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A B Cell Depleting Agent for the Treatment of Atherosclerosis

a technology of atherosclerosis and b cell depletion, which is applied in the direction of antibody medical ingredients, drug compositions, peptides, etc., can solve the problems of plaque vulnerability, development of atherosclerotic lesions, and the depletion of b cells is not a promising treatment method

Inactive Publication Date: 2011-11-10
DUKE UNIV +1
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  • Summary
  • Abstract
  • Description
  • Claims
  • Application Information

AI Technical Summary

Benefits of technology

[0012]The inventors have demonstrated that administration of a B cell depleting agent (i.e. an anti-CD20 antibody) allows significant reduction of atherosclerotic plaque size in a mouse model.
[0013]B cell-dependent responses are involved in the pathogenesis of (auto)-immune disorders and B cell depletion significantly reduces the burden of several immune-mediated diseases. However, B cell activation has been until now associated with a protection against atherosclerosis (Caligiuri et al., 2002; Major et al., 2002; Binder et al., 2004; Miller et al., 2008), suggesting that B cell depleting therapies would enhance cardiovascular risk.
[0014]Here, inventors unexpectedly show that mature B cell depletion using a CD20 monoclonal antibody induces a significant reduction of atherosclerosis in various mouse models of the disease. This treatment preserves the production of natural and potentially protective anti-oxidized low-density lipoprotein (oxLDL) IgM autoantibodies over IgG type anti-oxLDL antibodies, and markedly reduces pathogenic T cell activation. The atheroprotective mechanisms of B cell depletion involve a switch of the immune response towards diminished T cell-derived interferon-gamma secretion and enhanced production of interleukin-17, whose neutralization abrogates CD20 antibody-mediated atheroprotection.
[0056]Then after raising antibodies directed against a B cell surface marker as above described, the skilled man in the art can easily select those that deplete B cells, for example those that deplete B cells via antibody-dependent cell mediated cytotoxicity (ADCC), complement dependent cytotoxicity (CDC), inhibition of B cell proliferation or induction of B cell death (e.g. via apoptosis).

Problems solved by technology

Although the recruitment of monocytes to the arterial wall and their subsequent differentiation into macrophages may initially serve a function by removing cytotoxic and proinflammatory oxLDL particles or apoptotic cells, progressive accumulation of macrophages and their uptake of oxLDL ultimately leads to development of atherosclerotic lesions.
This plaque fragility gives rise to plaque vulnerability in turn becoming a cause of plaque rupture.
Accordingly, the prior art suggests that depletion of B cells is not a promising method for the treatment of atherosclerosis, contrary to what is disclosed, but not demonstrated, in the following patent applications US2004 / 202658, US2005 / 186206, US2008 / 260641, WO2007 / 053661 and US2004 / 167619.

Method used

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  • A B Cell Depleting Agent for the Treatment of Atherosclerosis
  • A B Cell Depleting Agent for the Treatment of Atherosclerosis
  • A B Cell Depleting Agent for the Treatment of Atherosclerosis

Examples

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Effect test

example 1

B Cell Depletion and Atherosclerosis

[0098]Results and Discussion

[0099]The development of atherosclerosis is associated with signs of B cell activation, particularly manifested by enhanced production of natural IgM type and adaptive IgG types anti-oxidized low-density lipoprotein (ox-LDL) (auto)antibodies (Caligiuri et al., 2002; Shaw et al., 2000). However, in contrast to other immune-mediated diseases, i.e., rheumatoid arthritis and systemic lupus erythematosus, B cells have been assigned a protective role in atherosclerosis (Caligiuri et al., 2002; Major et al., 2002; Binder et al., 2004; Miller et al., 2008). Although IgG types anti-ox-LDL antibodies show variable association with vascular risk, circulating levels of IgM type anti-ox-LDL antibodies have been more frequently linked with reduced vascular risk in humans (Karvonen et al., 2003; Tsimikas et al., 2007). In mice, IL-5- and IL-33-mediated atheroprotective effects have been indirectly associated with specific B1 cell acti...

example 2

B Cell Depletion is Associated with an Increase In Fractional Shortening in a Myocardial Infarction Model

[0118]Myocardial infarction was induced in 8 weeks old male C57BL6J mice by ligation of the left anterior descending coronary artery. One hour after myocardial ischemic injury mice were treated or not by intraperitoneal injection of a mouse monoclonal CD20 antibody (160 μg). Inventors showed that B cells infiltrated the infarct area. Blood B cells levels were analyzed by flow cytometry at days 1, 3, 7 and 14 after MI. The percentage of IgM+ B220+-B cells was markedly reduced after CD20 antibody treatment. Mice were sacrificed at day 14 post-MI and cardiac function was measured by echocardiography (FIG. 14). Such treatment was associated with an increase in fractional shortening suggesting that said treatment may be beneficial for the treatment of myocardial infarction.

example 3

Effects of B Cell Depletion in Abdominal Aortic Aneurysm

[0119]First, inventors use a validated mouse model of aneurysm formation. Apoe− / − mice fed a chow or high fat diet develop abdominal aortic aneurysm when infused with angiotensin (Ang) II for 28 days (Daugherty A et al, 2000). This model reproduces the accumulation of inflammatory cells, including B cells, within and around the aneurysmal vessel.

[0120]For more precise results, inventors may also use a new model of aortic aneurysm with a high incidence of aneurysm rupture, described in patent application WO2009056419. The model uses Apoe+ / + or Apoe− / − mice, and associates both AngII infusion and neutralization of TGF-β activity, two factors with a high relevance to the human disease. In this model, systemic neutralization of TGF-β activity leads to unexpected and marked increase in the susceptibility of these mice to AngII-induced aortic aneurysm (92.5%), and to a high level of mortality from aortic dissection and rupture (65%)....

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Abstract

The present invention relates to the prevention or treatment of atherosclerosis, in particular to a B cell depleting agent for the prevention or treatment of atherosclerosis.

Description

FIELD OF THE INVENTION[0001]The present invention relates to the prevention or treatment of atherosclerosis, in particular to a B cell depleting agent for the prevention or treatment of atherosclerosis.BACKGROUND OF THE INVENTION[0002]Atherosclerosis is the most common cause of death in western societies and is predicted to become the leading cause of cardiovascular disease in the world within two decades.[0003]Atherosclerosis contributes to the development of atherosclerotic vascular diseases (AVD) which may affect the coronary arteries (causing ischaemic heart disease), the cerebral circulation (causing cerebrovascular disease), the aorta (producing aneurysms that are prone to thrombosis and rupture) and peripheral blood vessels, typically the legs (causing peripheral vascular disease and intermittent claudication). Ischaemic heart disease (IHD) includes angina (chest pain caused by insufficient blood supply to cardiac muscle) and myocardial infarction (death of cardiac muscle) an...

Claims

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Application Information

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IPC IPC(8): C07K16/28
CPCA61K2039/505C07K16/2887A61K47/48561C07K16/244A61K39/3955C07K2317/24A61K47/6849A61P9/00A61P9/10
Inventor MALLAT, ZIADAIT-OUFELLA, HAFIDTEDGUI, ALAINTEDDER, THOMAS
Owner DUKE UNIV