USE OF A CARTILAGE-INDUCING FACTOR (CIF) FOR THE MANUFACTURE OF A MEDICAMENT FOR TREATING INFLAMMATION

Abstract: Inflammation, acute and/or chronic, is treated with a CIF (TGF-β). The CIF may be administered locally or systemically, depending upon the indication, and does not require coadministration of activator or cofactor for efficacy.

Description: This invention is in the field of anti-inflammatory compounds. More particularly it relates to using polypeptides called cartilage-inducing factors (CIFs) and functionally related polypeptides as factors for inhibiting inflammatory processes involving lymphohistiocytic inflammation, granulomatous inflammation, and acute inflammation. Commonly owned European Patent Application No. 85304848.6, published 22 January 1986 under No. 0169016, describes two bovine bone-derived CIFs. designated CIF-A and CIF-B. Both have molecular weights of approximately 26,000 daltons by SDS-PAGE and are dimers. They each exhibit in vitro chondrogenic activity by themselves, as measured by cartilage specific proteoglycan (PG) production in an agarose gel culture model using fetal rat mesenchymal cells. Neither, however, is chondrogenically active in vivo by itself. Amino acid sequencing of the CIF-A showed that it has a partial (30 amino acids) N-terminal sequence identical to that reported for a human placenta-derived polypeptide called beta-type transforming growth factor (TGF-β). The partial N-terminal sequence of CIF-B is different from that of TGF-β. Both CIFs exhibit activity in the TGF-β assay (ability to induce anchorage-independent growth of normal rat kidney cell colonies in soft agar). TGF-β derived from bovine kidney, human placenta, and human platelets is described in International Patent Application PCT/US83/01460, published 29 March 1984 under no. WO84/01106, and EPA 84450016.5, published 19 December 1984 under no. 0128849. These applications present data showing that such TGF-β, when combined with EGF or TGF-α, (1) promotes cell proliferation in the above mentioned soft agar culture assay and (2) promotes cell proliferation and protein deposition in a rat soft tissue wound healing model. The applications characterize the TGF-βs as being dimers having a molecular weight of approximately 26,000 daltons by SDS-PAGE. The present invention is based on the finding that the two bone-derived CIFs described above exhibit anti-inflammatory activity. Evaluations of implants containing CIF indicate that CIF is active both locally and systemically for inhibiting acute and/or chronic inflammation. Based on the similarity (or perhaps identity in the case of CIF-A) of these polypeptides to TGF-βs, it is believed that TGF-βs also have these newly discovered activities. These activities appear to be independent of the presence of activating agents or cofactors and are distinct from the in vitro chondrogenic activity and cell proliferation activity reported previously. For convenience, the term CIF is used in this section and the claims as a generic term to encompass CIF-A, CIF-B, the TGF-βs and functional equivalents thereof. Accordingly, the invention provides use of a cartilage-inducing factor (CIF) for the manufacture of a medicament for treating inflammation. Both acute and chronic forms of inflammation may be so treated. Further the treatment may be systemic or CIF may be administered locally to treat predetermined sites of inflammation. In the drawings: Figure 1 is the amino acid sequence of platelet-derived human TFG-β monomer. Figure 2 is a graph of the optical densities (absorbances) (280 nm) of the gel filtration fractions of the example 1 ( C): Figure 3 is a graph of the optical densities (280 nm) of eluate fractions from the preparative ion exchange chromatography of the example 1 ( D): and Figure 4 is a graph of the results of the T cell proliferation assays described in Example 4 ( B). As used herein the term "inflammation" is intended to encompass both acute responses (i.e., a response in which the inflammatory processes are active) and chronic responses (i.e., a response marked by slow progress and formation of new connective tissue). Chronic and acute inflammation may be distinguished by the cell types involved. Acute inflammation often involves polymorphonuclear neutrophils: whereas chronic inflammation is normally characterized by a lymphohistiocytic and/or granulomatous response. Examples of specific types of inflammation are diffuse inflammation, focal inflammation, croupous inflammation, interstitial inflammation, obliterative inflammation, parenchymatous inflammation, reactive inflammation, specific inflammation, toxic inflammation, and traumatic inflammation. As used herein the term "treat" is intended to mean prophylaxis or attenuation of an existing condition. Accordingly, in the case of inflammation, the invention method may be used to manufacture a medicament to prevent inflammation or alleviate existing inflammation. The term "functional equivalent" as used to describe a polypeptide is intended to mean polypeptides, whether native or synthetic and regardless of species or derivation, that have the same amino acid sequence as the referenced polypeptide, and polypeptides of substantially homologous (i.e., et least 90% identity in amino acid sequence) but different amino acid sequence, which difference(s) does not affect anti-inflammatory activity adversely. CIF-A, CIF-B and TGF-βs exhibit activity in the TGF-β assay described in Methods for Preparation of Media, Supplements, and Substrate for Serum-Free Animal Cell Culture (1984) pp 181-194, Alan R. Liss, Inc. That assay determines ability to induce anchorage-independent growth in non-neoplastic normal rat kidney (NRK) fibroblasts by measuring the formation of cell colonies in soft agar. Procedures for obtaining TGF-βs from platelets, placenta and kidney tissues are described in International patent publication WO84/01106 and EPA publication no 0128849. Briefly, they involve extracting the source material with acid-ethanol, sizing the extract by gel filtration, and isolating the TGF-β from the filtrate by high performance liquid chromatography (HPLC). A procedure for isolating CIFs from bovine bone is described in European Patent Application No. 85304848.6. It involves extracting demineralized bone (DMB) with an extractant (e.g., ≧4M guanidine hydrochloride, 8M urea) that solubilizes nonfibrous proteins, gel filtering the extract to obtain a < 30 Kd fraction, chromatographing the fraction on carboxymethyl cellulose (CMC) at pH 4.5-5.5, preferably 4.8, eluting the CMC-adsorbed fraction with an NaCl gradient, and purifying the proteins from the portion eluting at about 150-250 mM NaCl by RP-HPLC or gel electrophoresis. CIF-A, CIF-B, and the TGF-βs isolated to date from natural sources are polypeptide dimers of approximately 25 to 26 Kd molecular weight as determined by SDS-PAGE. Nature (1985) 316 :701-705 reports a cDNA nucleotide sequence and deduced amino acid sequence for platelet-derived human TGF-β. Mature platelet-derived human TGF-β is characterized as a homodimer of a 112 amino acid-long monomer. Platelet/placenta/kidney-derived TGF-β and CIF-A and CIF-B are non-species specific as regards TGF-β activity. It is believed, therefore, that these polypeptides have been highly conserved among animal species (i.e., a given polypeptide from different mammalian species has an amino acid sequence that varies, if at all, in one or more amino acid residue additives, deletions, or substitutions that do not affect the non-species specific activity of the molecule adversely) and have cross-species functionality. Accordingly, CIF-A, CIF-B, and the TGF-βs may be derived from cells or tissue of diverse animal origin or may be obtained by recombinant DNA technology. Correlatively, CIF (TGF-β) from one vertebrate species may be used to treat another vertebrate species. The most common usage of CIF (TGF-β) as an anti-inflammatory agent will be in the treatment of humans, domestic animals such as cattle, sheep, and pigs, and sport or pet animals such as dogs, cats, and horses. CIF-A and CIF-B are preferred for use in the invention method. Examples The following examples are intended to illustrate specific embodiments of the invention. They are not intended to limit the invention in any manner. 1. Preparation of CIFs from Bone A. Preparation of Demineralized Bond Bovine metatarsal bone was obtained fresh from the slaughterhouse and transported on dry ice. The bones were cleaned of marrow and non-bone tissues, broken in fragments smaller than 1 cm diameter, and pulverized in a mill at 4°C. The pulverized bone was washed twice with 9.4 liters of double distilled water per kg of bone for about 15 min each, and then washed overnight in 0.01 N HCl at 4°C. Washed bone was defatted using 3 X 3 volumes ethanol, followed by 3 X 3 volumes diethylether, each washed for 20 min. and all at room temperature. The resulting defatted bone powder was then demineralized in 0.5 N HCl (25 l/kg defatted bone) at 4°C. The acid was decanted and the resulting DMB washed until the wash pH was greater than 4, and the DMB dried on a suction filter. B. Extraction of Noncollagenous Proteins The DMB as prepared in A was extracted with 3.3 l of 4 M guanidine-HCl, 10 mM ethylenediaminetetraacetic acid (EDTA), pH 6.8, 1 mM PMSF, 10 mM NEM per kg for 16 hr, the suspension suction filtered and the non-soluble material extracted again for 4 hr. The soluble fractions were combined and concentrated at least 5-fold by ultrafiltration using an Amicon ultrafiltration (10K) unit, and the concentrate dialyzed against 6 changes of 35 volumes cold deionized water over a period of 4 days, and then lyophilized. All of the procedures of this paragraph were conducted at 4°C except the lyophilization which was conducted under standard lyophilization conditions. C. Gel Filtration The extract from B, redissolved in 4 M guanidine-HCl, was fractionated on a Sephacryl S-200 column equilibrated in 4 M guanidine-HCl, 0.02% sodium azide, 10 mM EDTA, pH 6.8. Fractions were assayed by their absorbance at 280 nm and the fractions were combined as shown in Figure 2. Fraction F2 of Figure 2, constituting a low molecular weight (LMW, 10,000-30,000 daltons) protein fraction was dialyzed against 6 changes of 180 volumes of deionized water and lyophilized. All operations except lyophilization and dialysis (4°C) were conducted at room temperature. D. Ion Exchange Chromatography Fraction F2 from C was dissolved in 6 M urea 10 mM NaCl, 1 mM NEM, 50 mM sodium acetate, pH 4.8 and centrifuged at 10,000 rpm for 5 min. The supernatant was fractionated on a CM52 (a commercially available CMC) column equilibrated in the same buffer. Bound proteins were eluted from the column using a 10 mM to 400 mM NaCl gradient in the same buffer, and a total volume of 350 ml at a flow rate of 27 ml/hr. Three major fractions, designated CM-1, CM-2 and CM-3, were collected as shown in Figure 3. CM-2 and CM-3 eluted at approximately 150-250 mM NaCl. Each fraction was dialyzed against 6 changes of 110 volumes of deionized water for 4 days and lyophilized. All of the foregoing operations were conducted at room temperature except dialysis (4°C). E. RP-HPLC The combined lyophilized fractions CM-2 and CM-3 from D were each dissolved in 0.1% trifluoroacetic acid (TFA) and aliquots of the solutions loaded onto a Vydac C18 RP-HPLC columns (4.6 mm ID X 25 cm) and washed with 0.1% TFA for 5 min at 1 ml/min. The eluting solvent was a 0%-60% acetonitrile gradient in 0.1% TFA at a rate of 2%/min. Two peaks were obtained from the RP-HPLC of combined CM-2 and CM-3--peak A at about 29.5 min and peak B at about 31.2 min. The proteins of these peaks are the subject of said U.S. patent application serial no. 630,938. They are designated CIF-A and CIF-B, respectively. The proteins were stored in 0.1% TFA/acetonitrile eluting solution at -20°C until used. F. Characterization of CIF-A and CIF-B Table 1 below gives the partial amino acid compositions of CIF-A and CIF-B. Amino Acid Amt (mols/100 mols recovered) CIF-A CIF-B Asp 9.2 12.0 Glu 9.2 8.5 Ser 7.0 10.6 His 2.7 0.9 Gly 16.5 22.0 Thr 2.7 0.0 Arg 5.9 4.3 Ala 6.6 6.7 Tyr 3.2 1.9 Met 0.0 0.0 Val 7.5 2.4 Phe 3.0 3.0 Ile 3.9 2.2 Leu 8.6 8.2 Lys 13.9 17.3 Pro ND ND Cys ND ND Trp ND ND SDS-PAGE analysis of CIF-A and CIF-B indicate that both have a molecular weight of approximately 26,000 daltons. Both proteins exhibited activity in the TGF-β assay referred to above comparable to that reported for TGF-βs derived from human platelets, human placenta, or bovine kidney. N-terminal amino acid sequencing of the first 30 amino acids of CIF-A and CIF-B was carried out and found to be as follows: The N-terminal amino acid sequence of CIF-A is identical to that reported for platelet-derived human TGF-β (see Nature , infra). 2. Anti-Inflammatory Activity of CIFs A. Formulation of CIF-A/CIF-B-Containing Implants A collagenous carrier was prepared by mixing collagen in solution (CIS, 1-3mg protein/ml: sold by Collagen Corporation under the trademark VITROGEN 100®) with bone collagen powder (BCP, lyophilized solids from bone collagen) to give a minimal final concentration of 10% collagen from CIS. A 2:1 weight ratio mixture of CIF-A and CIF-B (in 0.1% TFA) was added to carrier in weight ratios of 1:1200, 1:4500, 1:6000. 1:8000, and 1:20000. The formulations were stirred for 1-2 hr at 4°C and either directly lyophilized or dialyzed against water and lyophilized. Carrier alone was used as a comparative control. B. Histological Evaluation of Implant Formulations of A 1. Implantation The lyophilized formulations were rehydrated with two parts by weight of cold sterile water and mixed to form a homogeneous paste. The rehydrated material was formed into compact pellets (80-100 mg wet weight). The pellets were implanted subcutaneously in the ventral thoracic region of young male rats. Each rat received bilateral implants. The explants were recovered at 3, 10, and 14 days post implantation and evaluated histologically. 2. Histological Evaluation Explants were fixed in 10% neutral formalin and paraffin embedded by routine methods. Sections were subsequently stained with either hematoxylin-eosin or with Gomori trichome. 3. Results The results of the histological evaluations are summarized below. 3-Days Post Implantation 1. Carrier alone At three days post implantation, the implant was, for the most part, acellular. Sparse neutrophils were the most apparent cell type. 2. CIF-Carrier The implant was also relatively acellular at three days. However, there was an apparent activation of fibroblasts from adjacent muscle and the surrounding subcutaneous tissues. These fibroblasts contained abundant cytoplasm and were, for the most part, euchromatic suggesting the cells were highly activated. Fibroblast infiltration was beginning at the margins of the implant. 10-Days Post Implantation 1. Carrier alone The inflammatory profile was markedly changed by 10 days following implantation. The implant contained a diffuse mixed inflammatory cell infiltrate dominated by lymphocytes and histiocytes. Focal areas of granulocytes (neutrophils and eosinophils) and giant cells were evident around some of the bone collagen particles. 2. CIF-Carrier There were few inflammatory cells associated with the implant at this time point. Numerous hyperplastic fibroblasts were present throughout the implant. A collagenous connective tissue matrix was evident around and surrounding the bone collagen powder particles. 14-Days Post Implantation 1. Carrier alone By 14-days post implantation, most bone collagen particles were sequestered by granulomas consisting of lymphocytes, histiocytes and giant cells. Implant-associated fibrosis was evident as well as multifocal areas of eosinophils. 2. CIF-Carrier Implant-associated inflammation was negligible compared with the control implants. A dense collagenous connective tissue matrix was evident throughout the implant. Morphologically, the fibroblasts appeared to be metabolically less active than at earlier time points. These histological observations demonstrate that CIF inhibits inflammatory cell function in vivo . The lack of polymorphonuclear neutrophils, lymphocytes, and histiocytes at the CIF-containing implant sites suggests that CIF may function as a potent anti-inflammatory agent. In the implants having CIF to carrier weight ratios of 1:8000 and 1:20000 there was a marked reduction in implant-associated inflammation compared with carrier alone implants. The implants containing higher CIF to carrier weight ratios developed a dense collagenous connective tissue matrix throughout the implant. At all CIF levels, implant-associated inflammation was negligible compared to no CIF. In similar in vivo studies in which the rats received bilateral implants with and without CIF-containing extracts, it was noted that inflammation was reduced or absent in the implant remote from the CIF-containing implant. These observations indicate that CIF acts systemically as well as locally. When used as a local anti-inflammatory agent the CIF (and/or TGF-β) will usually be formulated in effective amounts with pharmaceutically acceptable carriers in weight ratios to carrier in the range of 1:1000 to 1:20000. If tissue deposition at the site is not desired, the level of CIF to carrier may be lowered to below that (e.g., at weight ratios below about 1:6000 in the case of collagen carrier) which promotes tissue deposition. In addition to being formulated as an injectable, the CIF may be incorporated (dispersed) into solid permeable implants such as collagenous soft and hard tissue implants, prostheses, sponges, wound dressings and sutures to modulate local inflammatory responses to such solid bodies. Since such implants are made from permeable materials the CIF can diffuse from the implant and exert its anti-inflammatory properties. If it is desired to minimize other activities of CIF (cell proliferation, tissue deposition) the CIF will be incorporated free of activating agents or cofactor, preferably at levels below that which promote tissue deposition. When used to treat inflammation at internal body sites locally, the CIF- or TGF-β-containing formulation is injected, inhaled, placed surgically, or otherwise administered locally, depending on the particular formulation, and the site where inflammation control is desired. For systemic administration CIF may be formulated with conventional carriers used with water-soluble proteins for injection into circulation. Alternatively, it may be formulated as a sustained release implant formulation if the indication being treated requires. The amount of CIF (TGF-β) administered to treat inflammation will depend upon the patient, the inflammatory condition being treated, and the mode of administration. In general, the amounts administered to adult humans will be in the range of about 0.1 to 1000 µg. When CIF is administered locally, amounts in the lower portion of this range will normally be used, typically 0.1 to 10 µg. Correspondingly, systemic administration will typically involve amounts in the 10-1000 µg range. CIF may be particularly effective in the treatment of inflammation involving the respiratory system. In this application, the CIFs may be administered by inhalation with a suitable aerosol. In this form, these factors would be useful for the treatment of diffuse interstitial diseases of the lung such as asbestosis, silicosis, or coal-miner's pneumoconiosis; the treatment of immunological diseases that involve the respiratory tract such as rheumatoid arthritis, lupus erythematosus, or Goodpasture's syndrome; and the treatment of granulomatous inflammation of the lungs and pulmonary tract such as Wegener's granulomatosus and eosinophilic granulomatosus. These anti-inflammatory peptides may be combined with carriers in the form of a salve, ointment, or other topical formulation and thereby by useful in the control of dermal inflammation by topical application. Such formulations would be particularly useful in the local treatment of psoriasis vulgaris, contact dermatitis, dermal ulcers, and acute or chronic eczematous dermatitis. CIF may be either used alone or combined with a slow release carrier and injected into or around joints, bone, or muscle for the control of inflammation associated with various diseases. Some examples include myositis (viral, bacterial, parasitic, fungal or autoimmune processes): myasthenia gravis: osteomyelitis: osteoarthritis and rheumatoid arthritis. Since the CIF molecules have been shown to be stable at low pH and resistent to enzyme digestion, these factors may be delivered systemically by ingestion. These properties make these factors particularly useful for controlling inflammation in the gastrointestinal tract. This would be particularly useful for the treatment of gastric and duodenal ulcers, granulomatous gastritis, esophagitis (numerous causes): enteristis (numerous causes): and colitis (numerous causes). 3. In Vivo Tests Using CIF in Rodent Arthritis Model Experimental collagen-induced arthritis (ECIA) can be induced in rats by intradermal injection of native type II collagen (bovine or rat) emulsified in incomplete Freund's adjuvant. The inbred Lewis rat strain, LEW (RTl¹), has been shown to develop peripheral polyarthritis within 14 to 30 days following immunization. Joint and ear cartilage develop a diffuse mononuclear cell infiltrate. Sensitized rats respond to intradermal skin test challenge and develop circulating antibodies to native type II collagen. Twelve LEW rats (12-15 weeks old) are divided into three groups of four animals each. Groups I and II are sensitized to type II bovine collagen by intradermal injection of bovine type II in complete Freund's adjuvant at 2.5 ml/kg weight. Group III serves as a nonsensitized control. Ankle measurements and subjective grading (0 to +4) of arthritis based on the degree of inflammation and swelling of digits, feet and ankles are made prior to sensitization and regularly throughout the test. Rats in Group I exhibiting a significant inflammatory response are treated by injection of CIF (500 ng in 0.05 ml sterile PBS) directly into the joint on days 1, 3, 5, and 7 following the observed response. Rats of Group II showing such a response are treated similarly by injection of PBS without CIF. Sera are collected from the rats pre-treatment and post-treatment and assayed for antibodies to type II collagen using an ELISA. The rats are given an intradermal skin test challenge at 3 days prior to sacrifice using 50 µg of type II collagen in the abdomen. Erythema and induration are measured at 24, 48, and 72 hr post challenge. At 72 hr the challenge site is biopsied and examined histologically. Rats are sacrificed 5 to 7 days after the final injection, exsanguinated, and their paws fixed in 10% neutral formalin for histologic examination. The results of these tests show that treatment with CIF reduces inflammation significantly compared to the nontreated control group. The CIF-treated groups exhibit a reduced response to a skin test challenge of type II collagen when compared with the nontreated control group. Further, the treated group has significantly reduced antibody titers to type II collagen. These results suggest that administration of CIF into the affected joints not only controls the inflammation locally, but acts as a systemic immuno-suppressive agent for the treatment of arthritis.

Claims: Use of a cartilage-inducing factor (CIF) of molecular weight of about 26,000 for the manufacture of a medicament for treating inflammation. Use of a CIF as in claim 1, wherein the CIF is a homodimer whose chains each have (a) the following partial N-terminal amino acid Sequence: Ala-Leu-Asp-Thr-Asn-Tyr-Cys-Phe-Ser-Ser-Thr-Glu-Lys-Asn-Cys-Cys-Val-Arg-Gln-Leu-Tyr-Ile-Asp-Phe-Arg-Lys-Asp-Leu-Gly-Trp-; or (b) the following partial N-terminal amino acid sequence: Ala-Leu-Asp-Ala-Ala-Tyr-Cys-Phe-Arg-Asn-Val-Glu-Asp-Asn-Cys-Cys-Leu-Arg-Pro-Leu-Tyr-Ile-Asp-Phe-Lys-Arg-Asp-Leu-Gly-Trp. Use of a CIF as in claim 1, wherein the CIF is a homodimer whose chains each have the amino acid sequence shown in Figure 1. Use of a CIF as in claim 1, wherein the CIF is substantially free of activating agent or co-factor. Use of a CIF as in any one of the preceding claims, wherein the CIF is applied systemically. Use of a CIF as in any one of claims 1-4, wherein the CIF is applied locally. Use of a CIF as in claim 6, wherein the CIF is applied as an implant in combination with a pharmaceutically acceptable carrier. Use of a CIF as in claim 7, wherein the carrier is a collagenous carrier.

Inventors: ARMSTRONG, ROSA, BENTZ, HANNE, ELLINGSWORTH, LARRY
Applicants: CELTRIX PHARMACEUTICALS, INC.
Application year: 1986
Main classification: A61K37
IPC codes: A61K35, C07K14, A61K38, A61P29, A61P7, A61P37