Abstract:
The present invention relates to a fusion protein comprising therapeutical and diagnostic potential against chronic vascular diseases, such as atherosclerosis, a nucleic acid molecule encoding said fusion protein, a pharmaceutical and diagnostic composition which comprises the fusion protein or the nucleic acid molecule, the use of the fusion protein or the nucleic acid molecule for the production of a pharmaceutical and diagnostic composition, a method for the diagnosis of acute or chronic vascular diseases, and a method for the production of a fusion protein.

Description:
CROSS-REFERENCES TO RELATES APPLICATIONS 
       [0001]    This application is a continuation application of copending international patent application PCT/EP2007/003984 filed on May 5, 2007 and designating the United States, which was not published under PCT Article 21(2) in English, and claims priority of German patent application DE 10 2006 024 113.4 filed on May 17, 2006, and of German patent application DE 10 2006 033 394.2 filed on Jul. 13, 2006, which are incorporated herein by reference. 
     
    
     BACKGROUND OF THE INVENTION 
       [0002]    1. Field of the Invention 
         [0003]    The present invention relates to a fusion protein comprising therapeutic and diagnostic capacity against chronic vascular diseases, such as atherosclerosis, a nucleic acid molecule encoding said fusion protein, a pharmaceutical and diagnostic composition which comprises said fusion protein or nucleic acid molecule, a use of said fusion protein or nucleic acid molecule for the production of a pharmaceutical or diagnostic composition, a method for the diagnosis of acute or chronic vascular diseases, as well as a method for the production of said fusion protein. 
         [0004]    2. Related Prior Art 
         [0005]    Atherosclerosis is a highly complex active pathological process, in the center of which is an inflammatory reaction in the walls of the sanguiferous vessels of an affected individuum. The development of atherosclerosis, the so-called atherogenesis, can be subdivided into several phases. 
         [0006]    The early phase of atherogenesis is characterized by a so-called endothelial dysfunction. A number of different risk factors such as smoking, overweight, physical inactivity, hyperlipidemia and type II diabetes as well as other so far not identified factors cause a damage of the endothelium. The permeability of the endothelium for lipoproteins and other circulating substances in the plasma is hereby increased. As a result endothelial cells are activated and increase the expression of so-called adhesion molecules on their cell surface. Among them in particular so-called selectins initially mediate a temporary contact of specific blood cells such as monocytes and T-lymphocytes with the endothelium. Another group of adhesion molecules, the so-called cellular adhesion molecules (CAMs), causes a tight attachment of these cells to the vascular wall. In particular at branchings of the vessels—the locations where atherosclerotic lesions very often develop—mechanical forces play an additional role. Increased shearing forces can reduce the production of endothelial nitrogen (NO). NO acts as a vasodilator and has anti-inflammatory properties. Furthermore, increased shearing forces result in an increased production of adhesion molecules with the above-described results. 
         [0007]    In the further course in particular monocytes and to a lesser extent T-lymphocytes infiltrate the subintimal room. This infiltration is mediated through another group of molecules to which e.g. the chemokine monocyte chemoattract ant protein 1 (MCP-1) belongs. This results in a differentiation of the monocytes into macrophages in the subintimal room. 
         [0008]    Moreover, in the damaged endothelium an oxidation of lipoproteins of low density (LDL) occurs and as a result oxLDL is formed. oxLDL is secreted into the subintimal room where it loaded on the macrophages resulting from the monocytes. As a result of this loading with oxLDL these macrophages are transformed into so-called foam cells, the characteristic cells of the atherosclerotic plaques which contain as further components inter alia T-lymphocytes and smooth muscle cells immigrated from the media. 
         [0009]    Such an atherosclerotic plaque deposits on the arterial walls and is covered by a stabilizing fibrous cap consisting of smooth muscle cells and extracellular matrix. The atherosclerotic plaque is now in the center of an inflammatory reaction which results in a production of different inflammation mediators such as cytokines, chemokines, proteases etc. This can result in a necrosis of tissue in which neighborhood calcium carbonates are deposited. Thereby the vascular lumen can be narrowed up to the complete closure with the result of disturbed blood flow. 
         [0010]    If the smooth muscle cells reduce the formation of extracellular matrix and the latter is increasingly degraded by degrading enzymes, the fibrous cap is thinned out and the atherosclerotic plaque is destabilized. The plaque can dehisce whereby the thrombogenic lipid core and collagen in the vascular wall is exposed. This results in an activation of the haemostasis system which in turn results in an occluding and non-occluding thrombus formation, i.e. in the activation of the coagulation cascade, in the center of which is the so-called tissue factor (TF). The rupture of the plaque with the formation of a thrombus becomes clinically manifest as instable Angina pectoris or acute myocard infarction. 
         [0011]    At present the atherosclerosis is normally treated by the application of lipid lowering drugs or statines, respectively. These are a group of active substances which finally inhibit the endogenic synthesis of cholesterol. Substances which belong to the statines are inter alia Atorvastatin, Cerivastatin, Fluvastatin, Lovastatin (Mevinolin), Mevastatin (Compactin), Pravastatin and Simvastatin. These substances have influence on the lipid metabolism in different ways, e.g. by a competitive inhibition of the key enzyme of the cholesterol synthesis, the 3-hydroxy-3-methylglutaryl-coenzyme-A-reductase, by lowering the biosynthesis of cholesterol in the liver, by amplification of the LDL receptors on the liver cell, and by modification of lipoprotein composition. Statines have a large influence on the composition of the serum lipids and cause inter alia a slight increase of the concentration of so-called “high density lipoproteins” (HDL) and a strong decrease of the LDL concentration. Finally, by the effect of the statines a fewer amount of fats circulate in the blood, so that the atherosclerotic plaques store less fat and thereby the risk of a thrombosis and the endangerings resulting therefrom decrease. 
         [0012]    Even though a number of other positive characteristics are attributed to the statines, the latter came under criticism for a noticeable accumulation of rare, however fatal side effects on muscles and kidneys in connection with their intake. For this reason in particular the active substance Cerivastatin (e.g. Lipobay®, Zenas®) has been removed from the German market in August 2001. 
       SUMMARY OF THE INVENTION 
       [0013]    Against this background the object underlying the invention is to provide a new substance which comprises therapeutic and diagnostic potential in relation with the treatment and diagnosis of acute or chronic vascular diseases, such as atherosclerosis or atherosclerotic plaques, and by which the before-mentioned disadvantages of the known lipid lowering drugs can be reduced or avoided to a large extent. 
         [0014]    This object is achieved by providing a fusion protein which comprises (a) a first polypeptide which specifically binds to modified LDL, and (b) a second polypeptide which mediates a dimerization. 
         [0015]    According to the invention a fusion protein refers to a hybrid protein or an artificial protein, respectively, which can be produced in vitro but also in vivo by molecular biological methods known in the art. For this purpose preferably common expression vectors are used, which encode the fusion protein according to the invention. These expression vectors are introduced in an appropriate cell which consequently produces the fusion protein. 
         [0016]    The first polypeptide is designed by choosing an appropriate amino acid sequence in such a manner that it takes a secondary or tertiary structure which selectively and highly affinely binds to modified low density lipoprotein (LDL). This is easy for a chemist familiar in the field of protein synthesis since the three-dimensional structure of modified LDL is known in the art. The second polypeptide is designed in view of its amino acid sequence in such a manner that it comprises a segment of a protein which is involved in the mediation of a dimerization of two separate proteins or protein subunits. Also this measure is easy for the skilled person since the microstructure including the amino acid sequences of peptidic dimeric structures of a large number of proteins are described in the art in detail. Known dimer-forming proteins which are known with regards to their sequence and structure comprise G-proteins, histones, interferon γ, interleukin-2-receptor, hsp90, tyrosine kinases, IgG molecules etc. Each of the domains of the mentioned proteins, which mediate the dimerization, can directly be used for the production of the fusion protein according to the invention. However, it can be favored to modify these domains by targeted mutagenesis or by adding specific amino acids to the C and/or N termini, resulting e.g. in a reduction of the immunologic effect of the fusion protein, to allow a better production of the fusion protein, however maintaining the dimerization function to a large extent. 
         [0017]    According to the invention modified LDL refers to a low density lipoprotein which is chemically modified in such a manner that it corresponds to a variant which is produced in the damaged endothelium within the context of the atherogenesis. This applies to oxidized LDL (oxLDL), acetylated LDL (acLDL), enzymatically oxidized LDL (eLDL), and minimally modified LDL (mmLDL). 
         [0018]    The object underlying the invention is herewith completely achieved. The inventors have realized that a fusion protein according to the invention after the application into a living being preferably accumulates exclusively at pre-damaged or atherosclerotically altered vascular areas, so that possible non-specific systemic side effects can be largely avoided. The fusion protein according to the invention absorbs the modified LDL due to the high affinity thereto, which is mediated by the first polypeptide segment. Even though also a monomer of the fusion protein is able to absorb modified LDL, by the dimerization of two fusion proteins according to the invention, which is mediated by the second polypeptide segment, the affinity to modified LDL is many times higher. 
         [0019]    The complexation inactivates the modified LDL and the loading of macrophages and the subsequent transformation of these cells into foam cells is thereby avoided or largely reduced. As a result an intervention into the atherogenesis takes place in an early phase. The formation of atherosclerotic plaques and the above-mentioned fatal effects on the organism are remarkably inhibited and possibly even prevented. Another important advantage is that the complex of the fusion protein and the modified LDL is less immunogenic due to its complete human origin, and any inflammatory reactions in relation with the “removal” take place in an extremely mild fashion or are even absent. 
         [0020]    It is thereby preferred if the first polypeptide is designed in such a manner that it binds to oxidized LDL (oxLDL). 
         [0021]    This measure has the advantage that such a fusion protein is provided which binds and absorbs exactly that LDL variant which plays a decisive role for the transformation of macrophages into foam cells. With this further development according to the invention oxLDL as a key factor of the atherogenesis is weakened in its function or even eliminated in a targeted manner. 
         [0022]    According to a further development of the invention the first polypeptide comprises the scavenger receptor CD68, preferably the extracellular domain of CD68 or a fragment or such a variant of the extracellular domain of CD68, which comprises the LDL binding function of CD68. 
         [0023]    This measure has the advantage that as the first polypeptide such a polypeptide is provided which comprises a particular high and selective affinity to modified LDL, in particular to oxLDL. CD68 which is also designated as macrosialin or gp110, is a transmembrane glycoprotein which is highly expressed in monocytes or tissue macrophages. The amino acid sequence as well as the encoding nucleotide sequence are disclosed in the art; cf. the NCBI database accession Nos. AAB25811 or NP — 001242 (amino acid sequence of the human variant), database accession No. NM — 001251 or AAH15557 (nucleotide sequence of the mRNA of the human variant). The before-identified amino acid and nucleotide sequences are herewith incorporated into the present application by reference. 
         [0024]    The human variant of CD68 is a protein having a size of 110 kD, which consists of 354 amino acids. CD68 belongs to the so-called scavenger receptors, since it can bind to modified LDL via its extracellular domain. CD68 is naturally expressed on the surface of monocytes, macrophages, neutrophil and basophil cells as well as large lymphocytes. 
         [0025]    It is further preferred if the first polypeptide does not comprise the entire amino acid sequence of CD68 but the extracellular domain of CD68. 
         [0026]    This measure has the particular advantage that peptide segments are omitted which are not required for the function of the fusion protein according to the invention. The fusion protein according to the invention is reduced in its size without losing its affinity to modified LDL. By this measure the solubility of the fusion protein according to the invention is remarkably increased. The inventors took advantage of the scientific discovery that the extracellular domain of CD68 is responsible and sufficient for the binding to modified LDL. The extracellular domain of CD68 of the human variant (NCBI accession No. AAH15557; Strausberg et al.) comprises about the amino acid residues of the positions 22 to 319 in the entire protein, which on the level of the mRNA correspond to the nucleotides at the positions 66 to 960. It goes without saying that a delimitation to exact one amino acid residual or one nucleotide is not possible by nature. 
         [0027]    It shall be understood for a skilled person that for the realization of the function according to the invention the fusion protein does not necessarily has to comprise the entire or identical amino acid sequence of CD68 or of the extracellular domain of CD68. On the contrary the function of the fusion protein according to the invention is also fulfilled if the first polypeptide comprises a segment or a sequence variant of CD68 or the extracellular domain of CD68, which exerts the LDL binding function of CD68, even in a reduced manner, if applicable. It is known that proteinogenic amino acids can be classified into four groups, namely in polar, non-polar, acidic and basic amino acids. The substitution of a polar amino acid against another polar amino acid, e.g. glycine against serine, as a rule does not cause a change of the biologic activity or does only cause an insignificant change of said biologic activity, that is such an amino acid substitution remains the function of the fusion protein according to the invention largely unaffected. Against this background the present invention also covers such a fusion protein which comprises as the first polypeptide a variant of CD68 or its extracellular domain, where one or several amino acids of one of the mentioned categories of amino acids are substituted by another amino acid of the same category. Such a sequence variant has preferably a homology in relation to the amino acid sequence of CD68 or the extracellular domain of CD68, respectively, of approx. 70%, more preferred of approx. 80%, and highly preferred of approx. 90 to 95%. 
         [0028]    It is preferred if the second polypeptide comprises a Fc domain of an immunoglobulin, or a fragment or a variant of the Fc domain, which comprises the dimerization function of the Fc domain. 
         [0029]    By this measure it is ensured by an advantageous manner that the fusion protein merely comprises peptide segments which are sufficient for the dimerization of two monomers of the fusion protein according to the invention. “Fc” refers to “fragment crystallizable”. This fragment in addition to the both Fab fragments results from a papain cleavage of the IgG molecule. The Fc domain consists of the paired C H 2 and C H 3 domains including the hinge region and contains that part of the immunoglobulin which is responsible for the dimerization function. It shall be understood that also a fragment or a variant of the Fc domain can be used without compromising the function of the fusion protein according to the invention, as long as the fragment or the variant, respectively, comprises the dimerization function of an antibody, even in reduced form, if applicable; cf. before mentioned explanations on the fragment or the variant of CD68, which apply to the fragment or the variant of Fc mutatis mutandis. 
         [0030]    According to a preferred further development the variant of the Fc domain comprises such a mutation in the complement and Fc receptor binding area which reduces the immunogenicity of the fusion protein according to the invention. 
         [0031]    This measure has the advantage that the tolerability of the fusion protein according to the invention is further increased. According to the findings of the inventors it is sufficient for the function of a fusion protein according to the invention if the second polypeptide comprises merely the dimerization function of the Fc domain of the antibody but not the effector function which causes an activation of the immune system. Therefore, for example also a synthetic Fc fragment can be used which is mutated in the complement and Fc receptor binding area in such a manner that an activation of the immune system is largely reduced or even absent. 
         [0032]    It is furthermore preferred if the fusion protein comprises an element which connects the first polypeptide to the second polypeptide. 
         [0033]    This measure has the advantage that the constructive preconditions are provided which enable the production of the fusion protein according to the invention by means of various expression vectors. The connecting element can be realized by a sequence of amino acids having any composition, however, which preferably comprises one to 100 amino acids. Such a connecting element can also be realized by amino acids which result from the production of the fusion protein according to the invention by ligation of the two polypeptides. 
         [0034]    According to a preferred variant the first polypeptide of the fusion protein according to the invention comprises the amino acid sequence SEQ ID No. 1 of the enclosed sequence listing. 
         [0035]    By this measure a polypeptide is provided in an advantageous manner which binds to modified LDL or oxLDL, respectively. The amino acid sequence SEQ ID No. 1 is derived from the amino acid sequence of the extracellular domain of the human CD68 protein. 
         [0036]    According to a preferred further development the fusion protein comprises a first polypeptide which is encoded by a nucleic acid molecule which comprises the nucleotide sequence SEQ ID No. 2 or 3 of the enclosed listing. 
         [0037]    This measure has the advantage that already a coding sequence is provided which encodes the extracellular domain of the human CD68 protein, and which can be easily produced after the introduction into an expression vector via bacteria by means of methods which are known in the art. The nucleotide sequence SEQ ID No. 2 is derived from the nucleotide sequence which encodes the extracellular domain of the human variant of the CD68 protein. The nucleotide sequence SEQ ID No. 3 provides for a polymorphism in the extracellular domain of the human CD68 protein which exists in the population, where a cag base triplet is substituted by an aag base triplet. A functional consequence of this polymorphism is not known. 
         [0038]    It shall be understood that not only the nucleotide sequence SEQ ID No. 2 or 3 is suitable for the production of the extracellular domain of the CD68 protein but also variants thereof which, due to the degeneration of the genetic code, encode the same polypeptide. It is known that the genetic code is degenerated since the number of possible codons is larger than the number of amino acids. For most of the amino acids there are more than one codon, e.g. arginine, leucine and serine are encoded by up to six codons. As a general rule the third position in the codon is in parts or fully substitutable. Against this background also such a fusion protein is provided where the first polypeptide is encoded by a nucleic acid molecule which, due to the degeneration of the genetic code, deviates in relation to the nucleotide sequence SEQ ID No. 2 or 3 in individual nucleotide positions, however encodes the extracellular domain of the CD68 protein in an equal manner. Preferably such a variant comprises approx. 70% homology, more preferably approx. 80% homology and highly preferably approx. 90 to 95% homology in relation to the nucleotide sequence SEQ ID No. 2 or 3. 
         [0039]    It is preferred if the second polypeptide comprises the amino acid sequence SEQ ID No. 4 of the enclosed sequence listing. 
         [0040]    By this measure a second polypeptide which mediates the dimerization is provided in an advantageous manner, which is derived from the Fc fragment of the human IgG1 variant and comprises a mutation in the complement and Fc receptor binding area, which reduces the immunogenicity. By targeted mutagenesis at the position 331 a proline was substituted by a serine and at the amino acid position 234 to 237 the tetrapeptide Leu-Leu-Gly-Gly was substituted by Ala-Ala-Ala-Ala. To make the expression of the peptide easier in relation with the natural sequence of the Fc fragment of human IgG1 the polypeptide was optimized in its codons with regard to CHO cells. 
         [0041]    According to a further development of the invention the second polypeptide is encoded by a nucleic acid molecule which comprises the nucleotide sequence SEQ ID No. 5 of the enclosed sequence listing. 
         [0042]    This measure has the advantage that already a nucleotide sequence is provided which encodes the before-described second polypeptide which is derived from the Fc domain of the human IgG1 molecule. After the introduction of the coding sequence into an expression vector appropriate cells, e.g. CHO cells, are transformed by means of methods which are known in the art, which in turn produce the intended second polypeptide. It shall be understood that not only the nucleotide sequence SEQ ID No. 5 is suitable for the production of the second polypeptide but also variants thereof. Such a nucleic acid molecule can also be used which, due to the degeneration of the genetic code, deviates in relation to the nucleotide sequence SEQ ID No. 5 in individual nucleotide positions, however encodes the intended second polypeptide in an equal manner. Preferably such a variant has a homology to the nucleotide sequence SEQ ID No. 5 of approx. 70%, further preferred of approx. 80%, and highly preferred of 90 to 95%. 
         [0043]    It is particularly preferred if the fusion protein according to the invention comprises the amino acid sequence SEQ ID No. 6 of the enclosed sequence listing. 
         [0044]    By this measure already an entire primary structure of a preferred fusion protein according to the invention is provided, which can easily be produced in a targeted manner either directly by means of peptide synthesis or after the transcription into the coding sequence by molecular biological methods. The amino acid sequence SEQ ID No. 6 does not only comprise the segment of the extracellular domain of CD68 at the N terminus and the segment of the Fc fragment at the C terminus, but also an intermediate element consisting of three amino acids, which connects the extracellular domain of CD68 to the Fc fragment. It shall be understood that within the amino acid sequence SEQ ID No. 6 individual amino acids of one category can be substituted by amino acids of the same category, as this is described further above, without clearly affecting the function of the fusion protein according to the invention. It shall also be understood that the amino acid sequence SEQ ID No. 6 can comprise further amino acids at its N and/or C terminals, which merely serve for a better expression of the fusion protein and to secrete the same from the expressing cells or are merely present for reasons of construction. Such amino acids can e.g. originate from the human IgG kappa chain or from a multiple cloning site (MCS). 
         [0045]    It is further preferred if, as the fusion protein according to the invention, such a protein is provided which is encoded by a nucleic acid molecule which comprises the nucleotide sequence SEQ ID No. 7 or 8 of the enclosed sequence listing. 
         [0046]    This measure has the advantage that the skilled person is already provided with a coding sequence which encodes a particularly preferred embodiment of the fusion protein according to the invention. The nucleotide sequence SEQ ID No. 7 does also not only comprise coding sequences which encode the extracellular domain of CD68 and the second polypeptide derived from the Fc fragment, but also an intermediate segment which consists of three base triplets and encodes the before-mentioned connecting element. The nucleotide sequence SEQ ID No. 8 provides for the above-mentioned polymorphism in the extracellular CD68 domain so that in relation to the nucleotide sequence SEQ ID No. 7 a cag base triplet is substituted by an aag base triplet. The nucleic acid molecule according to the invention can be introduced into an expression vector by means of methods well known in the art, by which in turn appropriate biological cells, e.g. CHO cells, are transformed, which produce the intended fusion protein. It shall be understood that instead of the nucleotide sequences SEQ ID No. 7 or 8 also variants thereof can be used which, due to the degeneration of the genetic code, encode the same fusion proteins. 
         [0047]    According to a preferred further development the fusion protein according to the invention comprises a detectable marker. 
         [0048]    This measure has the advantage that the fusion protein can be displayed at the place of its production in vitro but also in vivo by means of imaging methods and it is therefore in particular suited for the identification of e.g. atherosclerotic plaques. A detectable marker according to the invention refers to any component which can be identified by means of imaging methods. This applies to color indicators, such as colorants having fluorescent, phosphorescent or chemiluminescent properties, AMPPD, CSPD, radioactive indicators such  32 P,  35 S,  125 I,  131 I,  14 C,  3 H, non-radioactive indicators such as biotin or digoxigenin, alkaline phosphatase, horseradish peroxidase etc. According to the nature of the marker imaging methods could be autoradiography, blotting, hybridization or microscopic techniques. 
         [0049]    Another subject matter of the present invention relates to a homodimer which comprises the before-identified fusion protein according to the invention. 
         [0050]    The inventors have realized that the dimerization of the fusion protein according to the invention results in an activity which is many times higher. This has the advantage that e.g. CHO cell lines which are transformed by an expression vector that encodes the fusion protein according to the invention, secrete a soluble dimer which comprises two fusion proteins which are crosslinked by bisulfide bridges in the region of the second polypeptide, e.g. in the region of the Fc domain. 
         [0051]    Thereby it has turned out that with such a homodimer in relation to a monomer the affinity for modified LDL, in particular for oxLDL, is remarkably increased. The inventors have evidences that the homodimers after a systemic application into a living being rapidly and specifically accumulate exclusively at pre-damaged or atherosclerotically altered vascular areas and that a rapid degradation in the blood as well as any unspecific systemic side effects can be largely avoided. The inventors have further evidences that the homodimer according to the invention causes also a deactivation or blockage of the native CD68 receptors in the living being, by which the LDL endocytosis by macrophages and the transformation into foam cells can be additionally prevented. 
         [0052]    Such a mechanism is already described in the art for other soluble scavenger receptors, such as SRA1; cf. Gough et al. (2001), The use of human CD68 transcriptional regulatory sequences to direct high-level expression of class A scavenger receptor in macrophages in vitro and in vivo, Immunology 103, pages 351 to 361. The inventors were able to demonstrate in co-cultivation assays in vitro that the addition of increasing concentrations of the homodimer according to the invention results in a significant inhibition of the formation of foam cells and that several functions of foam cells, such as the secretion of MMP-9, can be inhibited. 
         [0053]    Against this background another subject matter according to the invention relates to a nucleic acid molecule which encodes the before-identified fusion protein according to the invention. The nucleic acid molecule according to the invention comprises preferably (a) a first nucleotide sequence which encodes a polypeptide which specifically binds to modified LDL, preferably to oxLDL, and (b) a second nucleotide sequence which encodes a polypeptide which mediates a dimerization. The nucleic acid molecule according to the invention comprises preferably the nucleotide sequence SEQ ID No. 2 or 3, No. 5, or No. 7, or 8, respectively, of the enclosed sequence listing, or in each case a variant thereof, which encodes, due to the degeneration of the genetic code, the same polypeptide. It shall be understood that the nucleic acid molecule can comprise further nucleotide segments which enable or favor e.g. an expression or production in correspondingly transformed cells. For example a leader segment of the kappa chain of the IgG molecule and amino acids connected thereto resulting from the multiple cloning site (MCS) for constructive reasons can be arranged at the 5′ end, which however in the translation product might be cleaved off from the entire construct and might therefore not necessarily be present in the fusion protein according to the invention. 
         [0054]    Another subject matter of the present invention relates to a pharmaceutical and/or diagnostic composition which comprises the fusion protein according to the invention and/or the homodimer according to the invention and/or the nucleic acid molecule according to the invention as well as a pharmaceutically and/or diagnostically acceptable carrier, if applicable, and further pharmaceutically and/or diagnostically effective additives, if applicable. 
         [0055]    Diagnostically and pharmaceutically acceptable carriers and any further additives are generally known in the art and are e.g. described in the essay of Kibbe A., Handbook of Pharmaceutical Excipients, Third Edition, American Pharmaceutical Association and Pharmaceutical Press 2000. According to the invention additives comprise any compound or composition which are advantageous for a diagnostic or therapeutic use of the composition, including salts, binding agents and further substances involved in the formulation of medicaments. 
         [0056]    Another subject matter of the present invention relates to the use of the fusion protein according to the invention and/or the homodimer according to the invention and/or the protein acid molecule according to the invention for the production of a pharmaceutical and/or diagnostic composition for the treatment and/or diagnosis of acute or chronic vascular diseases, including atherosclerosis, atherosclerotic plaques, cardiac infarction, apoplexy and peripheral artery occlusive disease (PAOD). 
         [0057]    The invention is further realized in a method for the production of a pharmaceutical and/or diagnostic composition for the treatment and/or diagnosis of before-mentioned diseases, which comprises the following steps: (a) Provision of the fusion protein according to the invention and/or of the homodimer according to the invention and/or the nucleic acid molecule according to the invention; (b) formulation into a pharmaceutically and/or diagnostically acceptable carrier, and, if applicable, (c) addition of further pharmaceutically and/or diagnostically active additives. 
         [0058]    Another subject matter of the present invention relates to a method for the diagnosis of acute or chronic vascular diseases, including atherosclerosis, atherosclerotic plaques, cardiac infarction, apoplexy and PAOD in a living being, comprising the following steps: (1) Provision of a fusion protein according to the invention and/or a homodimer according to the invention, which comprises a detectable marker, (2) introduction of the fusion protein and/or of the homodimer into the living being, and (3) visulization of the specific accumulation of the fusion protein in the living being by means of imaging methods, such as the positron emission tomography (PET). 
         [0059]    By means of this method atherosclerotic plaques or high concentrations of modified LDL, including oxLDL, can be detected due to the selective accumulation of the fusion protein according to the invention or the homodimer according to the invention, which enables a reliable diagnosis of corresponding vascular diseases or a predisposition therefor. So far the activity and stability of atherosclerotic plaques are not well detectable by means of angiography, application of contrast medium and the determination of the size of the lumen of the vessel, which are usually used in the art. The present invention provides effective remedy. 
         [0060]    Another subject matter of the present invention relates to a method for the production of the fusion protein according to the invention, which comprises the following steps: (1) Provision of a first nucleotide sequence encoding a polypeptide which specifically binds to modified LDL, preferably to oxLDL, (2) provision of a second nucleotide sequence encoding for a polypeptide which mediates the dimerization, (3) ligation of the first and the second nucleotide sequence to obtain a fusion sequence encoding the fusion protein, (4) cloning of the fusion sequence into an expression vector, (5) introduction of the expression vector in a cell suitable for the expression, (6) expression of the fusion protein in the cell, and (7) isolation of the fusion protein from the cell. 
         [0061]    By means of this method also the homodimer according to the invention can be produced, since suitable cells, e.g. HEK or CHO cells which are transformed according to step (5), already produce after the expression according to step (6) a homodimer which comprises disulfide bridges in the second polypeptide, which connect the two fusion proteins according to the invention, to each other. The homodimer is secreted by the cells into the extracellular medium. 
         [0062]    It shall be understood that the before-mentioned features and those to be explained in the following cannot only be used in the combination indicated in each case but also in other combinations or separately, without departing from the scope of the present invention. 
         [0063]    The present invention is now explained in detail by means of embodiments which are of pure exemplary nature and do not limit the scope of the invention. Reference is made to the enclosed figures: 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0064]      FIG. 1 : Detection of the fused dimeric CD68-Fc fusion protein by Western Blot analysis. 
           [0065]      FIG. 2 : Differentiation of CD34 +  stem cells into foam cells after 10 days of co-cultivation with thrombocytes. 
           [0066]      FIG. 3 : (A) Absorption of acetylated LDL by foam cells; (B) inhibition of the foam cell formation by the CD68-Fc homodimer. 
           [0067]      FIG. 4 : Inhibition of the MMP-9 expression in the supernatant of foam cells by incubation with increasing concentrations of CD68-Fc. 
           [0068]      FIG. 5 : Specific Fc-ELISA on atherosclerotic plaques in vitro. 
           [0069]      FIG. 6 : In vivo application of J124-labeled CD68-Fc in atherosclerotic Apo-E-mice and in wild type mice. 
       
    
    
     DESCRIPTION OF PREFERRED EMBODIMENTS 
     1. Nucleotide and Amino Acid Sequences 
       [0070]    The common one-letter codes are used in each case. In the presentation the amino acid sequences comprise at their left end the amino or N terminal end, and at their right end the carboxy or C terminal end. The nucleotide sequences comprise at their left end the 5′ end, and at their right end the 3′ end. 
       1.1 Amino Acid Sequence of the Extracellular Domain of CD68 Comprising the Polymorphism 1 (Glutamine) (SEQ ID No. 1) 
       [0071]      
         [0000]    
       
         
               
               
             
           
               
                 NDCPHKKSATLLPSFTVTPTVTESTGTTSHRTTKSHKTTTHRTTTTGTTS 
                   
               
               
                   
               
               
                 HGPTTATHNPTTTSHGNVTVHPTSNSTATSQGPSTATHSPATTSHGNATV 
               
               
                   
               
               
                 HPTSNSTATSPGFTSSAHPEPPPPSPSPSPTSKETIGDYTWTNGSQPCVH 
               
               
                   
               
               
                 LQAQIQIRVMYTTQGGGEAWGISVLNPNKTKVQGSCEGAHPHLLLSFPYG 
               
               
                   
               
               
                 HLSFGFMQDLQQKVVYLSYMAVEYNVSFPHAAQWTFSAQNASLRDLQAPL 
               
               
                   
               
               
                 GQSFSCSNSSIILSPAVHLDLLSLRLQAAQLPHTGVFGQSFSCPSDRS 
               
             
          
         
       
     
       1.2 Nucleotide Sequence Encoding the Extracellular Domain of CD68, Polymorphism 1 (SEQ ID No. 2) 
       [0072]      
         [0000]    
       
         
               
               
             
           
               
                 AATGACTGTCCTCACAAAAAATCAGCTACTTTGCTGCCATCCTTCACGGT 
                   
               
               
                   
               
               
                 GACACCCACGGTTACAGAGAGCACTGGAACAACCAGCCACAGGACTACCA 
               
               
                   
               
               
                 AGAGCCACAAAACCACCACTCACAGGACAACCACCACAGGCACCACCAGC 
               
               
                   
               
               
                 CACGGACCCACGACTGCCACTCACAACCCCACCACCACCAGCCATGGAAA 
               
               
                   
               
               
                 CGTCACAGTTCATCCAACAAGCAATAGCACTGCCACCAGCCAGGGACCCT 
               
               
                   
               
               
                 CAACTGCCACTCACAGTCCTGCCACCACTAGTCATGGAAATGCCACGGTT 
               
               
                   
               
               
                 CATCCAACAAGCAACAGCACTGCCACCAGCCCAGGATTCACCAGTTCTGC 
               
               
                   
               
               
                 CCACCCAGAACCACCTCCACCCTCTCCGAGTCCTAGCCCAACCTCCAAGG 
               
               
                   
               
               
                 AGACCATTGGAGACTACACGTGGACCAATGGTTCCCAGCCCTGTGTCCAC 
               
               
                   
               
               
                 CTCCAAGCCCAGATTCAGATTCGAGTCATGTACACAACCCAGGGTGGAGG 
               
               
                   
               
               
                 AGAGGCCTGGGGCATCTCTGTACTGAACCCCAACAAAACCAAGGTCCAGG 
               
               
                   
               
               
                 GAAGCTGTGAGGGTGCCCATCCCCACCTGCTTCTCTCATTCCCCTATGGA 
               
               
                   
               
               
                 CACCTCAGCTTTGGATTCATGCAGGACCTCCAGCAGAAGGTTGTCTACCT 
               
               
                   
               
               
                 GAGCTACATGGCGGTGGAGTACAATGTGTCCTTCCCCCACGCAGCA CAG T 
               
               
                   
               
               
                 GGACATTCTCGGCTCAGAATGCATCCCTTCGAGATCTCCAAGCACCCCTG 
               
               
                   
               
               
                 GGGCAGAGCTTCAGTTGCAGCAACTCGAGCATCATTCTTTCACCAGCTGT 
               
               
                   
               
               
                 CCACCTCGACCTGCTCTCCCTGAGGCTCCAGGCTGCTCAGCTGCCCCACA 
               
               
                   
               
               
                 CAGGGGTCTTTGGGCAAAGTTTCTCCTGCCCCAGTGACCGGTCC 
               
             
          
         
       
     
         [0073]    The polymorphism 1 is indicated in bold letters. 
       1.3 Nucleotide Sequence Encoding the Extracellular Domain of CD68, Polymorphism 2 (SEQ ID No. 3) 
       [0074]      
         [0000]    
       
         
               
               
             
           
               
                 AATGACTGTCCTCACAAAAAATCAGCTACTTTGCTGCCATCCTTCACGGT 
                   
               
               
                   
               
               
                 GACACCCACGGTTACAGAGAGCACTGGAACAACCAGCCACAGGACTACCA 
               
               
                   
               
               
                 AGAGCCACAAAACCACCACTCACAGGACAACCACCACAGGCACCACCAGC 
               
               
                   
               
               
                 CACGGACCCACGACTGCCACTCACAACCCCACCACCACCAGCCATGGAAA 
               
               
                   
               
               
                 CGTCACAGTTCATCCAACAAGCAATAGCACTGCCACCAGCCAGGGACCCT 
               
               
                   
               
               
                 CAACTGCCACTCACAGTCCTGCCACCACTAGTCATGGAAATGCCACGGTT 
               
               
                   
               
               
                 CATCCAACAAGCAACAGCACTGCCACCAGCCCAGGATTCACCAGTTCTGC 
               
               
                   
               
               
                 CCACCCAGAACCACCTCCACCCTCTCCGAGTCCTAGCCCAACCTCCAAGG 
               
               
                   
               
               
                 AGACCATTGGAGACTACACGTGGACCAATGGTTCCCAGCCCTGTGTCCAC 
               
               
                   
               
               
                 CTCCAAGCCCAGATTCAGATTCGAGTCATGTACACAACCCAGGGTGGAGG 
               
               
                   
               
               
                 AGAGGCCTGGGGCATCTCTGTACTGAACCCCAACAAAACCAAGGTCCAGG 
               
               
                   
               
               
                 GAAGCTGTGAGGGTGCCCATCCCCACCTGCTTCTCTCATTCCCCTATGGA 
               
               
                   
               
               
                 CACCTCAGCTTTGGATTCATGCAGGACCTCCAGCAGAAGGTTGTCTACCT 
               
               
                   
               
               
                 GAGCTACATGGCGGTGGAGTACAATGTGTCCTTCCCCCACGCAGCA AAG T 
               
               
                   
               
               
                 GGACATTCTCGGCTCAGAATGCATCCCTTCGAGATCTCCAAGCACCCCTG 
               
               
                   
               
               
                 GGGCAGAGCTTCAGTTGCAGCAACTCGAGCATCATTCTTTCACCAGCTGT 
               
               
                   
               
               
                 CCACCTCGACCTGCTCTCCCTGAGGCTCCAGGCTGCTCAGCTGCCCCACA 
               
               
                   
               
               
                 CAGGGGTCTTTGGGCAAAGTTTCTCCTGCCCCAGTGACCGGTCC 
               
             
          
         
       
     
         [0075]    The polymorphism 2 is indicated in bold letters. 
         [0000]    1.4 Amino Acid Sequence of the Second Polypeptide Derived from the Fc Domain, which Mediates the Dimerization (SEQ ID No. 4) 
         [0000]                        ESKSCDKTHTCPPCPAPEAAAAPSVFLFPPKPKDTLMISRTPEVTCVVVD                   VSHEDPEVKFNWYVDGVEVHNAKTKPREEQYNSTYRVVSVLTVLHQDWLN               GKEYKCKVSNKALPASIEKTISKAKGQPREPQVYTLPPSRDELTKNQVSL               TCLVKGFYPSDIAVEWESNGQPENNYKTTPPVLDSDGSFFLYSKLTVDKS               RWQQGNVFSCSVMHEALHNHYTQKSLSLSPGK            
1.5 Nucleotide Sequence Encoding the Second Polypeptide Derived from the Fc Domain, and which Mediates the Dimerization (SEQ ID No. 5)
 
         [0000]    
       
         
               
               
             
           
               
                 GAGTCTAAGTCCTGTGATAAGACTCATACCTGCCCCCCCTGCCCAGCACC 
                   
               
               
                   
               
               
                 CGAGGCAGCAGCCGCCCCCTCAGTGTTTCTCTTCCCTCCAAAACCCAAGG 
               
               
                   
               
               
                 ATACCCTGATGATCAGCCGTACACCTGAGGTCACCTGCGTAGTCGTCGAT 
               
               
                   
               
               
                 GTGTCTCACGAGGACCCGGAGGTGAAGTTTAATTGGTATGTGGACGGGGT 
               
               
                   
               
               
                 AGAAGTGCATAATGCCAAGACTAAACCTCGAGAGGAACAATATAACTCCA 
               
               
                   
               
               
                 CCTATAGGGTGGTCAGCGTTCTCACGGTCCTTCACCAGGACTGGTTGAAT 
               
               
                   
               
               
                 GGAAAGGAATACAAGTGTAAGGTGAGCAACAAAGCCCTGCCCGCTTCCAT 
               
               
                   
               
               
                 AGAAAAGACAATCTCCAAAGCTAAAGGGCAGCCACGGGAACCTCAGGTGT 
               
               
                   
               
               
                 ACACCCTGCCGCCTAGCAGAGATGAGCTCACAAAGAACCAGGTGTCTCTG 
               
               
                   
               
               
                 ACATGCTTGGTGAAGGGTTTCTATCCTTCGGACATTGCCGTTGAGTGGGA 
               
               
                   
               
               
                 AAGTAACGGCCAGCCTGAGAATAACTACAAGACCACACCACCCGTTCTTG 
               
               
                   
               
               
                 ACTCTGATGGGAGTTTCTTTTTGTACAGTAAGTTAACTGTCGACAAATCA 
               
               
                   
               
               
                 CGCTGGCAGCAAGGAAATGTTTTCTCTTGTTCCGTGATGCACGAGGCACT 
               
               
                   
               
               
                 GCACAACCATTACACTCAGAAATCCCTGAGCCTATCACCAGGCAAATAA 
               
             
          
         
       
     
       1.6 Amino Acid Sequence of the Entire CS68-Fc Construct, Including the Connecting Element (SEQ ID No. 6) 
       [0076]      
         [0000]    
       
         
               
               
             
           
               
                 NDCPHKKSATLLPSFTVTPTVTESTGTTSHRTTKSHKTTTHRTTTTGTTS 
                   
               
               
                   
               
               
                 HGPTTATHNPTTTSHGNVTVHPTSNSTATSQGPSTATHSPATTSHGNATV 
               
               
                   
               
               
                 HPTSNSTATSPGFTSSAHPEPPPPSPSPSPTSKETIGDYTWTNGSQPCVH 
               
               
                   
               
               
                 LQAQIQIRVMYTTQGGGEAWGISVLNPNKTKVQGSCEGAHPHLLLSFPYG 
               
               
                   
               
               
                 HLSFGFMQDLQQKVVYLSYMAVEYNVSFPHAAQWTFSAQNASLRDLQAPL 
               
               
                   
               
               
                 GQSFSCSNSSIILSPAVHLDLLSLRLQAAQLPHTGVFGQSFSCPSDRS GG   
               
               
                   
               
               
                   R ESKSCDKTHTCPPCPAPEAAAAPSVFLFPPKPKDTLMISRTPEVTCVVV 
               
               
                   
               
               
                 DVSHEDPEVKFNWYVDGVEVHNAKTKPREEQYNSTYRVVSVLTVLHQDWL 
               
               
                   
               
               
                 NGKEYKCKVSNKALPASIEKTISKAKGQPREPQVYTLPPSRDELTKNQVS 
               
               
                   
               
               
                 LTCLVKGFYPSDIAVEWESNGQPENNYKTTPPVLDSDGSFFLYSKLTVDK 
               
               
                   
               
               
                 SRWQQGNVFSCSVMHEALHNHYTQKSLSLSPGK 
               
             
          
         
       
     
         [0077]    The connecting element is underlined. Ahead of the connecting element (towards the N terminus) the segment of the extracellular domain of CD68 is located, following the connecting element (towards the C terminals) the segment of the polypeptide is located which is derived from the Fc domain and which mediates the dimerization. 
       1.7 Nucleotide Sequence Encoding the Entire Construct Inclusive the Connecting Element, Polymorphism 1 (SEQ ID No. 7) 
       [0078]      
         [0000]    
       
         
               
               
             
           
               
                 AATGACTGTCCTCACAAAAAATCAGCTACTTTGCTGCCATCCTTCACGGT 
                   
               
               
                   
               
               
                 GACACCCACGGTTACAGAGAGCACTGGAACAACCAGCCACAGGACTACCA 
               
               
                   
               
               
                 AGAGCCACAAAACCACCACTCACAGGACAACCACCACAGGCACCACCAGC 
               
               
                   
               
               
                 CACGGACCCACGACTGCCACTCACAACCCCACCACCACCAGCCATGGAAA 
               
               
                   
               
               
                 CGTCACAGTTCATCCAACAAGCAATAGCACTGCCACCAGCCAGGGACCCT 
               
               
                   
               
               
                 CAACTGCCACTCACAGTCCTGCCACCACTAGTCATGGAAATGCCACGGTT 
               
               
                   
               
               
                 CATCCAACAAGCAACAGCACTGCCACCAGCCCAGGATTCACCAGTTCTGC 
               
               
                   
               
               
                 CCACCCAGAACCACCTCCACCCTCTCCGAGTCCTAGCCCAACCTCCAAGG 
               
               
                   
               
               
                 AGACCATTGGAGACTACACGTGGACCAATGGTTCCCAGCCCTGTGTCCAC 
               
               
                   
               
               
                 CTCCAAGCCCAGATTCAGATTCGAGTCATGTACACAACCCAGGGTGGAGG 
               
               
                   
               
               
                 AGAGGCCTGGGGCATCTCTGTACTGAACCCCAACAAAACCAAGGTCCAGG 
               
               
                   
               
               
                 GAAGCTGTGAGGGTGCCCATCCCCACCTGCTTCTCTCATTCCCCTATGGA 
               
               
                   
               
               
                 CACCTCAGCTTTGGATTCATGCAGGACCTCCAGCAGAAGGTTGTCTACCT 
               
               
                   
               
               
                 GAGCTACATGGCGGTGGAGTACAATGTGTCCTTCCCCCACGCAGCA CAG T 
               
               
                   
               
               
                 GGACATTCTCGGCTCAGAATGCATCCCTTCGAGATCTCCAAGCACCCCTG 
               
               
                   
               
               
                 GGGCAGAGCTTCAGTTGCAGCAACTCGAGCATCATTCTTTCACCAGCTGT 
               
               
                   
               
               
                 CCACCTCGACCTGCTCTCCCTGAGGCTCCAGGCTGCTCAGCTGCCCCACA 
               
               
                   
               
               
                 CAGGGGTCTTTGGGCAAAGTTTCTCCTGCCCCAGTGACCGGTCC GGCGGC   
               
               
                   
               
               
                   CGC GAGTCTAAGTCCTGTGATAAGACTCATACCTGCCCCCCCTGCCCAGC 
               
               
                   
               
               
                 ACCCGAGGCAGCAGCCGCCCCCTCAGTGTTTCTCTTCCCTCCAAAACCCA 
               
               
                   
               
               
                 AGGATACCCTGATGATCAGCCGTACACCTGAGGTCACCTGCGTAGTCGTC 
               
               
                   
               
               
                 GATGTGTCTCACGAGGACCCGGAGGTGAAGTTTAATTGGTATGTGGACGG 
               
               
                   
               
               
                 GGTAGAAGTGCATAATGCCAAGACTAAACCTCGAGAGGAACAATATAACT 
               
               
                   
               
               
                 CCACCTATAGGGTGGTCAGCGTTCTCACGGTCCTTCACCAGGACTGGTTG 
               
               
                   
               
               
                 AATGGAAAGGAATACAAGTGTAAGGTGAGCAACAAAGCCCTGCCCGCTTC 
               
               
                   
               
               
                 CATAGAAAAGACAATCTCCAAAGCTAAAGGGCAGCCACGGGAACCTCAGG 
               
               
                   
               
               
                 TGTACACCCTGCCGCCTAGCAGAGATGAGCTCACAAAGAACCAGGTGTCT 
               
               
                   
               
               
                 CTGACATGCTTGGTGAAGGGTTTCTATCCTTCGGACATTGCCGTTGAGTG 
               
               
                   
               
               
                 GGAAAGTAACGGCCAGCCTGAGAATAACTACAAGACCACACCACCCGTTC 
               
               
                   
               
               
                 TTGACTCTGATGGGAGTTTCTTTTTGTACAGTAAGTTAACTGTCGACAAA 
               
               
                   
               
               
                 TCACGCTGGCAGCAAGGAAATGTTTTCTCTTGTTCCGTGATGCACGAGGC 
               
               
                   
               
               
                 ACTGCACAACCATTACACTCAGAAATCCCTGAGCCTATCACCAGGCAAAT 
               
               
                   
               
               
                 AA 
               
             
          
         
       
     
         [0079]    The coding sequence for the connecting element is underlined. Following the coding sequence of the connecting element (towards the N terminus) the segment is located which encodes the extracellular domain of CD68, whereby the polymorphism is indicated in bold letters, following the coding sequence of the connecting element (towards the C terminus) the segment is located which encodes the second polypeptide which is derived from the Fc fragment and mediates the dimerization. 
       1.8 Nucleotide Sequence Encoding the Entire Construct Including the Connecting Element, Polymorphism 2 (SEQ ID No. 8) 
       [0080]      
         [0000]    
       
         
               
               
             
           
               
                 AATGACTGTCCTCACAAAAAATCAGCTACTTTGCTGCCATCCTTCACGGT 
                   
               
               
                   
               
               
                 GACACCCACGGTTACAGAGAGCACTGGAACAACCAGCCACAGGACTACCA 
               
               
                   
               
               
                 AGAGCCACAAAACCACCACTCACAGGACAACCACCACAGGCACCACCAGC 
               
               
                   
               
               
                 CACGGACCCACGACTGCCACTCACAACCCCACCACCACCAGCCATGGAAA 
               
               
                   
               
               
                 CGTCACAGTTCATCCAACAAGCAATAGCACTGCCACCAGCCAGGGACCCT 
               
               
                   
               
               
                 CAACTGCCACTCACAGTCCTGCCACCACTAGTCATGGAAATGCCACGGTT 
               
               
                   
               
               
                 CATCCAACAAGCAACAGCACTGCCACCAGCCCAGGATTCACCAGTTCTGC 
               
               
                   
               
               
                 CCACCCAGAACCACCTCCACCCTCTCCGAGTCCTAGCCCAACCTCCAAGG 
               
               
                   
               
               
                 AGACCATTGGAGACTACACGTGGACCAATGGTTCCCAGCCCTGTGTCCAC 
               
               
                   
               
               
                 CTCCAAGCCCAGATTCAGATTCGAGTCATGTACACAACCCAGGGTGGAGG 
               
               
                   
               
               
                 AGAGGCCTGGGGCATCTCTGTACTGAACCCCAACAAAACCAAGGTCCAGG 
               
               
                   
               
               
                 GAAGCTGTGAGGGTGCCCATCCCCACCTGCTTCTCTCATTCCCCTATGGA 
               
               
                   
               
               
                 CACCTCAGCTTTGGATTCATGCAGGACCTCCAGCAGAAGGTTGTCTACCT 
               
               
                   
               
               
                 GAGCTACATGGCGGTGGAGTACAATGTGTCCTTCCCCCACGCAGCA AAG T 
               
               
                   
               
               
                 GGACATTCTCGGCTCAGAATGCATCCCTTCGAGATCTCCAAGCACCCCTG 
               
               
                   
               
               
                 GGGCAGAGCTTCAGTTGCAGCAACTCGAGCATCATTCTTTCACCAGCTGT 
               
               
                   
               
               
                 CCACCTCGACCTGCTCTCCCTGAGGCTCCAGGCTGCTCAGCTGCCCCACA 
               
               
                   
               
               
                 CAGGGGTCTTTGGGCAAAGTTTCTCCTGCCCCAGTGACCGGTCC GGCGGC   
               
               
                   
               
               
                   CGC GAGTCTAAGTCCTGTGATAAGACTCATACCTGCCCCCCCTGCCCAGC 
               
               
                   
               
               
                 ACCCGAGGCAGCAGCCGCCCCCTCAGTGTTTCTCTTCCCTCCAAAACCCA 
               
               
                   
               
               
                 AGGATACCCTGATGATCAGCCGTACACCTGAGGTCACCTGCGTAGTCGTC 
               
               
                   
               
               
                 GATGTGTCTCACGAGGACCCGGAGGTGAAGTTTAATTGGTATGTGGACGG 
               
               
                   
               
               
                 GGTAGAAGTGCATAATGCCAAGACTAAACCTCGAGAGGAACAATATAACT 
               
               
                   
               
               
                 CCACCTATAGGGTGGTCAGCGTTCTCACGGTCCTTCACCAGGACTGGTTG 
               
               
                   
               
               
                 AATGGAAAGGAATACAAGTGTAAGGTGAGCAACAAAGCCCTGCCCGCTTC 
               
               
                   
               
               
                 CATAGAAAAGACAATCTCCAAAGCTAAAGGGCAGCCACGGGAACCTCAGG 
               
               
                   
               
               
                 TGTACACCCTGCCGCCTAGCAGAGATGAGCTCACAAAGAACCAGGTGTCT 
               
               
                   
               
               
                 CTGACATGCTTGGTGAAGGGTTTCTATCCTTCGGACATTGCCGTTGAGTG 
               
               
                   
               
               
                 GGAAAGTAACGGCCAGCCTGAGAATAACTACAAGACCACACCACCCGTTC 
               
               
                   
               
               
                 TTGACTCTGATGGGAGTTTCTTTTTGTACAGTAAGTTAACTGTCGACAAA 
               
               
                   
               
               
                 TCACGCTGGCAGCAAGGAAATGTTTTCTCTTGTTCCGTGATGCACGAGGC 
               
               
                   
               
               
                 ACTGCACAACCATTACACTCAGAAATCCCTGAGCCTATCACCAGGCAAAT 
               
               
                   
               
               
                 AA 
               
             
          
         
       
     
         [0081]    The coding sequence for the connecting element is underlined. Following the coding sequence for the connecting element (towards the N terminus) the segment is located which encodes the extracellular domain of CD68, whereby the polymorphism 2 is indicated in bold letters, following the coding sequence for the connecting element (towards the C terminus) the segment is located which encodes the second polypeptide which is derived from the Fc fragment and mediates the dimerization. 
       2. Cloning of the CD68-Fc Fusion Protein 
       [0082]    The extracellular domain of human CD68 was amplified from a freshly prepared macrophages cDNA library by means of a polymerase chain reaction (PCR) by using specific primers. At the ends of the fragment new restriction sites were introduced. The fragment was cloned into a plasmid which comprises a leader sequence of the kappa chain of human Ig, by which the leader sequence of CD68 was replaced, to improve the secretion. An artificial gene was synthesized which is derived from the Fc domain of human IgG1. By targeted mutagenesis at the position 331 a proline was substituted by a serine and at the amino acid positions 234 to 237 the tetrapeptide Leu-Leu-Gly-Gly was substituted by Ala-Ala-Ala-Ala. To facilitate the expression of the peptide this polypeptide was optimized for CHO cells with regards to its codons. The two fragments were in each case digested with restriction enzymes and ligated, that the Fc portion is joined to the CD68 portion. This re-suited in a specific connecting sequence between the two parts of the fusion proteins, which consist of three amino acids. In the following the fusion cDMA resulting therefrom is shown: 
         [0000]    
       
         
               
               
             
               
               
             
               
               
             
           
               
                 
                   ATGGAGACAGACACACTCCTGCTATGGGTACTGCTGCTCTGGGTTCCAGGTTCCACTGGT 
                 
                   
               
               
                   
               
               
                   GACGCGGCCCAGCCGGCCAGGCGCGCGCGCCGTACGAAGCTT aatgactgtcctcacaa- 
               
               
                   
               
               
                 aaaatcagctactttgctgccatccttcacggtgacacccacggttacagagagcactg- 
               
               
                   
               
               
                 gaacaaccagccacaggactaccaagagccacaaaaccaccactcacaggacaaccac- 
               
               
                   
               
               
                 cacaggcaccaccagccacggacccacgactgccactcacaaccccaccaccaccagc- 
               
               
                   
               
               
                 catggaaacgtcacagttcatccaacaagcaatagcactgccaccagccagggaccct- 
               
               
                   
               
               
                 caactgccactcacagtcctgccaccactagtcatggaaatgccacggttcatccaa- 
               
               
                   
               
               
                 caagcaacagcactgccaccagcccaggattcaccagttctgcccacccagaac- 
               
               
                   
               
               
                 cacctccaccctctccgagtcctagcccaacctccaaggagaccattggagacta- 
               
               
                   
               
               
                 cacgtggaccaatggttcccagccctgtgtccacctccaagcccagattcagattc- 
               
               
                   
               
               
                 gagtcatgtacacaacccagggtggaggagaggcctggggcatctctgtactgaaccc- 
               
               
                   
               
               
                 caacaaaaccaaggtccagggaagctgtgagggtgcccatccccacctgcttctct- 
               
               
                   
               
               
                 cattcccctatggacacctcagctttggattcatgcaggacctccagcagaaggttgtc- 
               
               
                   
               
               
                 tacctgagctacatggcggtggagtacaatgtgtccttcccccacgcagca cag tgga- 
               
               
                   
               
               
                 cattctcggct 
               
               
                   
               
             
          
           
               
                 cag/aag polymorphism 
                   
               
             
          
           
               
                 cagaatgcatcccttcgagatctccaagcacccctggggcagagcttcagttgcagcaac 
                   
               
               
                   
               
               
                 tcgagcatcattctttcaccagctgtccacctcgacctgctctccctgaggctccaggct 
               
               
                   
               
               
                 gctcagctgccccacacaggggtctttgggcaaagtttctcctgccccagtgaccggtcc 
               
               
                   
               
               
                 GGCGGCCGCGAGTCTAAGTCCTGTGATAAGACTCATACCTGCCCCCCCTGCCCAGCACCC 
               
               
                   
               
               
                 GAGGCAGCAGCCGCCCCCTCAGTGTTTCTCTTCCCTCCAAAACCCAAGGATACCCTGATG 
               
               
                   
               
               
                 ATCAGCCGTACACCTGAGGTCACCTGCGTAGTCGTCGATGTGTCTCACGAGGACCCGGAG 
               
               
                   
               
               
                 GTGAAGTTTAATTGGTATGTGGACGGGGTAGAAGTGCATAATGCCAAGACTAAACCTCGA 
               
               
                   
               
               
                 GAGGAACAATATAACTCCACCTATAGGGTGGTCAGCGTTCTCACGGTCCTTCACCAGGAC 
               
               
                   
               
               
                 TGGTTGAATGGAAAGGAATACAAGTGTAAGGTGAGCAACAAAGCCCTGCCCGCTTCCATA 
               
               
                   
               
               
                 GAAAAGACAATCTCCAAAGCTAAAGGGCAGCCACGGGAACCTCAGGTGTACACCCTGCCG 
               
               
                   
               
               
                 CCTAGCAGAGATGAGCTCACAAAGAACCAGGTGTCTCTGACATGCTTGGTGAAGGGTTTC 
               
               
                   
               
               
                 TATCCTTCGGACATTGCCGTTGAGTGGGAAAGTAACGGCCAGCCTGAGAATAACTACAAG 
               
               
                   
               
               
                 ACCACACCACCCGTTCTTGACTCTGATGGGAGTTTCTTTTTGTACAGTAAGTTAACTGTC 
               
               
                   
               
               
                 GACAAATCACGCTGGCAGCAAGGAAATGTTTTCTCTTGTTCCGTGATGCACGAGGCACTG 
               
               
                   
               
               
                 CACAACCATTACACTCAGAAATCCCTGAGCCTATCACCAGGCAAATAA 
               
             
          
         
       
     
         [0083]    The IgG leader (human Ig kappa chain) including amino acids from the MCS for constructive reasons are shown in the first part of the molecule in capital and bold letters (IgG leader) and underlined (MCS), in the following the extracellular domain of human CD68 is shown in lower case letters, a cag-aag polymorphism is indicated in bold letters; in the following a connecting segment is shown, which comprises nine nucleotides and is printed in bold letters and underlined; in the following the coding sequence or the polypeptide derived from the Fc fragment are shown, which was optimized for CHO in view of their codons and which is mutated in complement and Fc receptor area. 
         [0084]    The encoded fusion protein is schematically shown in the following: 
         [0000]    
       
         
               
               
               
             
           
               
                   
                    Leader peptide        MCS spacer        CD68 
                   
               
               
                   1 
                   METDTLLLWV LLLWVPGSTG    DAAQPARRAR RTKL NDCPHK KSATLLPSFT 
               
               
                   
               
               
                  51 
                 VTPTVTESTG TTSHRTTKSH KTTTHRTTTT GTTSHGPTTA THNPTTTSHG 
               
               
                   
               
               
                 101 
                 NVTVHPTSNS TATSQGPSTA THSPATTSHG NATVHPTSNS TATSPGFTSS 
               
               
                   
               
               
                 151 
                 AHPEPPPPSP SPSPTSKETI GDYTWTNGSQ PCVHLQAQIQ IRVMYTTQGG 
               
               
                   
               
               
                 201 
                 GEAWGISVLN PNKTKVQGSC EGAHPHLLLS FPYGHLSFGF MQDLQQKVVY 
               
               
                   
               
               
                 251 
                 LSYMAVEYNV SFPHAAQWTF SAQNASLRDL QAPLGQSFSC SNSSIILSPA 
               
               
                   
               
               
                 301 
                 VHLDLLSLRL QAAQLPHTGV FGQSFSCPSD RS GGR ESKSC DKTHTCPPCP 
               
               
                   
               
               
                   
                                                connection     hIgGlmut 
               
               
                 351 
                 APEAAAAPSV FLFPPKPKDT LMISRTPEVT CVVVDVSHED PEVKFNWYVD 
               
               
                   
               
               
                 401 
                 GVEVHNAKTK PREEQYNSTY RVVSVLTVLH QDWLNGKEYK CKVSNKALPA 
               
               
                   
               
               
                 451 
                 SIEKTISKAK GQPREPQVYT LPPSRDELTK NQVSLTCLVK GFYPSDIAVE 
               
               
                   
               
               
                 501 
                 WESNGQPENN YKTTPPVLDS DGSFFLYSKL TVDKSRWQQG NVFSCSVMHE 
               
               
                   
               
               
                 551 
                 ALHNHYTQKS LSLSPGK* 
               
             
          
         
       
     
         [0085]    The leader peptide is shown in bold letters (this segment is preferably not present in the fusion protein according to the invention or only parts thereof), followed by the MCS spacer which is underlined (this segment can also be absent, however, might also be present in the fusion protein according to the invention), followed by the extracellular domain of human CD68, followed by the connecting element comprising three amino acids, which is also underlined, followed by the polypeptide derived from the Fc fragment of the human IgG1 molecule, which is optimized for CHO in view of its codons and is mutated in the complement and Fc receptor binding area (hIgG1mut). “*” at the carboxy terminal end represents the stop codon. 
         [0086]    The fusion cDNA was again digested by restriction enzymes and introduced into a pcDNA5 plasmid vector (Invitrogen) by means of conventional cloning. The resulting plasmid vector is designated as pcDNA5-FRT-CD68-Fc-opt. 
       3. Production of CHO Cells which Express the CD68-Fc Fusion Protein in a Stable Manner 
       [0087]    Flp-In™-CHO cells (invitrogen) at a confluence of 70% were co-transfected with the plasmids pOG44:pcDNA5-FRT-CD68-Fc-opt (both Invitrogen) in the ratio of 9:1. 24 hours after the transfection the cells were washed and fresh media was added. 48 hours after the transfection the cells were transferred 1:20 into fresh medium containing 500 mg/ml hygromycin. Hygromycin resistant foci were isolated and expanded. 
         [0088]    The expanded transformants were analyzed for the expression of the CD68-Fc fusion protein ( FIG. 1 : CD68-Fc) by means of Western Blot analysis (SDS-PAGE) by the use of antibodies directed against human Fc. A secondary anti-human Fc antibody was used. Fc protein was used as a control ( FIG. 1 : Fc), which did not comprise an extracellular CD68 domain. For CD68-Fc under non-reducing conditions a specific band at 160 kDa ( FIG. 1 , left) and under reducing conditions at 115 kDa ( FIG. 1 , right) was shown. 
         [0089]    Furthermore a quantitative detection was performed by means of a human IgG-ELISA. Herewith in the cell culture supernatants of the producing CHO cell line a concentration of CD68-Fc of about 2 mg/ml could be detected, whereas with the wild type cells no CD68-Fc fusion protein could be detected. 
       4. Purification of the CD68 Fusion Protein 
       [0090]    The CHO cells which express the CD68-Fc fusion protein in a stable manner were cultivated. Three days after the infection the culture supernatant was centrifuged at 3800 g for 30 minutes at 4° C. and filtrated through a filter having a pore size of 0.2 μm. The CD68 fusion protein was precipitated by the addition of 1.2 volumina of ammonium sulfate (761 g/l) and shaking over night at 4° C. 
         [0091]    The proteins were pelleted by centrifugation at 3000 g for 30 minutes at 4° C., dissolved in 0.1 volumina PBS and dialyzed in PBS at 4° C. over night. The protein solution was cleared by centrifugation at 14000 g for 30 minutes at 4° C. and filtration through a filter having a pore size of 0.2 μm and loaded onto a protein A column (HiTrap™) protein A HP, (Amersham Pharmacia Wiotech AB, Upsalla, Sweden) which was previously equilibrated with binding buffer (20 mM sodium phosphate buffer pH 7.0, 0.02% NaN 3 ). The column was washed with binding buffer up to a OD 280 &lt;0.01 and eluted with elution buffer (100 mM glycine pH 2.7). 
         [0092]    The eluted fractions of 900 μl each were neutralized with 100 μl neutralization buffer (1 M Tris-HCl pH 9.0, 0.02% NaN 3 ), pooled, dialyzed in PBS at 4° C. over night, aliquoted and freezed at −20° C. The column was neutralized with binding buffer, washed with 20% (v/v) of ethanol and stored in a refrigerator. 
       5. Differentiation of CD34 +  Stem Cells into Foam Cells by Co-Cultivation with Thrombocytes 
       [0093]    To isolate human thrombocytes venous blood was withdrawn from healthy test persons and collected into acidic citrate dextrose (ACD) buffer. After the centrifugation at 430 g for 20 minutes the platelet-rich plasma (PRP) was removed, added to Tyrodes HEPES buffer (2.5 mM HEPES, 150 mM NaCl, 1 mM HCl, 2.5 mM NaHCO 3 , 0.36 mM NaH 2 PO 4 , 5.5 mM glucose, 1 mg/ml BSA, pH 6.5) and centrifuged at 900 g for 10 minutes. After the removal of the supernatant the thrombocyte containing pellet was suspended in Tyrodes HEPES buffer (pH 7.4). 
         [0094]    This method results in a high purity of the thrombocytes without a measurable contamination by polymorph nuclear cells or monocytes, which was verified by the absence of CD14 (flow cytometry and myeloperoxydase-ELISA). The before-mentioned method is described in Langer H. et al. (2006; electronically 2005), Adherent platelets recruit and induce differentiation of murine embryonic endothelial progenitor cells to mature endothelial cells in vitro, Circ. Res. 98(2): e2-10. 
         [0095]    Human CD34 +  cells were isolated from human cord blood. This was obtained after the approval of the local ethics committee from healthy women immediately after the birth of a child. At least 95% of the isolated cells were positive for CD34 +  which was confirmed by means of flow cytometry analysis after each isolation. Human mononuclear cells were also obtained from cord blood by density gradient centrifugation on the Biocoll separation solution (BIOCROM Berlin, Germany) at 600 g for 15 minutes. CD34 +  cells were enriched by immunoaffinity selection (CD34 progenitor cell isolation kit; Milteenyi Biotec, Bergisch Gladbach, Germany) according to the manual of the producer. In the following the cells were incubated on 96 well plates which were covered with 0.2% gelatine. For the cultivation of the cells IMDM with glutamax, supplemented with 5% heat-inactivated fetal calf serum, 100 mg/ml penicillin-streptomycin, 1% MEM vitamins and 1% non-essential amino acids were used, all purchased from Gibco (Invitrogen, Karlsruhe, Germany). CD34 +  progenitor cells (50000 cells) were co-cultivated at 37° C. and 5% CO 2  with thrombocytes (2×10 8 -ml) in 96 well plates which were pre-covered with 0.2% gelatine. The formation of foam cells was counted in six windows by means of phase contrast microscopy. 
         [0096]    The phase contrast microscopy showed a differentiation of CD34 +  stem cells into foam cells as this is presented in  FIG. 2A . In the left image control CD34 +  cells without foam cells&#39; formation are shown, in the right image the foam cells&#39; formation in the presence of thrombocytes (arrow) is shown. It is demonstrated by positive immunofluorescent staining of the scavenger receptor CD68 ( FIG. 2B ) and transmission electromicroscopic images which show a foam cell ( FIG. 2C ) that the “giant cells” resulting from the co-cultivation of CD34 +  cells and thrombocytes are in fact foam cells. 
       6. Functional Characterization of the Obtained Foam Cells 
       [0097]    To functionally characterize the foam cells which were produced in vitro it was tested whether they can absorb acetylated LDL (acLDL). This was done by an incubation of the obtained foam cells with fluorescent-labeled acLDL (Dil-AcLDL) and a staining of the dense granules with mepacrine. The subsequent confocal lasermicroscopic imaging demonstrates clearly the absorption of acLDL into the obtained foam cells and therewith their functionality; cf.  FIG. 3A , scale bar 25 μm. 
         [0098]    Moreover the method of ROS (“Reactive Oxigen Species”) measurement was used. Typically in the course of an inflammation process monocytes infiltrate the vascular wall, there differentiate into macrophages and produce cytokines, proteases such as the matrix metalloproteinase (MMP) and complement factors, but also free oxidized radicals, i.e. ROS. For the foam cells resulting from the co-incubation of CD34 +  stem cells with thrombocytes in vitro it was detected that they release ROS and also produce matrix metalloproteinase 9 (MMP-9). This also demonstrates that functional foam cells were obtained. 
       7. Inhibition of the Foam Cell Formation and Functions by the CD68-Fc Fusion Protein 
       [0099]    Foam cells were produced by co-incubation of CD34 +  stem cells with thrombocytes for 10 days in vitro. A portion of the cultures was treated with CD68-Fc homodimers, another portion was treated with pure Fc as a control. In the following it was microscopically analyzed whether the foam cell formation was inhibited by the incubation with the CD68-Fc homodimers. The result is shown in  FIG. 3B . It is demonstrated that a treatment with Fc (left partial figure) has no effect on the foam cell formation, whereas the treatment with CD68-Fc homodimers (right partial figure) inhibited the formation of the foam cells. 
         [0100]    In  FIG. 3C  the dependence of the reduction of the foam cell formation on the dosage of the CD68-Fc homodimer is shown. At a concentration of 400 μg/ml of the CD68-Fc homodimer the foam cell formation is virtually completely inhibited. As a control again pure Fc was used. 
         [0101]    Further, in another experiment it was found that the expression of MMP-9 in the supernatant of foam cells was inhibited by the incubation of increasing concentrations of CD68-Fc homodimer in relation with control protein. The result of this experiment is shown in  FIG. 4 . The bands correspond to the expression level of MMP-9. In the corresponding lanes the following samples were loaded: 1. control CD34, 2. control CD34, 3. control protein 100 g/ml, 4. control protein 400 μg/ml, 5. CD68-Fc homodimer 100 g/ml, 6. CD68-Fc homodimer 200 g/ml, 7. CD68-Fc homodimer 400 g/ml, 8. Fluvastatin 1 μM. It could be demonstrated that the presence of CD68-Fc homodimer (lanes 5, 6, and 7) results in a clear inhibition of the formation of MMP-9 by the foam cells similar as with the well characterized statin Fluvastatin (lane 8). 
       8. CD68-Fc Fusion Protein as Diagnostic Agents 
       [0102]    Atherosclerotic plaques from the carotid of patients, removed within the context of a surgery, were disintegrated, suspended, transferred to culture plates and surface-dried. Then a specific ELISA against the Fc portion of the CD68 or GPVI or pure Fc, respectively, was performed. The result is shown in  FIG. 5A . In a parallel immunohistological analysis of human tissue from thrombus endarterectomy preparations of the Arteria carotis were performed. The result is shown in  FIG. 5B . 
         [0103]    In both cases it was shown that a significant binding of CD68-Fc fusion protein to atherosclerotic plaque tissue takes place in relation to control Fc protein (Fc) which shows no specific binding to plaque tissue. As a positive control a protein was used which binds to collagen structures in human plaque tissue (control). 
         [0104]    Furthermore an in vivo application of J124-labeled CD68-Fc in atherosclerotic Apo E mice and in wild type mice was performed. J124-labeled CD68-Fc was administered into 24 weeks old atherosclerotic mice or in control wild type mice without any significant atherosclerosis. The organs were then removed and the A. carotis on both sides and the aortic arch were analyzed by autoradiography ex vivo. The result is shown in  FIG. 6   
         [0105]    As shown in the partial figure (A) a remarkably increased radioactivity can be seen in the atherosclerotic vascular segments in relation to the non-atherosclerotic vessels. A staining with oil-red and a corresponding autoradiography is shown in partial figure (B). Partial figure (C) shows a quantitative evaluation of the autoradiography. 
         [0106]    It can be shown that atherosclerotic vessels (aortic arch) removed from the Apo E mice comprise considerably increased accumulation of J124 label CD68-Fc fusion protein in relation to non-atherosclerotic vessels removed from wild type mice. No significantly increased accumulation of CD68-Fc fusion protein in Apo E mice can be seen in the area of the A. carotis in relation to the wild type.