Patent Publication Number: US-2012034224-A1

Title: Treating Rheumatoid Arthritis with Anti-IL-19 Antibody

Description:
BACKGROUND OF THE INVENTION 
     In rheumatoid arthritis (RA), an autoimmune disease, immune cells attack and destroy normal body tissues, resulting in various symptoms such as fever, fatigue, weight loss, and red and swollen joints. 
     RA is characterized by infiltration in synovial joints of mononuclear phagocytes, lymphocyts, and neutrophils into synovial membranes and resultant intense inflammation. The self-antigen(s) that triggers autoimmune responses in RA patients remains elusive. 
     Interleukin 19 (IL-19) is a cytokine expressed in resting monocytes and B cells. It has been suggested that IL-19 plays a role in regulating inflammation. 
     SUMMARY OF THE INVENTION 
     The present invention is based on unexpected discoveries that monoclonal anti-IL-19 antibody 1BB1 reduces disease severity and rescues bone mineral density decrease in collagen-induced-arthritis rats, an animal model for RA. 
     Accordingly, one aspect of this invention features a method of treating RA by administering to a subject in need of the treatment an effective amount of a composition containing an anti-IL-19 antibody (e.g., monoclonal antibody 1BB1 or a genetically engineered antibody derived from 1BB1) and, optionally, another anti-RA agent, such as an anti-IL-20 antibody, an anti-IL-20R1 antibody, an anti-tumor necrosis factor α (TNFα) antibody, an, anti-IL-6 receptor antibody, or a soluble TNFα receptor (e.g., etanercept). The anti-IL-19, anti-IL-20, anti-IL-20R1, anti-IL-6 receptor, or anti-TNFαantibody can be a naturally-occurring antibody (e.g., a monoclonal antibody), an antigen-binding fragment thereof (e.g., F(ab′) 2 , Fab, or Fv), or a genetically engineered antibody (e.g., chimeric antibody, humanized antibody, or single-chain antibody) that neutralizes IL-19, IL-20, IL-20R1, IL-6 receptor, or TNFα, i.e., binding to one of these antigens and blocking the signaling pathway mediated by it. 
     The anti-IL-19 antibody used in the method of this invention can contain (1) a heavy chain variable region (V H ) that includes all of the complementarity-determining regions (CDRs) in the V H  of antibody 1BB1 (SEQ ID NO:2), and (2) a light chain variable region (V L ) that includes all of the CDRs in the V L  of antibody 1BB1 (SEQ ID NO:6). In one example, the anti-IL-19 antibody includes the same V H  and V L  as antibody 1BB1. 
     The anti-IL-20 antibody to be co-used with an anti-IL-19 antibody for treating RA can contain (1) a V H  that includes all of the CDRs in the V H  of monoclonal antibody 7E (SEQ ID NO:12), and (2) a V L  that includes all of the CDRs in the V L  of antibody 7E (SEQ ID NO:16). In one example, the anti-IL-20 antibody includes the same V H  and V L  as antibody 7E. 
     When the composition used in the above-described method includes two antibodies (i.e., an anti-IL-19 antibody and an antibody specific to IL-20, IL-20R1, IL-6 receptor, or TNFα), these two antibodies can form a bi-specific complex. In one example, both antibodies are Fab antigen-binding fragments that form a bi-specific antibody. 
     Also within the scope of this invention are (1) a pharmaceutical composition for treating RA, the composition containing an anti-IL-19 antibody and, optionally, an anti-IL-20 antibody, an anti-IL-20R1 antibody, an anti-TNFαantibody, or a soluble TNFαreceptor, and (2) the use of this composition in manufacturing a medicament for treating RA. 
     The details of one or more embodiments of the invention are set forth in the description below. Other features or advantages of the present invention will be apparent from the following drawings and detailed description of an example, and also from the appended claims. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The drawings are first described. 
         FIG. 1  is a diagram showing the effect of monoclonal antibody 1BB1 in reducing disease severity in collagen-induced-arthritic (CIA) rats. Panel A: A time-course of hind paw thickness in healthy and CIA rats treated with saline, a control mouse antibody (mIgG), or antibody 1BB1. Values shown in this panel are means±standard errors. Panel B: Box plots showing disease severity scores for healthy rats and CIA rats treated with saline, mIgG, or 1BB1. The upper and lower limits of the boxes mark the 25% and 75% values with the medians as the lines across the boxes. The upper and lower whiskers mark the 90% and 10% values, respectively. 
         FIG. 2  is a chart showing the effect of antibody 1BB1 in rescuing CIA-induced bone mineral density decrease. The values shown in this figure are means±standard deviations. *: P&lt;0.05 as compared with saline-treated rats. 
     
    
    
     DETAILED DESCRIPTION OF THE INVENTION 
     Disclosed herein is a method for treating RA with an effective amount of a pharmaceutical composition containing an anti-IL-19 antibody and, optionally, another anti-RA agent, such as an anti-IL-20, anti-IL-20R1, anti-TNFα antibody, anti-IL-6 receptor antibody, or a soluble TNFα receptor. 
     As used herein, the term “treating” refers to the application or administration of the composition mentioned above to a subject (e.g., a human patient), who has RA, a symptom of RA, or a predisposition toward this disease, with the purpose to cure, heal, alleviate, relieve, alter, remedy, ameliorate, improve, or affect the disease, the symptoms of the disease, or the predisposition toward the disease. “An effective amount” as used herein refers to the amount of each active agent required to confer therapeutic effect on the subject, either alone or in combination with one or more other active agents. Effective amounts vary, as recognized by those skilled in the art, depending on route of administration, excipient choice, and co-usage with other active agents. 
     Any of the antibodies to be used in the method of this invention can be a naturally-occurring antibody, an antigen-binding fragment thereof, or a generically engineered antibody derived therefrom (i.e., having substantially the same antigen-binding residues as a naturally-occurring antibody, thereby preserving the same antigen specificity). 
     Naturally-occurring anti-IL-19 antibodies, either polyclonal or monoclonal, can be prepared by conventional methods, using an IL-19 protein or a fragment thereof as the inducing antigen. See, e.g., Harlow and Lane, (1988) Antibodies: A Laboratory Manual, Cold Spring Harbor Laboratory, New York. A “monoclonal antibody” refers to a homogenous antibody population and a “polyclonal antibody” refers to a heterogenous antibody population. These two terms do not limit the source of an antibody or the manner in which it is made. IL-1.9 is a cytokine well known in the art. For example, human IL-19 can be retrieved from the GenBank under accession numbers: 
     Human IL-19 isoform 1: NP — 715639 (protein) and NM — 153758.1 (gene) 
     Human IL-19 isoform 2: NP — 037503 (protein) and NM — 013371.2 (gene) 
     To produce an anti-IL-19 antibody, this protein or a fragment thereof can be coupled to a carrier protein, such as KLH, mixed with an adjuvant, and injected into a host animal. Antibodies produced in the animal can then be purified by a protein A column and/or affinity chromatography. Commonly employed host animals include rabbits, mice, guinea pigs, and rats. 
     Various adjuvants that can be used to increase the immological response depend on the host species and include Freund&#39;s adjuvant (complete and incomplete), mineral gels such as aluminum hydroxide, CpG, surface-active substances such as lysolecithin, pluronic polyols, polyanions, peptides, oil emulsions, keyhole limpet hemocyanin, and dinitrophenol. Useful human adjuvants is include BCG (bacille Calmette-Guerin) and  Corynebacterium parvum.    
     Polyclonal antibodies are present in the sera of the immunized subjects. Monoclonal antibodies can be prepared using standard hybridoma technology (see, for example, Kohler et al. (1975) Nature 256, 495; Kohler et (1976) Eur. J. Immunol. 6, 51.1; Kohler et al. (1976) Eur J Immunol 6, 292; and Hammerling et al. (1981) Monoclonal Antibodies and T Cell Hybridomas, Elsevier, N.Y.). In particular, monoclonal antibodies can be obtained by any technique that provides for the production of antibody molecules by continuous cell lines in culture such as described in Kohler et al. (1975) Nature 256, 495 and U.S. Pat. No. 4,376,110; the human B-cell hybridoma technique (Kosbor et al. (1983) Immunol Today 4, 72; Cole et al. (1983) Proc. Natl. Acad. Sci. USA 80, 2026, and the EBV-hybridoma technique (Cole et al. (1983) Monoclonal Antibodies and Cancer Therapy, Alan R. Liss, Inc., pp. 77-96). Such antibodies can be of any immunoglobulin class including IgG, IgM, IgE, IgA, IgD, and any subclass thereof. The hybridoma producing the monoclonal antibodies of the invention may be cultivated in vitro or in vivo. The ability to produce high titers of monoclonal antibodies in vivo makes it a particularly useful method of production. After obtaining antibodies specific to IL-19, their ability to neutralize IL-19 can be determined by a routine procedure. 
     Fully human anti-IL-19 antibodies, such as those expressed in transgenic animals are also features of the invention. See, e.g., Green et al., Nature Genetics 7:13 (1994), and U.S. Pat. Nos. 5,545,806 and 5,569,825. 
     Antigen-binding fragments (e.g., F(ab′) 2 , Fab, or Fv) of a naturally-occurring antibody can be generated by known techniques. For example, F(ab′) 2  fragments can be produced by pepsin digestion of an antibody molecule and Fab fragments can be generated by reducing the disulfide bridges of F(ab′) 2  fragments. 
     The anti-IL-19 antibody to be used in this invention can also be a genetically engineered antibody, e.g., a humanized antibody, a chimeric antibody, a single chain antibody (scFv), or a domain antibody (dAb; see Ward, et. Al., 1989, Nature, 341:544-546). 
     A humanized antibody contains a human immunoglobulin (i.e., recipient antibody) in which regions/residues responsible for antigen binding (i.e., the CDRs, particularly the specific-determining residues therein) are replaced with those from a non-human immunoglobulin (i.e., donor antibody). In some instances, one or more residues inside a frame region of the recipient antibody are also replaced with those from the donor antibody. A humanized antibody may also contain residues from neither the recipient antibody nor the donor antibody. These residues are included to further refine and optimize antibody performance. Antibodies can also be humanized by methods known in the art, e.g., recombinant technology. 
     A chimeric antibody is a molecule in which different portions are derived from different animal species, such as those having a variable region derived from a murine monoclonal antibody and a human immunoglobulin constant region. Such an antibody can be prepared via routine techniques described in, e.g., Morrison et al. (1984) Proc. Natl. Acad. Sci. USA 81, 6851; Neuberger et al. (1984) Nature 312, 604; and Takeda et al. (1984) Nature 314:452. 
     A single-chain antibody can be prepared via recombinant technology by linking a nucleotide sequence coding for a V H  chain and a nucleotide sequence coding for a V L  chain. Preferably, a flexible linker is incorporated between the two variable regions. Alternatively, techniques described for the production of single chain antibodies (U.S. Pat. Nos. 4,946,778 and 4,704,692) can be adapted to produce a phage scFv library and scFv clones specific to IL-19 can be identified from the library following routine procedures. Positive clones can be subjected to further screening to identify those that suppress IL-1.9 activity. 
     In one example, the anti-IL-19 antibody to be used in the method of this invention is monoclonal antibody 1BB1 (see Hsing et al.,  Cytokine  44:221-228; 2008), an antigen binding fragment thereof, or a genetically-engineered functional variant thereof. Shown below are the amino acid sequences for the heavy and light chains of this monoclonal antibody, as well as their encoding nucleotide sequences: 
     
       
         
           
               
               
            
               
                 Heavy chain amino acid sequence: 
                   
               
               
                 (SEQ ID NO: 1) 
                   
               
               
                   M R V L I L L W L F T A F P G I L S   D V Q L Q E S G P G L V K P S Q S L S L T   
                   
               
               
                   
               
               
                 
                   C T V T G Y S I T  
                   
                     S D Y A W N 
                   
                    W I R Q F P G N K L E W M V  
                   
                     Y I T Y S G I T G Y 
                   
                 
               
               
                   
               
               
                 
                   
                     N P S L K S 
                   
                    R I S I T R D T S K N Q F F L Q L N S V T T G D T A T Y Y C A R  
                   
                     Y 
                   
                 
               
               
                   
               
               
                     T T T A F D Y      W G Q G T T L T V S S  A K T T P P S V Y P L A P G S A A Q T N S 
               
               
                   
               
               
                 M V T L G C L V K G Y F P E P V T V T W N S G S L S S G V H T F P A V L Q S D 
               
               
                   
               
               
                 L Y T L S S S V T V P S S T W P S E T V T C N V A H P A S S T K V D K K I  V P   
               
               
                   
               
               
                   R D C G C K P C I C T  V P E V S S V F I F P P K P K D V L T I T L T P K V T C 
               
               
                   
               
               
                 V V V D I S K D D P E V Q F S W F V D D V E V H T A Q T Q P R E E Q F N S T F 
               
               
                   
               
               
                 R S V S E L P I M H Q D W L N G K E F K C R V N S A A F P A P I E K T I S K T 
               
               
                   
               
               
                 K G R P K A P Q V Y T I P P P K E Q M A K D K V S L T C M I T D F F P E D I T 
               
               
                   
               
               
                 V E W Q W N G Q P A E N Y K N T Q P I M D T D G S Y F V Y S K L N V Q K S N W 
               
               
                   
               
               
                 E A G N T F T C S V L H E G L H N H H T E K S L S H S P G K 
               
               
                 Italic region: signal peptide 
               
               
                 Bold-faced region: variable chain (SEQ ID NO: 2) 
               
               
                 Bold-faced and underlined regions: CDRs 
               
               
                 Regular font regions: constant regions 
               
               
                 Underlined region: hinge region 
               
               
                   
               
               
                 Heavy chain nucleotide sequence: 
               
               
                 (SEQ ID NO: 3) 
                   
               
               
                 
                   ATGAGAGTGCTGATTCTTTTGTGGCTGTTCACAGCCTTTCCTGGTATCCTGTCT 
                   GATGTGCAGCTTCAGGAGTCGGG 
                 
                   
               
               
                   
               
               
                 
                   ACCTGGCCTGGTGAAACCTTCTCAGTCTCTGTCCCTCACCTGCACTGTCACTGGCTACTCAATCACC 
                   
                     AGTGATTATG 
                   
                 
               
               
                   
               
               
                 
                   
                     CCTGGAAC 
                   
                   TGGATCCGGCAGTTTCCAGGAAACAAACTGGAGTGGATGGTC 
                   
                     TACATAACCTACAGTGGTATCACTGGC 
                   
                 
               
               
                   
               
               
                 
                   
                     TATAACCCCTCTCTCAAAAGT 
                   
                   CGGATCTCTATCACTCGAGACACATCCAAGAACCAGTTCTTCCTGCAGTTGAATTC 
                 
               
               
                   
               
               
                 
                   TGTGACTACTGGGGACACAGCCACCTATTACTGTGCAAGA 
                   
                     TATACTACGACTGCGTTTGACTAC 
                   
                   TGGGGCCAAGGCA 
                 
               
               
                   
               
               
                   CCACTCTCACGGTCTCCTCA GCCAAAACGACACCCCCATCTGTCTATCCACTGGCCCCTGGATCTGCTGCCCAAACT 
               
               
                   
               
               
                 AACTCCATGGTGACCCTGGGATGCCTGGTCAAGGGCTATTTCCCTGAGCCAGTGACAGTGACCTGGAACTCTGGATC 
               
               
                   
               
               
                 CCTGTCCAGCGGTGTGCACACCTTCCCAGCTGTCCTGCAGTCTGACCTCTACACTCTGAGCAGCTCAGTGACTGTCC 
               
               
                   
               
               
                 CCTCCAGCACCTGGCCCAGCGAGACCGTCACCTGCAACGTTGCCCACCCGGCCAGCAGCACCAAGGTGGACAAGAAA 
               
               
                   
               
               
                 ATT GTGCCCAGGGATTGTGGTTGTAAGCCTTGCATATGTACA GTCCCAGAAGTATCATCTGTCTTCATCTTCCCCCC 
               
               
                   
               
               
                 AAAGCCCAAGGATGTGCTCACCATTACTCTGACTCCTAAGGTCACGTGTGTTGTGGTAGACATCAGCAAGGATGATC 
               
               
                   
               
               
                 CCGAGGTCCAGTTCAGCTGGTTTGTAGATGATGTGGAGGTGCACACAGCTCAGACGCAACCCCGGGAGGAGCAGTTC 
               
               
                   
               
               
                 AACAGCACTTTCCGCTCAGTCAGTGAACTTCCCATCATGCACCAGGACTGGCTCAATGGCAAGGAGTTCAAATGCAG 
               
               
                   
               
               
                 GGTCAACAGTGCAGCTTTCCCTGCCCCCATCGAGAAAACCATCTCCAAAACCAAAGGCAGACCGAAGGCTCCACAGG 
               
               
                   
               
               
                 TGTACACCATTCCACCTCCCAAGGAGCAGATGGCCAAGGATAAAGTCAGTCTGACCTGCATGATAACAGACTTCTTC 
               
               
                   
               
               
                 CCTGAAGACATTACTGTGGAGTGGCAGTGGAATGGGCAGCCAGCGGAGAACTACAAGAACACTCAGCCCATCATGGA 
               
               
                   
               
               
                 CACAGATGGCTCTTACTTCGTCTACAGCAAGCTCAATGTGCAGAAGAGCAACTGGGAGGCAGGAAATACTTTCACCT 
               
               
                   
               
               
                 GCTCTGTGTTACATGAGGGCCTGCACAACCACCATACTGAGAAGAGCCTCTCCCACTCTCCTGGTAAATGA  
               
               
                 Italic region: signal peptide coding sequence 
               
               
                 Bold-faced region: variable chain coding sequence (SEQ ID NO: 4) 
               
               
                 Bold-faced and underlined regions: CDR coding sequences 
               
               
                 Regular font regions: constant region coding sequences 
               
               
                 Underlined region: hinge region coding sequence 
               
               
                   
               
               
                 Light chain amino acid sequence: 
               
               
                 (SEQ ID NO: 5) 
                   
               
               
                   M K L P V R L L V L M F W I P A S R S   D I V M T Q T P L S L P V S L G D Q A S   
                   
               
               
                   
               
               
                 
                   I S C  
                   
                     R S S Q S L V H S N G K T Y L H 
                   
                    W Y L Q K P G Q S P K L L I Y  
                   
                     K V S  
                     N 
                      R 
                   
                 
               
               
                   
               
               
                     F S      G V P D R F S G S G S G T D F T L K I S R V E A E D L G V Y F C      S Q S T H     
               
               
                   
               
               
                     V P     W T F G G G T K L E I K R  A D A A P T V S I F P P S S E Q L T S G G A S V 
               
               
                   
               
               
                 V C F L N N F Y P K D I N V K W K I D G S E R Q N G V L N S W T D Q D S K D S 
               
               
                   
               
               
                 T Y S M S S T L T L T K D E Y E R H N S Y T C E A T H K T S T S P I V K S F N 
               
               
                   
               
               
                 R N E C 
               
               
                 Italic region: signal peptide 
               
               
                 Bold-faced region: variable chain (SEQ ID NO: 6) 
               
               
                 Bold-faced and underlined regions: CDRs 
               
               
                 Regular font region: constant region 
               
               
                 Underlined region: joining segment 
               
               
                   
               
               
                 Light chain nucleotide sequence: 
               
               
                 (SEQ ID NO: 7) 
                   
               
               
                 
                   ATGAAGTTGCCTGTTAGGCTGTTGGTGCTGATGTTCTGGATTCCTGCTTCCAGGAGT 
                   GATATTGTGATGACCCAAAC 
                 
                   
               
               
                   
               
               
                 
                   TCCACTCTCCCTGCCTGTCAGTCTTGGAGATCAAGCCTCCATCTCTTGC 
                   
                     AGATCTAGTCAGAGCCTTGTACACAGTA 
                   
                 
               
               
                   
               
               
                 
                   
                     ATGGAAAAACCTATTTACAT 
                   
                   TGGTACCTGCAGAAGCCAGGCCAGTCTCCTAAGCTCCTGATCTAC 
                   
                     AAAGTTTCCAAC 
                   
                 
               
               
                   
               
               
                 
                   
                     CGATTTTCT 
                   
                   GGGGTCCCAGACAGGTTCAGTGGCAGTGGATCAGGGACAGATTTCACACTCAAGATCAGCAGAGTGGA 
                 
               
               
                   
               
               
                 
                   GGCTGAGGATCTGGGAGTTTATTTCTGC 
                   
                     TCTCAAAGCACACATGTTCCG 
                     TGGACGTTCGGTGGAGGCACCAAGCTGG 
                   
                 
               
               
                   
               
               
                     AAATCAAACGG   GCTGATGCTGCACCAACTGTATCCATCTTCCCACCATCCAGTGAGCAGTTAACATCTGGAGGTGCC 
               
               
                   
               
               
                 TCAGTCGTGTGCTTCTTGAACAACTTCTACCCCAAAGACATCAATGTCAAGTGGAAGATTGATGGCAGTGAACGACA 
               
               
                   
               
               
                 AAATGGCGTCCTGAACAGTTGGACTGATCAGGACAGCAAAGACAGCACCTACAGCATGAGCAGCACCCTCACGTTGA 
               
               
                   
               
               
                 CCAAGGACGAGTATGAACGACATAACAGCTATACCTGTGAGGCCACTCACAAGACATCAACTTCACCCATTGTCAAG 
               
               
                   
               
               
                 AGCTTCAACAGGAATGAGTGTTAG 
               
               
                 Italic region: signal peptide coding sequence 
               
               
                 Bold-faced region: variable chain coding sequence (SEQ ID NO: 8) 
               
               
                 Bold-faced and underlined regions: CDR coding sequences 
               
               
                 Regular font region: constant region coding sequence 
               
               
                 Underlined region: joining segment coding sequence 
               
            
           
         
       
     
     Antibody 1BB1 can be produced by a conventional method, i.e., produced from a hybridoma cell line as described in Hsing et al.,  Cytokine  44:221-228; 2008, synthesized chemically, or expressed via recombinant technology. 
     A functional variant of 1BB1 contains a V H  at least 75% (80%, 85%, 90%, or 95%) identical to that of 1BB1 (SEQ ID NO:2) and a V L  at least 75% (80%, 85%, 90%, or 95%) identical to that of 1BB1 (SEQ ID NO:6). As used herein, “percent homology” of two amino acid sequences is determined using the algorism described in Karlin and Altschul,  Proc, Natl, Acad Sci. USA  87:2264-2268, 1990, modified as described in Karlin and Altschul,  Proc. Natl. Acad Sci. USA  5873-5877, 1993. Such an algorism is incorporated into the NBLAST and XBLAST programs of Altschul et al.,  J Mol. Biol.  215:403-410, 1990. BLAST protein searches are performed with the XBLAST program, score=50, wordlength=3, to obtain amino acid sequences homologous to a reference polypeptide. To obtain gapped alignments for comparison purposes, Gapped BLAST is utilized as described in Altschul et al.,  Nucleic Acids Res.  25:3389-3402, 1997. When utilizing the BLAST and Gapped BLAST programs, the default parameters of the respective programs (e.g., XBLAST and NBLAST) are used. See www.ncbi.nlm.nih.gov. 
     A functional variant of 1BB1 (e.g., a humanized antibody) can be generated by introducing mutations in a frame region (FR) of either the V H  or V L  of 1BB1 and keep intact their CDRs, particularly the specific-determining residues in these regions. It is well known that CDRs of an antibody determine its specificity. Accordingly, mutations in FRs normally would not affect antibody specificity. The CDRs and FRs of an antibody can be determined based on the amino acid sequences of its V H  and V L.  See www.bioinf.org.uk/abs. The binding-specificity of the functional equivalents described herein can be examined using methods known in the art, e.g., ELISA or western-blot analysis. 
     Alternatively, a functional variant of IBM is a genetically engineered antibody containing the same V H  and V L  as 1BB1. Such a variant (e.g., a chimeric antibody or a single-chain antibody) can be prepared following methods described above. 
     If necessary, any of the anti-IL-19 antibodies can be co-used with an additional anti-RA agent, such as an anti-IL-20, anti-IL-20R1, anti-TNFα, anti-IL-6 receptor antibody, or a soluble TNFα receptor, for treating RA. The anti-IL-20, anti-IL-20R1, anti-TNFα and anti-IL-6 receptor antibodies can be prepared by any of the methods described above, using IL-20, IL-20R1, IL-6 receptor, TNFα, or a fragment thereof as the inducing antigen. See, e.g., U.S. Pat. No. 7,582,298. Listed below are Genbank accession numbers of these antigens from humans: 
     Human IL-20: NP — 061194 (protein) and NM — 018724 (gene). 
     Human IL-20R1: NP — 055247 (protein) and NM — 014432.2 (mRNA) 
     Human TNFα: NP000585.2 (protein) and 000594.2 (gene). 
     Human IL-6 receptor: NP — 852004 (protein) and NM — 181359.1 (gene); NP — 000556 (protein) and NM — 000565.2 (gene). 
     In one example, monoclonal antibody 7E, which neutralizes IL-20 activity, or a functional variant thereof, is co-used with an anti-IL-19 antibody for treating RA mAb7E is produced by the hybridoma cell line deposited at the American Type Culture Collection, 10801 University Boulevard, Manassas, Va. 20110-2209, U.S.A. and assigned a deposit number PTA-8687. See U.S. Pat. No. 7,435,800 and US 20090048432. This hybridoma cell line will be released to the public irrevocably and without restriction/condition upon granting a US patent on this application, and will be maintained in the ATCC for a period of at least 30 years from the date of the deposit for the enforceable life of the patent or for a period of 5 years after the date of the most recent. The amino acid sequences/cDNA sequences of the heavy and light chains of mAb7E are shown below. 
                        Nucleotide sequence (SEQ ID NO: 9) and amino acid sequence           (SEQ ID NO: 10) of mAb 7E heavy chain                         atg tac ttg gga ctg aac tat gta ttc ata gtt ttt ctc tta aat                M   Y   L   G   L   N   Y   V   F   I   V   F   L   L   N   15                   ggt gtc cag agt  gaa ttg aag ctt gag gag tct gga gga ggc ttg              G   V   Q   S    E     L     K     L     E     E     S     G     G     G     L     30                 gtg cag cct gga gga tcc atg aaa ctc tct tgt gct gcc tct gga               V     Q     P     G     G     S     M     K     L     S     C     A     A     S     G     45                 ttc act ttt agt gac gcc tgg atg gac tgg gtc cgc cag tct cca               F     T     F     S     D     A     W     M     D     W     V     R     Q     S     P     60                 gag aag ggg ctt gag tgg att gct gaa att aga agc aaa gct aat               E     K     G     L     E     W     I     A     E     I     R     S     K     A     N     75                 aat tat gca aca tac ttt gct gag tct gtg aaa ggg agg ttc acc               N     Y     A     T     Y     F     A     E     S     V     K     G     R     F     T     90                 atc tca aga gat gat tcc aaa agt ggt gtc tac ctg caa atg aac               I     S     R     D     D     S     K     S     G     V     Y     L     Q     M     N     105                 aac tta aga gct gag gac act ggc att tat ttc tgt acc aag tta               N     L     R     A     E     D     T     G     I     Y     F     C     T     K     L     120                 tca cta cgt tac tgg ttc ttc gat gtc tgg ggc gca ggg acc acg               S     L     R     Y     W     F     F     D     V     W     G     A     G     T     T     135                 gtc acc gtc tcc tca  gcc aaa acg aca ccc cca tct gtc tat cca             V     T     V     S     S    A   K   T   T   P   P   S   V   Y   P   150               ctg gcc cct gga tct gct gcc caa act aac tcc atg gtg acc ctg            L   A   P   G   S   A   A   Q   T   N   S   M   V   T   L   165               gga tgc ctg gtc aag ggc tat ttc cct gag cca gtg aca gtg acc            G   C   L   V   K   G   Y   F   P   E   P   V   T   V   T    180               tgg aac tct gga tcc ctg tcc agc ggt gtg cac acc ttc cca gct            W   N   S   G   S   L   S   S   G   V   H   T   F   P   A    195               gtc ctg cag tct gac ctc tac act ctg agc agc tca gtg act gtc            V   L   Q   S   D   L   Y   T   L   S   S   S   V   T   V   210               ccc tcc agc acc tgg ccc agc gag acc gtc acc tgc aac gtt gcc            P   S   S   T   W   P   S   E   T   V   T   C   N   V   A   225               cac ccg gcc agc agc acc aag gtg gac aag aaa att gtg ccc agg            H   P   A   S   S   T   K   V   D   K   K   I   V   P   R   240               gat tgt ggt tgt aag cct tgc ata tgt aca gtc cca gaa gta tca            D   C   G   C   K   P   C   I   C   T   V   P   E   V   S   255               tct gtc ttc atc ttc ccc cca aag ccc aag gat gtg ctc acc att            S   V   F   I   F   P   P   K   P   K   D   V   L   T   I   270               act ctg act cct aag gtc acg tgt gtt gtg gta gac atc agc aag            T   L   T   P   K   V   T   C   V   V   V   D   I   S   K   285               gat gat ccc gag gtc cag ttc agc tgg ttt gta gat gat gtg gag            D   D   P   E   V   Q   F   S   W   F   V   D   D   V   E    300               gtg cac aca gct cag acg caa ccc cgg gag gag cag ttc aac agc            V   H   T   A   Q   T   Q   P   R   E   E   Q   F   N   S   315       act ttc cgc tca gtc agt gaa ctt ccc atc atg cac cag gac tgg            T   F   R   S   V   S   E   L   P   I   M   H   Q   D   W   330               ctc aat ggc aag gag ttc aaa tgc agg gtc aac agt gca gct ttc            L   N   G   K   E   F   K   C   R   V   N   S   A   A   F   345               cct gcc ccc atc gag aaa acc atc tcc aaa acc aaa ggc aga ccg            P   A   P   I   E   K   T   I   S   K   T   K   G   R   P   360               aag gct cca cag gtg tac acc att cca cct ccc aag gag cag atg            K   A   P   Q   V   Y   T   I   P   P   P   K   E   Q   M   375               gcc aag gat aaa gtc agt ctg acc tgc atg ata aca gac ttc ttc            A   K   D   K   V   S   L   T   C   M   I   T   D   F   F   390               cct gaa gac att act gtg gag tgg cag tgg aat ggg cag cca gcg            P   E   D   I   T   V   E   W   Q   W   N   G   Q   P   A   405               gag aac tac aag aac act cag ccc atc atg gac aca gat ggc tct            E   N   Y   K   N   T   Q   P   I   M   D   T   D   G   S   420               tac ttc gtc tac agc aag ctc aat gtg cag aag agc aac tgg gag            Y   F   V   Y   S   K   L   N   V   Q   K   S   N   W   E   435               gca gga aat act ttc acc tgc tct gtg tta cat gag ggc ctg cac            A   G   N   T   F   T   C   S   V   L   H   E   G   L   H   450               aac cac cat act gag aag agc ctc tcc cac tct cct ggt aaa TGA            N   H   H   T   E   K   S   L   S   H   S   P   G   K   —   464            
The bold-faced region refers to the V H  of mAb 7E heavy chain (DNA sequence SEQ ID NO: 11; protein sequence SEQ ID NO: 12)
 
                        Nucleotide sequence (SEQ ID NO: 13) and amino acid sequence           (SEQ ID NO: 14) of mAb Mlightchafin                         atg atg agt cct gcc cag ttc ctg ttt ctg tta gtg ctc tgg att                M   M   S   P   A   Q   F   L   F   L   L   V   L   W   I   15               cgg gaa acc aac ggt  gat ttt gtg atg acc cag act cca ctc act              R   E   T   N   G    D   F   V   M   T   Q   T   P   L   T     30                 ttg tcg gtt acc att gga caa cca gcc tcc atc tct tgc aag tca                L   S   V   T   I   G   Q   P   A   S   I   S   C   K   S     45                 agt cag agc ctc ttg gat agt gat gga aag aca tat ttg aat tgg                S   Q   S   L   L   D   S   D   G   K   T   Y   L   N   W     60                 ttg tta cag agg cca ggc cag tct cca aag cac ctc atc tat ctg                L   L   Q   R   P   G   Q   S   P   K   H   L   I   Y   L     75                 gtg tct aaa ctg gac tct gga gtc cct gac agg ttc act ggc agt                V   S   K   L   D   S   G   V   P   D   R   F   T   G   S     90                 gga tca ggg acc gat ttc aca ctg aga atc agc aga gtg gag gct                G   S   G   T   D   F   T   L   R   I   S   R   V   E   A     105                 gag gat ttg gga gtt tat tat tgc tgg caa agt aca cat ttt ccg                E   D   L   G   V   Y   Y   C   W   Q   S   T   H   F   P     120                 tgg acg ttc ggt gga ggc acc aag ctg gaa atc aaa cgg  gct gat              W   T   F   G   G   G   T   K   L   E   I   K   R    A   D   135               gct gca cca act gta tcc atc ttc cca cca tcc agt gag cag tta            A   A   P   T   V   S   I   F   P   P   S   S   E   Q   L   150               aca tct gga ggt gcc tca gtc gtg tgc ttc ttg aac aac ttc tac            T   S   G   G   A   S   V   V   C   F   L   N   N   F   Y   175               aag tgg aag att gat ggc agt gaa cga caa aat ggc gtc ctg aac            P   K   D   I   N   V   K   W   K   I   D   G   S   E   R   180               agt tgg act gat cag ccc aaa gac atc aat gtc gac agc aaa gac            Q   N   G   V   L   N   S   W   T   D   Q   D   S   K   D   195               agc acc tac agc atg agc agc acc ctc acg ttg acc aag gac gag            S   T   Y   S   M   S   S   T   L   T   L   T   K   D   E   210               tat gaa cga cat aac agc tat acc tgt gag gcc act cac aag aca            Y   E   R   H   N   S   Y   T   C   E   A   T   H   K   T   225               tca act tca ccc att gtc aag agc ttc aac agg aat gag tgt tag            S   T   S   P   I   V   K   S   F   N   R   N   E   C   —   239            
The bold-faced region refers to the V L  of mAb 7E light chain (DNA sequence SEQ ID NO:1.5; protein sequence SEQ ID NO:16).
 
     When two antibodies are used in treating RA, they can form a bi-specific complex (i.e., bi-specific antibody), which contains two antigen-binding domains (i.e., two heavy-light chain pairs), one specific to IL-19 and the other specific to IL-20, IL-20R1, or TNFα. Such a bi-specific antibody can be prepared via conventional methods. 
     In another example, a soluble TNFαreceptor is co-used with an anti-IL-19 antibody in the method of this invention. As an example, the soluble TNFαreceptor can have the amino acid sequence shown below: 
     
       
         
           
               
            
               
                 Amino acid sequence of human soluble TNF receptor 
               
               
                 (SEQ ID NO: 17) 
               
               
                     aqvaft pyapepgstc rlreyydqta qmccskcspg 
               
               
                   
               
               
                 qhakvfctkt sdtvcdsced stytqlwnwv peclscgsrc 
               
               
                   
               
               
                 ssdqvetqac treqnrictc rpgwycalsk qegcrlcapl 
               
               
                   
               
               
                 rkcrpgfgva rpgtetsdvv ckpcapgtfs nttsstdicr 
               
               
                   
               
               
                 phqic 
               
            
           
         
       
     
     Preferably, this soluble receptor is fused with the Fc component of an immunoglobulin (e.g., human IgG 1) to form a fusion polypeptide (e.g., etanercept). Such a fusion polypeptide can be made by conventional recombinant technology. 
     When used for treating RA, any of the anti-IL-19 antibodies described herein can be mixed with a pharmaceutically acceptable carrier, either alone or in combination with an additional anti-RA agent, to form a pharmaceutical composition. “Acceptable” means that the carrier must be compatible with the active ingredient of the composition (and preferably, capable of stabilizing the active ingredient) and not deleterious to the subject to be treated. Suitable carriers include microcrystalline cellulose, mannitol, glucose, defatted milk powder, polyvinylpyrrolidone, and starch, or a combination thereof. 
     The above-described pharmaceutical composition can be administered via a conventional route, e.g., orally, parenterally, by inhalation spray, topically, rectally, nasally, buccally, vaginally or via an implanted reservoir, to treat RA in a patient who suffers from RA. The term “parenteral.” as used herein includes subcutaneous, intracutaneous, intravenous, intramuscular, intraarticular, intraarterial, intrasynovial, intrasternal, intrathecal, intralesional, and intracranial injection or infusion techniques. 
     A sterile injectable composition, e.g., a sterile injectable aqueous or oleaginous suspension, can be formulated according to techniques known in the art using suitable dispersing or wetting agents (such as Tween 80) and suspending agents. The sterile injectable preparation can also be a sterile injectable solution or suspension in a non-toxic parenterally acceptable diluent or solvent, for example, as a solution in 1,3-butanediol. Among the acceptable vehicles and solvents that can be employed are mannitol, water, Ringer&#39;s solution and isotonic sodium chloride solution. In addition, sterile, fixed oils are conventionally employed as a solvent or suspending medium (e.g., synthetic mono- or diglycerides). Fatty acids, such as oleic acid and its glyceride derivatives are useful in the preparation of injectables, as are natural pharmaceutically-acceptable oils, such as olive oil or castor oil, especially in their polyoxyethylated versions. These oil solutions or suspensions can also contain a long-chain alcohol diluent or dispersant, or carboxymethyl cellulose or similar dispersing agents. Other commonly used surfactants such as Tweens or Spans or other similar emulsifying agents or bioavailability enhancers which are commonly used in the manufacture of pharmaceutically acceptable solid, liquid, or other dosage forms can also be used for the purposes of formulation. 
     In addition, the pharmaceutical composition described above can be administered to the subject via injectable depot routes of administration such as using 1-, 3-, or 6-month depot injectable or biodegradable materials and methods. 
     Without further elaboration, it is believed that one skilled in the art can, based on the above description, utilize the present invention to its fullest extent. The following example is, therefore, to be construed as merely illustrative, and not limitative of the remainder of the disclosure in any way whatsoever. All publications cited herein are incorporated by reference. 
     Example 
     Using Monoclonal Antibody 1BB1 for Treating RA 
     The anti-RA effect of monoclonal antibody 1BB1 was analyzed in collagen-induced arthritis (CIA) rats, a well-developed animal model for studying human rheumatoid arthritis. 
     CIA was induced in eight-week-old male Sprague-Dawley rats as follows. The rats were immunized initially by intradermal injection (in the dorsum) of 200 μl emulsion containing Freund&#39;s complete adjuvant, 4 mg/ml heat-killed  Mycobacterium tuberculosis  (Arthrogen-CIA; Chondrex, Redmond, Wash.), and bovine type II collagen (CII; 2 mg/ml dissolved in 0.05 M acetic acid) at a ratio of 1:1:1 (v/v/v). On day 8, the rats were injected subcutaneously with 100 μl of the just-described emulsion in the roots of the tails to boost their immune responses. Onset of arthritis in the CIA rats was observed between day 11 and day 13 after the initial immunization. 
     The following four groups of rats (n=7) were subjected to this study:
         Group (1): healthy rats   Group (2): CIA rats administered with PBS (s.c.) 10 days after the first injection of type II collagen, and   Group (3): CIA rats administered with a control mouse IgG mIgG (5 mg/kg, s.c.) 8 days after the first injection of type II collagen.   Group (4): CIA rats administered with antibody 1BB1 (5 mg/kg, s.c.) 8 days after the first injection of type II collagen.       

     Hind-paw thickness of each treated rat was measured with a vernier caliper once every day during day 10 to day 18 after the initial immunization with type II collagen. All raw results obtained from this study were subjected to statistical analysis using statistical software Prism 4.0; GraphPad Software, San Diego, Calif., USA. The Kruskal-Wallis test was used to compare the thickness of the hind paws from the 1BB1-treated CIA rats with that from the PBS-treated CIA rats. P-values &lt;0.05 were considered significant. Disease severity scores for all of the rats were determined based on their joint swelling degrees and the levels of erythema in their hind paws. 
     As shown in  FIG. 1 , panel A, little increase of hind paw thickness was observed in the Group (1) rats (i.e., healthy rats) over time, while significant increases in hind paw thickness were observed in the Group (2) and Group (3) rats (i.e., the CIA rats treated with PBS and mIgG, respectively) over time. Compared to the Group (2) rats, the Group (4) rats (i.e., the CIA rats treated with 1BB1) exhibited much less hind paw thickness, indicating that 1BB1 reduced hind paw swelling induced by CIA. The disease severity scores of the Group (4) rats were also much lower that those of the Group (2) and Group (3) rats (P&lt;0.05). See  FIG. 1 , Panel B. These results demonstrate that 1BB1 is effective in reducing disease severity in CIA rats. 
     Next, microcomputed tomographic analysis, using a 1076 microCT-40 system (Skyscan, Aartselaar, Belgium) equipped with a high resolution, low-dose X-ray scanner, was performed to assess the efficacy of 1BB1 in protecting bone destruction in CIA rats. The X-ray tube in the scanner was operated with photon energy of 48 kV, current of 200 uA, and exposure time of 1180 ms through a 0.5-mm-thick filter. The image pixel size was 17.20 um, and the scanning time was approximately 15 min. After standardized reconstruction of the scanned images, the data sets for each tibia sample were resampled with software (CTAn; Skyscan) to orient each sample in the same manner. Consistent conditions such as thresholds were applied throughout all analyses. Bone mineral density, a three-dimensional bone characteristic parameter, was analyzed in 50 consecutive slices. The results were calculated as a percentage versus values relative to a PBS control. 
     The tibias obtained from the CIA rats treated with PBS showed prominent bone damage compared to the intact joints found in healthy rats. The CIA rats treated with 1BB1 displayed alleviated bone loss as compared to the rats treated with PBS. 
     The bone mineral density, a quantitative parameter for assessing disease severity, was measured in each treated CIA rat as described above. As shown in  FIG. 2 , 1BB1-treated CIA rats exhibited a significantly higher bone mineral density relative to PBS-treated CIA rats (P&lt;0.05). 
     Other Embodiments 
     All of the features disclosed in this specification may be combined in any combination. Each feature disclosed in this specification may be replaced by an alternative feature serving the same, equivalent, or similar purpose. Thus, unless expressly stated otherwise, each feature disclosed is only an example of a generic series of equivalent or similar features. 
     From the above description, one skilled in the art can easily ascertain the essential Characteristics of the present invention, and without departing from the spirit and scope thereof, can make various changes and modifications of the invention to adapt it to various usages and conditions. Thus, other embodiments are also within the claims.