Bone histomorphometry on H and E sections and bone labeled sections were performed as previously described (Parfitt, et al. Report of the ASBMR Histomorphometry Nomenclature Committee. J. Bone Miner. Res. 1987, 2, 595-610). Analysis of bone volume (BV/TV), and trabecular spacing (Tb. Sp.) were performed on the metaphyseal region of tibia sections stained with H and E. Bone formation rate (BFR) per bone surface (BS) and mineral apposition rate (MAR) of trabeculae were calculated within the metaphyseal region of the tibia. For all histomorphometry, three sections per mouse with 4 to 5 mice per group were analyzed. Analysis was performed using Bioquant Osteo software (Bioquant Image Analysis Corporation, Nashville, Tenn.).
Assessment of Human Plasma CTX and BSAP Levels.
All samples were de-identified and the experiments were approved by the University of Utah Institutional Review Board. Plasma samples were submitted to ARUP for clinical testing of CTX. For BSAP, the Human Bone Panel I capture plate with the Human Alkaline Phosphatase detection kit was utilized (Meso Scale Discovery, Rockville, Md.; K151HEC-2) to measure BSAP levels in undiluted plasma samples per the manufacturer's protocol.
Statistical Analysis.
Data are shown as mean+/− SEM. All experiments were analyzed using 2-tailed, unpaired, Student's t test using Prism 6 (GraphPad Software, La Jolla, Calif.).
Example 2
RON Expression in the Host is Required for MSP-Driven Breast Cancer Osteolysis
MSP drives spontaneous osteolytic bone metastasis. To investigate whether MSP-mediated bone metastasis depends on non cell-autonomous activation of RON, PyMT or PyMT-MSP tumor cells were injected into the tibias of wild-type (WT) mice or mice in which the tyrosine kinase domain of RON had been deleted from the genome (RonTK−/−) (Waltz et al. J. Clin. Invest. 2001, 108, 567-76). Expression of MSP in the tumor cells significantly increased the ability of these tumors to induce osteolysis in WT bones (FIG. 1A). FIG. 1A shows Microcomputed tomography (μCT) of bone lesions in the tibia 21 days post tumor cell injection. (scale bar, 2 mm). In contrast, when tumors overexpressing MSP were injected into RonTK−/− bones, they induced very little osteolysis. This was comparable to the basal levels of osteolysis induced in control tumor cells, as FIG. 1B shows quantification of osteolytic area in tibias from mice ex vivo using high resolution X-ray analysis (n=10) 42 days post tumor cell injection (p<0.0005). MSP-driven osteolysis could not be explained by altered tumor growth in the bone, as no statistically significant differences in tumor size or proliferation were observed between cohorts (FIG. 1C and FIG. 1D). FIG. 1C shows tumor growth in tibias determined by caliper measurements, and FIG. 1D shows proliferation rate of PyMT control and MSP-expressing tumor cells expressed as the percent of cells staining positive for phospho-H3. This indicated that RON activity in the host was required for the ability of MSP expressing tumor cells to induce osteolysis in the bone microenvironment. The presence of residual tumor-induced osteolysis caused by control tumors both in WT and RonTK−/− mice demonstrated some degree of osteolysis that is independent of the MSP/RON pathway, likely RANKL-mediated (addressed below).
To determine if MSP-driven osteolysis was due to an increase in the number of osteoclasts present within the microenvironment, bone sections were stained for the osteoclast-specific protein tartrate resistant acid phosphatase (TRAP), and the number of TRAP-positive (TRAP+) multinuclear cells was quantified. No significant difference in the number of TRAP+ osteoclasts was detected when comparing bones harboring control tumors versus MSP expressing tumors (FIG. 1E and FIG. 1F). FIG. 1E shows TRAP staining on sections of tumor-bearing bones from each experimental group (scale bar, 100 μm), and FIG. 1F shows quantification of TRAP+ osteoclasts in each experimental group (n=5-7 per group). Normal, non tumor-bearing bones were also examined to determine whether the RonTK−/− mice displayed a defect in osteoclastogenesis. Again, there was no difference in the number of osteoclasts present in the bones of RonTK−/− mice when compared to WT mice (FIG. 1E and FIG. 8A). FIG. 8A shows quantification of TRAP+ osteoclasts from normal, uninjected WT, and Ron TK−/− mice (n=5; ns=not significant).
To determine if protection from osteolysis in the RonTK−/− mice was due to an increase in bone formation due to elevated osteoblast activity, WT and RonTK−/− bones were labeled in vivo and histomorphometric bone parameters were analyzed. There were no significant differences in the mineral apposition rate (MAR) or the bone formation rate (BFR), indicating that there was no inherent difference in osteoblast activity between WT and RonTK−/− mice (FIG. 8B-D). FIG. 8B shows bone formation as observed by calcein and Alizarin double labeling (scale bar=100 μm for images at 4× magnification and 50 μm for inset images at 40× magnification). FIG. 8C shows mineral apposition rate determined by bone histomorphometric analysis in WT and RonTK−/− mice (n=4-5; ns=not significant). FIG. 8D shows bone formation rate per total bone surface in WT and RonTK−/− mice (n=4-5; ns=not significant). To ensure that a tyrosine kinase-independent function of RON was not contributing to osteoblast activity, bones of mice completely lacking murine RON (STK) protein (Correll et al. Genes Funct. 1997, 1, 69-83) were also examined. Again, no differences in osteoblast activity were seen between WT and total RON knockout mice (STK−/−) (FIG. 8B and FIG. 8E-F). FIG. 8E shows mineral apposition rate in WT and STK−/− mice (n=4-5; ns=not significant). FIG. 8F shows bone formation rate per total bone surface in WT and STK−/− mice (n=4-5; ns=not significant). Consistent with this finding, staining bone sections with antibodies specific for RON showed expression in osteoclasts and chondrocytes, but not in osteoblasts (FIG. 8G), and no RON or phosphorylated RON expression was detected in the MC3T3-E1 osteoblast cell line (FIG. 8H). FIG. 8G shows tissue sections stained for RON in normal, uninjected WT, and STK−/− mice. FIG. 8H shows a western analysis for RON and phospho-RON in the MCF10A-RON and MC3T3-E1 cell lines. Cells were grown in the presence of 10% serum to 90% confluency. The media was then exchanged for media containing 0.5% serum and the cells were cultured overnight. 100 pg/mL MSP was added for 15 minutes and lysates were prepared. The MCF10A cell line overexpressing RON served as the positive control for RON and phospho-RON expression while the MC3T3-E1 cell line demonstrated the lack of RON expression in osteoblasts. Together, these data strongly suggest that the ability of MSP-expressing tumor cells to induce osteolysis was not due to changes in osteoclast numbers or osteoblast activity. The hypothesis that MSP-mediated osteolysis was due to RON-dependent effects on osteoclast activity was therefore pursued.
Example 3
Host RON Activity Drives Osteolysis from Metastatic Human Breast Cancer
To ensure that the findings were not restricted to the effects of mouse tumors or tumors engineered to overexpress MSP, the expression levels of MSP, RON, and matriptase in a panel of human breast cancer cell lines was examined and a cell line (DU4475) chosen that expressed each of these genes above an average expression level, similar to patient tumor samples (FIG. 9A). FIG. 9A shows mRNA expression levels of MSP, RON, and matriptase in a panel of human breast cancer cell lines, wherein dotted lines depict average expression level for each gene. The metastatic breast cancer cell line DU4475 was selected and injected into the tibias of WT or RonTK−/− mice (both crossed with NOD.SCID and then backcrossed into the FVB genetic background). While the DU4475 cell line was osteolytic in NOD.SCID mice carrying wild type alleles of RON (NOD.SCID/RonTK+/+), osteolysis was significantly reduced in the NOD.SCID/RonTK−/− mice (FIG. 2A and FIG. 2B). FIG. 2A shows representative X-ray images of DU4475 bone lesions in NOD.SCID/WT or NOD.SCID/Ron TK−/− mice, 42 days post tumor cell injection. FIG. 2B shows quantification of osteolytic area from tibial bone lesions (n=5; p<0.05). These results show that MSP/RON-dependent osteolysis was not restricted to the mouse overexpression model, but can be expanded to include human cell lines that naturally overexpress endogenous MSP. Again, there was no significant difference in the number of TRAP+ osteoclasts in NOD.SCID/RonTK+/+ versus NOD.SCID/RonTK−/− mice harboring DU4475 tumors (FIG. 2C and FIG. 2D) or in normal, non tumor-bearing NOD.SCID/RonTK+/+ and NOD.SCID/RonTK−/− mice (FIG. 9B and FIG. 9C). FIG. 2C shows TRAP staining on sections of tumor-bearing bones from each experimental group (scale bar, 100 μm), FIG. 2D shows quantification of TRAP+ osteoclasts in each experimental group (n=3-4; ns=not significant), FIG. 9B shows TRAP staining of normal, uninjected NOD.SCID:WT, and NOD.SCID:Ron TK−/− bones (scale bar, 100 μm), and FIG. 9C shows quantification of TRAP+ osteoclasts from normal, uninjected bones (n=4; ns=not significant). Again, the lack of osteolysis could not be explained by a decrease in tumor proliferation in the NOD.SCID/Ron TK−/− mice (FIG. 2E, which shows proliferation rate of DU4475 tumor cells in the bone; n=3-4; ns=not significant).
Example 4
T Cells are Dispensable for MSP-Induced Osteolysis
Because the above xenograft experiments had to be performed in immune-compromised mice, and because T cells have previously been shown to influence osteoclast activity, it was destired to ensure that the lack of tumor-induced osteolysis from human DU4475 cells in NOD.SCID/RonTK−/− mice was not due to a combination effect of RON TK deletion and the compromised immune system. To test whether T cells were required for MSP/RON-dependent osteolysis, the effects of injecting PyMT-MSP tumor cells into the tibias of syngenic immune-competent (FVB/RonTK+/+ or FVB/RonTK−/−), or immune-compromised (NOD.SCID/RonTK+/+ or NOD.SCID/RonTK−/−) mice were compared. MSP-mediated osteolysis was not significantly altered in the immune-compromised mice and still demonstrated the necessity for RON activity in the host (FIG. 9D and FIG. 9E). FIG. 9D shows X-ray images of bone lesions from each group. Mice were sacrificed 28 days post tumor cell injection for analysis. FIG. 9E shows quantification of osteolytic area of bone lesions in mice from each experimental group (n=3-5; p=0.04 and p=0.05 respectively). There was also no significant difference in tumor growth or in the number of TRAP+ osteoclasts in these experiments (FIG. 9F-H). FIG. 9F shows growth curves of PyMT-MSP bone lesions for each experimental group. Tumor size was determined by caliper measurements. FIG. 9G shows TRAP staining of bone tumors from each experimental group (scale bar, 100 μm). FIG. 9H shows quantification of TRAP+ osteoclasts from PyMT-MSP bone tumors of each experimental group (n=4). While not statistically significant, there was a trend toward increased growth in the immune-deficient background, but no difference in osteolysis. These data showed that the mechanism for MSP-driven bone destruction does not require T-cell activity, or any other component of the adaptive immune system.
Example 5
Treatment with RON Inhibitors Blocks Osteolysis
Based on the data obtained using RonTK−/− mice, it was tested whether pharmacological inhibition of RON could provide protection from osteolysis. Tibias were injected with MSP-expressing PyMT tumor cells or DU4475 breast cancer cells and treated them with two different small molecule tyrosine kinase inhibitors that are selective for RON and Met (OSI-296 and ASLAN002). OSI-296 is more selective for Met (IC50 of 42 nM for Met and 200 nM for RON; Steinig et al. Bioorg. Med. Chem. 2013, 23, 4381-4387), while ASLAN002 (also known as BMS-777607) is more selective for RON (IC50 of 3.9 nM for Met and 1.8 nM for RON; Schroeder et al. J. Med. Chem. 2009, 52, 1251-1254). When animals were treated with either drug, beginning three days after tumor injection, osteolysis from PyMT-MSP tumors was significantly inhibited, phenocopying the results obtained with RonTK−/− mice. OSI-296 caused an average 4-6 fold inhibition of osteolysis, and ASLAN002 caused 6-10 fold inhibition of osteolysis (FIG. 3A-D). FIG. 3A shows X-ray images of PyMT-MSP bone lesions from mice treated with OSI-296. Treatment began 3 days post tumor cell injection for pre-osteolysis treatment and 3 weeks post injection for post osteolysis treatment. Mice were sacrificed 42 days post injection for analysis. FIG. 3B shows X-ray images of PyMT-MSP bone lesions from mice treated with ASLAN002. Treatment began 3 days post tumor cell injection. Mice were sacrificed 21 days post injection for analysis. FIG. 3C shows quantification of osteolytic area in PyMT-MSP bone lesions from mice treated with OSI-296 (n=7-10 per group; p=0.01). FIG. 3D shows quantification of osteolytic area in PyMT-MSP bone lesions from mice treated with ASLAN002 (n=4-5 per group; p=0.0074). ASLAN002, but not OSI-296, also prevented osteolysis from DU4475 cells (FIG. 3E and FIG. 3F). FIG. 3E shows representative X-ray images of DU4475-induced bone lesions from mice treated with ASLAN002. Treatment began 3 days post tumor cell injection, and mice were sacrificed 28 days post injection for analysis. FIG. 3F shows quantification of osteolytic area in DU4475 bone lesions from mice in each experimental group (n=5; p=0.0016). RON inhibition did not have an effect on the ability of tumors that do not express MSP to cause osteolysis, again implicating an osteolytic pathway that is independent of MSP/RON signaling (FIG. 10A and FIG. 10B). FIG. 10A shows X-ray images of PyMT control bone lesions treated with OSI-296. FIG. 10B shows quantification of osteolytic area in mice with bone lesions treated with OSI-296 (n=8.5). Control tumor cells were injected into the tibia of WT mice, and treatment began 3 days post tumor cell injection. Mice were sacrificed 42 days post injection for analysis (ns=not significant). To determine the potential of RON inhibitors in a more clinically relevant setting, the animals were allowed to develop osteolysis that was visible by X-ray in live animals, and then began treatment (this was, on average, three weeks after tumor injection). While the osteolysis in vehicle treated mice continued to progress, RON inhibition was able to prevent further tumor-induced bone loss. These results carry clinical relevance, as they suggest that RON inhibitors could be useful in the post-metastatic, post-osteolytic setting (FIG. 3A and FIG. 3C). Treatment with OSI-296 also reduced PyMT-MSP tumor growth and proliferation rate in the bone, while treatment with ASLAN002 showed a trend in decreased growth, but did not reach statistical significance (FIG. 10D-F). FIG. 10C shows the proliferation rate for PyMT control tumors indicated as percent cells staining positive for phospho-H3 (n=3). FIG. 10D shows tumor growth curve and proliferation rate for PyMT-MSP bone lesions treated with OSI-296 (n=5.4). PyMT-MSP tumor cells were injected into the tibia of WT mice, and treatment began 3 days post tumor cell injection for pre-osteolysis treatment and 3 weeks post injection for post osteolysis treatment. Mice were sacrificed 42 days post injection for analysis. FIG. 10E shows tumor growth curve and proliferation rate for PyMT-MSP bone lesions treated with ASLAN002 (n=5.4). PyMT-MSP tumor cells were injected into the tibia of WT mice and treatment began 3 days post tumor cell injection. Mice were sacrificed 21 days post tumor cell injection; tumor size was determined by caliper measurements. FIG. 10F shows proliferation rate of PyMT-MSP tumors treated with OSI-296 (n=3). Neither drug significantly inhibited growth of DU4475 tumors (FIG. 10G, showing tumor growth curve and proliferation rate for DU4475 bone lesions from each experimental group treated with ASLAN002 (n=5); DU4475 tumor cells were injected into the tibia of NOD.SCID/Ron TK+/+; treatment began 3 days post tumor cell injection, and mice were sacrificed 42 days post tumor cell injection for analysis). Again, RON inhibition had no significant effect on the number of TRAP+ osteoclasts present (FIG. 11A and FIG. 11B). FIG. 11A shows TRAP staining of PyMT-MSP bone tumors from mice treated with OSI-296 either 3 days post tumor cell injection for pre-osteolysis or 3 weeks post injection for post osteolysis treatment. Mice were sacrificed 42 days post injection for analysis. FIG. 11B shows quantification of TRAP+ osteoclasts from bone tumors in each experimental group (n=4; ns=not significant). RON inhibitors also did not affect RANKL production as measured by serum ELISA, suggesting that the lack of bone destruction was not due to indirect inhibition of RANKL signaling (FIG. 3G, showing ELISA-based quantification of serum RANKL concentration from mice in each experimental group; n=3; ns=not significant). RON inhibitors also did not affect bone formation in vivo, supporting a model in which blockade of RON signaling leads to a specific reduction in osteoclast activity, not an increase in osteoblast activity (FIG. 11C-E). FIG. 11C shows bone formation as observed by calcein and Alizarin double labeling (scale bar=100 μm for images at 4× magnification and 50 μm for inset images at 40× magnification). FIG. 11D shows mineral apposition rate in normal, uninjected animals treated with ASLAN002 (ns=not significant). FIG. 11E shows bone formation rate per total bone surface in animals treated with ASLAN002 (ns=not significant).
Example 6
MSP/RON Signaling is a Novel Mechanism of Osteolysis that is not Dependent on RANKL or TGFβ Signaling
Both RANKL and TGFβ have been shown to play major roles in osteoclast activation and the “vicious cycle.” Denosumab, a RANKL antagonist, was recently FDA-approved to treat bone metastases and osteoporosis based on demonstration of increased time to development of skeletal-related events, such as fracture, in patients. Mechanistically, we wanted to determine if MSP/RON functionally interacts with RANKL and/or TGF pathways. To test whether MSP-driven osteolysis is dependent on activation of RANK by RANKL, mice were treated with the murine RANKL antagonist, muRANK-Fc, three days after intratibial injection of tumor cells. Destruction of bone in PyMT control tumors was significantly impaired upon treatment with the RANKL antagonist (FIG. 4A and FIG. 4B), despite no significant effect on tumor growth (FIG. 12A). FIG. 4A shows representative X-ray images of PyMT-MSP bone lesions from mice treated with muRANK-Fc; treatment began 3 days post tumor cell injection; mice were sacrificed 42 days post tumor cell injection for analysis. FIG. 4B shows quantification of osteolytic area in bone lesions from mice in each experimental group (n=16 per group for WT mice and 3-5 per group for Ron TK−/− mice respectively; p<0.0001; ns=not significant). FIG. 12A shows growth curve from bone lesions treated with muRANK-Fc in each experimental group, tumor cells were injected into the tibia of WT or Ron TK−/− mice, treatment began 3 days post tumor cell injection, and tumor size was determined by caliper measurements. These data supported the observation that the low level of RON-independent osteolysis present in control tumors is dependent upon the RANKL pathway and, importantly, that the antagonist is functional in the assays. However, PyMT tumor cells overexpressing MSP were able to cause significant osteolysis even in the presence of the RANKL antagonist. In addition, although the levels of MSP-driven osteolysis in the Ron TK−/− mice were already very low, inhibition of RANKL did not reduce this further (FIG. 4A and FIG. 4B). Staining of sections from these samples demonstrated successful RANKL inhibition by the lack of TRAP+ cells in these groups, as expected because TRAP expression is regulated downstream of RANK (FIG. 4C, showing TRAP staining of tumor-bearing bones from each experimental group; scale bar, 100 μm). FIG. 12B shows RON and NFATc1 staining of tissue sections from PyMT-MSP tumor bearing bones treated with muRANK-Fc, wherein arrows indicate positively stained osteoclasts (scale bar=50 μm). However, osteoclasts were still present following RANKL inhibition, as demonstrated by NFATc1 and RON immuno-staining (FIG. 12C, showing growth curve from bone lesions in mice from each experimental group, wherein tumor cells were injected into the tibia of WT mice, and tumor size was determined by caliper measurements). These data suggest that although the RANKL antagonist was effective in the assays, the ability of MSP to induce osteolysis does not require active RANKL signaling.
The TGFβ pathway has also been shown to be an integral part of the “vicious cycle.” TGFβ is released from the bone matrix by osteoclasts and binds to its receptor on tumor cells, stimulating production of pro-osteoclastogenic cytokines. RANKL-independent mechanisms of osteolysis involving TGFβ may exist; therefore, it is possible that MSP/RON functionally interacts with the TGFβ pathway to induce osteoclast activation. To test this possibility, PyMT tumor cells were used in which the TGFβ type-II receptor (TGFβRII) had been deleted using a Cre-lox system (Forrester et al. Cancer Res. 15 2005, 65, 2296-302). MSP was then overexpressed and these cells were injected into WT mice. While the absence of TGFβ signaling did not affect tumor growth, it did affect the ability of control tumors to induce basal levels of osteolysis (FIG. 4D and FIG. 4E). FIG. 4D shows X-ray images of PyMT bone lesions arising from tumors in the presence or absence of TGFβRII. Mice were sacrificed 38 days post tumor cell injection for analysis. FIG. 4E shows quantification of osteolytic area in bone lesions from mice in each experimental group (n=5; p=0.0041; ns=not significant). Similar to RANKL inhibition, TGFβRII loss in the tumor cells impaired the ability of control tumors to induce osteolysis. This again supports the notion that the basal level of osteolysis induced by PyMT control tumor cells is dependent on RANKL and TGFβ signaling. Tumors overexpressing MSP, in contrast, caused robust osteolysis regardless of whether they expressed TGFβRII. Taken together, this evidence suggested that, while the RANKL-TGFβ portion of the vicious cycle is active in the PyMT model of bone metastasis, MSP/RON activates osteoclasts through a mechanism that does not depend on RANKL or TGFβ.
To further test the hypothesis that MSP/RON is sufficient to stimulate osteolysis in a manner that does not rely on the RANKL pathway, another human breast cancer model (MDA-MB-231) was used, which has been shown to be highly dependent on RANKL for osteolysis. Concordant with this, MDA-MB-231 cells did not express MSP at detectable levels (FIG. 5A, showing a Western blot of MSP protein levels secreted into the media of parental, control, and MSP-overexpressing MDA-MB-231 cells), allowing us to assess the consequences of MSP overexpression, which occurs in approximately 40% of human breast cancers. MSP was overexpressed in this cell line and injected these cells into the tibias of NOD.SCID mice. The expression of MSP led to a significant increase in the ability of these cells to induce osteolysis (FIG. 5B and FIG. 5C). FIG. 5B shows X-ray images of bone lesions from NOD.SCID mice treated with muRANK-Fc or OSI-296 3 days post tumor cell injection. Mice were sacrificed 30 days post tumor cell injection for analysis. FIG. 5C shows quantification of osteolytic area from bone lesions in mice from each experimental group (n=5; p=0.0014; p<0.0002; ns=not significant). While treatment with the RANKL antagonist again reduced osteolysis from control tumor cells, it did not significantly reduce the osteolysis from MSP-expressing tumor cells. Treatment with OSI-296, in contrast, was able to reduce MSP-mediated osteolysis to levels seen in control tumor cells. These data demonstrate that MSP gain-of-function can significantly increase osteolysis through a mechanism that can override RANKL dependency. Taken together, our data strongly suggested that the MSP/RON pathway is a novel mediator of osteoclast activity in bone-metastatic breast cancer.
Example 7
MSP/RON Signaling Promotes Bone Degradation by Stimulating RANK-Independent Osteoclast Survival, c-Src Phosphorylation, and Osteolytic Activity
To determine the cellular mechanism by which RON signaling functions in specific steps during osteoclastogenesis and osteoclast activation, the effect of MSP on osteoclasts was analyzed in vitro. Differentiated osteoclasts were stimulated with recombinant MSP, and their ability to resorb an artificial bone matrix was analyzed. Addition of MSP to WT osteoclasts led to a significant increase in the resorptive capacity of these cells, while having no effect on RonTK−/− osteoclasts (FIG. 6A and FIG. 13A). FIG. 6A shows quantification of the resorption area from each experimental group (n=4). Bone marrow precursor cells were differentiated in the presence of M-CSF and RANKL for 9 days. 100 pg/mL of MSP was added daily beginning on day 9 with the experiment ending on day 12 (p<0.001). FIG. 13A shows representative images of resorption pits from WT and RonTK−/− osteoclasts in the presence and absence of MSP. This increase in osteoclast resorption was only slightly reduced upon addition of the RANKL antagonist muRANK-Fc (FIG. 6B), but was dramatically reduced upon addition of RON inhibitors ASLAN002 or OSI-296 (FIG. 6C and FIG. 13B). FIG. 6B shows quantification of the resorption area arising from WT and Ron TK−/− bone marrow precursor cells differentiated in the presence of M-CSF and RANKL for 9 days (n=3). 10 μg/mL of muRANK-Fc was added daily beginning on day 9 with the experiment ending on day 12 (***p<0.0001, *p=0.04, **p=0.0097). FIG. 6C shows quantification of the resorption area (n=3). WT bone marrow precursor cells were seeded on osteologic slides and differentiated in the presence of M-CSF and RANKL for 9 days. muRANK-Fc at a concentration of 10 μg/mL and/or ASLAN002 at a concentration of 10 μM was added daily beginning on day 9 with the experiment ending on day 12 (***p=0.0001, *p=0.01, **p<0.005). FIG. 13B shows quantification of resorption area in each experimental group (n=3). WT bone marrow precursor cells were seeded on osteologic slides and differentiated in the presence of M-CSF and RANKL for 9 days. muRANK-Fc at a concentration of 10 μg/mL and/or OSI-296 at a concentration of 10 μM was added daily beginning on day 9, ending on day 12 (**p=0.002, ***p<0.0001, *p=0.03). Simultaneous treatment with the RANKL antagonist and either of the RON inhibitors reduced osteoclast activity to a greater extent than either treatment alone (FIG. 6C and FIG. 13B), again suggesting that both RON and RANKL contribute to bone destruction, but do so through separate pathways in osteoclast activation.
As expected from the observations in vivo, MSP stimulation did not increase osteoclast differentiation, and even demonstrated an inhibitory effect when added at early time points relative to the onset of differentiation (FIG. 13C and FIG. 13D). FIG. 13C shows a timeline describing the addition of MSP during differentiation. M-CSF and RANKL were present continuously beginning on day 1 until experimental analysis. FIG. 13D shows quantification of TRAP+ osteoclasts in each experimental group (n=3). WT bone marrow precursor cells were seeded on glass coverslips and differentiated in the presence of M-CSF and RANKL. 100 pg/mL of recombinant MSP was added daily, beginning at the time points indicated. TRAP+ cells were identified by fluorescent TRAP stain and cells with 4 or more nuclei were counted (***p<0.0001). MSP was not sufficient for differentiation when added at any time during the differentiation process (FIG. 13E). FIG. 13E shows quantification of the number of TRAP+ osteoclasts per well for each experimental group (n=3). WT bone marrow precursor cells were seeded onto glass coverslips and differentiated in the presence of M-CSF and RANKL. RANKL was removed from the media, and 100 pg/mL of recombinant MSP was added at the indicated time points with the experiment terminating on day 9. This suggested that RANKL is required to prime these cells for cell fate determination and differentiation, similar to that of other factors which have been shown to activate osteoclasts. The ability of these cells to resorb matrix as they differentiated was also tested. Interestingly, MSP was able to stimulate osteoclast resorption of RANKL-differentiated osteoclast precursor cells, even when added at very early time points (FIG. 13F). FIG. 13F shows quantification of resorption area in each experimental group (n=3). WT bone marrow precursor cells were seeded on osteologic slides and differentiated in the presence of M-CSF and RANKL for 9 days. 100 pg/mL of recombinant MSP was added at the indicated time points with the experiment terminating on day 12 (***p<0.0001, *p=0.01, **p=0.0023). Together, these data suggested that RANKL is required for osteoclast differentiation, but can be dispensable for the resorptive activity of fully-differentiated osteoclasts when MSP is present.
Because RANK signaling is thought to be required for osteoclast survival, it was questioned whether MSP could affect the survival of existing osteoclasts in the absence of RANKL. To determine this, osteoclasts were fully differentiated in the presence of M-CSF and RANKL. These factors were then removed from the culture and MSP was added, see schematic in FIG. 13G, which is a timeline describing the addition of MSP and removal of RANKL to determine osteoclast survival. Cells were cultured in the presence of M-CSF and RANKL for 7 days. These factors were then removed from the culture, and 100 pg/mL of MSP was added daily, beginning on day 7, and continued for 48 hours. The cells were cultured for an additional 48 hours and osteoclast survival was determined by counting the number of TRAP+ cells present. While the number of surviving osteoclasts was reduced in all conditions tested without RANKL and M-CSF, the number of surviving osteoclasts was significantly augmented in the presence of MSP (FIG. 6D). FIG. 6D shows quantification of the number of TRAP+ osteoclasts per well from each experimental group (n=3). WT bone marrow precursor cells were differentiated in the presence of M-CSF and RANKL for 7 days. M-CSF and RANKL were washed out and 100 pg/mL of MSP was added daily, beginning on day 7, and continued for 48 hours. TRAP+ cells were identified by fluorescent TRAP stain and cells with 4 or more nuclei were counted (**p<0.007, ***p<0.0001). These experiments demonstrated that the MSP/RON pathway does not promote osteoclast differentiation, but instead functions to stimulate osteoclast activity and survival.
MSP promoted osteoclast survival (FIG. 13G, FIG. 17A), but not differentiation (FIG. 13C, FIG. 13E, FIG. 17C), in the absence of RANKL signaling. Shown in FIG. 17A is quantification of the number of TRAP+ osteoclasts per well from each experimental group (n=3 per group), wherein WT bone marrow precursor cells were differentiated in the presence of M-CSF and RANKL for 7 days. M-CSF and RANKL were then washed out and 100 pg/mL of MSP and/or 10 μM of the Src inhibitor AZD0530 were added daily, beginning on day 7, and continued for 48 hours. TRAP+ cells were identified by fluorescent TRAP stain and cells with 4 or more nuclei were counted (***p<0.0001; ns=not significant). Shown in FIG. 17C is quantification of TRAP+ osteoclasts in each experimental group (n=3 per group), wherein WT bone marrow precursor cells were seeded on glass coverslips and differentiated in the presence of M-CSF and RANKL. 100 pg/mL of recombinant MSP was added daily, beginning at the time points indicated. TRAP+ cells were identified by fluorescent TRAP stain, and cells with four or more nuclei were counted. Data in the figure represent mean+/− SEM; p values were based on Student's t test (*p<0.01; ***p<0.0001; ns, not significant). With regard to survival, a small molecule inhibitor of Src kinase blocked MSP-mediated survival (FIG. 13G, FIG. 17B) and expression of constitutively active Src led to a small but statistically significant increase in survival of Ron TK−/− osteoclasts in the absence of RANKL signaling (FIG. 17B). Shown in FIG. 17B is quantification of the number of TRAP+ osteoclasts per well in the presence or absence of MSP (n=3 per group). Ron TK−/− bone marrow precursor cells were transduced with WT, constitutively active (CA), or kinase dead (KD) Src. The cells were then differentiated in the presence of M-CSF and RANKL for 7 days. M-CSF and RANKL were then washed out and 100 pg/mL of MSP was added daily to activate the osteoclasts, beginning on day 7 for 48 hours. TRAP+ cells were identified by fluorescent TRAP stain and cells with 4 or more nuclei were counted (***p<0.0001; **p<0.001). Together, these data suggest that RANKL (not Ron) promotes osteoclast differentiation, but both Ron and RANKL contribute to osteoclast survival and activity through separate pathways that may converge on Src signaling.
c-Src is critical in the regulation of osteoclast survival, motility, cytoskeletal reorganization, and resorption ability. To determine whether MSP/RON signaling stimulates c-Src activity independently of RANK, c-src phosphorylation was tested in the presence or absence of RANKL signaling. Addition of the RANKL antagonist to WT osteoclasts resulted in a decrease in phosphorylated c-Src. Addition of MSP to WT osteoclasts increased Src phosphorylation, which was blocked by ASLAN002, but not muRANK-Fc (FIG. 6E). However, MSP was able to rescue the loss of phosphorylated c-Src, indicating that the MSP/RON pathway functions as an alternative pathway of c-Src activation in the absence of RANKL signaling (FIG. 6E showing Western blots of osteoclast lysates from WT cells treated with MSP, muRANK-Fc, and/or ASLAN002; and FIG. 6F showing a model of MSP/RON function in the bone microenvironment).
ASLAN002 treatment also reduced downstream Src signaling, as demonstrated by the decrease in phosphorylated AKT, while having no effect on ERK activity. To determine whether Src activation could rescue the poor resorptive activity of RonTK−/− osteoclasts, RonTK−/− osteoclast precursors were transduced with WT Src, constitutively-active Src, or kinase-dead Src mutants. Expression of WT Src led to a slight but statistically significant increase in the resorptive ability of RonTK−/− osteoclasts, while constitutively active Src fully rescued resorption, and the kinase-dead Src mutant had no effect (FIG. 16, showing quantification of resorption area from Ron TK−/− bone marrow precursor cells transduced with WT, constitutively active (CA), or kinase dead (KD) Src in the presence or absence of MSP, with WT osteoclasts as control (n=3 per group); where indicated, 100 pg/mL of MSP was added daily beginning on day 9 with the experiment ending on day 12; *p<0.01; ***p<0.0001). Taken together, these data suggested that (1) RON plays a critical role in a signaling pathway that is known to be essential for osteoclast activity (FIG. 13H, showing a model of signaling pathways activated downstream of RON activation in osteoclasts); (2) Ron signaling promotes both survival and activity of osteoclasts through a parallel pathway to RANK signaling; and (3) c-Src kinase activity is necessary and sufficient for Ron-dependent osteoclast resorption but not sufficient to rescue survival of osteoclasts deprived of both RANKL and Ron signaling (FIG. 6F).
Example 8
RON Expression in the Host is Required for Ovariectomy-Induced Bone Loss
Pathways involved in tumor-driven osteolysis are also often implicated in other pathologies leading to bone destruction. To investigate the role of the MSP/RON pathway in bone loss due to post-menopausal osteoporosis, ovariectomies were performed in WT and RonTK−/− mice and bone loss was analyzed by dual-energy X-ray absorptiometry (DXA) and bone histomorphometry 28 days later. The ovarectomized RonTK−/− mice were more resistant to loss of bone mineral density (BMD), bone volume, and trabecular thickness, with a concomitant decrease in trabecular spacing as compared to WT mice or sham-operated controls (FIG. 7A-E). FIG. 7A shows μCT images of the proximal tibia (axial view of the metaphyseal region) from WT and RonTK−/− mice following ovariectomy (OVX) or sham operation. WT OVX mice were treated with ASLAN002 beginning 1 day post-ovariectomy. Mice were sacrificed 28 days post-ovariectomy for analysis. FIG. 7B shows quantification of bone mineral density in the metaphyseal region of the tibia determined by bone histomorphometry analysis (n=5; **p<0.005, ***p<0.0005, and *p<0.02). FIG. 7C shows quantification of trabecular bone volume in the tibia expressed at percent per total volume and determined by bone histomorphometry analysis (n=5; **p<0.0001, *p<0.002). FIG. 7D shows quantification of trabecular separation in the tibia (n=5; **p<0.008, *p<0.05). FIG. 7E shows representative sections of tibia stained from various experimental groups. Loss of Ron activity protected from osteoporotic bone loss.
In fact, loss of RON resulted in complete protection from osteoporosis, as RonTK−/− bones were not statistically different than sham-operated controls. There also was no difference in the bone histomorphometric parameters between sham-operated mice of either genotype, demonstrating that there are no basal differences in bone density in the RonTK−/− mice under normal physiologic conditions. Importantly, treatment with ASLAN002 after ovary removal also completely prevented bone loss (FIG. 7A-E). These data further showed that MSP/RON activity is a critical pathway for osteoclast activation both in physiological and pathological states. FIG. 14A shows expression of MSP in normal plasma cells versus myeloma cells. FIG. 14B shows expression of MSP in lung carcinomas.
Example 9
ASLAN002 Reduces Bone Turnover in Postmenopausal Women
ASLAN002 is currently in Phase I testing as an anti-cancer agent (NCT01721148). Regardless of cancer diagnosis, and even in the absence of bone metastasis, RON inhibition might affect normal bone turnover, especially in postmenopausal women due to their high rate of bone loss. Plasma samples from early cohorts of Phase I patients were examined for evidence of bone turnover at baseline and after treatment with ASLAN002, using a standard clinical test to detect cleaved bone-derived collagen in plasma (beta-cross-linked C-telopeptide, or CTX). These data showed that 11/18 (61%) of patients exhibited decreased CTX levels with ASLAN002 treatment, and 64% of those had a sufficient drop in CTX levels (≧25% reduction) to meet the Mayo clinic guidelines for response to bone anti-resorptive therapies (FIG. 15A). Shown in FIG. 15A is quantification of the percent change in plasma CTX levels (compared to baseline prior to drug treatment) in blood plasma of patients receiving ASLAN002 in the Phase I clinical trial. Most patients received ASLAN002 for 28 days; the exceptions in duration are noted (*15 days and ^84 days). Dark bars represent males, and light bars represent females. Interestingly, the best responses were seen in women, where 7/10 women (70%) showed ≧25% decreases in CTX (versus 0/8 men). In this analysis, all subjects except one were >50 years old; women older than 50 were expected to have the greatest amount of physiologic bone turnover due to menopause. None of the patients analyzed were treated concurrently with anti-osteoporotic agents. The decrease in CTX was not due to non-specific changes in bone turnover, since bone-specific alkaline phosphatase levels (BSAP, a marker of osteoblast activity) did not decrease with ASLAN002 treatment. Rather, increased plasma BSAP was noted, suggesting bone repair (FIG. 15B). Shown in FIG. 15B is quantification of the percent change in BSAP levels (compared to baseline) in blood plasma of patients receiving ASLAN002. The patients are the same as those shown in FIG. 15A, except those receiving only 15 days of ASLAN002 were not tested for BSAP. Dark bars represent males, and light bars represent females. Note that these patients were not selected based on a diagnosis of bone metastasis; rather, markers of bone turnover in patients with various cancer diagnoses who participated in the Phase I trial of ASLAN002 were simply assessed. These correlative data, when taken together with the pre-clinical data in animal models, strongly suggested that inhibition of Ron reduces osteoclast activity. These results provide rationale for continued investigation of Ron inhibitors to treat bone destructive diseases like osteolytic bone metastasis and osteoporosis.
The foregoing description of the specific aspects will so fully reveal the general nature of the invention that others can, by applying knowledge within the skill of the art, readily modify and/or adapt for various applications such specific aspects, without undue experimentation, without departing from the general concept of the present disclosure. Therefore, such adaptations and modifications are intended to be within the meaning and range of equivalents of the disclosed aspects, based on the teaching and guidance presented herein. It is to be understood that the phraseology or terminology herein is for the purpose of description and not of limitation, such that the terminology or phraseology of the present specification is to be interpreted by the skilled artisan in light of the teachings and guidance.
The breadth and scope of the present disclosure should not be limited by any of the above-described exemplary aspects, but should be defined only in accordance with the following claims and their equivalents.
All publications, patents, patent applications, and/or other documents cited in this application are incorporated by reference in their entirety for all purposes to the same extent as if each individual publication, patent, patent application, and/or other document were individually indicated to be incorporated by reference for all purposes.
For reasons of completeness, various aspects of the invention are set out in the following numbered clauses:
Clause 1. A method for inhibiting osteolysis or treating osteoporosis in a subject in need thereof, the method comprising administering to the subject an effective amount of at least one RON inhibitor.
Clause 2. The method of clause 1, wherein the subject has been diagnosed with a condition selected from the group consisting of inflammation, cyst, and cancer.
Clause 3. The method of any one of the above clauses, wherein the subject has been diagnosed with cancer with bone metastasis or cancer-mediated bone destruction.
Clause 4. The method of any one of clauses 2-3, wherein the cancer is selected from the group consisting of lymphoma, lung cancer, pancreatic cancer, breast cancer, rectal cancer, colon cancer, stomach cancer, larynx cancer, liver cancer, brain cancer, and skin cancer.
Clause 5. The method of clause 1, wherein the osteolysis is caused by a condition selected from the group consisting of tumor, inflammation, and cyst.
Clause 6. The method of clause 5, wherein the condition comprises a bone tumor or a tumor located in bone.
Clause 7. The method of clause 1, wherein the subject is premenopausal.
Clause 8. The method of clause 1, wherein the subject is menopausal.
Clause 9. The method of clause 1, wherein the subject is postmenopausal.
Clause 10. The method of any one of clauses 1-9, wherein the RON inhibitor is OSI-296.
Clause 11. The method of any one of clauses 1-9, wherein the RON inhibitor is a RON-selective inhibitor.
Clause 12. The method of clause 11, wherein the RON-selective inhibitor is ASLAN002.
Clause 13. The method of any one of clauses 1-12, wherein the RON inhibitor does not depend on the function of RANKL or TGFβ.










SEQUENCES















SEQ ID NO: 1


RON polypeptide, homo sapiens, 1351 amino acids, accession no. NP_001231866.


MELLPPLPQS FLLLLLLPAK PAAGEDWQCP RTPYAASRDF DVKYVVPSFS AGGLVQAMVT


YEGDRNESAV FVAIRNRLHV LGPDLKSVQS LATGPAGDPG CQTCAACGPG PHGPPGDTDT


KVLVLDPALP ALVSCGSSLQ GRCFLHDLEP QGTAVHLAAP ACLFSAHHNR PDDCPDCVAS


PLGTRVTVVE QGQASYFYVA SSLDAAVAAS FSPRSVSIRR LKADASGFAP GFVALSVLPK


HLVSYSIEYV HSFHTGAFVY FLTVQPASVT DDPSALHTRL ARLSATEPEL GDYRELVLDC


RFAPKRRRRG APEGGQPYPV LRVAHSAPVG AQLATELSIA EGQEVLFGVF VTGKDGGPGV


GPNSVVCAFP IDLLDTLIDE GVERCCESPV HPGLRRGLDF FQSPSFCPNP PGLEALSPNT


SCRHFPLLVS SSFSRVDLFN GLLGPVQVTA LYVTRLDNVT VAHMGTMDGR ILQVELVRSL


NYLLYVSNFS LGDSGQPVQR DVSRLGDHLL FASGDQVFQV PIQGPGCRHF LTCGRCLRAW


HFMGCGWCGN MCGQQKECPG SWQQDHCPPK LTEFHPHSGP LRGSTRLTLC GSNFYLHPSG


LVPEGTHQVT VGQSPCRPLP KDSSKLRPVP RKDFVEEFEC ELEPLGTQAV GPTNVSLTVT


NMPPGKHFRV DGTSVLRGFS FMEPVLIAVQ PLFGPRAGGT CLTLEGQSLS VGTSRAVLVN


GTECLLARVS EGQLLCATPP GATVASVPLS LQVGGAQVPG SWTFQYREDP VVLSISPNCG


YINSHITICG QHLTSAWHLV LSFHDGLRAV ESRCERQLPE QQLCRLPEYV VRDPQGWVAG


NLSARGDGAA GFTLPGFRFL PPPHPPSANL VPLKPEEHAI KFEVCVDGEC HILGRVVRPG


PDGVPQSTLL GILLPLLLLV AALATALVFS YWWRRKQLVL PPNLNDLASL DQTAGATPLP


ILYSGSDYRS GLALPAIDGL DSTTCVHGAS FSDSEDESCV PLLRKESIQL RDLDSALLAE


VKDVLIPHER VVTHSDRVIG KGHFGVVYHG EYIDQAQNRI QCAIKSLSRI TEMQQVEAFL


REGLLMRGLN HPNVLALIGI MLPPEGLPHV LLPYMCHGDL LQFIRSPQRN PTVKDLISFG


LQVARGMEYL AEQKFVHRDL AARNCMLDES FTVKVADFGL ARDILDREYY SVQQHRHARL


PVKWMALESL QTYRFTTKSD VWSFGVLLWE LLTRGAPPYR HIDPFDLTHF LAQGRRLPQP


EYCPDSLYQV MQQCWEADPA VRPTFRVLVG EVEQIVSALL GDHYVQLPAT YMNLGPSTSH


EMNVRPEQPQ FSPMPGNVRR PRPLSEPPRP T


 


SEQ ID NO: 2


RON polynucleotide, homo sapiens, 4638 bp, accession no. NM_001244937.


agtgtacagc ggcggctggg gcggcaggtg aggcggctgg ggcgttgctg tcgtgcgtcc


gcaggcgtca ggtgctcaga cccgagggcc gggaagggat ttgggtttca caggaacctg


gggcgggggt ccgctatctt ggggctgtcg ggaccgctgc ttaaatttgg cccagtccag


acctcgagtc gggcccccag ccaggcccac gcccaggtcc aggcccaggc cggtagggat


cctctagggt cccagctcgc ctcgatggag ctcctcccgc cgctgcctca gtccttcctg


ttgctgctgc tgttgcctgc caagcccgcg gcgggcgagg actggcagtg cccgcgcacc


ccctacgcgg cctctcgcga ctttgacgtg aagtacgtgg tgcccagctt ctccgccgga


ggcctggtac aggccatggt gacctacgag ggcgacagaa atgagagtgc tgtgtttgta


gccatacgca atcgcctgca tgtgcttggg cctgacctga agtctgtcca gagcctggcc


acgggccctg ctggagaccc tggctgccag acgtgtgcag cctgtggccc aggaccccac


ggccctcccg gtgacacaga cacaaaggtg ctggtgctgg atcccgcgct gcctgcgctg


gtcagttgtg gctccagcct gcagggccgc tgcttcctgc atgacctaga gccccaaggg


acagccgtgc atctggcagc gccagcctgc ctcttctcag cccaccataa ccggcccgat


gactgccccg actgtgtggc cagcccattg ggcacccgtg taactgtggt tgagcaaggc


caggcctcct atttctacgt ggcatcctca ctggacgcag ccgtggctgc cagcttcagc


ccacgctcag tgtctatcag gcgtctcaag gctgacgcct cgggattcgc accgggcttt


gtggcgttgt cagtgctgcc caagcatctt gtctcctaca gtattgaata cgtgcacagc


ttccacacgg gagccttcgt atacttcctg actgtacagc cggccagcgt gacagatgat


cctagtgccc tgcacacacg cctggcacgg cttagcgcca ctgagccaga gttgggtgac


tatcgggagc tggtcctcga ctgcagattt gctccaaaac gcaggcgccg gggggcccca


gaaggcggac agccctaccc tgtgctgcgg gtggcccact ccgctccagt gggtgcccaa


cttgccactg agctgagcat cgccgagggc caggaagtac tatttggggt ctttgtgact


ggcaaggatg gtggtcctgg cgtgggcccc aactctgtcg tctgtgcctt ccccattgac


ctgctggaca cactaattga tgagggtgtg gagcgctgtt gtgaatcccc agtccatcca


ggcctccggc gaggcctcga cttcttccag tcgcccagtt tttgccccaa cccgcctggc


ctggaagccc tcagccccaa caccagctgc cgccacttcc ctctgctggt cagtagcagc


ttctcacgtg tggacctatt caatgggctg ttgggaccag tacaggtcac tgcattgtat


gtgacacgcc ttgacaacgt cacagtggca cacatgggca caatggatgg gcgtatcctg


caggtggagc tggtcaggtc actaaactac ttgctgtatg tgtccaactt ctcactgggt


gacagtgggc agcccgtgca gcgggatgtc agtcgtcttg gggaccacct actctttgcc


tctggggacc aggttttcca ggtacctatc caaggccctg gctgccgcca cttcctgacc


tgtgggcgtt gcctaagggc atggcatttc atgggctgtg gctggtgtgg gaacatgtgc


ggccagcaga aggagtgtcc tggctcctgg caacaggacc actgcccacc taagcttact


gagttccacc cccacagtgg acctctaagg ggcagtacaa ggctgaccct gtgtggctcc


aacttctacc ttcacccttc tggtctggtg cctgagggaa cccatcaggt cactgtgggc


caaagtccct gccggccact gcccaaggac agctcaaaac tcagaccagt gccccggaaa


gactttgtag aggagtttga gtgtgaactg gagcccttgg gcacccaggc agtggggcct


accaacgtca gcctcaccgt gactaacatg ccaccgggca agcacttccg ggtagacggc


acctccgtgc tgagaggctt ctctttcatg gagccagtgc tgatagcagt gcaacccctc


tttggcccac gggcaggagg cacctgtctc actcttgaag gccagagtct gtctgtaggc


accagccggg ctgtgctggt caatgggact gagtgtctgc tagcacgggt cagtgagggg


cagcttttat gtgccacacc ccctggggcc acggtggcca gtgtccccct tagcctgcag


gtggggggtg cccaggtacc tggttcctgg accttccagt acagagaaga ccctgtcgtg


ctaagcatca gccccaactg tggctacatc aactcccaca tcaccatctg tggccagcat


ctaacttcag catggcactt agtgctgtca ttccatgacg ggcttagggc agtggaaagc


aggtgtgaga ggcagcttcc agagcagcag ctgtgccgcc ttcctgaata tgtggtccga


gacccccagg gatgggtggc agggaatctg agtgcccgag gggatggagc tgctggcttt


acactgcctg gctttcgctt cctaccccca ccccatccac ccagtgccaa cctagttcca


ctgaagcctg aggagcatgc cattaagttt gaggtctgcg tagatggtga atgtcatatc


ctgggtagag tggtgcggcc agggccagat ggggtcccac agagcacgct ccttggtatc


ctgctgcctt tgctgctgct tgtggctgca ctggcgactg cactggtctt cagctactgg


tggcggagga agcagctagt tcttcctccc aacctgaatg acctggcatc cctggaccag


actgctggag ccacacccct gcctattctg tactcgggct ctgactacag aagtggcctt


gcactccctg ccattgatgg tctggattcc accacttgtg tccatggagc atccttctcc


gatagtgaag atgaatcctg tgtgccactg ctgcggaaag agtccatcca gctaagggac


ctggactctg cgctcttggc tgaggtcaag gatgtgctga ttccccatga gcgggtggtc


acccacagtg accgagtcat tggcaaaggc cactttggag ttgtctacca cggagaatac


atagaccagg cccagaatcg aatccaatgt gccatcaagt cactaagtcg catcacagag


atgcagcagg tggaggcctt cctgcgagag gggctgctca tgcgtggcct gaaccacccg


aatgtgctgg ctctcattgg tatcatgttg ccacctgagg gcctgcccca tgtgctgctg


ccctatatgt gccacggtga cctgctccag ttcatccgct cacctcagcg gaaccccacc


gtgaaggacc tcatcagctt tggcctgcag gtagcccgcg gcatggagta cctggcagag


cagaagtttg tgcacaggga cctggctgcg cggaactgca tgctggacga gtcattcaca


gtcaaggtgg ctgactttgg tttggcccgc gacatcctgg acagggagta ctatagtgtt


caacagcatc gccacgctcg cctacctgtg aagtggatgg cgctggagag cctgcagacc


tatagattta ccaccaagtc tgatgtgtgg tcatttggtg tgctgctgtg ggaactgctg


acacggggtg ccccaccata ccgccacatt gacccttttg accttaccca cttcctggcc


cagggtcggc gcctgcccca gcctgagtat tgccctgatt ctctgtacca agtgatgcag


caatgctggg aggcagaccc agcagtgcga cccaccttca gagtactagt gggggaggtg


gagcagatag tgtctgcact gcttggggac cattatgtgc agctgccagc aacctacatg


aacttgggcc ccagcacctc gcatgagatg aatgtgcgtc cagaacagcc gcagttctca


cccatgccag ggaatgtacg ccggccccgg ccactctcag agcctcctcg gcccacttga


cttagttctt gggctggacc tgcttagctg ccttgagcta accccaagct gcctctgggc


catgccaggc cagagggcag tggccctcca ccttgttcct gccctttaac tttcagaggc


aataggtaaa tggggcccat taggtccctc actccacaga gtgagccagt gagggcagtc


ctgcaacatg tatttatgga gtgcctgctg tggaccctgt cttctgggca cagtggactc


agcagtgacc acaccaacac tgacccttga accaataaag gaacaaatga ctattaaagc


acaaaaaaaa aaaaaaaa


 


SEQ ID NO: 3


Met polypeptide, homo sapiens, 1390 amino acids, accession no. NP_000236.


MKAPAVLAPG ILVLLFTLVQ RSNGECKEAL AKSEMNVNMK YQLPNFTAET PIQNVILHEH


HIFLGATNYI YVLNEEDLQK VAEYKTGPVL EHPDCFPCQD CSSKANLSGG VWKDNINMAL


VVDTYYDDQL ISCGSVNRGT CQRHVFPHNH TADIQSEVHC IFSPQIEEPS QCPDCVVSAL


GAKVLSSVKD RFINFFVGNT INSSYFPDHP LHSISVRRLK ETKDGFMFLT DQSYIDVLPE


FRDSYPIKYV HAFESNNFIY FLTVQRETLD AQTFHTRIIR FCSINSGLHS YMEMPLECIL


TEKRKKRSTK KEVFNILQAA YVSKPGAQLA RQIGASLNDD ILFGVFAQSK PDSAEPMDRS


AMCAFPIKYV NDFFNKIVNK NNVRCLQHFY GPNHEHCFNR TLLRNSSGCE ARRDEYRTEF


TTALQRVDLF MGQFSEVLLT SISTFIKGDL TIANLGTSEG RFMQVVVSRS GPSTPHVNFL


LDSHPVSPEV IVEHTLNQNG YTLVITGKKI TKIPLNGLGC RHFQSCSQCL SAPPFVQCGW


CHDKCVRSEE CLSGTWTQQI CLPAIYKVFP NSAPLEGGTR LTICGWDFGF RRNNKFDLKK


TRVLLGNESC TLTLSESTMN TLKCTVGPAM NKHFNMSIII SNGHGTTQYS TFSYVDPVIT


SISPKYGPMA GGTLLTLTGN YLNSGNSRHI SIGGKTCTLK SVSNSILECY TPAQTISTEF


AVKLKIDLAN RETSIFSYRE DPIVYEIHPT KSFISGGSTI TGVGKNLNSV SVPRMVINVH


EAGRNFTVAC QHRSNSEIIC CTTPSLQQLN LQLPLKTKAF FMLDGILSKY FDLIYVHNPV


FKPFEKPVMI SMGNENVLEI KGNDIDPEAV KGEVLKVGNK SCENIHLHSE AVLCTVPNDL


LKLNSELNIE WKQAISSTVL GKVIVQPDQN FTGLIAGVVS ISTALLLLLG FFLWLKKRKQ


IKDLGSELVR YDARVHTPHL DRLVSARSVS PTTEMVSNES VDYRATFPED QFPNSSQNGS


CRQVQYPLTD MSPILTSGDS DISSPLLQNT VHIDLSALNP ELVQAVQHVV IGPSSLIVHF


NEVIGRGHFG CVYHGTLLDN DGKKIHCAVK SLNRITDIGE VSQFLTEGII MKDFSHPNVL


SLLGICLRSE GSPLVVLPYM KHGDLRNFIR NETHNPTVKD LIGFGLQVAK GMKYLASKKF


VHRDLAARNC MLDEKFTVKV ADFGLARDMY DKEYYSVHNK TGAKLPVKWM ALESLQTQKF


TTKSDVWSFG VLLWELMTRG APPYPDVNTF DITVYLLQGR RLLQPEYCPD PLYEVMLKCW


HPKAEMRPSF SELVSRISAI FSTFIGEHYV HVNATYVNVK CVAPYPSLLS SEDNADDEVD


TRPASFWETS


 


SEQ ID NO: 4


Met polynucleotide, homo sapiens, 6641 bp, accession no. NM_000245.


gccctcgccg cccgcggcgc cccgagcgct ttgtgagcag atgcggagcc gagtggaggg


cgcgagccag atgcggggcg acagctgact tgctgagagg aggcggggag gcgcggagcg


cgcgtgtggt ccttgcgccg ctgacttctc cactggttcc tgggcaccga aagataaacc


tctcataatg aaggcccccg ctgtgcttgc acctggcatc ctcgtgctcc tgtttacctt


ggtgcagagg agcaatgggg agtgtaaaga ggcactagca aagtccgaga tgaatgtgaa


tatgaagtat cagcttccca acttcaccgc ggaaacaccc atccagaatg tcattctaca


tgagcatcac attttccttg gtgccactaa ctacatttat gttttaaatg aggaagacct


tcagaaggtt gctgagtaca agactgggcc tgtgctggaa cacccagatt gtttcccatg


tcaggactgc agcagcaaag ccaatttatc aggaggtgtt tggaaagata acatcaacat


ggctctagtt gtcgacacct actatgatga tcaactcatt agctgtggca gcgtcaacag


agggacctgc cagcgacatg tctttcccca caatcatact gctgacatac agtcggaggt


tcactgcata ttctccccac agatagaaga gcccagccag tgtcctgact gtgtggtgag


cgccctggga gccaaagtcc tttcatctgt aaaggaccgg ttcatcaact tctttgtagg


caataccata aattcttctt atttcccaga tcatccattg cattcgatat cagtgagaag


gctaaaggaa acgaaagatg gttttatgtt tttgacggac cagtcctaca ttgatgtttt


acctgagttc agagattctt accccattaa gtatgtccat gcctttgaaa gcaacaattt


tatttacttc ttgacggtcc aaagggaaac tctagatgct cagacttttc acacaagaat


aatcaggttc tgttccataa actctggatt gcattcctac atggaaatgc ctctggagtg


tattctcaca gaaaagagaa aaaagagatc cacaaagaag gaagtgttta atatacttca


ggctgcgtat gtcagcaagc ctggggccca gcttgctaga caaataggag ccagcctgaa


tgatgacatt cttttcgggg tgttcgcaca aagcaagcca gattctgccg aaccaatgga


tcgatctgcc atgtgtgcat tccctatcaa atatgtcaac gacttcttca acaagatcgt


caacaaaaac aatgtgagat gtctccagca tttttacgga cccaatcatg agcactgctt


taataggaca cttctgagaa attcatcagg ctgtgaagcg cgccgtgatg aatatcgaac


agagtttacc acagctttgc agcgcgttga cttattcatg ggtcaattca gcgaagtcct


cttaacatct atatccacct tcattaaagg agacctcacc atagctaatc ttgggacatc


agagggtcgc ttcatgcagg ttgtggtttc tcgatcagga ccatcaaccc ctcatgtgaa


ttttctcctg gactcccatc cagtgtctcc agaagtgatt gtggagcata cattaaacca


aaatggctac acactggtta tcactgggaa gaagatcacg aagatcccat tgaatggctt


gggctgcaga catttccagt cctgcagtca atgcctctct gccccaccct ttgttcagtg


tggctggtgc cacgacaaat gtgtgcgatc ggaggaatgc ctgagcggga catggactca


acagatctgt ctgcctgcaa tctacaaggt tttcccaaat agtgcacccc ttgaaggagg


gacaaggctg accatatgtg gctgggactt tggatttcgg aggaataata aatttgattt


aaagaaaact agagttctcc ttggaaatga gagctgcacc ttgactttaa gtgagagcac


gatgaataca ttgaaatgca cagttggtcc tgccatgaat aagcatttca atatgtccat


aattatttca aatggccacg ggacaacaca atacagtaca ttctcctatg tggatcctgt


aataacaagt atttcgccga aatacggtcc tatggctggt ggcactttac ttactttaac


tggaaattac ctaaacagtg ggaattctag acacatttca attggtggaa aaacatgtac


tttaaaaagt gtgtcaaaca gtattcttga atgttatacc ccagcccaaa ccatttcaac


tgagtttgct gttaaattga aaattgactt agccaaccga gagacaagca tcttcagtta


ccgtgaagat cccattgtct atgaaattca tccaaccaaa tcttttatta gtggtgggag


cacaataaca ggtgttggga aaaacctgaa ttcagttagt gtcccgagaa tggtcataaa


tgtgcatgaa gcaggaagga actttacagt ggcatgtcaa catcgctcta attcagagat


aatctgttgt accactcctt ccctgcaaca gctgaatctg caactccccc tgaaaaccaa


agcctttttc atgttagatg ggatcctttc caaatacttt gatctcattt atgtacataa


tcctgtgttt aagccttttg aaaagccagt gatgatctca atgggcaatg aaaatgtact


ggaaattaag ggaaatgata ttgaccctga agcagttaaa ggtgaagtgt taaaagttgg


aaataagagc tgtgagaata tacacttaca ttctgaagcc gttttatgca cggtccccaa


tgacctgctg aaattgaaca gcgagctaaa tatagagtgg aagcaagcaa tttcttcaac


cgtccttgga aaagtaatag ttcaaccaga tcagaatttc acaggattga ttgctggtgt


tgtctcaata tcaacagcac tgttattact acttgggttt ttcctgtggc tgaaaaagag


aaagcaaatt aaagatctgg gcagtgaatt agttcgctac gatgcaagag tacacactcc


tcatttggat aggcttgtaa gtgcccgaag tgtaagccca actacagaaa tggtttcaaa


tgaatctgta gactaccgag ctacttttcc agaagatcag tttcctaatt catctcagaa


cggttcatgc cgacaagtgc agtatcctct gacagacatg tcccccatcc taactagtgg


ggactctgat atatccagtc cattactgca aaatactgtc cacattgacc tcagtgctct


aaatccagag ctggtccagg cagtgcagca tgtagtgatt gggcccagta gcctgattgt


gcatttcaat gaagtcatag gaagagggca ttttggttgt gtatatcatg ggactttgtt


ggacaatgat ggcaagaaaa ttcactgtgc tgtgaaatcc ttgaacagaa tcactgacat


aggagaagtt tcccaatttc tgaccgaggg aatcatcatg aaagatttta gtcatcccaa


tgtcctctcg ctcctgggaa tctgcctgcg aagtgaaggg tctccgctgg tggtcctacc


atacatgaaa catggagatc ttcgaaattt cattcgaaat gagactcata atccaactgt


aaaagatctt attggctttg gtcttcaagt agccaaaggc atgaaatatc ttgcaagcaa


aaagtttgtc cacagagact tggctgcaag aaactgtatg ctggatgaaa aattcacagt


caaggttgct gattttggtc ttgccagaga catgtatgat aaagaatact atagtgtaca


caacaaaaca ggtgcaaagc tgccagtgaa gtggatggct ttggaaagtc tgcaaactca


aaagtttacc accaagtcag atgtgtggtc ctttggcgtg ctcctctggg agctgatgac


aagaggagcc ccaccttatc ctgacgtaaa cacctttgat ataactgttt acttgttgca


agggagaaga ctcctacaac ccgaatactg cccagacccc ttatatgaag taatgctaaa


atgctggcac cctaaagccg aaatgcgccc atccttttct gaactggtgt cccggatatc


agcgatcttc tctactttca ttggggagca ctatgtccat gtgaacgcta cttatgtgaa


cgtaaaatgt gtcgctccgt atccttctct gttgtcatca gaagataacg ctgatgatga


ggtggacaca cgaccagcct ccttctggga gacatcatag tgctagtact atgtcaaagc


aacagtccac actttgtcca atggtttttt cactgcctga cctttaaaag gccatcgata


ttctttgctc ttgccaaaat tgcactatta taggacttgt attgttattt aaattactgg


attctaagga atttcttatc tgacagagca tcagaaccag aggcttggtc ccacaggcca


cggaccaatg gcctgcagcc gtgacaacac tcctgtcata ttggagtcca aaacttgaat


tctgggttga attttttaaa aatcaggtac cacttgattt catatgggaa attgaagcag


gaaatattga gggcttcttg atcacagaaa actcagaaga gatagtaatg ctcaggacag


gagcggcagc cccagaacag gccactcatt tagaattcta gtgtttcaaa acacttttgt


gtgttgtatg gtcaataaca tttttcatta ctgatggtgt cattcaccca ttaggtaaac


attccctttt aaatgtttgt ttgttttttg agacaggatc tcactctgtt gccagggctg


tagtgcagtg gtgtgatcat agctcactgc aacctccacc tcccaggctc aagcctcccg


aatagctggg actacaggcg cacaccacca tccccggcta atttttgtat tttttgtaga


gacggggttt tgccatgttg ccaaggctgg tttcaaactc ctggactcaa gaaatccacc


cacctcagcc tcccaaagtg ctaggattac aggcatgagc cactgcgccc agcccttata


aatttttgta tagacattcc tttggttgga agaatattta taggcaatac agtcaaagtt


tcaaaatagc atcacacaaa acatgtttat aaatgaacag gatgtaatgt acatagatga


cattaagaaa atttgtatga aataatttag tcatcatgaa atatttagtt gtcatataaa


aacccactgt ttgagaatga tgctactctg atctaatgaa tgtgaacatg tagatgtttt


gtgtgtattt ttttaaatga aaactcaaaa taagacaagt aatttgttga taaatatttt


taaagataac tcagcatgtt tgtaaagcag gatacatttt actaaaaggt tcattggttc


caatcacagc tcataggtag agcaaagaaa gggtggatgg attgaaaaga ttagcctctg


tctcggtggc aggttcccac ctcgcaagca attggaaaca aaacttttgg ggagttttat


tttgcattag ggtgtgtttt atgttaagca aaacatactt tagaaacaaa tgaaaaaggc


aattgaaaat cccagctatt tcacctagat ggaatagcca ccctgagcag aactttgtga


tgcttcattc tgtggaattt tgtgcttgct actgtatagt gcatgtggtg taggttactc


taactggttt tgtcgacgta aacatttaaa gtgttatatt ttttataaaa atgtttattt


ttaatgatat gagaaaaatt ttgttaggcc acaaaaacac tgcactgtga acattttaga


aaaggtatgt cagactggga ttaatgacag catgattttc aatgactgta aattgcgata


aggaaatgta ctgattgcca atacacccca ccctcattac atcatcagga cttgaagcca


agggttaacc cagcaagcta caaagagggt gtgtcacact gaaactcaat agttgagttt


ggctgttgtt gcaggaaaat gattataact aaaagctctc tgatagtgca gagacttacc


agaagacaca aggaattgta ctgaagagct attacaatcc aaatattgcc gtttcataaa


tgtaataagt aatactaatt cacagagtat tgtaaatggt ggatgacaaa agaaaatctg


ctctgtggaa agaaagaact gtctctacca gggtcaagag catgaacgca tcaatagaaa


gaactcgggg aaacatccca tcaacaggac tacacacttg tatatacatt cttgagaaca


ctgcaatgtg aaaatcacgt ttgctattta taaacttgtc cttagattaa tgtgtctgga


cagattgtgg gagtaagtga ttcttctaag aattagatac ttgtcactgc ctatacctgc


agctgaactg aatggtactt cgtatgttaa tagttgttct gataaatcat gcaattaaag


taaagtgatg caacatcttg taaaaaaaaa aaaaaaaaaa a

## Claims

1. A method for inhibiting osteolysis or treating osteoporosis in a subject in need thereof, the method comprising administering to the subject a composition comprising an effective amount of at least one Recepteur d'Origine Nantais (RON) inhibitor selected from the group consisting of OSI-296 and ASLAN002.

2. The method of claim 1, wherein the subject has been diagnosed with a condition selected from the group consisting of inflammation, cyst, and cancer.

3. The method of claim 2, wherein the subject has been diagnosed with cancer with bone metastasis or cancer-mediated bone destruction.

4. The method of claim 2, wherein the cancer is selected from the group consisting of lymphoma, lung cancer, pancreatic cancer, breast cancer, rectal cancer, colon cancer, stomach cancer, larynx cancer, liver cancer, brain cancer, and skin cancer.

5. The method of claim 1, wherein the osteolysis is caused by a condition selected from the group consisting of tumor, inflammation, and cyst.

6. The method of claim 5, wherein the condition comprises a bone tumor or a tumor located in bone.

7. The method of claim 1, wherein the subject is premenopausal.

8. The method of claim 1, wherein the subject is menopausal.

9. The method of claim 1, wherein the subject is postmenopausal.

10. The method of claim 1, wherein the RON inhibitor does not depend on the function of RANKL or TGFβ.