Abstract:
A composition and method comprising an anti-adjuvant such as DOI (an anti-inflammatory) together with any gene therapy plasmid is disclosed. A method for GHRH production in-vivo using a set of compositions and methods for use of those compositions is provided.

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
       [0001]    This application is related to a U.S. patent application filed on an even date herewith: “Treatment of Infection Using Single Chain Antibody Gene Therapy”, filed as a U.S. Nonprovisional Patent Application (Attorney docket 244.13). 
     
    
     REFERENCE TO SEQUENCE LISTING, COMPUTER PROGRAM, OR COMPACT DISK 
       [0002]    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 Sep. 16, 2011, is named “Sequence listing.txt” and is 53,705 bytes in size. 
       FIELD OF THE INVENTION 
       [0003]    The present invention relates to DNA constructs for in-vivo production of growth hormone releasing hormone (GHRH), and to methods for minimizing activation of the immune system by any DNA constructs introduced into mammalian tissues where the constructs are brought by normal biological mechanisms into the nucleus of cells. A preferred method of introduction of DNA constructs uses plasmids. 
       GENERAL BACKGROUND AND OBJECTS OF THE INVENTION 
       [0004]    A number of publications exist for various forms of GHRH-coding DNA plasmid constructs including patents for a product currently marketed for veterinary use in Australia under the name Lifetide® by VGX PHARMACEUTICALS, LLC out of Blue Bell, Pa., a company acquired by Inovio Pharmaceuticals of Blue Bell, Pa. 
         [0005]    There are two major conventional methods of gene therapy, the first, generally better known method, is to use viral capsids to encapsulate a DNA sequence of interest for introduction into animal tissue. Such viral capsids are generally termed viral vectors, and a variety of vectors have been used including HIV and adenoviruses. Such viral vectors are generally constructed so that they should not reproduce in-vivo, and usually contain a reverse transcriptase that results in splicing of the viral vector borne DNA into the host animal&#39;s genome. 
         [0006]    The viral vector method has multiple drawbacks, not least of which is that it has caused patient death and serious illness, both short term (e.g. idiopathic apparent immune system storm) and long term (e.g. cancer), despite the relative rarity of this type of gene therapy&#39;s use. One patient has also died due to the gene of interest resulting in sufficient immune system suppression that a probably quiescent infection to bloom. Thus, while gene therapy had been perceived as having much promise, there are issues, most of which have little to do with the genes of interest that are introduced. 
         [0007]    By contrast, the second major conventional method of gene therapy, DNA gene therapy, uses the much simpler method of injection of DNA into the patient. This introduces considerably less packaging material into the host, and DNA constructs are generally smaller. DNA is not incorporated into the host genome, but is instead maintained separately in circlets either inside the nucleus or at the nuclear wall inside the cell. These circlets may become associated with histones within the nucleus. However, DNA gene therapy has few inherent problems. DNA gene therapy does suffer from difficulty producing enough of the gene product. It also may have a small percentage of subjects who are stimulated to produce an immune response to the protein product of the gene of interest. This effect is due to the self-adjuvant effect of plasmids, which contain gene sequence motifs which are recognized by animal immune systems as having a non-self origin. These motifs contain cytosine followed by guanine in the 5′ to 3′ direction, also called CpG sequences (Brazalot-Millan et al, 1998). 
         [0008]    Because GHRH has a half-life after injection of roughly 8 minutes, it has not been practical to supplement using conventional methods. However, GHRH is a peptide hormone, which makes DNA gene therapy a viable alternative for supplementation. In addition, GHRH is a hormone that is required in very small amounts. These three factors together make it an appropriate choice to consider for DNA gene therapy. 
         [0009]    Thus, there is a need to improve GHRH gene constructs. The present invention minimizes immune system activation by anti-adjuvant codon optimization to eliminate CpG sequences to prevent binding to bacterial DNA intracellular receptors. 
         [0010]    In addition, methods and compositions are provided that further minimize the activation of the immune system by any DNA construct delivered in-vivo using co-delivered compounds (Yu et al, 2008). 
         [0011]    The Applicant further provides compositions for improved regulation and expression of the plasmids by means of AT rich regions that are in the range of 20 base pairs to 1000 base pairs long placed 5′ and 3′ to the gene expression cassette. 
         [0012]    There are further compositions to improve secretion of the produced protein by providing a leader sequence on the gene which codes for a peptide that signals the cell to transport the gene product to the cell membrane for export. (Zou, 2006) 
         [0013]    And finally, there is postproduction modification of plasmids to excise the bacterial components so as to yield a smaller circlet of DNA bearing the expression cassette only. This allows use of higher yield bacterial origins of replication containing large CpG sequences so as to get higher concentration of plasmid in production, while preventing the shutdown of plasmid gene expression that is associated with DNA bearing bacterial sequences. 
         [0014]    It is therefore a primary object of the invention to improve suitability of GHRH constructs for human therapeutic use. 
         [0015]    It is a further object of the invention to provide methods for minimizing immunogenicity of DNA constructs delivered into cells. 
         [0016]    It is a further object of the invention to provide methods for maximizing ongoing expression of DNA constructs delivered into cells. 
         [0017]    Other objects and advantages of the present invention will become apparent to the reader and it is intended that these objects and advantages are within the scope of the present invention. 
         [0018]    As a practical matter, when expanding cultures of bacteria to reproduce usable quantities of plasmids for gene therapy, minor mutations occur, most of which are of no significance. In this invention, such mutations are only significant when they result in changes that create antigenic responses not created by the designed plasmid or else functional modification of the peptide sequence for the GHRH gene. 
       SUMMARY OF THE INVENTION 
       [0019]    This present invention provides a set of constructs for delivering DNA coding for GHRH into cells. These constructs are completely or mostly free of what are termed CpG sequences as well as larger bacterial DNA motifs that have been identified as having adjuvant activity to minimize immune activation. A CpG sequence is a 5′ to 3′ cytosine linked by a deoxyribose sugar phosphate to a guanine in a nucleotide sequence. 
         [0020]    The present invention also uses an anti-inflammatory as an anti-adjuvant that may be either delivered together with the DNA or else separately as an oral or injected treatment. The primary anti-adjuvant compound, hereinafter referred to as DOI, is 2,5-dimethoxy-4-iodoamphetamine, also (1-(2,5-dimethoxy-4-iodophenyl)-2-aminopropane) and congeners. DOI is currently the strongest anti-inflammatory with published data, a therapeutic dosage level being generally in a range from approximately 1 to 3 micrograms per kilogram. Other anti-inflammatory compounds may also be used. An advantage of DOI is that it is long acting, with a rough half-life of 12-15 hours, giving it a therapeutic effect for 30 hours or more. For co-injection, powerful, long acting agents that counter cytokines and chemokines which signal the immune system are optimum for use as anti-adjuvants because the stronger they are the less material needs to be injected. 
         [0021]    The provision of DOI or some other anti-adjuvant agent may be enhanced by delivery of the material impregnated into microbeads that are present in the mixture when it is injected. These microbeads are preferably in a range of size within several microns of 2 micrometers in diameter since this roughly 2 micron size is optimal for uptake by animal cell membranes. Microbeads of other suitable sizes may be used as well. Microbeads may be made from various materials, including polyethylene glycol (PEG) and poly-lactide-co-glycolide (PLG) (Vila et al, 2002; Tracy et al, 1999). This provides a time release of the agent intracellularly where it is most needed and extends the amount of time the agent is active. Such microbeads, themselves, have a degree of adjuvant effect, so the inclusion of DOI or other anti-adjuvant counteracts the adjuvant effect of the beads while allowing certain advantages of bead-based delivery to be retained. Thus, provision of an anti-adjuvant in microbeads is a significant improvement on the art. 
         [0022]    In addition, microbeads may optionally have a non-antigenic fluorophore or a radioactive material such as gallium radioisotope impregnated into them in order to track the location in the body where the beads are taken up. Finally, DNA plasmids may optionally be adsorbed onto the surface of beads or impregnated into the beads to enhance uptake by animal cells. 
         [0023]    Most of the constructs contain a promoter specific to the intended target, which are muscle cells. Muscle cells are targeted because they have relatively high metabolism and higher rates of protein synthesis. The promoters used in these constructs are myosin promoters, however, any promoter that expresses with specificity in muscle cells could be used. The purpose of this feature of the constructs is to minimize or eliminate expression of the gene product in cells which are not the intended target. Non-specific promoters such as variants on the cytomegalovirus (CMV) promoter produce proteins of interest when they are taken up by antigen-presenting cells (APCs). Such APCs can then present to the immune system the peptides originating from the gene of interest in the construct, which can lead to the unwanted result of an immune system response against the gene product. The invention disclosed herein has as one of its foundations immune system optimization, which means in this context, that the sequence is optimized so that it minimizes stimulation of the immune system. 
         [0024]    The constructs of this invention comprise one or more AT rich regions that are 5′ or 3′ to the expression cassette. These AT rich regions help to improve the expression in animal cells of the gene carried by the plasmid. These AT rich regions avoid start codons in order to prevent the presence of an open reading frame (ORF). Certain sequences of AT rich regions were also developed on the basis of literature showing efficacy, but redesigned to conform with the immune system optimization of the present invention. 
         [0025]    In some cases it may be desirable to remove the sections of the plasmid which are required for reproduction of the plasmid in bacterial cells. This generally requires cutting the plasmid with a set of endonucleases and ligating the resulting circlets. This removal could also be accomplished by use of topoisomerase methods. 
         [0026]    The advantages of the Applicant&#39;s system are that the system (1) removes all or most immune system triggers from the DNA construct itself, (2) suppresses immune system responses locally and systemically, (3) minimizes or eliminates presentation of the gene of interest to the immune system, (4) stabilizes long-term expression of the plasmid in-vivo, (5) for maximizing production of plasmid in bacteria and removal of the antigenic bacterial sequences prior to injection, and (6) provides the gene product, GHRH. 
         [0027]    A first and preferred embodiment of the Applicant&#39;s invention is a DNA plasmid construct containing a bacterial plasmid without CpG sequences (for the purpose of immune system optimization) comprising a promoter, an antibiotic resistance gene, a tissue specific promoter, a secretion signal peptide, a peptide sequence GHRH gene, a poly-A gene terminator, and one or more flanking AT rich regions between the bacterial section and the mammalian expression section of the plasmid, as shown in  FIG. 2 . This construct is delivered into muscle cells together with DOI at a dose generally above 0.5 micrograms per kilogram, dissolved into water and salts medium. 
         [0028]    Other embodiments of the Applicant&#39;s invention are possible and are discussed below. One embodiment which is of special interest is the alternate embodiment shown in  FIGS. 1   a  and  1   b . These figures show how the invention could be grown within any generic plasmid in any suitable bacteria (e.g. yeast) and post processed after purification to separate the therapeutic segment of the invention. 
         [0029]    A similar strategy to that shown in  FIGS. 1   a  and  1   b  removes only the bacterial origin of replication from the plasmid, instead of all elements pertaining to the bacteria. This is useful because the shorter segment can be more amenable to removal by topoisomerase, and generally it is the bacterial origin of replication that has the greatest impact on copy number. 
         [0030]    This invention provides, for the first time, a system that minimizes host immune response while providing persistent high activity for delivered GHRH gene therapy and hence makes gene therapy for GHRH in humans a practical matter. It also provides, for the first time, a practical system for minimizing host immunity with any DNA construct delivered into cells by making use of an anti-adjuvant compound. 
         [0031]    In vaccines, the study of adjuvants, which are materials that enhance immune system response, is a field which has yielded benefits. This application breaks ground with the invention of anti-adjuvants as a class of compounds. An anti-adjuvant is a material or method that interferes with host immunity occurring in response to an injection. 
     
    
     
       BRIEF DESCRIPTION OF THE FIGURES 
         [0032]    The foregoing aspects and many of the attendant advantages of the invention will become more readily appreciated as the same becomes better understood by reference to the following detailed description, when taken in conjunction with the accompanying drawings, wherein: 
           [0033]      FIG. 1   a  is a diagram of generic plasmid containing the most basic features of the invention; 
           [0034]      FIG. 1   b  is a diagram of a post-processed minimum therapeutic circlet; and 
           [0035]      FIG. 2  is a diagram of the invention wherein additional optional components are shown. 
       
    
    
     DETAILED DESCRIPTION OF THE INVENTION 
       [0036]    The Applicant discloses several embodiments and provides guidance for aspects of the method to be applied to other situations. 
         [0037]      FIG. 1   a  is a diagram of generic plasmid containing the most basic features of the invention. There is a promoter and a poly-A terminator flanking the gene cassette, and these are, in turn, flanked by AT rich regions. Specific restriction enzyme sites are present to allow separation of the active therapeutic parts of the plasmid invention from the inactive parts. In practice, all of the regions shown may be spliced into virtually any generic plasmid, which may be raised in any suitable bacteria. 
         [0038]      FIG. 1   b  is a diagram of a post-processed minimum therapeutic circlet. In  FIG. 1   a  the plasmid comprises two restriction enzyme sites flanking the AT rich regions. Use of restriction enzymes followed by re-ligation of the sticky ends results in a circlet of DNA composed only of the active components. Said re-ligation of the sticky ends may occur by means of a linker with compatible, but different, sticky ends. The whole process may occur in one step by use of a topoisomerase system, and in that case the restriction enzyme sites of  FIG. 1   a  would be replaced by suitable sequences necessary for the topoisomerase to function. Thus, using this method of post-processing into a circlet, the large section of the plasmid which is only present so that it can reproduce within suitable bacteria may be dispensed with. This allows the zero CpG strategy to be pursued using any standard plasmid, whether or not the plasmid has been optimized. It has been shown that such small circlets of DNA perform better in mammalian cells. 
         [0039]      FIG. 2  is a diagram of the invention wherein additional optional components are shown. There are multiple implementations of the antibiotic resistance gene claimed, and any of these could take the place of the generic antibiotic resistance gene shown. There are multiple implementations of the bacterial origin of replication claimed, and any of these could take the place of the generic bacterial origin of replication claimed. A secretion sequence is claimed for the invention and this is optionally present. Such a secretion sequence is shown at the 5′ end of the GHRH cassette; however, its location may vary as appropriate for the secretion sequence chosen. In this diagram the AT rich regions may have sequences that vary as claimed. A significant feature of the AT rich regions is that they not generally contain CpG sequences. 
         [0040]    A first and preferred embodiment of the present invention is a DNA plasmid construct containing a bacterial plasmid origin of replication that does not contain CpG sequences, a bacterial antibiotic resistance gene that does not contain CpG sequences, a myosin promoter containing no CpG sequences, a human peptide sequence GHRH gene that contains no CpG sequences, a poly-A termination sequence containing no CpG sequences, and one or more AT rich regions between the bacterial section and the mammalian expression half of the plasmid which also contain no CpG sequences. This construct is delivered into muscle cells together with DOI at a dose generally above 0.5 micrograms per kilogram, dissolved into a water and salts medium suitable for preservation of DNA. 
         [0041]    In an alternative embodiment, the invention is identical to the first embodiment with the exception that the bacterial promoter is of a standard variety that does contain CpG sequences. This alternative embodiment may have the bacterial promoter flanked by restriction enzyme or topoisomerase sites for the purpose of removing the CpG sequences from the final therapeutic product. It may be desired to make use of an affinity surface to which is bonded nucleotide sequences compatible with the sticky ends of the section of the plasmid which is removed. This method can be used to purify the final product. 
         [0042]    In a second alternative embodiment, the invention is nearly identical to one of the first two embodiments with the difference that the host cell promoter is CMV or some other high activity general promoter. Generally, this promoter would be immune system optimized by removal of CpG sequences. 
         [0043]    In a third alternative embodiment, the cassette is one of several contained within a super-cassette designed to deliver more than one gene therapy. An example of how this could be accomplished is by use of the CHYSEL system (P. de Felipe, 2004). 
         [0044]    In a fourth alternative embodiment, the invention utilizes microbeads impregnated with DOI in a solution generally containing small quantities of DOI as the vehicle for delivering any vector. This embodiment could also, potentially, adsorb the DNA vector onto the surface of the beads or impregnate the beads with the vector. These microbeads may generally be made from poly (lactide co-glycolide) (PLG), polyethylene glycol (PEG) or a combination. The microbeads may contain other materials, for instance to regulate pH. 
         [0045]    In typical operation, a solution containing double distilled or molecular biology grade water with a suitable DNA preservation buffer, which may contain a suitable protease to preserve a single dose of the DNA construct, may be mixed in a small bottle or tube with between 80 and 250 micrograms of DOI. This mixture may then be vacuum dried (lyophilized) to stabilize it for storage. After drying, the bottles or tubes may be sealed and stored at a temperature of 4° C. or lower. The invention may be shipped in an insulated cool container with ice to keep it from overheating. (However, the invention should be quite stable at room temperature or above, thus making it suitable for use in the developing world where refrigeration is often lacking) To use the invention, it may be mixed with an appropriate quantity of distilled or molecular biology grade water, then drawn into a syringe and injected directly into a muscle which is well used and has a high metabolic rate, such as the gastrocnemius. In some patients a different muscle might be chosen to maximize activity. Prior to injection, the muscle may be chilled with ice packs to as low a temperature as practical without freezing or causing other cold damage to the patient. After injection, the ice pack may be reapplied for a period of up to approximately 1 hour. To improve DNA transfer into cells, the injector used may have a set of 3 or more very sharp needles surrounding it extending to the same depth as the primary injector needle and a series of microsecond pulses of direct current to electroporate the DNA into the muscle cells more efficiently may be applied after completely pressing down the plunger. 
         [0046]    In alternative operations of the invention, there may not be electroporation, or the muscle may not be cooled. Different preservation methods may be used for the DNA as well, and variants on the injector may include a gene gun applied directly to the muscle after exposing the muscle through a small incision. In addition, for some patients, injecting a numbing agent may be desirable, however, generally this would not be done into the area of the gene injection, but would be a nerve block with a 1-2 hour action. 
         [0047]    Additional alternatives of the invention may be described as follows:
       a. a cell and optionally a myoblast may be transformed in vitro with a vector for expression of a nucleic acid sequence in a cell, the vector comprising a nucleic acid cassette comprising a nucleotide sequence encoding a human sequence growth hormone releasing hormone (“GHRH”); a first 5′ flanking region to said nucleic acid cassette including one or more promoter sequences for expression of said nucleic acid cassette; a second 5′ region flanking said promoter sequences at any distance from said promoter, wherein said second 5′ flanking region contains between 20 and 2000 nucleotides comprising AT rich sequences wherein said second 5′ flanking region contains no CpG sequences; a first 3′ flanking region to the nucleic acid cassette at any distance from said cassette, wherein said first 3′ flanking region contains between 20 and 2000 nucleotides with AT rich sequences wherein said first 3′ flanking region contains no CpG sequences; and wherein said human GHRH cassette has the sequence of SEQ ID NO: 1, 2, 3, 4 or 5.   b. A method of administration of the GHRH treatment wherein a plurality of said cells from paragraph (a) are delivered into the muscle of a living animal.   c. A method for transfection of a muscle cell in vivo, comprising the step of administering directly to said cell the vector of paragraph (a) leading to transfection of said cell.   d. A method for delivery and expression of a GHRH gene in a plurality of muscle cells, comprising the steps of: (a) administering directly to said plurality of muscle cells the vector of paragraph (a); and (b) incubating said plurality of muscle cells under conditions that allow the expression of the nucleotide sequence encoding the GHRH in said vector. In additional embodiments the cells of this paragraph are human cells, and in additional embodiments said cells are chilled in vivo below normal body temperature for a minimum of 5 minutes prior to administering said vector, and said cells are maintained below normal body temperature for a minimum of 10 minutes after administration of said vector.   e. The vector of paragraph (a), wherein said vector comprises a nucleotide sequence which is the same as the nucleotide sequence of plasmid p80715-5.1 which has the sequence of SEQ ID NO: 23.   f. The vector of paragraph (a), wherein said vector comprises a nucleotide sequence which is the same as the nucleotide sequence of plasmid p80716-B6.1 which has the sequence of SEQ ID NO: 24.   g. The vector of paragraph (a), wherein said vector comprises a nucleotide sequence which is the same as the nucleotide sequence of plasmid p80717-B7.1 which has the sequence of SEQ ID NO: 25.   h. The vector of paragraph (a), wherein said vector comprises a nucleotide sequence which is the same as the nucleotide sequence of plasmid p80718-B8.1 which has the sequence of SEQ ID NO: 26.   i. The vector of paragraph (a), wherein said vector comprises a nucleotide sequence which is the same as the nucleotide sequence of plasmid p80715-5.2 which has the sequence of SEQ ID NO: 27.   j. The vector of paragraph (a), wherein said vector comprises a nucleotide sequence which is the same as the nucleotide sequence of plasmid p80716-B6.2 which has the sequence of SEQ ID NO: 28.   k. The vector of paragraph (a), wherein said vector comprises a nucleotide sequence which is the same as the nucleotide sequence of plasmid p80717-B7.2 which has the sequence of SEQ ID NO: 29.   l. The vector of paragraph (a), wherein said vector comprises a nucleotide sequence which is the same as the nucleotide sequence of plasmid p80718-B8.2 which has the sequence of SEQ ID NO: 30.       
 
         [0060]    In yet other alternative embodiments, the following sequences are disclosed:
       a. The sequence of SEQ ID NO: 3, an immune system optimized human GHRH gene.   b. The sequence of SEQ ID NO: 4, an immune system optimized human GHRH gene.   c. The sequence of SEQ ID NO: 5, an immune system optimized human GHRH gene.   d. The sequence of SEQ ID NO: 7, an immune system optimized human actin alpha 1 promoter.   e. The sequence of SEQ ID NO: 9, an immune system optimized expression enhancer.   f. The sequence of SEQ ID NO: 10, an immune system optimized expression enhancer.   g. The sequence of SEQ ID NO: 11, an immune system optimized an expression enhancer.   h. The sequence of SEQ ID NO: 12, an immune system optimized an expression enhancer.   i. The sequence of SEQ ID NO: 13, an immune system optimized antibiotic resistance gene.   j. The sequence of SEQ ID NO: 14, an immune system optimized antibiotic resistance gene.   k. The sequence of SEQ ID NO: 15, an immune system optimized antibiotic resistance gene.   l. The sequence of SEQ ID NO: 16, an immune system optimized antibiotic resistance gene.   m. The sequence of SEQ ID NO: 17, an immune system optimized antibiotic resistance gene.   n. The sequence of SEQ ID NO: 18, an immune system optimized antibiotic resistance gene.   o. The sequence of SEQ ID NO: 19, an immune system optimized R6K origin of replication.   p. The sequence of SEQ ID NO: 21, an immune system optimized R6K origin of replication.   q. The sequence of SEQ ID NO: 22, an immune system optimized pBR322 origin of replication.       
 
         [0078]    The invention as it relates to anti-adjuvants as exemplified by DOI has wide application for plasmid gene therapy. The step of chilling muscles pre-injection and post-injection as an anti-adjuvant method also has wide application for plasmid gene therapy. 
         [0079]    While the invention has been described in connection with specific embodiments thereof, it will be understood that it is capable of further modifications and this application is intended to cover any variations, uses, or alterations of the invention following. In general, the principles of the invention and including such departures from the present disclosure as come within known or customary practice within the art to which the invention pertains and as may be applied to the essential features hereinbefore set forth and as follows in the scope of the appended claims.