A METHOD OF TREATMENT OF HUNTINGTON'S CHOREA WITH A PROTEIN EXTRACTABLE FROM MAMMALIAN ORGANS

Abstract: A method of treatment of patients affected by Huntington's chorea comprising the administration of an effective amount of a 14 kDa protein extractable from mammalian organs, particularly mammalian liver.

Description: A METHOD OF TREATMENT OF HUNTINGTON'S CHOREA WITH A PROTEIN EXTRACTABLE FROM MAMMALIAN ORGANS The present invention concerns a method of treatment of patients affected by Huntington's chorea comprising the administration of an effective amount of a 14 kDa protein extractable from mammalian organs, particularly mammalian liver. Huntington's chorea (incidence of about 6.4/100,000) is an autosomal dominant degenerative disorder characterized by paralysis and intellectual deterioration beginning in young age and rapidly causing death. As in the case of Alzheimer's disease, this pathology also shows accumulation of protein agglomerates (huntingtine) which presumably lead to neurodegeneration. Several biochemical and genetic factors seem to be involved in the pathogenesis of Huntington's chorea, which remains however to be still elucidated. The formation of huntingtine in the brain of affected patients seems to be anyhow one of the main causes of the neurodegenerative effects typical of this disease. According to a recent hypothesis, the first step in the onset of Huntington's chorea appears to be connected with an increase of toxic factors such as oxygen radicals and the cited formation of huntingtine agglomerates whereas the degenerative and progressive phase would seem to be at least partially activated and sustained by autoimmune mechanisms. No treatment for this disease is known presently. Several experimental therapies have been proposed, none of which seems however until now particularly promising. One of the major difficulties in developing an effective treatment for Huntington's chorea is due to the lack of a reliable and predictive animal model so that the only definitive evidence on the actual effectiveness of a new therapy has to be obtained from clinical tests. It has now been found that the first phases of Huntington's chorea can be treated by administering to affected patients a 14kDa protein which is normally present in mammalian liver, particularly in goat liver, and which can be prepared either by extraction or by recombinant DNA methods. Said protein, hereinafter referred to with the abbreviation of MFP 14 (derived from Multiple Function Protein 14 kDa) has been disclosed by Ceciliani et al., FEBS Lett., 1996;393;147-50. Its cytotoxic activity has been reported in Int.J. Oncol., 1996; 8:543- 48 whereas its cDNA and expression in E.coli is reported by Colombo et al. in Biochem. Biophys. Acta, 1998; 1442:49-59. The preparation of the extractive protein as well as the preparation of the recombinant protein have been respectively disclosed in US 5792744 and in PCT/EP/00 03003 which are herein incorporated by reference. Therapeutic uses of this protein in the treatment of AIDS, autoimmune disease and TNF-induced disease have been disclosed in WO 98/42366. Moreover, said protein has been found to be an inhibitor of protein synthesis, a modulator of cytokines synthesis as well as specific calpain activator. MFP 14 has some sequence similarities with Heat shock proteins or HSP, with the protein binding to the Major Histocompatibilty Complex-1 (MHC-1 binding protein) and with the YER057C/YIL051C/Y5GF family of proteins having a still unknown function, highly evolutionary conserved from prokaryotes to mammals. The invention, according to a first embodiment, provides therefore a method of treatment of Huntington's chorea comprising the administration to patients in need of such treatment of a therapeutically active dose of MFP 14 or active fragment. The invention also provides pharmaceutical compositions useful for treating Huntington's chorea containing as the active component an MFP 14 protein or active fragment. The term MFP 14 refers also to proteins having high degree of homology with the amino acid sequence disclosed in the above-cited references. By high degree of homology, proteins having at least 70% homology with the 137 amino acid sequence of the native protein are meant. Preferably, the degree of homology is higher than 80%, more preferably higher than 90%>. The term "active fragment" refers to shorter sequences derived from the native or recombinant MFP 14 protein and still retaining the pharmacological activity of the parent sequence. It is in fact known that the therapeutic activity of a given protein does not always require a complete sequence, the activity being often confined to smaller regions, e.g. to N-terminal, Carboxy-terminal or internal regions. In such an event, it may be advantageous the administration of the active fragment rather than the intact protein in view of lower production costs, higher metabolic stability and other possible advantages connected with the administration of polypeptides having lower molecular weight. The fragments and homologues of MFP 14 may also derive from deletion, substitutions and/or insertion mutation of amino acids. For instance, it is known that the so called "conservative" mutations, i.e. the substitution of an amino acid with another one of the same category (acidic, basic, neutral, hydrophilic or lipophilic), is usually acceptable for the preservation of activity. The use of recombinant MFP 14 is particularly preferred in view of the easier availability and standardization of production methods. Alternatively, an extract comprising MFP 14 such as that disclosed in WO 92/10197 may also be used. For the considered therapeutic use, MFP 14 or active fragments thereof will be administered parenterally, e.g. by intramuscular or subcutaneous route, in form of sterile solutions or suspensions in acceptable carriers such as saline solutions, oils for parenteral administration and the like. Other administration routes can also be envisaged, for instance the oral or transdermal route, using known methods for the delivery of proteins or polypeptides by these routes (e.g. by means of liposomes or micro-encapsulation methods). The administration of MFP 14 proteins could also be carried out using gene therapy protocols, for instance by administering suitable vectors, which may deliver to target cells a gene sequence coding for MFP 14. Suitable vectors as well as corresponding control sequences and protocols are disclosed in FASEB J. 9, 190-199, 1995 and in Nature 392 (suppl. 30 April) 25-30, 1998. MFP 14 dose range which was found to be effective in the treatment of Huntington's chorea is comprised from about 1 mg to 10 mg/day. The dose can be divided in more than one daily administration, for instance two or three administrations. In particular cases, the administrations can also be separated one from the other by longer period of times, up to 1-4 weeks. This can particularly apply to the chronic long- term treatment, once the first cycle of treatment has been completed. The dosage regimen can anyhow vary within wide limits, in view of the very low toxicity of MFP 14, so that the skilled physicians will easily adapt the doses according to individual patients' requirements, particularly taking into consideration the age, sex, weight of the patient and the seriousness and advancement stage of the disease. It has also been found that the administration of ubiquitin in combination with MFP 14 is advantageous in the treatment of Huntington's chorea. Ubiquitins belong to a well-known family of proteins, the use of which has been proposed for several pathologies which do not have anything in common with Huntington's chorea. For the considered therapeutic use, ubiquitins will be administered, preferably contemporaneously, together with MFP 14, at a dosage ranging from about 1 mg to 10 mg /day. According to a further embodiment, the invention provides therefore also pharmaceutical compositions comprising as the active ingredient a combination of MFP 14 and of ubiquitin, in admixture with a suitable pharmaceutical carrier. The administration of MFP 14 or of fragments thereof, optionally in combination with ubiquitin, proved to be effective in clinical trials carried out on patients affected by Huntington's chorea at different stages. In particular the treatment of the invention turned out to be effective both in the first stages as well as in the late stages of this pathology, inducing a significant recovery of the cognitive functions and the improvement of the social life in affected patients. The following examples are given to further illustrate the invention in more detail. EXAMPLE 1 Pharmaceutical composition of MFP 14 in form of vials for parenteral administration Lyophilised Recombinant MFP 14 obtained according to PCT/EP/00 03003 mg 0.5 Sterile Saline Solution ml 2 EXAMPLE 2 Pharmaceutical composition of MFP 14 and Ubiquitin in form of vials for parenteral administration Lyophilised Recombinant MFP 14 obtained according to PCT/EP/00 03003 mg 0.5 Ubiquitin mg 1 Sterile Saline Solution ml 2 EXAMPLE 3 Clinical tests Two male patients, 49 and 58 year old, respectively, affected by Huntington's chorea for more than 10 years, with dementia, behavioral disturbances and dyskinesia of all four distal extremities and buccal-facial dyskinesia, were administered with 1 mg of recombinant MFP 14 for five consecutive days followed by 2 mg daily for one month. At the end of the one-month treatment, a slight decrease in dyskinesia was observed in both patients, one of them showed also a remarkable improvement of the behavioral disturbances.

Claims: CLAIMS 1. A method of treatment of patients affected by Huntington's chorea comprising the administration to patients in need of such treatment of a therapeutically active dose of MFP 14 or active fragment thereof. 2. A method according to claim 1 wherein MFP 14 is selected from recombinant MFP 14 or MFP extracted from goat liver. 3. A method according to claim 1 further comprising the administration of Ubiquitin.

Inventors: PANERAI ALBERTO, PANERAI, ALBERTO
Applicants: PANERAI ALBERTO, RAKEPOLL HOLDING B V, PANERAI, ALBERTO, RAKEPOLL HOLDING B.V.
Application year: 2001
Main classification: A61K38
IPC codes: A61K35, A61K38, A61P25