# Patent

## Title
Anti-IL-20 antibody and its use in treating IL-20 associated inflammatory diseases

## Abstract

This invention features an antibody specifically binding to human IL-20 (e.g., mAb 7E and a equivalent thereof) and its use in treating an IL-20 associated inflammatory disease, such as atherosclerosis, RA, psoriasis, psoriatic arthritis, bacteria-induced gastric ulcer, and acute renal failure.

## Background
BACKGROUND
Inflammation refers to a localized, protective response to trauma or microbial invasion to remove the injurious stimuli and initiate the healing process for the tissue. Deficiencies of inflammation render a patient vulnerable to pathogen infections. Excessive inflammation caused by abnormal recognition of host tissues as foreign, on the other hand, may lead to various inflammatory diseases, e.g., atherosclerosis and rheumatoid arthritis (RA).
Atherosclerosis is a chronic inflammatory disease in which fatty materials aggregate along the walls of arteries to form atherosclerotic plaques. It is suggested that foam cell macrophages play an important role in the progress of this disease. They secret various types of cytokines and chemokines, which direct and amplify local immune responses. Several chemokines and cytokines have been found to be expressed at elevated levels at atherosclerotic lesions, suggesting their involvement in disease development.
RA is the most common form of inflammatory arthritis characterized by intense inflammation in synovial joints, causing infiltration of mononuclear phagocytes, lymphocyts, and neutrophils into synovial membranes. Recent studies show that cytokines and chemokines, such as tumor necrosis factor α (TNFα), interleukin-1β (IL-1β), IL-6, and IL-8, are substantially involved in disease progression
IL-20 is a newly discovered member of the IL-10 family. Other members of this family have been found to be crucial in the development of many inflammatory diseases, e.g., RA. IL-20 selectively increases levels of multipotential hematopoietic progenitors. It also induces the proliferation of keratinocytes, which in turn over-express proinflammatory genes.
SUMMARY
In one aspect, this invention features an antibody specifically binding to human IL-20, i.e., mAb 7E, and its functional equivalents. Examples of a functional equivalents of mAb 7E include antibodies that have the same heavy and light chain variable regions (VH and VL) as mAb 7E, such as fragments of mAb 7E (e.g., Fab, F(ab′)2), single-chain variable fragment (scFv) of mAb 7E, and chimeric antibody made from mAb 7E. Other examples include humanized antibodies of mAb 7E.
In another aspect, this invention features a method of treating IL-20 associated inflammatory diseases by administering an effective amount of an anti-IL-20 antibody, e.g., mAb 7E or its functional equivalents. The IL-20 associated inflammatory disease includes but is not limited to atherosclerosis, rheumatoid arthritis, psoriasis, psoriatic arthritis, acute renal failure, and gastric nicer (e.g., bacteria-induced gastric ulcer). The antibody can be administered intravenously or directed to the site where inflammation occurs.
Also within the scope of this invention is a method of treating tumor, such as solid tumor, by administering an effective amount of an anti-IL-20 antibody, e.g., mAb 7E or a functional equivalent thereof, to a patient who needs the treatment.
MAb 7E and its functional equivalents also can be used in the manufacture of medicaments for treating IL-20 associated inflammation.
The details of one or more embodiments of the invention are set forth in the description below. Other features, objects, and advantages of the invention will be apparent from the description, and from the claims.


DETAILED DESCRIPTION
Within the scope of this invention are a monoclonal anti-IL-20 antibody 7E (mAb 7E) and its functional equivalents. The term “functional equivalent” refers to an antibody that (1) specifically binds to human IL-20, and (2) contains a VH region at least 70% (e.g., 80%, 90%, or 95%) identical to that of mAb 7E (SEQ ID NO:20) and a VL region at least 70% (e.g., 80%, 90%, or 95%) identical to that of mAb 7E (SEQ ID NO:21).
MAb 7E can be made according to the method described below. The amino acid sequences/cDNA sequences of its heavy and light chains are shown below.










Nucleotide sequence (SEQ ID NO:1) and amino acid sequence (SEQ ID NO:2)


of mAb 7E heavy chain




























The highlighted region refers to the variable region of mAb 7E heavy chain DNA: SEQ ID NO: 3; PRT: SEQ ID NO: 20)











Nucleotide sequence (SEQ ID NO:4) and amino acid sequence (SEQ ID NO:5)


of mAb 7E light chain




























The highlighted region refers to the variable region of mAb 7E light chain DNA: SEQ ID NO: 6; PRT: SEQ ID NO: 21)

As used herein, “percent homology” of two amino acid sequences is determined using the algorism described in Karlin and Altschul, Proc. Natl. Acad. Sci. USA 87:2264-2268, 1990, modified as described in Karlin and Altschul, Proc. Natl. Acad. Sci. USA 5873-5877, 1993. Such an algorism is incorporated into the NBLAST and XBLAST programs of Altschul et al., J. Mol. Biol. 215:403-410, 1990. BLAST nucleotide searches are performed with the NBLAST program, score=100, wordlength=12, to obtain nucleotide sequences homologous to a nucleic acid molecule of the invention. BLAST protein searches are performed with the XBLAST program, score=50, wordlength=3, to obtain amino acid sequences homologous to a reference polypeptide. To obtain gapped alignments for comparison purposes, Gapped BLAST is utilized as described in Altschul et al., Nucleic Acids Res. 25:3389-3402, 1997. When utilizing the BLAST and Gapped BLAST programs, the default parameters of the respective programs (e.g., XBLAST and NBLAST) are used. See www.ncbi.nlm.nih.gov.
A functional equivalent of mAb 7E can be its fragment generated by enzyme digestion, e.g., Fab or F(ab′)2. It also can be a single-chain antibody including the VH and VL of mAb 7E covalently fused via a linker, e.g., a peptide linker. In addition, it can be a mouse-human chimeric antibody that contains the VH and VL of mAb 7E, which are respectively linked with the constant regions of the heavy and light chains of a human IgG. Alternatively, the functional equivalent can be a humanized antibody. The term “humanized antibody” refers to a non-human antibody, in which the frame regions (FRs) of its VH and VL are replaced with FRs of a human antibody. Further, the mAb 7E functional equivalent can be generated by introducing mutations in the FRs of either VH or VL. It is well known that complementarity-determining regions (CDRs) of an antibody determine its specificity. Accordingly, mutations in FRs normally would not affect antibody specificity. The CDRs and FRs of an antibody can be determined based on the amino acid sequences of its VH and VL See www.bioinf.org.uk/abs. The binding-specificity of the functional equivalents described herein can be examined using methods known in the art, e.g., ELISA or western-blot analysis.
MAb 7E and its functional equivalents can be prepared either by purifying the antibody secreted from the hybridoma cells described above, or by genetic engineering.
This invention also features a method of treating an IL-20 associated inflammatory disease using an effective amount of anti-IL-20 antibody, e.g., mAb 7E or its functional equivalents.
The term “IL-20 associated inflammatory disease” refers to an inflammatory disease in which IL-20 plays a role in either its initiation or progression. IL-20 has been found to be involved in the development of inflammatory diseases such as atherosclerosis and rheumatoid arthritis. See Chen et al., Arteriosclerosis, Thrombosis, and Vascular Biology, 26:2090-2095, 2006; and Hsu et al., Arthritis & Rheumatism, 54(9); 2722-2733, 2006. In addition, IL-20 upregulates IL-8, a proinflammatory factor that plays important roles in many inflammatory diseases, e.g., psoriasis, septic shock, and inflammatory bowel disease. See US Patent Application 2006/0269551. IL-20 has also been found to be involved in acute renal failure and bacteria-induced gastric nicer. Thus, antibodies that inhibit IL-20 function are effective in treating IL-20 associated inflammatory diseases.
A subject suffering from an IL-20 associated inflammatory disease refers to a subject (e.g., a human patient) who has at least one symptom of the disease, e.g., redness, swelling, or pain at the site where inflammation occurs. For example, a patient suffering from atherosclerosis refers to a patient who has at least one atheromatous plaque (a symptom of atherosclerosis), which can be detected by routine medical procedures. Such a patient can exhibit insufficient blood supply to an organ due to plaque ruptures or artery stenosis. He and she can have symptoms such as chest pain if an artery to the heart is involved or leg pain when a leg artery is involved. In another example, a patient suffering from RA has inflammation in synovial joints, resulting in redness, swelling, pain, or stiffness in the joints, and infiltration of immune cells into synovial membranes. In some RA patients, chronic inflammation leads to the destruction of the cartilage, bone, and ligaments, causing deformity of the joints. Patients having severe RA can lose function of their joints.
A subject having a risk of an IL-20 associated inflammatory disease refers to a subject who bears one or more risk factors of that disease, such as genetic background, family history, and life habits (e.g., diet, or smoking). A patient who is “at risk for atherosclerosis” bears one or more risk factors for atherosclerosis, e.g., personal or family history of heart diseases, high-fat diet, smoking, obesity, high blood pressure, and a high blood cholesterol level. A patient having a risk for RA may have a smoking habit or a family history of autoimmune diseases.
The term “treating an inflammatory disease” used herein, unless otherwise indicated, means relieving the symptoms of the disease, reversing, ameliorating, or inhibiting the progress of the inflammation associated with the disease.
The term “effective amount” as used herein, refers to an amount or concentration of an agent utilized for a period of time (including acute or chronic administration and periodic or continuous administration) that is effective within the context of its administration for causing an intended effect or physiological outcome. An effective amount of an anti-IL-20 antibody for use in this invention include, for example, amounts that are effective for preventing or inhibiting an IL-20 associated inflammation in a subject, or for relieving or ameliorating the symptoms of such inflammation, e.g., redness, swelling, pain, and loss of function of an organ where inflammation occurs.
The anti-IL-20 antibody described herein can be mixed with a pharmaceutically acceptable carrier to form a pharmaceutical composition. “Acceptable” means that the carrier must be compatible with the active ingredient of the composition (and preferably, capable of stabilizing the active ingredient) and not deleterious to the subject to be treated. Suitable carriers include microcrystalline cellulose, mannitol, glucose, defatted milk powder, polyvinylpyrrolidone, and starch, or a combination thereof.
Conventional methods, known to those of ordinary skill in the art of medicine, can be used to administer the anti-IL-20-antibody-containing pharmaceutical composition to the subject, depending upon the type of inflammatory disease to be treated or the site of the inflammation associated with the disease. For treating atherosclerosis, the composition can be administered via intravenous injection. For treating rheumatoid arthritis, the antibody-containing composition can be delivered directly to synovial joints via injection. This composition can also be administered via other conventional routes, e.g., subcutaneous. In addition, it can be administered to the subject via injectable depot routes of administration such as using 1-, 3-, or 6-month depot injectable or biodegradable materials and methods.
Injectable compositions may contain various carriers such as vegetable oils, dimethylactamide, dimethylformamide, ethyl lactate, ethyl carbonate, isopropyl myristate, ethanol, and polyols (glycerol, propylene glycol, liquid polyethylene glycol, and the like). For intravenous injection, water soluble antibodies can be administered by the drip method, whereby a pharmaceutical formulation containing the antibody and a physiologically acceptable excipients is infused. Physiologically acceptable excipients may include, for example, 5% dextrose, 0.9% saline, Ringer's solution or other suitable excipients. Intramuscular preparations, e.g., a sterile formulation of a suitable soluble salt form of the antibody, can be dissolved and administered in a pharmaceutical excipient such as Water-for-Injection, 0.9% saline, or 5% glucose solution.
Without further elaboration, it is believed that the above description has adequately enabled the present invention. The following examples are, therefore, to be construed as merely illustrative, and not limitative of the remainder of the disclosure in any way whatsoever. All of the publications cited herein are hereby incorporated by reference in their entirety.
Upregulation of Both IL-20 and its Receptors in Atherosclerosis Lesions of apoE−/− Mice
C57BL/6 apoE−/− (from The Jackson Laboratory, Bar Harbor, Me.) mice were fed with a regular chow diet or an atherogenic diet containing 0.15% of cholesterol. At week 24, hearts and ascending aortas of the mice were excised, fixed in formaldehyde, and serial 10-μm-thick cryosections were cut from the aortic arch to the ventricles.
The cryosections were then fixed in 4% paraformaldehyde on a slide and immersed in antibody diluent with background-reducing components (DakoCytomation, Carpinteria, Calif.) for 60 minutes to suppress nonspecific immunoglobulin staining. The slides were soaked in 90 ml of methanol and 10 ml of 30% H2O2 for 10 minutes at room temperature to block endogenous peroxidases, washed with PBS, and then incubated with anti-hIL-20R2 rabbit-polyclonal antibody in blocking reagent at 4° C. overnight. The slides were then treated consecutively with HRP-conjugated goat anti-rabbit IgG (Biolegend, San Diego, Calif.) and incubated for 2 hours at room temperature. Slides were incubated with the diaminobenzidine DAB substrate kit (Vector Laboratories, Burlingame, Calif.) and counterstained with Mayer's hematoxylin (Thermoshandon, Pittsburgh, Pa.). Negative control, which was not incubated with primary antibody, was performed simultaneously.
To stain IL-20R1, one of the IL-20 receptors, primary antibody (R&D Systems) was diluted to 1:150 using a staining kit (Vector M.O.M. Peroxidase Kit PK-2200; Vector Laboratories) and Vectastain Elite ABC reagent (included in the M.O.M. kit) according to the manufacturer's protocol. Mouse IgG1 isotype (clone 1171 1; R&D Systems) was used as a negative control. HRP-conjugated goat anti-mouse IgG (Biolegend) was used as the secondary antibody to defect the signal of the primary antibody bound to the tissue.
To slain mouse IL-20, primary antibody (clone 176005; R&D Systems) was diluted to 1:200 and detected with biotin-labeled rat anti-mouse IgG secondary antibody and ABC reagent.
IL-20 was found to be upregulated in in the atherosclerosis plaques of apoE−/− mice compared with normal C57BL/6 mice. IL-20 was also detected in Mac-3-rich (foam cells/macrophages) area. Increased immunoreactivity was also detected for both IL-20R1 and IL-20 R2 in the atherosclerosis plaques, the endothelium, and the adventitia of the aortic arches of apoE−/− mice, compared to the wild-type mice.
These results indicate that the levels of both IL-20 and IL-20 receptors were increased in atherosclerosis plaques and were markedly upregulated in the endothelium of atherosclerotic aortas. It is likely that foam cells/macrophages are the major producer of IL-20 in the plaques.
Upregulation of Both IL-20 and its Receptors in Human Atherosclerotic Artery
The levels of IL-20 and its receptors were also examined in human atherosclerotic artery following the method described above. Briefly, surgical femoral arterial samples from atherosclerotic patients were fixed in paraffin and sliced to 10-μm-thick sections. In these sections, pronounced thickening occurred in the intima and media, both of which exhibited extensive angiogenesis.
IL-20 was detected in endothelial cells lining the microvessels and macrophage-derived foam cells that exhibited positive staining of CD68. Both IL-20R1 and IL-20R2 were detected primarily in endothelial cells of the vasa vasorum. By contrast, IL-20 was not detected in normal aorta sections and only a low level of its receptors was detected in the endothelium of normal aorta sections.
To determine whether IL-20 was induced by existing inflammatory stimuli in the atherosclerotic lesions, reverse transcription polymerase chain reactions (RT-PCRs) were performed to examine IL-20 mRNA levels in Oxidized LDL (OxLDL)-treated human peripheral monocytes.
Human native LDL was isolated from human blood plasma using discontinuous centrifugation. LDL was oxidized by exposing it to CuSO4 (5-μM free Cu2+) in PBS at 37° C. for 8 hours. OxLDL was kept in 50 mM Tris-HCl, 0.15 M NaCl, and 2 mM EDTA at pH7.4 and was used within 10 days after preparation. Human monocytes were isolated from peripheral blood samples of healthy donors and cultured in serum-free RPMI. RAW264.7, a mouse macrophage cell line, was cultured in DMEM medium with 10% FBS. Human monocytes (1×106 cells) or RAW264.7 (1×106 cells) cells were incubated with OxLDL (1, 10, or 100 μg/ml) for 6 hours. Total RNAs were purified from these cells and subjected to RT-PCR analysis to determine the mRNA levels of IL-20.
Results obtained from this experiment show that OxLDL induced IL-20 expression in human peripheral monocytes and mouse RAW264.7 macrophages.
OxLDL has been shown to promote foam cell development and other comprising endothelial functions by triggering the secretion of chemokines and increasing the expression of leukocyte adhesion molecules. See Seinberg et al., Nat Med., 8:1211-1217, 2002. Thus, the above-described results explain the co-localization of foam cells and IL-20 determined by immunohistochemical staining.
II-20 was also found to be induced under hypoxic conditions. It is known that hypoxia induces various angiogenesis factors, resulting in neovascularization in ischemic tissues.
Human peripheral monocytes were treated with CoCl2, a factor that elicits hypoxia-like responses by activating hypoxia-inducible factor-1α in vitro. See Yuan et al., J. Biol. Chem., 278:15911-15916, 2003; and Semenza et al., Annu. Rev. Cell Dev. Biol., 15:551-578, 1999. Briefly, human peripheral monocytes (1×106) were isolated and incubated with 100 μM or 500 μM of CoCl2 for 6 hours. Human umbilical vein endothelial cells (HUVECs) were incubated with serum-free M199 and treated with CoCl2 for 6 hours at the same concentration or incubated with 1% O2 and 5% CO2 for 12 hours.
Results of RT-PCR indicate that IL-20 was induced in CoCl2 treated human peripheral monocytes. CoCl2 upregulates the expression of IL-20, IL-20R1, and IL-20R2, but not IL-22R1 in human umbilical vein endothelial cells (HUVECs). Similar results were obtained in HUVECs incubated in a chamber supplied with 1% O2 to mimic a hypoxia condition for 12 hours.
Taken together, hypoxia was found to induce the expression of both IL-20 and its receptors.
IL-20 Induces Chemokines and Promotes Angiogenesis
The progression of atherosclerosis involves recruitment of T lymphocytes to atherosclerotic lesions. Three CXCR3 ligands, Mig/CXCL9, IP-10/CXCL10, and I-TAC/CXCL11, mediate this T lymphocyte recruitment process and are found to be associated with atheroma. Mach et al., J. clin. Invest., 104:1041-1050, 1999.
The effect of IL-20 on the levels of these chemokines was investigated. HUVEC cells were cultured in media containing IL-20 and the levels of these CXCR3 ligands were examined by RT-PCR. Results indicate that CXCL9 and CXC11, but not CXCL10, are upregulated by IL-20 in HUVECs and in human microvessel endothelial cells.
The effect of IL-20 on angiogenesis was also investigated. Balb/c mice were subcutaneously injected with mouse hepatoma cells, ML-1 (1×106), together with Matrigel containing mIL-20, mIL-20 and anti-mIL-20R1 antibody, or VEGF. Seven days later, tumors were excised and stained with CD31 for microvessel density analysis. Similar to VEFG, mIL-20 enhanced vascularization around the solid tumors compared to saline-treated controls. CD31 staining also showed higher microvessel density in tumors excised from mIL-20 treated mice than that in saline-treaded mice. In addition, antibody against mouse IL-20R1 inhibited mIL-20 induced angiogenesis, indicating that IL-20R1 was involved in IL-20 induced angiogenesis.
As angiogenesis is critical to the development of tumor, especially solid tumor, agents that inhibit IL-20 induced angiogenesis, e.g., anti-IL-20 antibody, can be used to treat tumor.
IL-20 Promotes Atherosclerosis in Apolipoprotein E-Deficient Mice
Full length mIL-20 cDNA was amplified by PCR, using the following primers:











Sense primer:





5′- ATGAAAGGCTTTGGTCTTGA -3′
(SEQ ID NO: 7)



 



Antisense primer:



5′- TAGCATCTCCTCCATCCATCT -3′
(SEQ ID NO: 8)






The amplified cDNA, with a hexa-histidine tag, was inserted into pcDNA3.1 to construct an mIL-20 expression vector.

Fifty micrograms of the mIL-20 expression vector was delivered to 14-week old female ApoE−/− mice by intramuscular injection at the bilateral quadriceps muscle. Immediately after injection, transcutaneous electric pulses were applied as described in Chen et al., Genes Immun., 6:493-499, 2005. The electroporation was performed on muscles of alternate tibias of each mouse once a week for 10 weeks. These mice were fed with atherogenic diet during this period of time. They were then sacrificed and their atherosclerotic lesion areas analyzed.
The serum IL-20 levels after electroporation were measured using ELISA. Results show that the IL-20 protein levels peaked at the first week after electroporation and gradually reduced in the following weeks. Administration of IL-20 led to enhanced en face lesions of aortas, aortic sinus. Numbers of Mac-3 positive macrophages were also increased at the aortic sinus. The expression of Mig and I-TAC were also increased in aortas of mice treated with mIL-20 compared to control mice. Further, proinflammatory cytokines, e.g., tumor necrosis factor-α and IL-6, were also unregulated in the aortas of mice treated with mIL-20. These results suggest that IL-20 is a proatherogenic factor and may contribute to the pathogenesis of atherosclerosis.
Upregulation of Both IL-20 and its Receptors in Synovial Fluid of RA Patients
Sixteen rheumatoid arthritis (RA) patients, 32 osteoarthritis (OA) patients, 8 gout patients, and 10 healthy volunteers were participated in this study.
All of the RA patients (10 females and 6 males, aged 34-87) showed radiographic features of uniform joint space narrowing and were rheumatoid factor positive. In addition, all of them met 4 out of the seven criteria for RA established by the American College of Rheumatology. See Arnett, et al., Arthritis Rheum., 31:315-324, 1988.
The OA patients (21 females and 11 males, aged 48-82) displayed radiographic features including non-uniform joint space narrowing, subchondral sclerosis, subchondral cysts, and osteohyte formation. The gout patients (1 female and 7 males, aged 47-83) were diagnosed based on the presence of uric acid crystal deposits in their joint fluids.
Synovial fluid samples were collected from keen joints of all of the participants using needle aspiration. Blood samples were also collected from these participants. Fresh synovial fluid, synovial tissue, and blood samples were prepared according to standard procedures. Briefly, synovial fluid was digested, with hyaluronidase and applied to a nylon-mesh column (100-mm pore size). The flow-through was collected and added to an equal volume of Histopaque, centrifuged (1,800 rpm for 30 minutes at room temperature), and the supernatant was collected. Synovial tissues were rinsed twice with phosphate buffered saline, stored overnight in 3.7% formaldehyde, and then dehydrated (in formalin, alcohol, and xylene series) and embedded in paraffin (5-mm paraffin blocks on silane-coated slides). Blood was centrifuged (2,000 rpm for 10 minutes) and sera were collected. All samples were stored at −80° C. until being used.
Enzyme-linked immunosorbent assay (ELISA) was performed to determine the IL-20 levels in synovial fluid and serum, using a human IL-20 monoclonal antibody. See Wei et al., Clin. Immunol., 117:65-72, 2005.
The IL-20 concentration in synovial fluid of the RA patients was significantly higher than that of the OA patients (p<0.0001) and gout patients (p<0.05). Median levels of IL-20 in synovial fluid from the RA, OA, and gout patients were 432.1 ng/ml (25th to 75th percentiles 25.4-1,653 ng/ml), 0 ng/ml (25th to 75th percentiles 0-8.5 ng/ml), and 0 ng/ml (25th to 75th percentiles 0-26.7 ng/ml), respectively.
IL-20 levels in sera of 12 RA patients and 10 healthy volunteers were determined following the method described above. Serum IL-20 levels of IL-20 in the RA patients were very similar to that in the healthy controls (P=0.3544). Median levels of IL-20 in serum from RA patients and healthy controls were 99.5 ng/ml (25th to 75th percentiles 96.5-102.5 ng/ml) and 98.5 ng/ml (25th to 75th percentiles 90.5-102.5 ng/ml), respectively.
These data suggest that the high level of IL-20 in the synovial fluid of RA patients is produced locally.
Expression of IL-20 and its Receptors in RA Synovial Membranes and RA Synovial Fibroblasts
Immunohistochemical staining was performed to examine the expression of IL-20 and its receptors in RA synovial membranes. Briefly, the synovial tissues were prepared as described above. The paraffin on the synovial membranes was removed using xylene, and the membranes were rehydrated using ethanol. The slides were treated with blocking agents, which can reduce background staining (DakoCttomation, Carpinteria, Calif.) and then incubated with monoclonal antibodies specific to IL-20, IL-20RI (both from R&D Systems, Minneapolis, Minn.) and IL-20RII in the blocking agents. The slides were then treated consecutively with the secondary antibody, horseradish peroxidase-conjugated goat anti-mouse IgG (Chemicon, Temecula, Calif.), and diaminobenzidine substrates (Vector, Burlingame, Calif.). After incubation, the slides were washed and counterstained with Nayer's hematoxylin (Thermo Shandon, Pittsburgh, Pa.). Mouse IgG1 isotype (clone 11711; R&D Systems) was used as a negative control.
Most of the synovial membrane cells in the intimal lining layer showed strong positive immunoreactivity, while cells in the sublining layer showed moderate positive immunoreactivity. Negative controls using mouse IgG1 isotype antibody showed no detectable immunoreactivity. These results indicate that IL-20 and its receptors IL-20RI and IL-20RII are all expressed in RA synovial membranes.
The expression of IL-20 and its receptors was also examined in RA synovial fibroblasts (RASFs). Freshly isolated synovial tissue obtained from RA patients was finely minced into 2-3 mm pieces and subjected to Dispase (Roche, Mannheim, Germany) digestion in Dulbecco's modified Eagle's medium (DEME, Gibco BRL, Grand Island, N.Y.) for 1 hour at 37° C. RASFs were cultured in DEME containing 10% fetal bovine serum. All in vitro experiments were performed using primary cultures of the RASFs between passages 5 and 12. The RASFs were cultured on sterile glass slides and then fixed in 3.7% paraformaldehyde, permeabilized using PBS with 0.1% Triton X-100. Nonspecific binding sites were blocked by incubating the RASFs in PBS with 0.1% bovine serum albumin (weight/volume). The presence of IL-20, IL-20RI and IL-20RII proteins were then detected by immunostaining as described above.
Cells isolated from RA synovial membranes (RASFs) were found to express IL-20 and its receptors. Their expression patterns are similar to those found in immunostaining of RA synovial membranes. It was also found that IL-20 induces expression of phosphorylated ERK-1⁄2 in a time-dependent manner. No significant changes of levels of phorphorylated p38, MAPK or JNK were observed in RASFs treated with IL-20.
IL-20 Induces Neutrophil Chemotaxis and RASF Migration In Vitro
Neutrophil chemotaxis was analyzed using a 48-well chamber (modified Boyden chamber) housing a polycarbonate filter with 8 μM pores (Nucleopore, Cabin John, Md.). The upper wells were loaded with 5×104 neutrophils. The lower chambers were filled with human IL-20 (200 ng/ml) or phorbol myristate acetate (PMA) (20 ng/ml), in RPMI 1640 medium containing 0.2% FBS. RPMI 1640 with 0.2% FBS was used as a negative control, and PMA as a positive control. The chambers were incubated for 1 hour at 37° C. Cells adhering to the lower side of the filter were fixed in methanol and stained in a Giemsa solution for cell counting. The number of neutrophils on the lower surface of the filter was determined microscopically by counting 12 randomly selected fields at 200× magnification.
T cell migration was analyzed following the method described above, except that a polycarbonate filter with 5-μM pores was used.
To investigate RASF migration, the upper wells were loaded with 6,500 RASFs and a polycarbonate filter with 8-mM pores were used. The lower chambers were filled with human IL-20 (200 ng/ml) or transforming growth factor β1 (TGFβ1) (50 ng/ml) as a positive control, in DMEM containing 0.2% FBS. The chambers were incubated for 4.5 hours at 37° C., The number of RASFs was determined microscopically at 100× magnification.
IL-20 induced significantly greater neutrophil chemotaxis and RASF migration than negative controls (P<0.01). It, however, did not induce T cell migration. Chemotaxis of neutrophils and RASF migration are known to be important in the pathogenesis of RA. These data thus suggest that IL-20 is involved in RA development.
Statistical comparisons of each treated group with control groups with regard to these migration data were performed with one-way analysis of variance (ANOVA), using Dunnett's procedure for multiple comparisons.
IL-20 Receptor I Prevents Collagen-Induced Arthritis
Eight-week old male Sprague-Dawley rats were immunized with an emulsion containing equal parts of Freund's complete adjuvant, 4 mg/ml of heat-killed mycobacterium tuberculosis and bovine type II collagen solubilized at 2 mg/ml in 0.05M acetic acid. Each rat was injected intradermally in its dorsum with 200 μl of the emulsion. It also received booster doses on day 7 subcutaneously in the base of its tail with 100 ml of the same emulsion.
The severity of arthritis in each hind paw was monitored and scored on a scale of 0-5, where:
0: no redness or swelling;
1: slight swelling in rat's ankle or redness in its foot;
2: progressive swelling, inflammation, and redness from the ankle to the midfoot;
3: swelling and inflammation of the entire foot, not including toes;
4: swelling and inflammation of the entire foot, including toes;
5: swelling and inflammation of the entire foot with loss of mobility.
A score≧3 represents severe swelling. The severity of arthritis in each rat was determined independently and blindly by four individual observers, and the average of their scores were calculated.
Soluble forms (extracellular domains) of rat IL-20 receptors IL-20RI and IL-20RII (sIL-20RI and sIL-20RII) were fused with a histidine tag at their 3′ end and cloned into pcDNA3.1 expression vector. The plasmind DNAs were delivered into testing rats as follows. Two hundred fifty micrograms of plasmid DNAs carrying either sIL-20RI or sIL-20RII were injected into their bilateral quadriceps muscles, and transcutaneous electric pulses were administered immediately thereafter as described above. Five pulses of 200 volts were administered at each injection site at a rate of 1 pulse/second and a duration of 75 msec for each pulse. Electrode paste was used to prevent skin burns.
Two days after the initial immunization with CII, the rats were divided On day 5 and 10 after initial injections of bovine CII, the testing rats were divided into 5 groups, each subjected to electroporation on days 5 and 10 with sIL-20RI, sIL-20RII, pcDNA 3.1, PBS, and CII. The effect of in vivo intramuscular administration of soluble IL-20 receptors on the severity of CLL induced arthritis was evaluated from day 12 to day 20. The severity of arthritis in each hind paw was evaluated visually and scored as described above. Arthritis severity scores on day 20 were significantly lowered in rats injected with sIL-20RI compared with that in rats injected with plasmid control (p<0.01). The median severity scores were 4.3 (25th to 75th percentiles 4-4.4) for the collagen control, 4.1 (25th to 75th percentiles 3.8-4.3) for the PBS control, and 3.5 (25th to 75th percentiles 3.3-4.4) for the plasmid control. The median stores for rats treated with soluble IL-20 receptors were much lower, i.e., 0.6 (25th to 75th percentiles 0-2.1) for rats treated with sIL-20RI and 3.4 (25th to 75th percentiles 1.1-4.3) for rats treated with sIL-20RII. These results demonstrate that sIL-20RI significantly reduced the severity of collagen-induced-arthritis. As soluble IL-20 receptors are known to block IL-20/IL-20 receptor signaling pathway, these data suggest that IL-20 signaling plays an important role in collagen-induced arthritis. Accordingly, agents that can inhibit this pathway, e.g., anti-IL-20 antibodies, might be effective in treating this disease.
Statistical analysis using GraphPad Prism 4.0 software was performed to all of the obtained data. The Kruska-Wallis test was used to compare synovial fluid IL-20 levels and arthritis severity scores between different groups. Post hoc comparisons were performed with Dunn's multiple comparison test. The difference between treated and control groups regarding severity swelling (defined as a severity score≧3) in hind paws of these animals was statistically significant.
Generation of Anti-IL-20 Monoclonal Antibody 7E
BALB/cJ mice were immunized subcutaneously once a week for 4 weeks with recombinant hIL-20 protein (100 μg/mouse) emulsified with an equal volume of Freund's complete/incomplete adjuvant. Three days before cell fusion, three mice were boosted with the antigen free from adjuvant by intravenous injection. Spleen cells (1.2×108) from the immunized mice were fused with X63-Ag8-6.5.3 myeloma cells (1.5×107) with PEG 4000 (Merck & Co., Inc., Whitehouse Station, N.J.). The fused cells were distributed into 24-well plates and cultured in HAT medium for 14 days. Culture supernatant was examined for antibody reacting with hIL-20 by ELISA. Limited dilution was performed to fused cells that produce antibodies reacting to hIL-20. The hybridoma cells were cultured in Dulbecco's Modified Eagle's medium (GIBCO; Invitrogen Corporation, Carlsbad, Calif.) containing 15% fetal calf serum, 1% penicillin/streptomycin, 2% L-glutamine, and 1% adjusted NaHC03 solution. The isotype of the selected antibody, IgG, was determined using isotyping ELISA. The antibody was purified from ascites using Protein-A chromatography. The hybridoma producing anti hIL-20 monoclonal antibody 7E (mAb 7E) is deposited at the American Type Culture Collection, University Boulevard, Manassas, Va. 20110-2209, U.S.A on Oct. 16, 2007 and has a deposit number PTA-8687. This antibody was found to specifically recognize human IL-20 by western-blot analysis.
Genes encoding the heavy and light chains of mAb 7E were cloned as follows. Total RNA was isolated from the hybridoma cells and then treated with calf intestinal phosphatase (CIP) to remove the 5′ phosphates. The dephosphorylated RNA was treated with tobacco acid pyrophosphatase (TAP) to remove the 5′ cap structure from intact, full-length mRNA followed by ligating to the GeneRacerTM RNA Oligo (5′-CGACUGGAGCACGAGGACACUGACAUGGACUGAAGGAGUAGAAA-3′) (SEQ ID NO:9) (GeneRacer kit, Invitrogen) at the 5′ end of the mRNA using T4 RNA ligase.
The ligated mRNA was reverse transcribed using SuperScriptTM III reverse transcriptase and the GeneRacerTM Oligo dT Primer (5′-GCTGTCAACGATACGCTACGTAACG GCATGACAGTGTTTTTTTTTTTTTTTTTTTTTTTT-3′) (SEQ ID NO:10) to generate the RACE-ready first-strand cDNA with known priming sites at the 5′ and 3′ ends. To obtain the 5′ ends of cDNA, PCR was performed on the first-strand cDNA template using sequences of constant region of antibody as a reverse gene-specific primer (For heavy chain: 5′-CTGCTGGCCGGGTGGGCAACGT-3′ (SEQ ID NO:11); for light chain: 5′-GTGAGTGGCCTCACAGGTATAGCT-3′) (SEQ ID NO:12) and the GeneRacerTM 5′ Primer (5′-CGACTGGAGCACGAGGACACTGA-3′) (SEQ ID NO:13). Only mRNA that has the GeneRacerTM RNA Oligo ligated to the 5′ end was completely reverse transcribed and amplified using PCR. Additional PCR was performed with the GeneRacerTM 5′ nested primer (5′-GGACACTGACATGGACTGAAGGAGTA-3′) (SEQ ID NO:14) and gene-specific nested primer (For heavy chain: 5′-ACCGCTGGACAGGGATCCAGAGTT-3′ (SEQ ID NO:15); for light chain: 5′-GAGGGTGCTGCTCATGCTGTAGGT-3′) (SEQ ID NO: 19) to identify specific PCR products.
To obtain 3′ ends, the first-strand cDNA was amplified using a forward gene-specific primer (For heavy chain: 5′-CATGAGGGCCTGCACAACCACCAT-3′ (SEQ ID NO:16); for light chain: 5′-CCCACCATCCAGTGAGCAGTTAACA-3′) (SEQ ID NO:17) and the GeneRacerTM 3′ Primer (5′-GCTGTCAACGATACGCTACGTAACG-3′) (SEQ ID NO:18). Only mRNA that has a polyA tail was reverse transcribed and amplified by PCR. All the PCR products were gel-purified and subcloned into pCR4-TOPO vector for sequencing. According to the nucleotide sequences obtained from 5′ and 3′ RACE, specific primers for heavy and light chains were designed to amplify the foil-length cDNA from RACE-ready cDNA template for antibody expression in mammalian cells.
Monoclonal Antibody 7E Inhibits IL-20 Induced Proliferation of Calf Pulmonary Artery Endothelial Cells (CPAEs) and Human HUVEC
mAb 7E was found to neutralize the proliferation of CPAE cells and HUVEC cells induced by IL-20.
CPAEs were plated in 24-well plates at a density of 1×104 cells per well. After 24 hours of incubation in normal growth medium, cells were exposed to various concentrations of hIL-20 for 72 hours. Cells were then incubated with a 1-mg/ml solution of 3-[4,5-Dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide (MTT) (Sigma, St. Louis, Mo.) for 4 hours. Two hundred pI of DMSO (Dimethyl Sulfoxide) (Sigma) was added to the culture. Absorbance of 550 nm was determined using an ELISA reader. The absorbance of cytokine-treated cells was expressed as a percentage of untreated control cells. Basic fibroblast growth, factor (bFGF) (Sigma) was used as the positive control in the cell proliferation assay.
Human IL-20W, a splicing variant of human IL-20, induced CPAE proliferation at a concentration of 25-1000 ng/ml. Human IL-20S, another splicing variant of human IL-20, also induced CPAE proliferation, but at a much lower concentration, i.e., 12-100 ng/ml. Interestingly, a high concentration of IL-20 (>1000 ng/ml of IL-20W and >200 ng/ml of IL-20S) inhibited CPAE proliferation.
The effect of monoclonal antibody 7E on IL-20 induced cell proliferation was examined as follows. CPAEs were seeded at a density of 1×104 cells per well in 24-well plates for 24 hours at 37° C. Before treatment, 10-folds excess of anti-hIL-20 monoclonal antibody 7E or sIL-20R1 or sIL-20R2 protein were incubated with an optimal concentration of hIL-20S (100 ng/ml) or hIL-20W (250 ng/ml) for 30 minutes at 4° C. The mixtures of IL-20 with 7E or IL-20 with sIL-20R1 or IL-20 with sIL-20R2 were added to the CPAEs and incubated for 72 hours. Cells were then incubated with 1 mg/ml MTT solution for 4 hours. Two hundred μl of DMSO was added to the culture. Absorbance of 550 nm was determined using an ELISA reader.
Similar to the soluble receptors of IL-20, Antibody 7E blocked IL-20W induced CPAE proliferation significantly. It also blocked IL-20S induced cell proliferation, but less significantly.
The effect of Antibody 7E on IL-20 induced HUVEC proliferation was also investigated following the method described above and similar results were revealed.
These results demonstrate that monoclonal antibody 7E inhibits the activity of human IL-20.
Treating Collagen-Induced Arthritis with Monoclonal Antibody 7E
Rats having collagen-induced arthritis (CIA) is a well-developed animal model for studying human rheumatoid arthritis. This model is thus employed to examine the efficacy of monoclonal antibody 7E for treating RA.
Male Sprague-Dawley rats were divided into four groups (5 rats in each, group): 1, vehicle control group, in which rats were treated with collagen II (CII) and PBS; 2, Enbrel group, in which rats were treated with CII and Enbrel [3 mg/kg subcutaneously]; 3, antibody 7E group, in which rats were treated with CII and 7E [3 mg/kg subcutaneously]; 4, healthy control group. All of the rats were first immunized with collagen II to induce CIA. The thickness of the hind paws in all rats was significantly and consistently increased from day 11 after immunization. Rats of groups 1-3 were then injected with Enbrel, 7E or PBS once every two days for four times (on days 11, 13, 15, and 17). Group 4 rats were used as healthy controls.
The severity of arthritis after drug treatment was measured and compared with the healthy controls. During the course of treatment, no significant difference in body weight was observed before and after treatment (P>0.05), indicating that 7E has no significant impact on the systemic physical condition of the rats with CIA. The effect of 7E in CIA rats was evaluated from day 11 until day 25. The swelling of each hind paw was measured in millimeters by a vernier caliper. The swelling of the hind paws was significantly suppressed after 7E or Enbrel treatment, when compared with the vehicle controls (P<0.05). The thicknesses of the hind paws on day 18 were also significantly lower in rats treated with 7E than in PBS control rats (P<0.05). The median values of hind paws thickness of vehicle controls and healthy controls were 1.05 (25th to 75th percentiles 1.0-1.11) and 0.52 (25th to 75th percentiles 0.52-0.53), respectively. Those of rats treated with 7E and Enbrel were 0.85 (25th to 75th percentiles 0.71-0.95) and 0.86 (25th to 75th percentiles 0.76-0.91), respectively. These results clearly demonstrate that monoclonal antibody 7E reduced the severity of CIA as efficiently as Enbrel, a commercial drug for treating RA and other inflammatory diseases. Thus, the IL-20 monoclonal antibody, 7E, can be used as a drug to treat rheumatoid arthritis or other inflammatory disease as Enbrel, e.g., psoriasis, psoriatic arthritis.
Other Embodiments
All of the features disclosed in this specification may be combined in any combination. Each feature disclosed in this specification may be replaced by an alternative feature serving the same, equivalent, or similar purpose. Thus, unless expressly stated otherwise, each feature disclosed is only an example of a generic series of equivalent or similar features.
From the above description, one skilled in the art can easily ascertain the essential characteristics of the present invention, and without departing from the spirit and scope thereof, can make various changes and modifications of the invention to adapt it to various usages and conditions. Thus, other embodiments are also within the scope of the following claims.

## Claims

1. A method of treating an IL-20 associated inflammatory disease, the method comprising:
identifying a patient suffering from an IL-20 associated inflammatory disease, and administering to the patient an antibody, wherein the antibody contains a VH region including all of the complementarity-determining regions in the VH region of mAb 7E and a VL region including all of the complementarity-determining regions in the VL region of mAb 7E.

2. The method of claim 1, wherein the IL-20 associated inflammatory disease is selected from the group consisting of RA, psoriasis, psoriatic arthritis, bacteria-induced gastric ulcer, and acute renal failure.

3. The method of claim 2, wherein the IL-20 associated inflammatory disease is RA.

4. The method of claim 3, wherein the antibody is administered directly to an arthritic joint.

5. The method of claim 1, wherein the antibody is mAb 7E.

6. The method of claim 1, wherein the antibody is an antibody containing the VH and VL of mAb 7E.

7. The method of claim 6, wherein the antibody is Fab, F(ab′)2, scFv, or chimeric antibody of mAb 7E.

8. The method of claim 1, wherein the antibody is a humanized antibody of mAb 7E.