RECOMBINANT IgG Fc MULTIMERS FOR TREATMENT OF IMMUNE COMPLEX-MEDIATED KIDNEY DISORDERS

Abstract

To provide the use of recombinant IgG Fc multimers for the treatment of immune complex-mediated kidney disorders, and methods of treating immune complex-mediated kidney disorders by administering such multimers.SOLUTION: An IgG Fc multimer for use in the treatment of an immune complex-mediated kidney disorder, wherein the Fc multimer lacks any mutation to increase binding affinity of the Fc multimer to C1q.SELECTED DRAWING: None

Description

[Technical Field]

[0001] FIELD OF THE INVENTION The present disclosure provides the use of recombinant IgG Fc multimers for the treatment of immune complex-mediated kidney injury, and methods of treating immune complex-mediated kidney injury by administering said multimers. [Background technology]

[0002] background Plasma-derived immunoglobulin G (IgG) is used in the clinic to treat primary and secondary immunodeficiencies. In this case, IgG is administered either intravenously (IVIG) or subcutaneously (SCIG). Both are produced from large plasma pools of more than 10,000 donors, ensuring a diverse antibody repertoire.

[0003] Administration of high-dose IVIG or SCIG (1–2 g / kg / dose) has been increasingly used for the treatment of patients with chronic or acute autoimmune and inflammatory diseases, such as immune thrombocytopenia (ITP), Guillain-Barré syndrome, Kawasaki disease, chronic inflammatory demyelinating polyneuropathy (CIDP), myasthenia gravis (MG), and several other rare diseases. Additionally, off-label use of IVIG or SCIG for several other indications is currently under investigation, such as for the treatment of rheumatoid arthritis (RA).

[0004] Numerous mechanisms of action have been proposed for the anti-inflammatory effects of high-dose IVIG / SCIG, including blockade of Fcγ receptors (FcγR), saturation of neonatal FcR (FcRn) that enhances autoantibody clearance, upregulation of inhibitory FcγRIIB (CD32B), removal of complement protein fragments and inhibition of complement fragment deposition, anti-idiotypic antibodies (Abs) in IVIG / SCIG, binding or neutralization of immune mediators (e.g., cytokines), or modulation of immune cells (e.g., induction of regulatory T cells, B cells, or tolerogenic dendritic cells).

[0005] There is a need for effective and safe treatments for immune complex-mediated kidney disorders, which are mediated by inflammation of the kidney or kidney-shaped structures, including, among others, nephritis, glomerulonephritis, interstitial nephritis, anti-glomerular basement membrane (anti-GBM) glomerulonephritis, Goodpasture's syndrome, autoimmune kidney disease, lupus nephritis, membranous nephropathy, membranoproliferative glomerulonephritis (MPGN), and Bright's disease.

[0006] Anti-GBM antibodies play an essential role in the pathogenesis of Goodpasture's syndrome, a life-threatening kidney disease characterized by the deposition of these antibodies along the glomerular basement membrane (Non-Patent Document 1). These deposits lead to crescent formation, scarring, and loss of kidney function.

[0007] A variety of recombinant Fc-based therapeutic agents are under development, including Fc fusion and multimeric proteins, which have shown efficacy in experimental animal models of arthritis, ITP, and inflammatory neuropathy (Non-Patent Document 2; Non-Patent Document 3; Non-Patent Document 4; Non-Patent Document 5; Non-Patent Document 6; Non-Patent Document 7).

[0008] Potential IVIG replacement proteins containing multiple Fc domains are described in U.S. Patent No. 5,629,297, U.S. Patent No. 5,629,297, U.S. Patent No. 5,629,298, U.S. Patent No. 5,629,29 ... or U.S. Patent No. 5,629,299. While a variety of different configurations of constructs with multiple Fc fragments are envisioned, the main class of such constructs disclosed are so-called stradomers, which contain multiple Fc fragments in the IgG2 hinge region. The multimeric protein includes an Fc fragment having a multimerization domain such as a IgG1 region. However, no examples are provided regarding the effectiveness of the multimeric protein envisioned in Patent Document 1.

[0009] Sun et al. describe the use of certain stradomers in the treatment of complement-dependent diseases (Non-Patent Document 8). Specifically, Sun et al. describe the testing of two recombinant Fc multimers (developed from the stradomer GL-2045), which have been modified to interact with FcγRs with low / moderate affinity but have limited ability to interact with C1q with high affinity. These compounds were found to be composed of contiguous, highly organized Fc multimers. The authors concluded that, like GL-2045, these drugs functioned by acting as C1q sinks. Zuercher et al. speculate that GL-2045 was designed by fusing a human IgG2 hinge region to a human IgG1 Fc, allowing the IgG1 Fc fragments to polymerize sequentially to generate a heterogeneous pool of Fc multimers of various lengths or degrees of multimerization, essentially forming a ladder (Non-Patent Document 9).

[0010] Other Fc multimer constructs with multimerization domains that may be useful in the present invention include hexameric constructs in which an IgM tail is used to multimerize IgG Fc fragments. For example, Patent Document 6 discloses an Fc multimer construct comprising an IgG1 Fc region with a truncated hinge region, a four-amino acid linker at the C-terminus of the Fc, and an IgM tail, which multimerizes to a predominantly hexameric structure. Mutations at Fc residues 309 and 310 (L309C and H310L) were introduced to mimic the IgM sequence.

[0011] Patent Documents 7 and 8 disclose several Fc multimer constructs comprising a five-amino acid hinge region, an Fc region derived from IgG1, IgG4, or a hybrid of IgG1 and IgG4 CH2 and CH3 domains, and an IgM or IgA tail. These disclosures relate to improving the safety and efficacy of IgG Fc multimers by introducing amino acid changes in the Fc region of the fusion peptide.

[0012] Optimized hexameric Fc-μTP constructs are disclosed in U.S. Patent No. 5,629,493, and have been shown to have several advantages over previously described constructs in vivo, ex vivo, and in vitro. Fc-μTP- and Fc-μTP-L309C-bound C1q did not induce cleavage of complement protein C2, thus preventing the formation of C3 convertase (C4b2a). Fc-μTP and Fc-μTP-L309C selectively inhibited activation of the complete classical complement pathway; no interference with the alternative pathway was observed.

[0013] Other Fc multimers were disclosed in U.S. Patent No. 5,623,299, U.S. Patent No. 5,623,299, and U.S. Patent No. 5,623,299. These Fc multimers comprise multiple Fc monomers constructed without the use of multimerization domains. Instead, two or more Fc polypeptides can be fused in a linear configuration, e.g., via a flexible peptide linker, and co-expressed with additional Fc polypeptides; construction of the Fc monomers can be directed by the use of selectivity modules (e.g., knobs-in-holes or electrostatic mutations), such that only specific Fc polypeptides can be combined. [Prior art documents] [Patent documents]

[0014] [Patent Document 1] WO2008 / 151088 [Patent Document 2] WO2012 / 016073 [Patent Document 3] WO2013 / 112986 [Patent Document 4] WO2017 / 214321 [Patent Document 5] WO2017 / 019565 [Patent Document 6] WO2014 / 060712 [Patent Document 7] WO2015 / 132364 [Patent Document 8] WO2015 / 132365 [Patent Document 9] WO2017 / 129737

Patent Document 10

Patent Document 11

Patent Document 12

Non-Patent Document

[0015]

Non-Patent Document 1

Non-Patent Document 2

Non-Patent Document 3

Non-Patent Document 4

Non-Patent Document 5

Non-Patent Document 6

Non-Patent Document 7

Non-Patent Document 8

Non-Patent Document 9

Summary of the Invention

Problems to be Solved by the Invention

[0016] The inventors have now surprisingly found that the Fc multimers used in the present invention, including Fc-μTP-L309C, CC, SIF1, and Q1, are effective in treating immune complex-mediated kidney damage, such as anti-GBM glomerulonephritis.

[0017] The Fc multimers used in the present invention lack any mutations for enhanced binding to complement system proteins such as C1q, as in the stradomers of Sun et al., yet can strongly inhibit the pathogenesis of immune complex-mediated kidney injury. For example, in a mouse model of anti-GBM glomerulonephritis, the Fc multimers of the present invention that do not have any mutations that induce enhanced binding to C1q showed excellent efficacy in preventing albuminuria by inhibiting complement-dependent cytotoxicity and antibody-dependent cellular cytotoxicity. [Means for solving the problem]

[0018] Abstract The present disclosure provides a method for treating immune complex-mediated kidney damage, the method comprising administering an Fc multimer constructed through the presence of a multimerization domain or linker and not containing any mutations that increase binding affinity to complement system proteins.

[0019] In some embodiments of the present invention, the Fc multimers used in the present invention comprise two to six IgG Fc fusion monomers. Each IgG Fc fusion monomer comprises two Fc fusion monomers. and each Fc fusion polypeptide chain comprises an IgG1 Fc polypeptide and a multimerization domain, wherein the Fc multimer lacks any mutation that increases its binding affinity to a complement system protein. In some preferred embodiments, the complement system protein is C1q. In some embodiments, the mutations not present in the Fc multimers used in the present invention include at least one point mutation in the IgG1 Fc domain of the Fc multimer at any one of positions 267, 268, or 324. In some embodiments, the excluded mutations are at least one of S267E, H268F, or S324T. In some embodiments, the excluded mutations include at least one mutation at any one of positions 267, 268, and 324, and further include at least one point mutation at any one of positions 233, 234, 235, 236, 238, 265, 297, 299, or 328. In some embodiments, the excluded mutations include at least one of N297A, T299A, P238D, E233P, G236R, L234V, E233P, L234A, L235A, P238D, D265A, D265W, N297A, N297Q, T299A, or L328F. In some embodiments, the amino acid at position 299 is not mutated from threonine to any other amino acid other than serine or cysteine. In some embodiments, the amino acid at position 298 is not mutated to any amino acid other than proline. In some embodiments, the amino acid at position 236 is not deleted. In preferred embodiments, the excluded mutations are S267E, H268F, and S324T. In another preferred embodiment, the excluded mutations are S267E, H268F, S324T, and N297A. In another preferred embodiment, the mutations excluded are S267E, H268F, S324T, N297A, L234A, and L235A. In another preferred embodiment, the mutations excluded are S267E, H268F, S324T, N297A, E233P, L234V, L235A, and deletion of G236.In another preferred embodiment, the mutations excluded are S267E, H268F, S324T, L234A, and L235A. In another preferred embodiment, the mutations excluded are S267E, H268F, S324T, E233P, L234V, L235A, and a G236 deletion. In another preferred embodiment, the mutations excluded are S267E, H268F, S324T, and D265A. In another preferred embodiment, the mutations excluded are E233P, G236R, S267E, H268F, and S324T. In another preferred embodiment, the mutations excluded are G236R, S267E, H268F, and S324T. In another preferred embodiment, the mutations excluded are E233P, G236R, S267E, H268F, S324T, and L328F. In another preferred embodiment, the mutations excluded are P238D, D265G, S267E, H268F, and S324T. In another preferred embodiment, the mutations excluded are P238D, D265W, S267E, H268F, and S324T. In another preferred embodiment, the mutations excluded are E233P, L234V, L235A, S267E, H268F, N297A, S324T, S328F, and a deletion of G236. In another preferred embodiment, the mutations excluded are S267E, H268F, S324T, and L328F. In another preferred embodiment, the mutations excluded are P238D, S267E, H268F, and S324T. In another preferred embodiment, the mutations excluded are P238D, S267E, H268F, S324T, and N297A.

[0020] In some embodiments, the Fc multimer is not a stradomer. In some embodiments, the Fc multimer does not comprise an IgG2 hinge domain as a multimerization domain.

[0021] In some embodiments, the Fc multimer comprises two to six IgG Fc fusion monomers, wherein each Fc fusion monomer comprises two Fc fusion polypeptide chains, wherein each Fc fusion polypeptide chain comprises an IgG Fc polypeptide and a multimerization domain, and wherein the multimer The merization domain does not comprise an IgG2 hinge. In some aspects of these embodiments, the Fc multimer is not a stradomer.

[0022] In some embodiments of the invention, the Fc multimer comprises two to six IgG Fc fusion monomers, wherein each Fc fusion monomer comprises two Fc fusion polypeptide chains, wherein each Fc polypeptide chain comprises an IgG Fc polypeptide and a multimerization domain; and wherein the Fc multimer is not a stradomer.

[0023] In some preferred embodiments, the Fc multimer is an Fc hexamer comprising six IgG Fc fusion monomers, hi some preferred embodiments, the Fc multimer comprises an IgM tail as the multimerization domain.

[0024] In some preferred embodiments, the Fc fusion polypeptide chain further comprises an IgG hinge region, and the Fc fusion polypeptide chain does not comprise a Fab polypeptide.

[0025] For example, in some preferred embodiments, the Fc fusion polypeptide chains used in the present invention comprise an IgG1 hinge region, an IgG1 Fc domain, and an IgM tail, and do not comprise a Fab polypeptide. In preferred embodiments, the IgM tail in each fusion polypeptide chain comprises 18 amino acids fused to the C-terminal 232 amino acids of the constant region of the IgG1 Fc polypeptide. In a preferred embodiment, the Fc fusion polypeptide chain is SEQ ID NO: 1. In a further preferred embodiment, the Fc fusion polypeptide chain is SEQ ID NO: 1 with up to five conservative amino acid changes. In another preferred embodiment, the Fc fusion polypeptide chain is represented as SEQ ID NO: 2 (corresponding to SEQ ID NO: 7 in WO2017 / 129737), from which the signal peptide is cleaved during secretion and formation of the mature Fc hexamer. In some embodiments, the Fc hexamer is not a stradomer.

[0026] In some preferred embodiments, the mature Fc hexamer is a recombinant human Fc hexamer. In some embodiments, the Fc hexamer lacks any mutations that increase its binding affinity to a complement system protein. In some preferred embodiments, the complement system protein is C1q. In some embodiments, mutations that are not present in the Fc multimers used in the present invention include at least one point mutation in the IgG1 Fc domain of the Fc hexamer at any one of positions 267, 268, or 324. In some embodiments, the excluded mutations are at least one of S267E, H268F, or S324T. In some embodiments, the excluded mutations include at least one mutation at any one of positions 267, 268, and 324, and further include at least one point mutation at any one of positions 233, 234, 235, 236, 238, 265, 297, 299, or 328. In some embodiments, the excluded mutations include at least one of N297A, T299A, P238D, E233P, G236R, L234V, E233P, L234A, L235A, P238D, D265A, D265W, N297A, N297Q, T299A, or L328F. In some embodiments, the amino acid at position 299 is not mutated from threonine to any other amino acid other than serine or cysteine. In some embodiments, the amino acid at position 298 is not mutated to any amino acid other than proline. In some embodiments, the amino acid at position 236 is not deleted. In preferred embodiments, the excluded mutations are S267E, H268F, and S324T. In another preferred embodiment, the excluded mutations are S267E, H268F, S324T, and N297A. In another preferred embodiment, the excluded mutations are S267E, H268F, S324T, N297A, L234A, and L235A. In another preferred embodiment, the excluded mutations are S267E, H268F, S324T, N297A In another preferred embodiment, the mutations excluded are S267E, H268F, S324T, L234A, and G236 deletions. In another preferred embodiment, the mutations excluded are S267E, H268F, S324T, E233P, L234V, L235A, and G236 deletions. In another preferred embodiment, the mutations excluded are S267E, H268F, S324T, E233P, L234V, L235A, and G236 deletions. In another preferred embodiment, the mutations excluded are S267E, H268F, S324T, and D265A. In another preferred embodiment, the mutations excluded are E233P, G236R, S267E, H268F, and S324T. In another preferred embodiment, the mutations excluded are G236R, S267E, H268F, and S324T. In another preferred embodiment, the mutations excluded are E233P, G236R, S267E, H268F, S324T, and L328F. In another preferred embodiment, the mutations excluded are P238D, D265G, S267E, H268F, and S324T. In another preferred embodiment, the mutations excluded are P238D, D265W, S267E, H268F, and S324T. In another preferred embodiment, the mutations excluded are E233P, L234V, L235A, S267E, H268F, N297A, S324T, S328F, and a deletion of G236. In another preferred embodiment, the mutations excluded are S267E, H268F, S324T, and L328F. In another preferred embodiment, the mutations excluded are P238D, S267E, H268F, and S324T. In another preferred embodiment, the mutations excluded are P238D, S267E, H268F, S324T, and N297A.

[0027] In a preferred embodiment, the Fc fusion polypeptide chain comprises an IgG1 hinge region, an IgG1 Fc domain, and an IgM tail, wherein the IgG1 Fc domain has a cysteine ​​instead of leucine at position 309 (according to EU numbering), and wherein the Fc fusion polypeptide does not comprise a Fab polypeptide, and wherein the Fc fusion polypeptide chain is SEQ ID NO: 3 (corresponding to SEQ ID NO: 2 in WO2017 / 129737). In a further preferred embodiment, the Fc fusion polypeptide chain is SEQ ID NO: 3 with up to five conservative amino acid changes. In another preferred embodiment, the Fc fusion polypeptide chain is expressed as SEQ ID NO: 4 (corresponding to SEQ ID NO: 8 in WO2017 / 129737), from which the signal peptide is cleaved during secretion and formation of the mature Fc hexamer.

[0028] A further embodiment for use in the present invention is a polynucleotide encoding an Fc fusion polypeptide chain, which preferably also encodes a signal peptide linked to the Fc fusion polypeptide chain.

[0029] In some embodiments, the Fc multimer does not contain a multimerization domain.

[0030] In one embodiment, the Fc multimer is composed of four polypeptides that form three monomers. The first polypeptide comprises a first Fc polypeptide, a first linker, and a second Fc polypeptide. The second polypeptide comprises a third Fc polypeptide, a second linker, and a fourth Fc polypeptide. The third polypeptide comprises a fifth Fc polypeptide, and the fourth polypeptide comprises a sixth Fc polypeptide. In this embodiment, the first Fc polypeptide and the third Fc polypeptide combine together to form the first Fc monomer; the fifth Fc polypeptide and the second Fc polypeptide combine together to form the second Fc monomer; and the sixth Fc polypeptide and the fourth Fc polypeptide combine together to form the third Fc monomer.

[0031] In some embodiments, the Fc multimer comprises an antigen recognition region, e.g., a variable domain (e.g., a V H , V L , hypervariable regions (HVRs)) or complementarity determining regions (CDRs).

[0032] In some embodiments of this aspect, the first and third Fc polypeptides each comprise a complementary dimerization selectivity module that promotes dimerization between the first Fc polypeptide and the third Fc polypeptide; and / or the second and fifth Fc polypeptides each comprise a complementary dimerization selectivity module that promotes dimerization between the second Fc polypeptide and the fifth Fc polypeptide; and / or the fourth and sixth Fc polypeptides each comprise a complementary dimerization selectivity module that promotes dimerization between the fourth Fc polypeptide and the sixth Fc polypeptide.

[0033] In some embodiments, the complementary dimerization selectivity module promotes selective dimerization of Fc polypeptides. In any of the Fc constructs described herein that use a complementary dimerization selectivity module to promote selective dimerization of Fc polypeptides, the Fc polypeptides can have a sequence that differs between the two Fc polypeptides (i.e., between an Fc polypeptide of the Fc construct and another Fc polypeptide), e.g., a sequence that differs by 20 or fewer amino acids (e.g., 15 or fewer, 10 or fewer amino acids), e.g., 20, 15, 10, 8, 7, 6, 5, 4, 3, or 2 or fewer amino acids. For example, the complementary dimerization selectivity module of either Fc construct can be used to promote selective dimerization of the C of one Fc polypeptide. H 3. Engineered cavities in antibody constant domains and C of other Fc polypeptides H The Fc polypeptide sequences of the constructs described herein may be different, as they may comprise an engineered bulge in the Fc polypeptide constant domain, where the engineered cavity and engineered bulge are positioned to form a protuberance-into-cavity pair in the Fc polypeptide. In some embodiments, the Fc constructs may comprise a C HIn some embodiments, the Fc construct comprises an amino acid modification in the C3 domain of an Fc polypeptide (one or more Fc polypeptides). H In another embodiment, the complementary dimerization selectivity module comprises an amino acid modification for selective dimerization in the C3 domain of one Fc polypeptide. Exemplary engineered cavities and protuberances are known in the art. In another embodiment, the complementary dimerization selectivity module comprises an amino acid modification for selective dimerization in the C3 domain of one Fc polypeptide. H 3. Negatively charged amino acids engineered (substituted) in the antibody constant domain and C of the other Fc polypeptide H 3 antibody constant domains, including engineered (substituted) positively charged amino acids, where the negatively and positively charged amino acids are positioned to facilitate Fc domain formation between complementary Fc polypeptides. Exemplary complementary amino acid changes are known in the art. In some embodiments, one or more of the Fc polypeptides are the same sequence. In some embodiments, one or more of the Fc polypeptides have the same modification. In some embodiments, only one, two, three, or four of the Fc polypeptides have the same modification.

[0034] In some embodiments, the Fc multimer comprises four polypeptides that form three Fc monomers, wherein the first polypeptide comprises a first Fc polypeptide, a first linker, and a second Fc polypeptide, wherein the second polypeptide comprises a third Fc polypeptide, a second linker, and a fourth Fc polypeptide, wherein the third polypeptide comprises a fifth Fc polypeptide, and the fourth polypeptide comprises a sixth Fc polypeptide, wherein the first Fc polypeptide and the third Fc polypeptide form the first Fc monomer, wherein the fifth Fc polypeptide and the second Fc polypeptide form the second Fc monomer, and wherein the sixth Fc polypeptide and the fourth Fc polypeptide form the third Fc monomer.

[0035] In some embodiments, an Fc multimer comprises at least two Fc monomers joined via a linker. In some embodiments, an Fc multimer comprises at least one linker. The linker may be 3 to 200 amino acids (e.g., 3 to 150, 3 to 100, 3 to 60, 3 to 50, 3 to 40, 3 to 30, 3 to 20, 3 to 10, 3 to 8, 3 to 5, 4 to 30, 5 to 30, 6 to 30, 8 to 30, 10 to 20, 10 to 30, 12 to 30, 14 to 18, 15 to 20, 16 to 20, 17 to 20, 18 to 30, 19 to 20, 20 to 25, 21 to 25, 22 to 26, 23 to 27, 24 to 28, 25 to 30, 26 to 31, 27 to 32, 28 to 33, 29 to 40, 30 to 31, 30 to 32, 31 to 33, 32 to 34, 33 to 35, 34 to 36, 35 to 37, 36 to 38, 37 to 49, 38 to 49, 49 to 50, 49 to 51, 49 to 51, 52 to 52, 53 to 54, 54 to 55, 55 to 56, 56 to 57, 57 to 58, 58 to 59, 59 to 60, 60 to 61, 61 to 62, 62 to 63, 63 to 64, 6 The linker may be an amino acid spacer comprising a nucleotide sequence (e.g., 30, 20-30, 15-25, 15-30, 18-22, or 20-30 amino acids). Suitable peptide linkers are known in the art and include, for example, peptide linkers containing flexible amino acid residues such as glycine and serine. In certain embodiments, the linker may contain a single, multiple, or repeating motif, such as GS, GGS, GGSG, GGGGS, GGG, or GGGG. In certain embodiments, the linker may comprise GS, GGS, GGSG, GGGGS, GGG, or any of SEQ ID NOs: 128-155. In some embodiments, the linker is used to connect two Fc polypeptides in tandem. In other embodiments, the linker may be a C L and C H1 Used to connect antibody constant domains. In other embodiments, the linker may contain amino acids other than glycine and serine, for example, SEQ ID NOs: 156-162.

[0036] In some embodiments described herein, an Fc multimer can comprise SEQ ID NOs: 97-127, or a polypeptide comprising SEQ ID NOs: 97-127 with up to 10 (e.g., 9, 8, 7, 6, 5, 4, 3, 2, or 1) single amino acid modifications (e.g., substitutions, e.g., conservative substitutions). In some embodiments, the Fc polypeptides of the Fc domains of a construct can have sequences that differ between two Fc polypeptides (i.e., between an Fc polypeptide of an Fc construct and another Fc polypeptide), e.g., by no more than 20 amino acids (e.g., no more than 15, 10 amino acids), e.g., no more than 20, 15, 10, 8, 7, 6, 5, 4, 3, or 2 amino acids.

[0037] In some embodiments, one or more polypeptides in the Fc construct contain a terminal lysine residue. In some embodiments, one or more Fc polypeptides in the Fc construct do not contain a terminal lysine residue. In some embodiments, all Fc polypeptides in the Fc construct contain a terminal lysine residue. In some embodiments, all Fc polypeptides in the Fc construct do not contain a terminal lysine residue. In some embodiments, a terminal lysine residue in an Fc polypeptide comprising, consisting of, or consisting essentially of the sequence of any one of SEQ ID NOs: 98, 100, 101, 103, 105, 107, 109, 111, 113, 115, and 117 can be removed to generate a corresponding Fc polypeptide that does not contain a terminal lysine residue. In some embodiments, a terminal lysine residue may be added to an Fc polypeptide comprising, consisting of, or consisting essentially of SEQ ID NOs: 97, 99, 102, 104, 106, 108, 110, 112, 114, 116, and 118-127 to generate a corresponding Fc polypeptide containing a terminal lysine residue.

[0038] In some embodiments, the Fc multimer lacks any mutations that increase the binding affinity of the Fc multimer to a complement system protein. In some preferred embodiments, the complement system protein is C1q. In some embodiments, mutations that are not present in the Fc multimers used in the present invention include at least one point mutation in the IgG1 Fc domain of the Fc multimer at any one of positions 267, 268, or 324. In some embodiments, the excluded mutations are at least one of S267E, H268F, or S324T. In some embodiments, the excluded mutations include at least one mutation at any one of positions 267, 268, and 324, and further include at least one point mutation at any one of positions 233, 234, 235, 236, 238, 265, 297, 299, or 328. In some embodiments, excluded mutations include at least one of N297A, T299A, P238D, E233P, G236R, L234V, E233P, L234A, L235A, P238D, D265A, D265W, N297A, N297Q, T299A, or L328F. In some embodiments, the amino acid at position 299 is not mutated from threonine to any other amino acid other than serine or cysteine. In some embodiments, The amino acid at position 298 is not mutated to any amino acid other than proline. In some embodiments, the amino acid at position 236 is not deleted. In a preferred embodiment, the mutations excluded are S267E, H268F, and S324T. In another preferred embodiment, the mutations excluded are S267E, H268F, S324T, and N297A. In another preferred embodiment, the mutations excluded are S267E, H268F, S324T, N297A, L234A, and L235A. In another preferred embodiment, the mutations excluded are S267E, H268F, S324T, N297A, E233P, L234V, L235A, and the deletion of G236. In another preferred embodiment, the mutations excluded are S267E, H268F, S324T, L234A, and L235A. In another preferred embodiment, the mutations excluded are S267E, H268F, S324T, E233P, L234V, L235A, and a G236 deletion. In another preferred embodiment, the mutations excluded are S267E, H268F, S324T, and D265A. In another preferred embodiment, the mutations excluded are E233P, G236R, S267E, H268F, and S324T. In another preferred embodiment, the mutations excluded are G236R, S267E, H268F, and S324T. In another preferred embodiment, the mutations excluded are E233P, G236R, S267E, H268F, S324T, and L328F. In another preferred embodiment, the mutations excluded are P238D, D265G, S267E, H268F, and S324T. In another preferred embodiment, the mutations excluded are P238D, D265W, S267E, H268F, and S324T. In another preferred embodiment, the mutations excluded are E233P, L234V, L235A, S267E, H268F, N297A, S324T, S328F, and a deletion of G236. In another preferred embodiment, the mutations excluded are S267E, H268F, S324T, and L328F. In another preferred embodiment, the mutations excluded are P238D, S267E, H268F, and S324T.In another preferred embodiment, the mutations excluded are P238D, S267E, H268F, S324T and N297A.

[0039] In a preferred embodiment, the Fc multimer is administered intravenously or non-intravenously. In one embodiment, the Fc multimer is administered subcutaneously. In one embodiment, the Fc multimer is administered orally, intrathecally, or pulmonary by inhalation.

[0040] In a preferred embodiment, the Fc multimer is administered in an amount ranging from about 3 mg / kg to about 200 mg / kg. In one embodiment, the Fc multimer is administered in an amount ranging from about 1 mg / kg to about 500 mg / kg. All doses are per kg of body weight of the subject to which the Fc multimer is administered.

[0041] In an alternative embodiment, the Fc multimer used in the present invention is a stradomer, in which the IgG Fc fragment comprises a multimerization domain, preferably an IgG2 hinge region, as disclosed in WO2008 / 151088, WO2012 / 016073, WO2017 / 214321, or WO2017 / 019565, but wherein the Fc multimer lacks any mutations that increase its binding affinity to a complement system protein. In some preferred embodiments, the complement system protein is C1q. In a preferred embodiment, the Fc multimer is produced by expressing a polypeptide chain comprising SEQ ID NO: 5, whereby the mature Fc multimer comprises residues 21-264 of SEQ ID NO: 5.

[0042] It is to be understood that both the foregoing general description and the following detailed description are exemplary and explanatory only and are intended to provide a further, non-limiting explanation of the disclosure. [Brief explanation of the drawings]

[0043] [Figure 1]Figure 1 shows the effect of Fc-μTP-L309C hexamer (CSL777) produced in CHO cells in an in vivo model of anti-GBM glomerulonephritis, as represented by the level of albumin detected in mouse urine by an ELISA kit. [Figure 2] Figure 2 shows the effects of Fc-μTP-L309C hexamer (CSL777) produced in CHO cells (Fc-μTP-L309C(CHO)) and HEK293 cells (Fc-μTP-L309C(HEK)), as well as a mutant hexamer with reduced C1q binding ability (K322A), in an in vivo model of anti-GBM glomerulonephritis, as represented by the level of albumin detected in mouse urine by an ELISA kit. [Figure 3] Figure 3 shows the effects of Fc-μTP-L309C hexamer (CSL777) and other Fc multimers (CC, SIF1, and Q1) in an in vivo model of anti-GBM glomerulonephritis, as represented by the level of albumin detected in mouse urine by an ELISA kit. [Figure 4] FIG. 4 shows the dose-response effect of Fc-μTP-L309C hexamer (CSL777) in an in vivo model of anti-GBM glomerulonephritis, as represented by the level of albumin detected in mouse urine by ELISA kit. [Figure 5] Figure 5: Sequence from WO2017 / 129737 [Figure 6-1] Figure 6: Other hexameric sequences used in embodiments of the present invention [Figure 6-2] Continued from Figure 6-1. [Figure 6-3] Continued from Figure 6-2. [Figure 6-4] Continued from Figure 6-3. [Figure 6-5] Continued from Figure 6-4. [Figure 6-6] Continued from Figure 6-5. [Figure 6-7] Continued from Figure 6-6. [Figure 7] Figure 7: Stradomer sequences used in embodiments of the present invention [Figure 8]Figure 8: Recombinant Fc compounds disclosed in WO2017 / 172853 used in embodiments of the present invention [Figure 9] Figure 9: Examples of suitable hinge regions for use in Fc multimers used in embodiments of the present invention [Figure 10-1] Figure 10: Sequences for trivalent Fc multimers used in embodiments of the invention [Figure 10-2] Continued from Figure 10-1. [Figure 10-3] Continued from Figure 10-2. [Figure 10-4] Continued from Figure 10-3. [Figure 10-5] Continued from Figure 10-4. DETAILED DESCRIPTION OF THE INVENTION

[0044] Detailed Description The following detailed description and examples describe specific embodiments of the present disclosure. Those skilled in the art will appreciate that there are numerous variations and modifications of the present disclosure that fall within its scope. Accordingly, the description of a specific embodiment should not be considered limiting.

[0045] In some embodiments, the Fc multimer comprises two to six IgG Fc fusion monomers, wherein each Fc fusion monomer comprises two Fc fusion polypeptide chains, and each Fc fusion polypeptide chain comprises an IgG Fc polypeptide and a multimerization domain; and wherein the Fc multimer lacks any mutations that increase the binding affinity of the Fc multimer for complement system proteins.

[0046] In some embodiments, a mutation that increases the binding affinity of an Fc multimer to a complement system protein and is therefore excluded from an Fc multimer used in the present invention is at least one point mutation in one or more IgG1 Fc domains of the Fc multimer. In some embodiments, the excluded mutations correspond to point mutations at positions 267, 268, and / or 324 of the IgG1 Fc domain. In some embodiments, the excluded mutations are at least one of S267E, H268F, and S324T. In some embodiments, the excluded mutations can be one or more point mutations corresponding to at least one of positions 267, 268, and / or 324, and further include at least one point mutation at positions 233, and / or 234, and / or 235, and / or 236, and / or 238, and / or 265, and / or 297, and / or 299, and / or 328. In some embodiments, the excluded mutations may be at least one point mutation at position 233, and / or position 234, and / or position 235, and / or position 236, and / or position 238, and / or position 265, and / or position 297, and / or position 299, and / or position 328. In some embodiments, the excluded mutations are at least one of N297A, T299A, P238D, E233P, G236R, L234V, E233P, L234A, L235A, P238D, D265A, D265W, N297A, N297Q, T299A, and L328F. In some embodiments, the amino acid at position 299 is not mutated from threonine to any other amino acid other than serine or cysteine. In some embodiments, the amino acid at position 298 is not mutated to any amino acid other than proline. In some embodiments, the amino acid at position 236 is not deleted. In some embodiments, it may be a complement system protein C1q.

[0047] In some embodiments, the Fc multimer is not a stradomer. In some embodiments, the Fc multimer does not comprise an IgG2 hinge as a multimerization domain.

[0048] In some embodiments, the Fc multimer comprises two to six IgG Fc fusion monomers, wherein each Fc fusion monomer comprises two Fc fusion polypeptide chains, and each Fc fusion polypeptide chain comprises an IgG Fc polypeptide and a multimerization domain, and wherein the multimerization domain does not comprise an IgG2 hinge. In further embodiments, the Fc multimer is not a stradomer.

[0049] In some embodiments, the Fc multimer comprises two to six IgG Fc fusion monomers, wherein each Fc fusion monomer comprises two Fc fusion polypeptide chains, and each Fc fusion polypeptide chain comprises an IgG Fc polypeptide and a multimerization domain; and wherein the Fc multimer is not a stradomer.

[0050] In some embodiments, the Fc multimer comprises six IgG fusion monomers, hi some embodiments, the Fc multimer comprises an IgGM tail as the multimerization domain.

[0051] In some embodiments, the Fc multimer is a recombinant human Fc hexamer. In some embodiments, the recombinant human Fc hexamer comprises six human IgG1 Fc fusion monomers, wherein each Fc fusion monomer comprises two human Fc fusion polypeptide chains, and each Fc fusion polypeptide chain comprises a human IgG1 Fc polypeptide and a human IgM tail, and further, the IgM tail in each Fc fusion polypeptide chain comprises 18 amino acids fused to the C-terminal 232 amino acids of the constant region of the IgG1 Fc polypeptide.

[0052] In some embodiments, the recombinant human Fc hexamer lacks any mutations that increase its binding affinity to a complement system protein. In some preferred embodiments, the complement system protein is C1q. In some embodiments, the mutations that are not present in the Fc multimers used in the present invention include at least one point mutation in the IgG1 Fc domain of the Fc hexamer at any one of positions 267, 268, or 324. In some embodiments, the excluded mutations include at least one of S267E, H268F, or S324T. In some embodiments, the excluded mutations include at least one mutation at any one of positions 267, 268, and 324, and further include at least one point mutation at any one of positions 233, 234, 235, 236, 238, 265, 297, 299, or 328. In some embodiments, the excluded mutations include at least one of N297A, T299A, P238D, E233P, G236R, L234V, E233P, L234A, L235A, P238D, D265A, D265W, N297A, N297Q, T299A, or L328F. In some embodiments, the amino acid at position 299 is not mutated from threonine to any other amino acid other than serine or cysteine. In some embodiments, the amino acid at position 298 is not mutated to any amino acid other than proline. In some embodiments, the amino acid at position 236 is not deleted. In preferred embodiments, the mutations excluded are S267E, H268F, and S324T. In another preferred embodiment, the mutations excluded are S267E, H268F, S324T, and N297A. In another preferred embodiment, the mutations excluded are S267E, H268F, S324T, N297A, L234A, and L235A. In another preferred embodiment, the mutations excluded are S267E, H268F, S324T, N297A, E233P, L234V, L235A, and deletion of G236. In another preferred embodiment, the mutations excluded are S267E, H268F, S324T, L234A, and L235A. In another preferred embodiment, the mutations excluded are S267E, H268F, S324T, E233P, L234V, L235A, and a deletion of G236. In another preferred embodiment, the mutations excluded are S267E, H268F, S324T, and D265A. In another preferred embodiment, the mutations excluded are E233P, G236R, S267E, H268F, and S324T.In another preferred embodiment, the mutations excluded are G236R, S267E, H268F, and S324T. In another preferred embodiment, the mutations excluded are E233P, G236R, S267E, H268F, S324T, and L328F. In another preferred embodiment, the mutations excluded are P238D, D265G, S267E, H268F, and S324T. In another preferred embodiment, the mutations excluded are P238D, D265W, S267E, H268F, and S324T. In another preferred embodiment, the mutations excluded are E233P, L234V, L235A, S267E, H268F, N297A, S324T, S328F, and the deletion of G236. In another preferred embodiment, the mutations excluded are S267E, H268F, S324T, and L328F. In another preferred embodiment, the mutations excluded are P238D, S267E, H268F, and S324T. In another preferred embodiment, the mutations excluded are P238D, S267E, H268F, S324T, and N297A. In some embodiments, the recombinant human Fc hexamer is not a stradomer.

[0053] In some embodiments, the Fc multimer comprises four polypeptides that form three Fc monomers, wherein the first polypeptide comprises a first Fc polypeptide, a first linker, and a second Fc polypeptide, wherein the second polypeptide comprises a third Fc polypeptide, a second linker, and a fourth Fc polypeptide, wherein the third polypeptide comprises a fifth Fc polypeptide, wherein the fourth polypeptide comprises a sixth Fc polypeptide, wherein the first Fc polypeptide and the third Fc polypeptide form the first Fc monomer, wherein the fifth Fc polypeptide and the second Fc polypeptide form the second Fc monomer, and wherein the sixth Fc polypeptide and the fourth Fc polypeptide form the third Fc monomer.

[0054] In further embodiments, the Fc multimer lacks any mutations that increase its binding to complement system proteins. The protein is C1q. In some embodiments, the mutations not present in the Fc multimers used in the invention comprise at least one point mutation in the IgG1 Fc domain of the Fc multimer at any one of positions 267, 268, or 324. In some embodiments, the mutations excluded are at least one of S267E, H268F, or S324T. In some embodiments, the mutations excluded comprise at least one mutation at any one of positions 267, 268, and 324, and further comprise at least one point mutation at any one of positions 233, 234, 235, 236, 238, 265, 297, 299, or 328. In some embodiments, the excluded mutations include at least one of N297A, T299A, P238D, E233P, G236R, L234V, E233P, L234A, L235A, P238D, D265A, D265W, N297A, N297Q, T299A, or L328F. In some embodiments, the amino acid at position 299 is not mutated from threonine to any other amino acid other than serine or cysteine. In some embodiments, the amino acid at position 298 is not mutated to any amino acid other than proline. In some embodiments, the amino acid at position 236 is not deleted. In preferred embodiments, the excluded mutations are S267E, H268F, and S324T. In another preferred embodiment, the excluded mutations are S267E, H268F, S324T, and N297A. In another preferred embodiment, the mutations excluded are S267E, H268F, S324T, N297A, L234A, and L235A. In another preferred embodiment, the mutations excluded are S267E, H268F, S324T, N297A, E233P, L234V, L235A, and the deletion of G236. In another preferred embodiment, the mutations excluded are S267E, H268F, S324T, L234A, and L235A. In another preferred embodiment, the mutations excluded are S267E, H268F, S324T, E233P, L234V, L235A, and the deletion of G236.In another preferred embodiment, the mutations excluded are S267E, H268F, S324T, and D265A. In another preferred embodiment, the mutations excluded are E233P, G236R, S267E, H268F, and S324T. In another preferred embodiment, the mutations excluded are G236R, S267E, H268F, and S324T. In another preferred embodiment, the mutations excluded are E233P, G236R, S267E, H268F, S324T, and L328F. In another preferred embodiment, the mutations excluded are P238D, D265G, S267E, H268F, and S324T. In another preferred embodiment, the mutations excluded are P238D, D265W, S267E, H268F, and S324T. In another preferred embodiment, the mutations excluded are E233P, L234V, L235A, S267E, H268F, N297A, S324T, S328F, and a deletion of G236. In another preferred embodiment, the mutations excluded are S267E, H268F, S324T, and L328F. In another preferred embodiment, the mutations excluded are P238D, S267E, H268F, and S324T. In another preferred embodiment, the mutations excluded are P238D, S267E, H268F, S324T, and N297A.

[0055] As used herein, the term "Fc monomer" is defined as a portion of the immunoglobulin G (IgG) heavy chain constant region containing the IgG heavy chain CH2 and CH3 domains, or a variant or fragment thereof. The IgG CH2 and CH3 domains are also referred to as the Cγ2 and Cγ3 domains, respectively.

[0056] An Fc monomer may be composed of two identical Fc polypeptides linked by disulfide bonds between cysteine ​​residues at the N-terminal portion of the polypeptide. The disulfide bond arrangement described for IgG is that of natural human antibodies. Although there is some variation among antibodies from other vertebrate species, such antibodies may be suitable in the context of the present invention. Fc polypeptides may be produced by recombinant expression techniques, and Alternatively, one or more new cysteine ​​residues can be introduced at appropriate positions in the Fc polypeptide to allow disulfide bond formation.

[0057] In one embodiment, the Fc monomer used in the present invention comprises two identical polypeptide chains comprising human IgG1 CH2 and CH3 domains as described in WO2017 / 129737.

[0058] In another embodiment, the Fc monomer used in the present invention comprises the entire CH2 and CH3 domains and is truncated at the N-terminus of CH2 or the C-terminus of CH3, respectively, as disclosed in WO2017 / 129737. Typically, the Fc monomer lacks the Fab polypeptide of the immunoglobulin. The Fab polypeptide is composed of the CH1 domain and the heavy chain variable region domain.

[0059] The Fc monomers used in the present invention may comprise more than the CH2 and CH3 portions of an immunoglobulin. For example, in one embodiment, the monomer comprises an immunoglobulin hinge region, a fragment or variant thereof, or a modified hinge region. A native hinge region is the region of an immunoglobulin that is present between the CH1 and CH2 domains in a native immunoglobulin. A variant or modified hinge region is any hinge that differs in length and / or composition from the native hinge region. Such hinges may include hinge regions from other species. Other modified hinge regions include complete hinge regions derived from antibodies of a class or subclass different from that of the Fc portion. Alternatively, modified hinge regions comprise portions of native hinges or repeating units in which each unit in the repeat is derived from a native hinge region. In another alternative, the native hinge region is altered by increasing or decreasing the number of cysteine ​​residues. Other modified hinge regions are completely non-natural and are designed to have desired properties such as length, cysteine ​​composition, and flexibility.

[0060] A number of modified hinge regions for use in the present invention are described in, for example, US 5,677,425, WO1998 / 25971, WO1999 / 15549, WO2005 / 003169, WO2005 / 003170 and WO2005 / 003171.

[0061] The Fc polypeptide in the Fc multimer used in one embodiment of the present invention has a human IgG1 hinge region at its N-terminus. In one embodiment, the hinge region has the sequence of residues 1 to 15 of SEQ ID NO:1.

[0062] The Fc polypeptide chains used in some embodiments of the invention are expressed including a signal peptide, such as that disclosed in WO 2017 / 129737, which directs the secretion of the Fc polypeptide chain and is subsequently cleaved from the remainder of the Fc polypeptide chain.

[0063] The Fc polypeptides used in embodiments of the invention include a signal peptide fused to the N-terminus of the hinge region. The signal peptide may have the sequence of residues 1-19 of SEQ ID NO: 2; however, those skilled in the art will appreciate that other signal sequences that direct secretion of a protein from mammalian cells may also be used.

[0064] To improve the formation of multimeric structures of two or more Fc monomers, an Fc polypeptide is fused to a tail, which allows the monomer units to assemble into multimers. The product of the fusion of an Fc polypeptide to a tail is an "Fc fusion polypeptide" as used herein. Just as Fc polypeptides dimerize to form Fc monomers, Fc fusion polypeptides similarly dimerize to form Fc fusion monomers.

[0065] Thus, as used herein, an "Fc fusion monomer" comprises two Fc fusion polypeptide chains, and each Fc fusion polypeptide chain comprises an IgG Fc polypeptide and an IgM tail or an IgA tail, preferably an IgM tail.

[0066] Suitable tails are derived from IgM or IgA. IgM and IgA naturally occur in humans as covalently linked multimers of the common H2L2 antibody unit. IgM exists as a pentamer when it incorporates a J chain or as a hexamer when it lacks a J chain. IgA exists as a monomer and forms dimers. The heavy chains of IgM and IgA each have an 18-amino acid extension to the C-terminal constant domain known as the tail. This tail contains cysteine ​​residues that form disulfide bonds between heavy chains in the polymer and is thought to play an important role in polymerization. The tail also contains glycosylation sites.

[0067] Tails of the present disclosure comprise any suitable amino acid sequence. The tails may be those found in naturally occurring antibodies or, alternatively, may be modified tails that differ in length and / or composition from naturally occurring tails. Other modified tails are completely non-natural and are designed to have properties desired for multimerization, such as length, flexibility, and cysteine ​​composition.

[0068] The tail in the Fc multimer used in the embodiments of the present invention comprises all or part of the 18 amino acid sequence derived from human IgM as shown in residues 233 to 250 of SEQ ID NO: 1 and in SEQ ID NO: 9. Alternatively, the tail may be a fragment or variant of the human IgM tail.

[0069] In one embodiment of the present invention, the tail of the Fc multimer is directly fused to the C-terminus of the constant region of an Fc polypeptide to form an Fc fusion polypeptide. Alternatively, the tail is fused to a 232 amino acid segment at the C-terminus of the constant region of an Fc polypeptide, preferably a human IgG1 Fc polypeptide. Alternatively, the tail is fused indirectly using an intervening amino acid sequence. For example, a short linker sequence can be provided between the tail and the Fc polypeptide. The linker sequence can be between 1 and 20 amino acids in length.

[0070] The formation of multimeric structures can be further improved by mutating leucine 309 in the Fc portion of the Fc fusion polypeptide to cysteine. The L309C mutation allows for additional disulfide bond formation between Fc fusion monomers, which further promotes multimerization of the Fc fusion monomers. Residues in the IgG Fc portion are numbered according to the EU numbering system for IgG as described in Edelman GM et al. (1969), Proc Natl Acad Sci 63, 78-85; see also Kabat et al., 1983, Sequences of proteins of immunological interest, US Department of Health and Human Services, National Institutes of Health, Washington, DC. Leu309 in IgG corresponds, by sequence homology, to Cys414 in the Cμ3 domain of IgM and Cys309 in the Cα2 domain of IgA.

[0071] Other mutations may also or alternatively be introduced into the Fc fusion polypeptide to achieve a desired effect. As used herein, the term "mutation" includes the substitution, addition, or deletion of one or more amino acids. In some embodiments, the Fc fusion polypeptide may contain up to 20, up to 10, or up to 12 amino acids, as described in WO2017 / 129737. Contains up to five or up to two amino acid mutations.

[0072] The mutations in the Fc multimer used in one embodiment of the present invention are conservative amino acid changes as described in WO2017 / 129737. As used herein, the term "conservative amino acid change" refers to changing an amino acid to a different amino acid with similar biochemical properties, such as charge, hydrophobicity, structure, and / or size. The Fc fusion polypeptide used in one embodiment of the present invention contains up to 20, up to 10, up to 5, or up to 2 conservative amino acid changes. For example, the Fc fusion polypeptide contains up to 5 conservative amino acid changes.

[0073] Conservative amino acid changes include changes between the following groups of residues: Val, Ile, Leu, Ala, Met; Asp, Glu; Asn, Gln; Ser, Thr, Gly, Ala; Lys, Arg, His; and Phe, Tyr, Trp.

[0074] "Variant," as used herein to describe a peptide, protein, or fragment thereof, may have modified amino acids. Suitable modifications include acetylation, glycosylation, hydroxylation, methylation, nucleotidylation, phosphorylation, ADP-ribosylation, and other modifications known in the art. Such modifications may occur post-translationally when the peptide is produced recombinantly. Otherwise, modifications may be made to synthetic peptides using techniques known in the art. Modifications may be included prior to incorporation of the amino acid into the peptide. Carboxylic acid groups may be esterified or converted to amides, and amino groups may be alkylated, e.g., methylated. Variants may also be post-translationally modified, for example, to remove or add carbohydrate side chains or individual sugar moieties.

[0075] As used herein, the term "Fc multimer" describes two or more polymerized Fc monomers. The Fc monomers can be Fc fusion monomers. Fc multimers contain two to six Fc monomers, resulting in Fc dimers, Fc trimers, Fc tetramers, Fc pentamers, and Fc hexamers. Fc monomers can combine to form polymers with various numbers of monomer units.

[0076] As used herein, the term "conjugated" is used to describe the combination or linkage of two or more elements, components, or protein domains, e.g., polypeptides, by means including chemical conjugation, recombinant means, and chemical bonds, e.g., disulfide bonds and amide bonds. For example, two single polypeptides may be joined via chemical conjugation, chemical bonds, peptide linkers, or any other covalent linking means to form a continuous protein structure. In some embodiments, a first Fc polypeptide is joined to a second Fc polypeptide using a linker, e.g., a peptide linker, wherein the N-terminus of the peptide linker is joined to the C-terminus of the first Fc polypeptide via a chemical bond, e.g., a peptide bond, and the C-terminus of the peptide linker is joined to the N-terminus of the second Fc polypeptide via a chemical bond, e.g., a peptide bond.

[0077] As used herein, the term "linker" refers to a "spacer" between two elements, e.g., an Fc polypeptide. The term "spacer" refers to a moiety (e.g., a polyethylene glycol (PEG) polymer) or amino acid sequence (e.g., a sequence of 3-200 amino acids, 3-150 amino acids, or 3-100 amino acids) that is present between two polypeptides or polypeptide domains and provides space and / or flexibility between the two polypeptides or polypeptide domains. An amino acid spacer is part of the primary sequence of a polypeptide (e.g., a polypeptide or polypeptide domain spaced apart via the polypeptide backbone). A "linker" can be present between two polypeptides to provide flexibility and / or space.

[0078] In WO2017 / 129737, the majority of the Fc multimers are hexamers. As used herein, the term "majority" refers to more than 50%, more than 60%, more than 70%, more than 80%, or more than 90%. In one embodiment, more than 80% of the Fc multimers are Fc hexamers.

[0079] If Fc multimers containing a specific number of monomers are required, the Fc multimers can be separated by molecular size, for example, by gel filtration (size exclusion chromatography).

[0080] In one embodiment, the Fc multimers used in the present invention are potential IVIG replacement proteins comprising multiple Fc domains, for example as described in WO2008 / 151088 or WO2012 / 016073.

[0081] In another embodiment, the multimeric Fc is a stradomer having a multimerization domain such as an IgG2 hinge region, as described in WO2008 / 151088, where the stradomer lacks any mutations that increase its binding affinity to a complement system protein. In a preferred embodiment, the complement system protein is C1q.

[0082] In one embodiment, as disclosed in, for example, WO2008 / 151088, WO2012 / 016073, and WO2017 / 214321 (which are incorporated by reference in their entireties), an Fc multimer used in the present invention is a compound comprising two or more multimerization units, wherein each of the units comprises a multimerization region and a region comprising at least one Fc domain capable of binding to an Fcγ receptor, wherein each of the units comprises a multimerization region monomer and a region comprising at least one Fc polypeptide, wherein dimerization of two monomers forms a multimerization region and a region comprising at least one Fc domain capable of binding to an Fcγ receptor, wherein the multimerization regions of the two or more units multimerize to form a compound, and wherein the compound is capable of binding to a first Fcγ receptor via a first Fc domain and a second Fcγ receptor via a second Fc domain, wherein the multimerization region comprises an IgG2 hinge, an IgE The regions comprising at least one Fc domain capable of binding to an Fcγ receptor are selected from the group consisting of a CH2 domain, a leucine zipper, an isoleucine zipper, and a zinc finger, and each comprise an IgG1 hinge, an IgG1 CH2 domain, and an IgG1 CH3 domain. However, embodiments of the present invention lack any mutations that increase their binding affinity to complement system proteins such as C1q. In some embodiments, the multimerization region is an IgG2 hinge region, for example, the IgG2 12-amino acid hinge region ERKCCVECPPCP (residues 253-264 in SEQ ID NO: 5). More preferably, the Fc multimer is obtained by expression of the polypeptide of SEQ ID NO: 5 (SEQ ID NO: 4 in WO 2012 / 016073), which spontaneously multimerizes via the IgG2 hinge multimerization domain.

[0083] In another alternative embodiment, the recombinant Fc compound used in the present invention is as disclosed in WO2017 / 172853, which is incorporated herein by reference in its entirety. Preferably, the recombinant Fc compound comprises a single-chain Fc peptide comprising two CH2-CH3 Fc domains and an oligomerization peptide domain. Preferably, the recombinant Fc compound comprises the protein of SEQ ID NO: 6 (SEQ ID NO: 6 in WO2017172853) or SEQ ID NO: 7 (SEQ ID NO: 4 in WO2017172853).

[0084] In some embodiments, the Fc multimer comprises a complement system protein. Any mutations that increase binding affinity are omitted. An example of a complement system protein is C1q. In some embodiments, the mutations excluded include at least one point mutation in the IgG1 Fc domain of the Fc multimer at any one of positions 267, 268, or 324. In some embodiments, the mutations excluded are at least one of S267E, H268F, or S324T. In some embodiments, the mutations excluded include at least one mutation at any one of positions 267, 268, and 324, and further include at least one point mutation at any one of positions 233, 234, 235, 236, 238, 265, 297, 299, or 328. In some embodiments, the excluded mutations include at least one of N297A, T299A, P238D, E233P, G236R, L234V, E233P, L234A, L235A, P238D, D265A, D265W, N297A, N297Q, T299A, or L328F. In some embodiments, the amino acid at position 299 is not mutated from threonine to any other amino acid other than serine or cysteine. In some embodiments, the amino acid at position 298 is not mutated to any amino acid other than proline. In some embodiments, the amino acid at position 236 is not deleted. In preferred embodiments, the excluded mutations are S267E, H268F, and S324T. In another preferred embodiment, the excluded mutations are S267E, H268F, S324T, and N297A. In another preferred embodiment, the mutations excluded are S267E, H268F, S324T, N297A, L234A, and L235A. In another preferred embodiment, the mutations excluded are S267E, H268F, S324T, N297A, E233P, L234V, L235A, and the deletion of G236. In another preferred embodiment, the mutations excluded are S267E, H268F, S324T, L234A, and L235A. In another preferred embodiment, the mutations excluded are S267E, H268F, S324T, E233P, L234V, L235A, and the deletion of G236.In another preferred embodiment, the mutations excluded are S267E, H268F, S324T, and D265A. In another preferred embodiment, the mutations excluded are E233P, G236R, S267E, H268F, and S324T. In another preferred embodiment, the mutations excluded are G236R, S267E, H268F, and S324T. In another preferred embodiment, the mutations excluded are E233P, G236R, S267E, H268F, S324T, and L328F. In another preferred embodiment, the mutations excluded are P238D, D265G, S267E, H268F, and S324T. In another preferred embodiment, the mutations excluded are P238D, D265W, S267E, H268F, and S324T. In another preferred embodiment, the mutations excluded are E233P, L234V, L235A, S267E, H268F, N297A, S324T, S328F, and a deletion of G236. In another preferred embodiment, the mutations excluded are S267E, H268F, S324T, and L328F. In another preferred embodiment, the mutations excluded are P238D, S267E, H268F, and S324T. In another preferred embodiment, the mutations excluded are P238D, S267E, H268F, S324T, and N297A.

[0085] In another alternative embodiment, the recombinant Fc compound used in the present invention is as disclosed in WO2015 / 168643, WO2017 / 205436, WO2017 / 205434, and WO2018 / 129255 (incorporated herein by reference in their entireties). Preferably, the recombinant Fc compound comprises an Fc construct having 2 to 10 Fc domains, e.g., 2, 3, 4, 5, 6, 7, 8, 9, or 10 Fc domains. In some embodiments, the recombinant Fc compound comprises three Fc domains.

[0086] In one embodiment, the present disclosure provides a method for the preparation of a medicament comprising administering to a mammalian subject the invention, ... a method for the preparation of a medicament comprising administering to a mammalian subject the invention, The present invention features an Fc construct. The first polypeptide has the formula ALB, where A comprises a first Fc polypeptide; L is a linker; and B comprises a second polypeptide. The second polypeptide has the formula A'-L'-B', where A' comprises a third Fc polypeptide; L' is a linker; and B' comprises a fourth Fc polypeptide. The third polypeptide comprises a fifth Fc polypeptide, and the fourth polypeptide comprises a sixth Fc polypeptide. In this embodiment, A and A' combine to form a first Fc domain, B and the fifth Fc polypeptide combine to form a second Fc domain, and B' and the sixth Fc polypeptide combine to form a third Fc domain.

[0087] In some embodiments of this aspect, A and A' each comprise a dimerization selectivity module that promotes dimerization between these Fc polypeptides. In other embodiments, B and the fifth Fc polypeptide each comprise a dimerization selectivity module that promotes dimerization between these Fc polypeptides. In yet other embodiments, B' and the sixth Fc polypeptide each comprise a dimerization selectivity module that promotes dimerization between these Fc polypeptides.

[0088] In some embodiments of this aspect, one or more of A, B, A', B', the third polypeptide, and the fourth polypeptide consist of an Fc polypeptide. In some embodiments, A, B, A', B', the third polypeptide, and the fourth polypeptide each consist of an Fc polypeptide.

[0089] In some embodiments of this aspect, B and B' each comprise the mutations D399K and K409D, A and A' each comprise the mutations S354C, T366W, and E357K, and the fifth and sixth Fc polypeptides each comprise the mutations Y349C, T366S, L368A, Y407V, and K370D.

[0090] In some embodiments of this aspect, A and A' each comprise the mutations D399K and K409D, B and B' each comprise the mutations S354C, T366W, and E357K, and the fifth and sixth Fc polypeptides each comprise the mutations Y349C, T366S, L368A, Y407V, and K370D.

[0091] In some embodiments of this aspect, L and L' each comprise at least 4, 8, 12, 14, 16, 18, or 20 glycines. In some embodiments, L and L' each comprise between 4 and 30, between 8 and 30, or between 12 and 30 glycines. In some embodiments of this aspect, L and L' each comprise, consist, or consist essentially of GGGGGGGGGGGGGGGGGGGG (SEQ ID NO: 155).

[0092] In some embodiments, the Fc construct is an IgG C L Antibody constant domains and IgG C H 1 antibody constant domain, wherein the IgG C L The antibody constant domains are linked to the IgG C H 1 Attached to the N-terminus of the antibody constant domain and IgG C H 1 The antibody constant domain is attached to the N-terminus of A, for example, using a linker. In one embodiment, the Fc construct comprises a second IgG C L Antibody constant domain and second IgG C H 1 antibody constant domain, wherein the second IgG C L The antibody constant domain can be linked to a second IgG C, for example using a linker. H one antibody constant domain attached to the N-terminus of the IgG C H An antibody constant domain is attached to the N-terminus of A', for example using a linker.

[0093] In some embodiments, the Fc construct comprises a heterologous moiety, e.g., a peptide, e.g., an albumin-binding peptide, joined to the N-terminus or C-terminus of B or B', e.g., using a linker. It further includes

[0094] In other embodiments, the first and second polypeptides of the Fc construct have the same amino acid sequence, and the third and fourth polypeptides of the Fc construct have the same amino acid sequence.

[0095] In some embodiments, the first and second polypeptides comprise, consist of, or consist essentially of the sequence of SEQ ID NO: 120, and the third and fourth polypeptides comprise, consist of, or consist essentially of the sequence of SEQ ID NO: 119. In some embodiments of the present disclosure, each of the first and second polypeptides comprises, consists of, or consists essentially of the sequence of SEQ ID NO: 120 with up to 10 (e.g., up to 9, 8, 7, 6, 5, 4, 3, 2, or 1) single amino acid alterations (e.g., substitutions, e.g., conservative substitutions), and the third and fourth polypeptides comprise, consist of, or consist essentially of the sequence of SEQ ID NO: 119 with up to 10 (e.g., up to 9, 8, 7, 6, 5, 4, 3, 2, or 1) single amino acid alterations (e.g., substitutions, e.g., conservative substitutions). In some cases, the first and second polypeptides comprise, consist of, or consist essentially of the sequence of SEQ ID NO: 125, and the third and fourth polypeptides comprise, consist of, or consist essentially of the sequence of SEQ ID NO: 124. In some embodiments of the present disclosure, each of the first and second polypeptides comprises, consists of, or consists essentially of the sequence of SEQ ID NO: 125 with up to 10 (e.g., up to 9, 8, 7, 6, 5, 4, 3, 2, or 1) single amino acid modifications (e.g., substitutions, e.g., conservative substitutions), and the third and fourth polypeptides comprise, consist of, or consist essentially of the sequence of SEQ ID NO: 124 with up to 10 (e.g., up to 9, 8, 7, 6, 5, 4, 3, 2, or 1) single amino acid modifications (e.g., substitutions, e.g., conservative substitutions).In some embodiments, the first and second polypeptides comprise, consist of, or consist essentially of the sequence of SEQ ID NO:113 or 114, and the third and fourth polypeptides comprise, consist of, or consist essentially of the sequence of SEQ ID NO:107 or 108. In some embodiments of the present disclosure, the first and second polypeptides each comprise, consist of, or consist essentially of the sequence of SEQ ID NO: 113 or 114 with up to 10 (e.g., up to 9, 8, 7, 6, 5, 4, 3, 2, or 1) single amino acid modifications (e.g., substitutions, e.g., conservative substitutions), and the third and fourth polypeptides comprise, consist of, or consist essentially of the sequence of SEQ ID NO: 107 or 108 with up to 10 (e.g., up to 9, 8, 7, 6, 5, 4, 3, 2, or 1) single amino acid modifications (e.g., substitutions, e.g., conservative substitutions). In some embodiments, the first and second polypeptides comprise, consist of, or consist essentially of the sequence of SEQ ID NO: 126, and the third and fourth polypeptides comprise, consist of, or consist essentially of the sequence of SEQ ID NO: 122. In some embodiments of the present disclosure, the first and second polypeptides each comprise, consist of, or consist essentially of the sequence of SEQ ID NO: 126 with up to 10 (e.g., up to 9, 8, 7, 6, 5, 4, 3, 2, or 1) single amino acid modifications (e.g., substitutions, e.g., conservative substitutions), and the third and fourth polypeptides comprise, consist of, or consist essentially of the sequence of SEQ ID NO: 122 with up to 10 (e.g., up to 9, 8, 7, 6, 5, 4, 3, 2, or 1) single amino acid modifications (e.g., substitutions, e.g., conservative substitutions).

[0096] In some embodiments of this aspect of the disclosure, the first and third Fc polypeptides each comprise a complementary dimerization selectivity module that promotes dimerization between the first Fc polypeptide and the third Fc polypeptide, and the second and fourth Fc polypeptides each comprise a complementary dimerization selectivity module that promotes dimerization between the second Fc polypeptide and the fourth Fc polypeptide. In some embodiments, the complementary dimerization selectivity module of each of the first and second Fc polypeptides comprises an engineered bulge, and the complementary dimerization selectivity module of each of the third and fourth Fc polypeptides comprises an engineered cavity.

[0097] In some embodiments, one or more of the Fc polypeptides comprises an IgG hinge domain or portion thereof, an IgG C H 2 antibody constant domains, and IgG C H In some embodiments, each of the Fc polypeptides comprises three antibody constant domains. H 2 antibody constant domains, and IgG C H In some embodiments, each of the Fc polypeptides comprises an IgG1 Fc polypeptide.

[0098] In some embodiments of the previous two aspects of the disclosure, the N-terminal Asp in one or more of the first, second, third, and fourth polypeptides is mutated to Gln, hi some embodiments, the N-terminal Asp in each of the first, second, third, and fourth polypeptides is mutated to Gln.

[0099] In some embodiments, one or more of the first, second, third, and fourth polypeptides lack a C-terminal lysine, hi some embodiments, each of the first, second, third, and fourth polypeptides lacks a C-terminal lysine.

[0100] In some embodiments, the first polypeptide and the second polypeptide have the same amino acid sequence, and the third polypeptide and the fourth polypeptide have the same amino acid sequence. In some embodiments, the first polypeptide and the second polypeptide do not have the same amino acid sequence. In some embodiments, the third polypeptide and the fourth polypeptide do not have the same amino acid sequence.

[0101] In some embodiments, at least one of the Fc domains comprises an amino acid modification that alters one or more of: (i) binding affinity to one or more Fc receptors, (ii) effector function, (iii) level of Fc domain sulfation, (iv) half-life, (v) protease resistance, (vi) Fc domain stability, and / or (vii) susceptibility to degradation. In some embodiments, the Fc domain comprises an amino acid modification, e.g., S267E / L328F, that alters binding affinity to one or more Fc receptors. In some embodiments, the Fc receptor is FcγRIIb. In some cases, the modifications described herein increase affinity for the FcγRIIb receptor. In some cases, the S267E / L328F modification increases binding affinity to FcγRIIb. In some embodiments, the Fc domain comprises an amino acid modification, e.g., 241F, 243F, 246K, 260T, or 301R, that alters the level of Fc domain sulfation. In some embodiments, the Fc domain comprises amino acid modifications that alter protease resistance, e.g., selected from the following set: 233P, 234V, 235A, and 236 deletion; 237A, 239D, and 332E; 237D, 239D, and 332E; 237P, 239D, and 332E; 237Q, 239D, and 332E; 237 S, 239D, and 332E; 239D, 268F, 324T, and 332E; 239D, 326A, and 333A; 239D and 332E; 243L, 292P, and 300L; 267E, 268F, 324T, and 332E; 267E and 332E; 268F, 324T, and 332E; 326A, 332E, and 333A; or 326A and 333A. In some embodiments, the Fc domain comprises an amino acid modification that alters the Fc domain susceptibility to degradation, e.g., C233X, D234X, K235X, S236X, T236X, H237X, C239X, S241X, and G249X, where X is any amino acid.

[0102] In some embodiments, the disclosure features an Fc construct comprising: a) a first polypeptide comprising: i) a first Fc polypeptide; ii) a second Fc polypeptide; and iii) a linker joining the first Fc polypeptide to the second Fc polypeptide; b) a second polypeptide comprising: i) a third Fc polypeptide; ii) a fourth Fc polypeptide; and iii) a linker joining the third Fc polypeptide to the fourth Fc polypeptide; c) a third polypeptide comprising a fifth Fc polypeptide; and d) a fourth polypeptide comprising a sixth Fc polypeptide; wherein the first Fc polypeptide and the fifth Fc polypeptide combine to form a first Fc domain, the second Fc polypeptide and the fourth Fc polypeptide combine to form a second Fc domain, and the third Fc polypeptide and the sixth Fc polypeptide combine to form a third Fc domain, and wherein at least one Fc domain comprises an amino acid modification at position 1253 (e.g., a single amino acid modification at position 1253).

[0103] In some embodiments, the first and second polypeptides are identical to each other, and the third and fourth polypeptides are identical to each other. In some embodiments, the first Fc domain comprises an amino acid modification at position 1253. In some cases, one or both of the first and fifth Fc polypeptides comprise an amino acid substitution at position 1253. In some embodiments, the second Fc domain comprises an amino acid modification at position 1253. In some embodiments, one or both of the second and fourth Fc domain monomers comprise an amino acid substitution at position 1253. In some embodiments, the third Fc domain comprises an amino acid modification at position 1253. In some embodiments, one or both of the third and sixth Fc polypeptides comprise an amino acid substitution at position 1253. In some embodiments, each amino acid modification (e.g., substitution) at position 1253 is independently selected from the group consisting of: I253A, I253C, I253D, I253E, I253F, I253G, I253H, I253I, I253K, I253L, I253M, I253N, I253P, I253Q, I253R, I253S, I253T, I253V, I253W, and I253Y. In some embodiments, each amino acid modification (e.g., substitution) at position 1253 is I253A.

[0104] In another aspect, the disclosure features an Fc construct comprising: a): i) a first Fc polypeptide; ii) a second Fc polypeptide; and iii) a first polypeptide comprising: i) a first Fc polypeptide; ii) a second Fc polypeptide; and iii) a second polypeptide comprising: i) a third Fc polypeptide; ii) a fourth Fc polypeptide; and iii) a second polypeptide comprising: a linker joining the third Fc polypeptide to the fourth Fc polypeptide; c) a third polypeptide comprising a fifth Fc polypeptide; and d) a fourth polypeptide comprising a sixth Fc polypeptide; wherein the first Fc polypeptide and the fifth Fc polypeptide combine to form a first Fc domain, the second Fc polypeptide and the fourth Fc polypeptide combine to form a second Fc domain, and the third Fc polypeptide and the sixth Fc polypeptide combine to form a third Fc domain, and wherein at least one Fc domain comprises an amino acid modification (e.g., a single amino acid modification) at position R292.

[0105] In some embodiments, the first Fc domain comprises an amino acid modification at position R292. In some embodiments, one or both of the first and fifth Fc polypeptides comprises an amino acid substitution at position R292. In some embodiments, the second The Fc domain of the second Fc polypeptide comprises an amino acid modification at position R292. In some embodiments, one or both of the second and fourth Fc polypeptides comprises an amino acid substitution at position R292. In some embodiments, the third Fc domain comprises an amino acid modification at position R292. In some embodiments, one or both of the third and sixth Fc polypeptides comprises an amino acid substitution at position R292. In some embodiments, the first, second, and third Fc domains each comprise an amino acid modification (e.g., a substitution) at position R292. In some embodiments, the first, second, and third Fc domains each comprise the amino acid modification (e.g., substitution) R292P (i.e., each Fc monomer has an R292P modification). In some embodiments, one or both of the first and fifth Fc polypeptides comprise the amino acid substitution R292P, one or both of the second and fourth Fc polypeptides comprise the amino acid substitution R292P, and one or both of the third and sixth Fc polypeptides comprise the amino acid substitution R292P.

[0106] In some embodiments, each amino acid modification (e.g., substitution) at position R292 is independently selected from R292D, R292E, R292L, R292P, R292Q, R292R, R292T, or R292Y. In some embodiments, each amino acid modification (e.g., substitution) at position R292 is R292P. In some embodiments, the first and third Fc domains each comprise the amino acid modification (e.g., substitution) I253A, and the first, second, and third Fc domains each comprise the amino acid modification (e.g., substitution) R292P. In some embodiments, one or both of the first and fifth Fc polypeptides comprise the amino acid substitution 1253A, one or both of the third and sixth Fc polypeptides comprise the amino acid substitution 1253A, one or both of the first and fifth Fc polypeptides comprise the amino acid substitution R292P, one or both of the second and fourth Fc polypeptides comprise the amino acid substitution R292P, and one or both of the third and sixth Fc polypeptides comprise the amino acid substitution R292P. In some embodiments, each of the first, second, and third Fc domains comprises the amino acid modifications (e.g., substitutions) 1253A and R292P. In some embodiments, one or both of the first and fifth Fc polypeptides comprise the amino acid substitution I253A, one or both of the second and fourth Fc polypeptides comprise the amino acid substitution I253A, and one or both of the third and sixth Fc polypeptides comprise the amino acid substitution I253A, one or both of the first and fifth Fc polypeptides comprise the amino acid substitution R292P, one or both of the second and fourth Fc polypeptides comprise the amino acid substitution R292P, and one or both of the third and sixth Fc polypeptides comprise the amino acid substitution R292P.

[0107] In some embodiments, the first Fc domain and the third Fc domain each comprise the amino acid substitutions I253A and R292P, and the second Fc domain comprises the amino acid substitution R292P. In some cases, one or both of the first and fifth Fc polypeptides comprise the amino acid substitution I253A; one or both of the first and fifth Fc polypeptides comprise the amino acid substitution R292P; one or both of the third and sixth Fc polypeptides comprise the amino acid substitution I253A; one or both of the third and sixth Fc polypeptides comprise the amino acid substitution R292P; and one or both of the second and fourth Fc polypeptides comprise the amino acid substitution R292P.

[0108] In some embodiments, the second Fc domain comprises the amino acid substitution I253A. In some embodiments, one or both of the second and fourth Fc polypeptides comprise the amino acid substitution I253A. In some embodiments, the first Fc domain and the third Fc domain each comprise the amino acid substitution I253A. In some embodiments, one or both of the first and fifth Fc polypeptides comprise the amino acid substitution I253A, and one or both of the third and sixth Fc polypeptides comprise the amino acid substitution I253A. In some embodiments, the first Fc domain, the second Fc domain, and the third Fc domain each comprise the amino acid substitution I253A. Each of the c domains comprises the amino acid substitution 1253A. In some embodiments, one or both of the first and fifth Fc polypeptides comprises the amino acid substitution 1253A, one or both of the second and fourth Fc polypeptides comprises the amino acid substitution 1253A, and one or both of the third and sixth Fc polypeptides comprises the amino acid substitution 1253A.

[0109] In some embodiments, the second Fc domain comprises the amino acid substitution R292P. In some embodiments, one or both of the second and fourth Fc polypeptides comprise the amino acid substitution R292P. In some embodiments, the second Fc domain comprises the amino acid substitutions I253A and R292P. In some embodiments, one or both of the second and fourth Fc polypeptides comprise the amino acid substitution I253A, and one or both of the second and fourth Fc polypeptides comprise the amino acid substitution R292P. In some embodiments, each of the first Fc domain and the third Fc domain comprises the amino acid substitution I253A, and the second Fc domain comprises the amino acid substitution R292P. In some embodiments, one or both of the first and fifth Fc polypeptides comprise the amino acid substitution I253A; one or both of the third and sixth Fc polypeptides comprise the amino acid substitution I253A; and one or both of the second and fourth Fc polypeptides comprise the amino acid substitution R292P.

[0110] In some embodiments, the first Fc domain and the third Fc domain each comprise the amino acid substitution I253A, and the second Fc domain comprises the amino acid substitutions I253A and R292P. In some embodiments, one or both of the first and fifth Fc polypeptides comprise the amino acid substitution I253A; one or both of the third and sixth Fc polypeptides comprise the amino acid substitution I253A; one or both of the second and fourth Fc polypeptides comprise the amino acid substitution I253A; and one or both of the second and fourth Fc polypeptides comprise the amino acid substitution R292P. In some embodiments, the first Fc domain and the third Fc domain each comprise the amino acid substitution R292P. In some embodiments, one or both of the first and fifth Fc polypeptides comprise the amino acid substitution R292P, and one or both of the third and sixth Fc polypeptides comprise the amino acid substitution R292P.

[0111] In some embodiments, the first Fc domain and the third Fc domain comprise the amino acid substitution R292P, and the second Fc domain comprises the amino acid substitution I253A. In some embodiments, one or both of the first and fifth Fc polypeptides comprise the amino acid substitution R292P; one or both of the third and sixth Fc polypeptides comprise the amino acid substitution R292P; and one or both of the second and fourth Fc polypeptides comprise the amino acid substitution I253A. In some embodiments, the first Fc domain and the third Fc domain each comprise I253A and R292P (e.g., comprise the amino acid substitutions I253A and R292P). In some embodiments, one or both of the first and fifth Fc polypeptides comprise the amino acid substitution I253A; one or both of the first and fifth Fc polypeptides comprise the amino acid substitution R292P; one or both of the third and sixth Fc polypeptides comprise the amino acid substitution I253A; and one or both of the third and sixth Fc polypeptides comprise the amino acid substitution R292P.

[0112] In some embodiments, the first Fc domain and the third Fc domain each comprise the amino acid substitutions 1253A and R292P, and the second Fc domain comprises the amino acid substitution 1253A. In some embodiments, one or both of the first and fifth Fc polypeptides comprise the amino acid substitution 1253A; one or both of the first and fifth Fc polypeptides comprise the amino acid substitution R292P; one or both of the third and sixth Fc polypeptides comprise the amino acid substitution 1253A; one or both of the third and sixth Fc polypeptides comprise the amino acid substitution R292P; and one or both of the second and fourth Fc polypeptides. In some embodiments, the first Fc domain, the second Fc domain, and the third Fc domain each comprise the amino acid substitution R292P. In some embodiments, one or both of the first and fifth Fc polypeptides comprise the amino acid substitution R292P; one or both of the second and fourth Fc polypeptides comprise the amino acid substitution R292P; and one or both of the third and sixth Fc polypeptides comprise the amino acid substitution R292P.

[0113] In some embodiments, the first Fc domain and the third Fc domain each comprise the amino acid substitution R292P, and the second Fc domain comprises the amino acid substitutions I253A and R292P. In some embodiments, one or both of the first and fifth Fc polypeptides comprise the amino acid substitution R292P; one or both of the third and sixth Fc polypeptides comprise the amino acid substitution R292P; one or both of the second and fourth Fc polypeptides comprise the amino acid substitution I253A; and one or both of the second and fourth Fc polypeptides comprise the amino acid substitution R292P. In some embodiments, the first Fc domain, the second Fc domain, and the third Fc domain each comprise the amino acid substitutions I253A and R292P. In some embodiments, one or both of the first and fifth Fc polypeptides comprise the amino acid substitution I253A; one or both of the first and fifth Fc polypeptides comprise the amino acid substitution R292P; one or both of the second and fourth Fc polypeptides comprise the amino acid substitution I253A; one or both of the second and fourth Fc polypeptides comprise the amino acid substitution R292P; one or both of the third and sixth Fc polypeptides comprise the amino acid substitution I253A; and one or both of the third and sixth Fc polypeptides comprise the amino acid substitution R292P.

[0114] In some embodiments, each of the first, second, and third Fc domains comprises the amino acid substitution R292P. In some embodiments, one or both of the first and fifth Fc polypeptides comprises the amino acid substitution R292P. In some embodiments, one or both of the third and sixth Fc polypeptides comprises the amino acid substitution R292P. In some embodiments, one or both of the second and fourth Fc polypeptides comprises the amino acid substitution R292P.

[0115] In some embodiments, the Fc constructs described herein do not comprise an antigen recognition region, e.g., a variable domain or a complementarity-determining region (CDR). In some embodiments, the Fc construct (or the Fc domain within the Fc construct) is formed, in whole or in part, by the association of Fc polypeptides present on different polypeptides. In certain embodiments, the Fc construct does not comprise an additional domain (e.g., an IgM tail or an IgA tail) that facilitates the association of the two polypeptides. In other embodiments, a covalent linkage (e.g., a disulfide bridge) exists only between the two Fc polypeptides that join to form the Fc domain. In other embodiments, the Fc construct does not comprise a covalent linkage (e.g., a disulfide bridge) between the Fc domains. In yet other embodiments, the Fc construct provides sufficient structural flexibility such that all or substantially all of the Fc domains in the Fc construct can simultaneously interact with Fc receptors on the cell surface. In one embodiment, the Fc polypeptides differ in primary sequence from wild-type or from each other in that they possess a dimerization selectivity module.

[0116] In another aspect, the disclosure features compositions and methods for promoting selective dimerization of Fc polypeptides. The disclosure provides methods for promoting selective dimerization of Fc polypeptides, wherein two Fc polypeptides of an Fc domain are C H The present disclosure also includes an Fc domain containing identical mutations at at least two positions within the ring of charged residues at the interface between three antibody constant domains. The present disclosure also includes a method for producing the Fc domain, the method comprising: H3. Complementary Fc polypeptides with identical mutations in the two Fc polypeptide sequences at at least two positions within the ring of charged residues at the interface between the antibody constant domains. C. H The interface between the three antibody constant domains consists of a hydrophobic patch surrounded by a ring of charged residues. H When three antibody constant domains are combined with one another, these charged residues pair with residues of the opposite charge. By reversing the charge of both members of two or more complementary residue pairs, the mutated Fc polypeptide remains complementary to Fc polypeptides of the same mutated sequence but has lower complementarity to Fc polypeptides without those mutations. In this embodiment, the same dimerization selectivity module promotes homodimerization. Such Fc domains include Fc polypeptides containing the double mutations K409D / D399K, K392D / D399K, E357K / K370E, D356K / K439D, K409E / D399K, K392E / D399K, E357K / K370D, or D356K / K439E. In another embodiment, the Fc domain comprises an Fc polypeptide comprising any pair of double mutations, for example, a quadruple mutation combining K409D / D399K / E357K / K370E.

[0117] In another embodiment, in addition to identical dimerization selectivity modules, the Fc polypeptides of the Fc domain contain complementary dimerization selectivity modules with non-identical mutations (e.g., engineered cavities and bulges) that promote specific binding. As a result, two Fc polypeptides contain two dimerization selectivity modules and remain complementary to each other but have reduced complementarity to other Fc polypeptides. This embodiment promotes heterodimerization between a gap-containing Fc polypeptide and a bulge-containing Fc polypeptide. In one example, complementary dimerization selectivity modules with non-identical mutations in charged residue pairs on both Fc polypeptides are combined with a bulge on one Fc polypeptide and a gap on the other Fc polypeptide. In another embodiment, the Fc polypeptides of the Fc domain contain complementary dimerization selectivity modules with non-identical mutations (e.g., engineered cavities and bulges) that promote specific binding, and do not contain identical dimerization selectivity modules.

[0118] It is understood that in any of the Fc constructs described herein, the order of the Fc polypeptides is interchangeable. For example, in a polypeptide having the formula ALB, the carboxy terminus of A can be joined to the amino terminus of L, which is in turn joined at its carboxy terminus to the amino terminus of B. Alternatively, the carboxy terminus of B can be joined to the amino terminus of L, which is in turn joined at its carboxy terminus to the amino terminus of C. Both of these configurations are encompassed by the formula ALB.

[0119] The properties of these constructs allow for the efficient production of substantially homogeneous compositions. The degree of homogeneity of a composition affects the pharmacokinetics and in vivo performance of the composition. Such homogeneity in a composition is desirable to ensure the safety, efficacy, uniformity, and reliability of the composition. The Fc constructs of the present disclosure can be present in a population or composition that is substantially homogeneous (e.g., at least 85%, 90%, 95%, 98%, or 99% homogeneous).

[0120] As described in further detail herein, the present disclosure features substantially homogeneous compositions containing Fc constructs that all have the same number of Fc domains, as well as methods for making such substantially homogeneous compositions.

[0121] The Fc constructs of the disclosure may be present in a pharmaceutical composition comprising a substantially homogeneous population (e.g., at least 85%, 90%, 95%, 98%, or 99% homogeneous) of Fc constructs having 2-10 Fc domains (e.g., 2-8 Fc domains, 2-6 Fc domains, 2-4 Fc domains, 2-3 Fc domains, 3-5 Fc domains, or 5-10 Fc domains), e.g., constructs having 2, 3, 4, 5, 6, 7, 8, 9, or 10 Fc domains as described herein. Consequently, the Fc constructs Pharmaceutical compositions can be prepared that do not have substantial aggregation or undesired multimerization of the product.

[0122] Polynucleotides The present disclosure further relates to polynucleotides encoding polypeptides for Fc fusion polypeptides or Fc multimers. The term "polynucleotide" generally refers to any polyribonucleotide or polydeoxyribonucleotide, which may be unmodified RNA or DNA or modified RNA or DNA. A polynucleotide may be single- or double-stranded DNA, single- or double-stranded RNA. As used herein, the term "polynucleotide" also includes DNA or RNA containing one or more modified and / or unusual bases, such as inosine. Of course, various modifications can be made to DNA and RNA that serve many useful purposes known to those skilled in the art. As used herein, the term "polynucleotide" encompasses chemically, enzymatically, or metabolically modified forms of such polynucleotides, as well as the chemical forms of DNA and RNA characteristic of viruses and cells, including, for example, simple and complex cells.

[0123] Those skilled in the art will appreciate that due to the degeneracy of the genetic code, a given polypeptide may be encoded by different polynucleotides. These "variants" are encompassed by the Fc multimers disclosed herein.

[0124] The polynucleotide of the Fc multimer may be an isolated polynucleotide. The term "isolated" polynucleotide refers to a polynucleotide that is substantially free of other nucleic acid sequences, including, but not limited to, other chromosomal and extrachromosomal DNA and RNA. In one embodiment, an isolated polynucleotide is purified from a host cell. Conventional nucleic acid purification methods known to those skilled in the art can be used to obtain an isolated polynucleotide. The term also includes recombinant polynucleotides and chemically synthesized polynucleotides.

[0125] Another aspect of the present disclosure is a plasmid or vector comprising a polynucleotide according to the present disclosure. In one embodiment, the plasmid or vector comprises an expression vector as disclosed in WO2017 / 129737. In one embodiment, the vector is a transfer vector for use in human gene therapy. Another aspect of the present disclosure is a host cell comprising a polynucleotide, plasmid, or vector of the present disclosure.

[0126] The host cells of the present disclosure are used in a method for producing Fc multimers, the method comprising: (a) culturing a host cell of the present disclosure under conditions such that the desired inserted protein is expressed; and (b) optionally recovering the desired inserted protein from the host cell or from the culture medium. Includes:

[0127] In another embodiment, the Fc multimer is purified to a purity of ≥80%, ≥90%, ≥95%, ≥99%, or ≥99.9% with respect to contaminating macromolecules, e.g., other proteins and nucleic acids, and is free of infectious and pyrogenic agents. The isolated Fc multimer of the present disclosure can be substantially free of other unrelated polypeptides.

[0128] In certain embodiments of the invention, the Fc multimer is one described in / 060712. Examples include polymeric proteins comprising 5, 6, or 7 polypeptide monomer units, wherein each polypeptide monomer unit comprises an Fc receptor binding moiety comprising two immunoglobulin G heavy chain constant regions, wherein each immunoglobulin G heavy chain constant region comprises a cysteine ​​residue linked via a disulfide bond to a cysteine ​​residue of the immunoglobulin G heavy chain constant region of an adjacent polypeptide monomer unit, and wherein the polymeric protein further comprises an immunomodulatory moiety that causes antigen-specific immunosuppression when administered to a mammalian subject. or does not contain an antigen moiety. In certain embodiments, two immunoglobulin G heavy chain constant regions are linked via a polypeptide linker as a single chain Fc. In other embodiments, a polypeptide monomer unit consists of an Fc receptor binding portion and a tail region fused to two immunoglobulin G heavy chain constant regions, which facilitates assembly of the monomer units into a polymer.

[0129] In another embodiment, each of the immunoglobulin G heavy chain constant regions comprises the amino acid sequence of a mammalian heavy chain constant region, preferably a human heavy chain constant region; or a variant thereof. A suitable human IgG subtype is IgG1.

[0130] The Fc receptor binding portion may comprise more than the Fc portion of an immunoglobulin. For example, as described in WO 2014 / 060712, it may comprise the hinge region of an immunoglobulin, which is present between the CH1 and CH2 domains in a native immunoglobulin. For certain immunoglobulins, the hinge region is necessary for binding to an Fc receptor. Preferably, the Fc receptor binding portion lacks the CH1 domain and the heavy chain variable region (VH) domain. The Fc receptor binding portion may be truncated at the C-terminus and / or N-terminus compared to the Fc portion of the corresponding immunoglobulin. The polymer protein is formed by each immunoglobulin G heavy chain constant region containing a cysteine ​​residue linked via a disulfide bond to a cysteine ​​residue in the immunoglobulin G heavy chain constant region of an adjacent polypeptide monomer unit. The ability to form a polymer of monomer units based on IgG heavy chain constant regions can be improved by modifying portions of the IgG heavy chain constant region to more closely resemble the corresponding portions of IgM or IgA. Each of the immunoglobulin heavy chain constant regions or variants thereof is an IgG heavy chain constant region comprising an amino acid sequence comprising a cysteine ​​residue at position 309 and preferably a leucine residue at position 310.

[0131] For embodiments of the invention in which a tail region is present, each polypeptide monomer unit comprises a tail region fused to each of two immunoglobulin G heavy chain constant regions, where the tail region of each polypeptide monomer unit facilitates assembly of the monomer units into a polymer as described in WO 2014 / 060712. For example, the tail region is fused C-terminally to each of two immunoglobulin heavy chain constant regions. The tail region may be an IgM or IgA tail, or a fragment or variant thereof.

[0132] In one embodiment, an intervening amino acid sequence can be provided between the heavy chain constant region and the tail, or the tail can be fused directly to the C-terminus of the heavy chain constant region, as disclosed in WO2014 / 060712. For example, a short linker sequence can be provided between the tail region and the immunoglobulin heavy chain constant region. Typical linker sequences are between 1 and 20 amino acids in length, typically 2, 3, 4, 5, 6, or up to 8, 10, 12, or 16 amino acids in length. A suitable linker for inclusion between the heavy chain region and the tail region encodes Leu-Val-Leu-Gly (SEQ ID NO: 8). A preferred tail region is the tail region of human IgM, which is PTLYNVSLVMSDTAGTCY (SEQ ID NO: 9) (Rabbitts TH et al., 1981. Nucleic Acids Res.9 (18), 4509-4524; Smith et al (1995) J Immunol 154:2226-2236). This tail can be modified at the N-terminus by substituting the first Thr with Pro. This does not affect the ability of the tail to promote polymerization of monomers. A further suitable variant of the human IgM tail is described in Sorensen et al (1996) J Immunol 156:2858-2865. An additional IgM tail sequence is GKPTLYNVSLIMSDTGGTCY (SEQ ID NO: 10) from rodents. An alternative preferred tail region is the tail region of human IgA, which is PTHVNVSVVMAEVDGTCY (SEQ ID NO: 11). Other suitable tails from IgM or IgA of other species, or synthetic sequences that promote assembly of monomer units into polymers, can also be used. The same species from which the immunoglobulin heavy chain constant region is derived It is not necessary to use the immunoglobulin tail from which it was derived, but it is preferred to do so.

[0133] In certain embodiments, the polymer protein does not activate the classical complement pathway but may be able to bind C1q. The polymer protein typically has a diameter of about 20 nm, such as 15-25 nm or up to 30 nm. As a result of their molecular size and diameter, the polymer protein typically has a good degree of tissue penetration.

[0134] A preferred Fc multimer described in WO2014 / 060712 is a hexamer of SEQ ID NO: 12 (SEQ ID NO: 8 in WO2014 / 060712), from which the signal peptide is cleaved during secretion such that the mature product comprises residues 21 to 269 of SEQ ID NO: 12.

[0135] In a specific embodiment of the invention, the Fc multimer used is that described in WO2015 / 132364, which relates to a multimeric fusion protein that binds to human Fc receptors, the fusion protein comprising a tail and no cysteine ​​residue at position 309.

[0136] In one embodiment, the multimeric protein comprises two or more polypeptide monomer units, wherein each polypeptide monomer unit comprises an antibody Fc domain comprising two heavy chain Fc regions. Each heavy chain Fc region comprises any amino acid residue other than cysteine ​​at position 309 and is fused at its C-terminus to a tail, causing the monomer units to assemble into multimers. Each polypeptide monomer unit does not comprise an antibody variable region.

[0137] In certain embodiments, the multimeric protein further comprises a fusion partner, which may be an antigen, pathogen-associated molecular pattern (PAMP), drug, ligand, receptor, cytokine, or chemokine. The fusion partner is fused to the N-terminus of each heavy chain Fc region either directly or indirectly via an intervening amino acid sequence such as a hinge. Alternatively, a short linker sequence may be provided between the fusion partner and the heavy chain Fc region.

[0138] In other embodiments, the multimeric proteins do not comprise one or more antibody variable regions. Typically, the molecules do not comprise either a VH or a VL antibody variable region. In certain further embodiments, the multimeric proteins of WO2015 / 132364 do not comprise Fab fragments.

[0139] In another embodiment, each polypeptide monomer unit of the multimeric protein comprises an antibody Fc domain, which may be derived from any suitable species, including, for example, humans. Furthermore, the antibody Fc domain may be derived from any suitable antibody class, including IgA (including subclasses IgA1 and IgA2), IgD, IgE, IgG (including subclasses IgG1, IgG2, IgG3, and IgG4), and IgM.

[0140] An antibody Fc domain contains two Fc polypeptide chains, each referred to as a heavy chain Fc region. The two heavy chain Fc regions dimerize to form an antibody Fc domain. The two heavy chain Fc regions within an antibody Fc domain can be different from each other, but are typically the same.

[0141] Typically, each heavy chain Fc region comprises or consists of two or three heavy chain constant domains. For example, IgA, IgD, and IgG are composed of two heavy chain constant domains (CH2 and CH3), while IgE and IgM are composed of three heavy chain constant domains (CH2, CH3, and CH4). The heavy chain Fc region may comprise heavy chain constant domains from one or more different antibody classes, for example, one, two, or three different classes.

[0142] Therefore, the heavy chain Fc region in the Fc multimer used in one embodiment of the present invention is In another embodiment, the heavy chain Fc region comprises a CH2 domain derived from IgG4 and a CH3 domain derived from IgG1 as disclosed in WO2015 / 132364. In a specific embodiment, the heavy chain Fc region comprises an arginine residue at position 355. In another embodiment, the heavy chain Fc region comprises a cysteine ​​residue at position 355.

[0143] The heavy chain Fc region in the Fc multimer used in one embodiment of the present invention comprises a CH4 domain derived from IgM. The IgM CH4 domain is typically located between the CH3 domain and the tail.

[0144] In other embodiments, the heavy chain Fc region comprises the CH2 and CH3 domains derived from an IgG and the CH4 domain derived from an IgM.

[0145] The tail of the multimeric protein can comprise any suitable amino acid sequence. It can be a tail found in a naturally occurring antibody, or alternatively, it can be a modified tail that differs in length and / or composition from the natural tail. Other modified tails can be entirely synthetic and designed to have desirable properties for multimerization, such as length, flexibility, and cysteine ​​composition. The tail can be from any suitable species, including human.

[0146] The tail may comprise all or part of the 18 amino acid tail sequence from human IgM or IgA shown in SEQ ID NO:9 or SEQ ID NO:11.

[0147] The tail can be fused directly to the C-terminus of the heavy chain Fc region, or alternatively, indirectly using an intervening amino acid sequence, for example, a short linker sequence can be provided between the tail and the heavy chain Fc region.

[0148] The tails may comprise variants or fragments of the above native sequences. Variants of IgM or IgA tails typically have amino acid sequences identical to the native sequences at 8, 9, 10, 11, 12, 13, 14, 15, 16, or 17 of the 18 amino acid positions. Fragments typically contain 8, 9, 10, 11, 12, 13, 14, 15, 16, or 17 amino acids. The tail may be a hybrid IgM / IgA tail.

[0149] Each heavy chain Fc region in an Fc multimer used in embodiments of the present invention may optionally have a native or modified hinge region at its N-terminus. Types of modified hinge regions that can be incorporated into Fc multimers used in the present invention are disclosed in WO2015 / 132364. For example, the heavy chain Fc region has an intact hinge region at its N-terminus. In a specific embodiment, as disclosed in WO2015 / 132364, the heavy chain Fc region and hinge region are derived from IgG4, and the hinge region comprises the mutated sequence CPPC (SEQ ID NO: 13).

[0150] Examples of suitable hinge sequences are shown in SEQ ID NOs: 13-35.

[0151] For example, a multimeric fusion protein can contain 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, or 12 or more polypeptide monomer units. Additionally, a multimeric fusion protein can include a mixture of multimeric fusion proteins of different sizes, having different numbers of polypeptide monomer units.

[0152] Thus, in certain embodiments, the multimeric proteins used in the present invention comprise , and six polypeptide monomer units, wherein each polypeptide monomer unit consists of an antibody Fc domain and a tail region, wherein each antibody Fc domain consists of two heavy chain Fc regions in which the amino acid residue at position 309 is any amino acid residue other than cysteine, and optionally each heavy chain Fc region has a hinge region at its N-terminus, and wherein the tail region is fused to the C-terminus of each heavy chain Fc region and causes the monomer units to assemble into multimers.

[0153] Similarly, the polypeptide monomer units within a particular multimeric protein may be the same as one another or different from one another.

[0154] In certain embodiments, the polypeptide chain of a polypeptide monomer unit comprises the amino acid sequence provided in SEQ ID NOs: 36-57, optionally with alternative hinge or tail sequences.

[0155] In another example, a multimeric protein used in the present invention comprises or consists of two or more, preferably six, polypeptide monomer units, wherein each polypeptide monomer unit comprises two identical polypeptide chains, each polypeptide chain comprising or consisting of a sequence set forth in any one of SEQ ID NOs: 36 to 57 above (SEQ ID NOs: 26 to 47 of WO2015 / 132364), and wherein each polypeptide monomer unit does not comprise an antibody variable region.

[0156] In certain embodiments, the multimeric protein comprises one or more mutations that, when compared to the unmodified multimeric protein, reduce cytokine release, reduce platelet activation, reduce C1q binding, increase the potency of inhibiting macrophage phagocytosis of antibody-coated target cells, and / or alter binding to one or more Fc receptors.

[0157] In a particular embodiment of the invention, the Fc multimer used is that described in WO2015 / 132365, which relates to a multimeric protein that binds to human Fc receptors.

[0158] The multimeric proteins used in embodiments of the present invention comprise two or more polypeptide monomer units, where each polypeptide monomer unit comprises an antibody Fc domain comprising two heavy chain Fc regions, such as those disclosed in WO2015 / 132365. Each heavy chain Fc region contains a cysteine ​​residue at position 309 and at least one additional mutation that alters FcR binding, and is fused at its C-terminus to a tail, which allows the monomer units to assemble into multimers. Each polypeptide monomer unit does not comprise an antibody variable region.

[0159] In certain aspects, the multimeric protein further comprises a fusion partner as described above. In other aspects, the multimeric protein does not comprise one or more antibody variable regions or Fab fragments as described above. In one embodiment, each polypeptide monomer unit of the multimeric protein comprises an antibody Fc domain having a heavy chain Fc region as described above. The tails, modified hinge regions, and polypeptide monomer units of the multimeric proteins of the invention comprise the features described above.

[0160] In certain embodiments of the present invention, the multimeric protein is comprised of six polypeptide monomer units, wherein each polypeptide monomer unit comprises an antibody Fc domain and a tail region, wherein each antibody Fc domain comprises two heavy chain Fc regions in which the amino acid residue at position 309 in each heavy chain Fc region is a cysteine ​​residue, and wherein each heavy chain Fc region comprises a cysteine ​​residue at position 309 in each heavy chain Fc region. contains at least one additional mutation that alters FcR binding, and optionally, each heavy chain Fc region has a hinge region at its N-terminus, and wherein a tail region is fused to the C-terminus of each heavy chain Fc region and causes assembly of the monomeric units into multimers.

[0161] In certain embodiments, the polypeptide chain of a polypeptide monomer unit comprises the amino acid sequence set forth above.

[0162] In another example, the multimeric protein comprises or consists of two or more, preferably six, polypeptide monomer units, wherein each polypeptide monomer unit comprises two identical polypeptide chains, each polypeptide chain comprising or consisting of a sequence set forth in any one of SEQ ID NOs: 58 to 94 (corresponding to SEQ ID NOs: 26 to 32 and 50 to 64 of WO2015 / 132365), and wherein each polypeptide monomer unit does not comprise an antibody variable region.

[0163] In certain embodiments, as taught in WO2015 / 132365, the multimeric proteins used in the present invention contain one or more mutations that enable them to function as described above.

[0164] Various products of the present disclosure are useful as pharmaceuticals. Accordingly, the present disclosure relates to pharmaceutical compositions comprising Fc multimers, polynucleotides of the present disclosure, or plasmids or vectors of the present disclosure.

[0165] One aspect of the present invention is a method for treating immune complex-mediated kidney damage in a subject in need thereof. The method comprises administering a therapeutically effective amount of an Fc multimer to the subject. In another embodiment, the method comprises administering a therapeutically effective amount of a polynucleotide of the present disclosure or a plasmid or vector of the present disclosure to the subject.

[0166] Expression of proposed Fc multimers High-level production of recombinant proteins in appropriate host cells requires the construction of an effective transcription unit, along with appropriate regulatory elements, in a recombinant expression vector that can be propagated in various expression systems, according to methods known to those skilled in the art. Effective transcription regulatory elements can be derived from viruses that have animal cells as their natural hosts or from the chromosomal DNA of animal cells. For example, promoter-enhancer combinations derived from the long terminal repeats of simian virus 40, adenovirus, BK polyoma virus, human cytomegalovirus, or Rous sarcoma virus, or promoter-enhancer combinations containing genes that are strongly and constitutively transcribed in animal cells, such as beta-actin or GRP78, can be used. To achieve stable, high-level mRNA transcribed from the cDNA, the transcription unit should contain a DNA region encoding a transcription termination-polyadenylation sequence in its 3'-proximal portion. For example, this sequence can be derived from the simian virus 40 early transcription region, the rabbit beta-globin gene, or the human tissue plasminogen activator gene.

[0167] The cDNA can then be integrated into the genome of a suitable host cell for expression of the Fc multimer. In some embodiments, the cell line should be an animal cell line of vertebrate origin to ensure correct folding, disulfide bond formation, asparagine-linked glycosylation, and other post-translational modifications, as well as secretion into the culture medium. Examples of other post-translational modifications include tyrosine O-sulfation and proteolytic processing of the nascent polypeptide chain. Examples of cell lines that can be used include monkey COS cells, mouse L cells, mouse C127 cells, hamster BHK-21 cells, human embryonic kidney 293 cells, and hamster CHO cells.

[0168] The recombinant expression vector encoding the corresponding cDNA can be introduced into animal cell lines in several different ways. For example, the recombinant expression vector can be generated from vectors based on different animal viruses. Examples of these are vectors based on baculovirus, vaccinia virus, adenovirus, and bovine papilloma virus.

[0169] To facilitate the isolation of specific cell clones that have integrated the recombinant DNA into their genome, the transcription unit encoding the corresponding DNA can also be introduced into animal cells along with another recombinant gene that can function as a dominant selectable marker in these cells. Examples of this type of dominant selectable marker gene are TN4 aminoglycoside phosphotransferase, which confers resistance to geneticin (G418), hygromycin phosphotransferase, which confers resistance to hygromycin, and puromycin acetyltransferase, which confers resistance to puromycin. The recombinant expression vector encoding such a selectable marker can be on the same vector as that encoding the cDNA for the desired protein, or it can be encoded on a separate vector that is simultaneously introduced and integrated into the genome of the host cell, often resulting in a tight physical link between the different transcription units.

[0170] Other types of selectable marker genes that can be used together with the cDNA of the desired protein are based on various transcription units encoding dihydrofolate reductase (dhfr). After introduction of such genes into cells lacking endogenous dhfr activity, such as CHO cells (DUKX-B11, DG-44), it becomes possible to grow them in a medium lacking nucleosides. An example of such a medium is Ham's F12, which lacks hypoxanthine, thymidine, and glycine. These dhfr genes, either ligated on the same vector or on a different vector, can be introduced into the above-mentioned types of CHO cells together with a cDNA encoding an IgG Fc fusion monomer, resulting in the generation of a dhfr-positive cell line producing the recombinant protein.

[0171] When the above cell lines are grown in the presence of the cytotoxic dhfr inhibitor methotrexate, new cell lines resistant to methotrexate emerge. These cell lines can produce recombinant proteins at increased rates due to the amplified number of linked dhfr and desired protein transcription units. When these cell lines are grown in increasing concentrations of methotrexate (1-10,000 nM), new cell lines can be obtained that produce the desired protein at very high rates.

[0172] The cell lines producing the desired protein can be grown on a large scale in suspension culture or on various solid supports. Examples of these supports are microcarriers based on dextran or collagen matrices, or solid supports in the form of hollow fibers or various ceramic materials. When grown in cell suspension culture or on microcarriers, the cell lines can be cultured either as tank cultures or in perfusion cultures with continuous production of conditioned medium over long periods of time. Thus, according to the present disclosure, the cell lines are well suited for the development of industrial processes for the production of the desired recombinant protein.

[0173] Purification and Formulation Recombinant proteins can be concentrated and purified by a variety of biochemical and chromatographic methods, including methods that exploit differences in size, charge, hydrophobicity, solubility, specific affinity, etc., between the desired protein and other substances in the host cell or cell culture medium.

[0174] An example of such purification is, for example, a monoclonal antibody specific for the Fc portion of an Fc multimer or another Fc-binding ligand (e.g., Protein A or Protein G) immobilized on a solid support. The adsorption of recombinant proteins to a monoclonal antibody is one example. After adsorption, washing, and desorption of the Fc multimer to the support, the protein can be further purified by various chromatography techniques based on the above characteristics. The order of purification steps can be selected based on, for example, the capacity and selectivity of the steps, the stability of the support, or other aspects. Purification steps can be, for example, but are not limited to, ion exchange chromatography, immunoaffinity chromatography, affinity chromatography, dye chromatography, and size exclusion chromatography.

[0175] To minimize the theoretical risk of viral contamination, additional steps may be included in the process that allow for effective inactivation or removal of viruses. For example, such steps may include heat treatment in the liquid or solid state, treatment with solvents and / or detergents, irradiation in the visible or UV spectrum, gamma irradiation, partitioning during purification, or viral filtration (nanofiltration).

[0176] The Fc multimers described herein can be formulated into pharmaceutical preparations for therapeutic use. The components of the pharmaceutical preparation can be resuspended or dissolved in a conventional physiologically compatible aqueous buffer solution, optionally with pharmaceutical excipients, to provide the pharmaceutical preparation. The components of the pharmaceutical preparation can already contain all the necessary pharmaceutically and physiologically compatible excipients and can be dissolved in water for injection to provide the pharmaceutical preparation.

[0177] Such pharmaceutical carriers and excipients, as well as the preparation of suitable pharmaceutical formulations, are well known in the art (see, for example, "Pharmaceutical Formulation Development of Peptides and Proteins" by Frokjaer et al., Taylor & Francis (2000) or "Handbook of Pharmaceutical Excipients," 3rd ed., by Kibbe et al., Pharmaceutical Press (2000)). In certain embodiments, the pharmaceutical composition may contain at least one additive, such as a bulking agent, buffer, or stabilizer. Standard pharmaceutical formulation techniques are well known to those skilled in the art (see, for example, 2005 Physicians' Desk Reference®, Thomson Healthcare: Monvale, NJ, 2004; Remington: The Science and Practice of Pharmacy, 20th ed., edited by Gennaro et al., Lippincott Williams & Wilkins: Philadelphia, PA, 2000). Suitable pharmaceutical additives include, for example, sugars such as mannitol, sorbitol, lactose, sucrose, trehalose, or others; amino acids such as histidine, arginine, lysine, glycine, alanine, leucine, serine, threonine, glutamic acid, aspartic acid, glutamine, asparagine, phenylalanine, proline, or others; additives for achieving isotonic conditions such as sodium chloride or other salts; stabilizers such as polysorbate 80, polysorbate 20, polyethylene glycol, propylene glycol, calcium chloride, or others; physiological pH buffers such as tris(hydroxymethylaminomethane). In certain embodiments, the pharmaceutical composition may contain a pH buffering agent and a wetting or emulsifying agent. In further embodiments, the composition may contain a preservative or stabilizer. In particular, pharmaceutical formulations comprising the Fc multimers described herein may be formulated in a lyophilized form or a stable soluble form. The Fc multimers may be lyophilized by various procedures known in the art.The lyophilized formulation is reconstituted prior to use by the addition of one or more pharmaceutically acceptable diluents, such as sterile water for injection or sterile saline or an appropriate buffer.

[0178] The compositions of pharmaceutical formulations of Fc multimers can be delivered to an individual by any pharmaceutically appropriate means. Various delivery systems are known and can be used to administer the compositions by any convenient route. The compositions of pharmaceutical formulations of Fc multimers can be administered intravenously or parenterally according to conventional methods. The Fc multimer composition may be formulated for intravenous injection or for enteral (e.g., oral, vaginal, or rectal) delivery. For non-intravenous administration, the Fc multimer composition may be formulated for subcutaneous, intramuscular, intraarticular, intraperitoneal, intracerebral, intrathecal, intrapulmonary (e.g., aerosol), intranasal, intradermal, oral, or transdermal administration. In one embodiment, the Fc multimer composition is formulated for intravenous injection. In another embodiment, the Fc multimer composition is formulated for subcutaneous, intramuscular, or transdermal administration, preferably subcutaneous administration. The formulation may be administered continuously by infusion or by bolus injection. Some formulations may comprise sustained release systems.

[0179] The composition of the pharmaceutical formulation of Fc multimer is administered to a patient at a therapeutically effective dose. As used herein, the term "therapeutically effective" describes a dose sufficient to produce the desired effect, prevent or reduce the severity or extent of immune complex-mediated kidney damage, or exhibit a detectable therapeutic or preventive effect, without prescribing a dose that produces unacceptable adverse side effects. The exact dose depends on many factors, such as the formulation and mode of administration. Therapeutically effective amounts can be initially estimated in cell culture assays or in animal models, such as rodent, rabbit, dog, pig, or primate models. Such information can then be used to determine useful doses and routes of administration in humans.

[0180] In one embodiment, the dose of Fc multimer for one intravenous or one non-intravenous injection is less than 1,000 mg per kg of body weight, less than 800 mg per kg of body weight, less than 600 mg per kg of body weight, less than 400 mg per kg of body weight, less than 200 mg per kg of body weight, or less than 100 mg per kg of body weight. For example, in one embodiment, the dose of the Fc multimer is from about 0.1 mg / kg body weight to about 1,000 mg / kg body weight, from about 1 mg / kg body weight to about 800 mg / kg body weight, from about 1 mg / kg body weight to about 700 mg / kg body weight, from about 1 mg / kg body weight to about 600 mg / kg body weight, from about 1 mg / kg body weight to about 500 mg / kg body weight, from about 1 mg / kg body weight to about 400 mg / kg body weight, from about 1 mg / kg body weight to about 300 mg / kg body weight, or from about 3 mg / kg body weight to about 200 mg / kg body weight. In one embodiment, the dose of the Fc multimer is from about 3 mg / kg body weight to about 1,000 mg / kg body weight, from about 3 mg / kg body weight to about 800 mg / kg body weight, from about 3 mg / kg body weight to about 600 mg / kg body weight, from about 3 mg / kg body weight to about 500 mg / kg body weight, from about 3 mg / kg body weight to about 400 mg / kg body weight, from about 3 mg / kg body weight to about 300 mg / kg body weight, from about 3 mg / kg body weight to about 200 mg / kg body weight, or from about 3 mg / kg body weight to about 100 mg / kg body weight. In one embodiment, the dose of the Fc multimer is from about 10 mg / kg body weight to about 500 mg / kg body weight, from about 10 mg / kg body weight to about 400 mg / kg body weight, from about 10 mg / kg body weight to about 300 mg / kg body weight, or from about 10 mg / kg body weight to about 200 mg / kg body weight.

[0181] In another embodiment, the pharmaceutical composition of the Fc multimer is administered alone or in combination with other therapeutic agents. In one embodiment, these agents are incorporated into the same pharmaceutical. In one embodiment, the Fc multimer is administered in combination with immunosuppressive therapy, such as steroids. In another embodiment, the Fc multimer is administered with any B cell or T cell modulating agent or immunomodulatory drug.

[0182] The frequency of administration of the Fc multimer depends on many factors, such as the formulation, dosage, and mode of administration. In one embodiment, the dose of the Fc multimer is administered multiple times a day, once a day, once every other day, once every three days, twice a week, once a week, once every two weeks, once every three weeks, or once a month.

[0183] Treatment effect The term "therapeutic effect," as used herein, describes treating a disease or disorder by improving a parameter that characterizes it, or alternatively, by preventing the disease / disorder parameter altogether. For example, therapeutic effect can be determined (1) in vitro in a cell culture model, or (2) in vivo in a mouse model of the disease by administering a dose of Fc multimer. The dose of Fc multimer can be 10 to 1000 mg / kg, e.g., 200 mg / kg. The Fc multimer can be administered by intravenous or non-intravenous injection or intravenous infusion. Clinical evaluation of the animal can be performed at predetermined time points up to the final time point after administration of the Fc multimer. Clinical evaluation can include scoring based on clinical symptoms of a particular disease or disorder. Biological samples can also be collected from the animal at predetermined time points up to the final time point after administration of the Fc multimer. The term "biological sample," as used herein, refers to, for example, tissue, blood, and urine. The biological sample can then be evaluated for improvement in markers or indicators of immune complex-mediated kidney damage.

[0184] The term "induce," as used herein, is defined as to cause, provide, effect, produce, occur, bring about, or promote.

[0185] In a preferred embodiment, the therapeutic effect of Fc multimers can be demonstrated by a decrease in urinary albumin levels in a mouse model of anti-GBM glomerulonephritis upon treatment with the Fc multimer. A mouse model of anti-GBM glomerulonephritis was described by Otten et al. (Otten et al., J Immunol 2009;183:3980-3988). In this study, the authors concluded that both FcγR and complement processes are essential for exacerbated inflammation in a novel, attenuated, passive model of anti-GBM disease. In this model, animals were administered a subnephritogenic dose of rabbit anti-GBM antibody, followed by a fixed dose of mouse mAb against rabbit IgG, allowing for timing and dosing for induction of glomerulonephritis. This resulted in reproducible complement activation and albuminuria via the classical complement pathway in wild-type mice. Albuminuria is associated with activation of the FcR-γ chain. - / - mouse or C3 - / - C1q was not detected in mice with reduced C1q, suggesting a role for both FcR-γ and complement in the pathogenesis of this model. Furthermore, C1q, which likely lacks functional classical and lectin pathways, - / - and C4 - / - Mice were found to develop albuminuria, leading Otten et al. to suggest the involvement of the alternative complement pathway.

[0186] Classical complement pathway activation The classical complement pathway mediates specific antibody responses and is mediated by a cascade of complement components. This cascade is primarily activated by antigen-antibody complexes. The initial component of this pathway is the protein complex C1, which is composed of two subunits, C1q and C1r2s2. Binding of immunoglobulins to C1q initiates the first step in activating the classical complement pathway, leading to the activation of the catalytically active subunit C1r2s2. Activated C1 cleaves C4 into C4a and C4b and C2 into C2a and C2b. C2a then binds to C4b to form C4b2a, also known as C3 convertase. C3 convertase catalyzes the cleavage of C3 into C3a and C3b. C3b then binds to activated C4b2a to form C4b2a3b, also known as C5 convertase. C5 convertase converts C5 into fragments C5a and C5b. C5b, together with components C6, C7, C8, and C9, forms a complex known as the C5b-9 complex, also known as the membrane attack complex (MAC) or terminal complement complex (TCC), which forms a transmembrane channel in target cells, leading to cell lysis.

[0187] As used herein, "activation of the complete classical complement pathway" is defined as activation of the entire classical complement pathway as described above. Activation of the complete classical complement pathway includes the first step in the activation of the classical complement pathway, which is the binding of Fc multimers to C1q, and the binding of the classical complement pathway to C1q. This can be determined by examining the formation of C4a, C5a, or soluble or membrane-bound C5b-9 complexes, which are the final effectors in the complement pathway. For example, if a protein binds to C1q but essentially no soluble C5b-9 is formed, i.e., less than 50% of the respective positive controls are formed, preferably less than 40%, preferably less than 30%, preferably less than 20%, preferably less than 10%, and more preferably less than 5%, then the Fc multimer does not induce full activation of the classical complement pathway. Activation of the classical complement pathway can also be determined by assessing the generation of C4a, the cleavage of C2, or the formation of C3 convertase. For example, if an Fc multimer induces the generation of C4a but not the cleavage of C2 or the formation of C3 convertase, then the Fc multimer does not induce full activation of the classical complement pathway. "No induction" means that less than 50%, preferably less than 40%, preferably less than 30%, preferably less than 20%, preferably less than 10%, more preferably less than 5% of the respective positive control is formed.

[0188] The ability of the Fc multimer to bind to C1q can be determined by an in vitro binding assay such as enzyme-linked immunosorbent assay (ELISA). For example, the wells of a 96-well plate can be precoated with human C1q, followed by the addition of the Fc multimer. Purified peroxidase-labeled anti-human IgG conjugates can be added, and the bound conjugates can be visualized using a chromogenic peroxidase substrate, such as 3,3',5,5'-tetramethylbenzidine (TMB).

[0189] Activation of the classical complement pathway by Fc multimers can be determined by in vitro assays and can be indicated by the production of C4a and soluble C5b-9. For example, various concentrations of Fc multimers can be incubated in whole blood or serum for a predetermined period of time, and the resulting production of C4a or soluble C5b-9 (sC5b-9) can be determined by immunodetection such as ELISA. The concentration of Fc multimer used can be 0.01 mg / ml to 2 mg / ml, for example, 0.04 mg / ml, 0.2 mg / ml, or 1.0 mg / ml.

[0190] The production of C4a and sC5b-9 induced by Fc multimers can be compared to the production of these components induced by heat-aggregated gamma globulin (HAGG), a potent activator of the classical complement pathway. For example, this assay can be performed in whole blood. According to some embodiments, as described in WO 2017 / 129737, Fc multimers induce less than 50% of sC5b-9 production, less than 40% of sC5b-9 production, less than 30% of sC5b-9 production, less than 20% of sC5b-9 production, or less than 10% of sC5b-9 production induced by HAGG. In one embodiment, Fc multimers induce less than 20% of sC5b-9 production in whole blood compared to sC5b-9 production induced by HAGG. In another embodiment, the Fc multimer induces less than 10% of sC5b-9 production in whole blood compared to sC5b-9 production induced by HAGG in whole blood, hi yet another embodiment, the Fc multimer does not induce sC5b-9 production.

[0191] The term "normal human serum activated with heat-aggregated IgG," as used herein, refers to a normal human serum sample in which almost all C4 cleavage has been induced with heat-aggregated IgG.

[0192] Activation of the classical complement pathway by Fc multimers can also be determined by detecting C2 protein. When C2 protein is cleaved into C2a and C2b, the level of C2 protein decreases, indicating activation of the classical complement pathway. Various concentrations of Fc multimers can be incubated in whole blood or serum for a predetermined time, for example, 2 hours, after which the C2 protein level can be determined by immunodetection, such as immunoblotting. Classical Complement Pathway Activity The activation is indicated by cleavage of the C2 protein. The level of C2 protein in normal human serum can be compared to the level of C2 protein after preincubation with the Fc multimer to determine the amount of C2 cleavage, and thus, activation of the classical complement pathway. A known activator of the classical complement pathway, such as HAGG, can be used as a positive control to induce cleavage of most of the C2 protein in normal human serum. The term "most," as used herein, is defined to include more than 50%, more than 60%, more than 70%, more than 80%, or more than 90%. In some embodiments, as described in WO2017 / 129737, the Fc multimer does not induce cleavage of most of the C2 protein.

[0193] Activation of the classical complement pathway by Fc multimers can also be determined by assessing the formation of C3 convertase. As described above, C3 convertase consists of C2a and C4b subunits (C4b2a). If the C2 protein is not cleaved into C2a and C2b, C3 convertase cannot be formed. Thus, C3 convertase formation can be assessed as described above to determine C2 protein cleavage. In some embodiments, as described in WO2017 / 129737, Fc multimers do not induce the formation of C3 convertase.

[0194] Classical complement pathway inhibition Inhibition of the classical complement pathway by Fc multimers can be determined by determining the inhibition of C5a and sC5b-9 production or by determining the inhibition of C2 protein cleavage. Various concentrations of Fc multimers can be incubated in whole blood or serum with a known activator of the classical complement pathway. The level of sC5b-9 produced in the presence of Fc multimers and a known activator of the classical complement pathway can then be compared with the level of sC5b-9 produced using only the known activator of the classical complement pathway. The level of sC5b-9 produced can be determined as described above. The concentration of Fc multimer used can be 0.01 mg / ml to 2 mg / ml, for example, 0.04 mg / ml, 0.2 mg / ml, or 1.0 mg / ml. The known activator of the classical complement pathway can be HAGG. The lower the level of sC5b-9 produced in the presence of Fc multimers and a classical complement pathway activator, compared to the level of sC5b-9 produced in the presence of a classical complement pathway activator alone, the greater the inhibition of sC5b-9 production by Fc multimers. In some embodiments, Fc multimers inhibit sC5b-9 production by more than 50%, more than 60%, more than 70%, more than 80%, or more than 90% compared to sC5b-9 production induced by HAGG. In one embodiment, as described in WO2017 / 129737, Fc multimers inhibit sC5b-9 production induced by HAGG by more than 80%.

[0195] The term "inhibit," as used herein, is defined as to suppress, restrict, prevent, interfere, stop, or block.

[0196] Inhibition of C2 protein cleavage can be determined similarly. Various concentrations of Fc multimers can be incubated in whole blood or serum with a known activator of the classical complement pathway. The higher the level of C2 protein in the presence of Fc multimers and a known activator of the classical complement pathway, compared to the level of C2 protein in the presence of the known activator of the classical complement pathway alone, the greater the inhibition of C2 cleavage by the Fc multimer. The level of C2 protein can be determined as described above. The concentration of the Fc multimer used can be 0.01 mg / ml to 2 mg / ml, for example, 0.04 mg / ml, 0.2 mg / ml, or 1.0 mg / ml. The known activator of the classical complement pathway can be HAGG. In some embodiments, as described in WO2017 / 129737, the Fc multimer inhibits most cleavage of C2 protein by HAGG.

[0197] Inhibition of the classical complement pathway can also be determined using a hemolytic assay for the classical complement pathway using antibody-sensitized or opsonized red blood cells. For example, sheep red blood cells can be opsonized with rabbit anti-sheep antibodies. Normal human serum (NHS) induces lysis of the opsonized red blood cells. Fc proteins are preincubated with NHS and then added to the red blood cells, and The mixture can be incubated for 1 hour at 37°C. The concentration of the Fc construct can be 1-1000 μg / ml, for example, 2.5, 25, 50, 125, 250, or 500 μg / ml. Alternatively, Fc monomers can also be preincubated with NHS at the same concentrations as those indicated for the Fc construct. After incubation, the mixture can be centrifuged, and the extent of lysis can be determined by measuring the absorbance of the released hemoglobin at 412 nm of the supernatant.

[0198] Inhibition of the classical complement pathway by Fc multimers can be demonstrated by reduced lysis of red blood cells in mixtures containing Fc multimers compared to mixtures with NHS but without Fc multimers. Inhibition of lysis of opsonized red blood cells by Fc multimers can be compared to lysis of opsonized red blood cells in the presence of Fc monomers. In some embodiments, Fc multimers inhibit lysis of opsonized sheep red blood cells compared to Fc monomers. In one embodiment, as described in WO2017 / 129737, Fc multimers inhibit lysis of opsonized sheep red blood cells by more than 70% compared to Fc monomers.

[0199] In an embodiment of the present invention, Fc multimers prevent the pathogenesis of immune complex-mediated kidney injury by inhibiting activation of the classical or alternative complement pathway.

[0200] Activation of antibody-dependent cellular cytotoxicity Antibody-dependent cellular cytotoxicity, also called antibody-dependent cellular cytotoxicity (ADCC), is a process in which antibodies coat target cells and recruit effector cells to induce target cell death through a non-phagocytic mechanism (Zahavi et al. Antibody Therapeutics 2018;1(1):7-12). Antibodies bind to their specific antigens on the target cell surface via their antigen-binding fragment (Fab) portion and interact with effector cells via their fragment crystallizable region (Fc) portion, thereby acting as a bridge linking the effector to the target. Effector cells can perform ADCC due to the expression of Fc receptors (FcR), which bind to antibodies. ADCC activity is observed in neutrophils, monocytes, and Fc receptor-bearing (FcR) cells. +FcγRs have been reported for T and non-T lymphocytes (Katz et al., J Clin Invest. 1980;65(1):55-63). Known classes of FcRs include FcγRs (which bind IgG); FcαRs (which bind IgA); and FcεRs (which bind IgE). FcγRs are most important for tumor cell clearance by myeloid cells and are composed of the activating FcγRI (CD64), FcγRIIA (CD32A), FcγRIIIA (CD16A), and inhibitory FcγRIIB (CD32B) receptors (Zahavi et al.). Binding of FcγRs to the Fc portion of an antibody results in receptor cross-linking and downstream signaling. Once activated, these effector cells mediate the death of antibody-coated target cells by cytotoxic granule release, Fas signaling, or reactive oxygen species generation. The best-characterized mechanism utilized in ADCC is the release of perforin and granzymes from effector cell granules.

[0201] Inhibition of antibody-dependent cellular cytotoxicity High physiological levels of immunoglobulin G were found to strongly inhibit ADCC in antibody-based cancer treatments aimed at inducing ADCC (Preithner et al. Mol Immunol. 2006;43(8):1183-93). An explanation for this finding is the competition between serum IgG and therapeutic antibodies for binding to Fc receptors. This competitive mechanism can be utilized in the treatment of autoimmune and inflammatory diseases. As previously mentioned, one of the proposed mechanisms for the anti-inflammatory effect of high-dose IVIG is blockade of Fcγ receptors (FcγRs). In some embodiments, the Fc multimers of the present invention can bind to Fc receptors, compete with disease antibodies, and inhibit antibody-dependent cellular cytotoxicity.

[0202] Exemplary Embodiments In some embodiments, the present invention relates to an Fc multimer for use in treating immune complex-mediated kidney damage, wherein the Fc multimer comprises two to six IgG Fc fusion monomers, wherein each Fc fusion monomer comprises two Fc fusion polypeptide chains, wherein each Fc fusion polypeptide chain comprises an IgG Fc polypeptide and a multimerization domain; and wherein the Fc multimer lacks any mutations that increase the binding affinity of the Fc multimer for complement system proteins. In some embodiments of the invention, the excluded mutations are at least one of S267E, H268F, S324T, N297A, T299A, P238D, E233P, G236R, L234V, E233P, L234A, L235A, P238D, D265A, D265W, N297A, N297Q, T299A, and L328F in the IgG1 Fc domain of the Fc multimer. In a preferred embodiment of the invention, the excluded mutations are S267E, H268F, and S324T. In another preferred embodiment of the invention, the excluded mutations are S267E, H268F, S324T, and N297A. In another preferred embodiment of the present invention, the mutations excluded are S267E, H268F, S324T, N297A, L234A, and L235A. In another preferred embodiment of the present invention, the mutations excluded are S267E, H268F, S324T, N297A, E233P, L234V, L235A, and the deletion of G236. In another preferred embodiment of the present invention, the mutations excluded are S267E, H268F, S324T, L234A, and L235A. In another preferred embodiment of the present invention, the mutations excluded are S267E, H268F, S324T, E233P, L234V, L235A, and the deletion of G236. In another preferred embodiment of the present invention, the mutations excluded are S267E, H268F, S324T, and D265A. In another preferred embodiment of the invention, the mutations excluded are E233P, G236R, S267E, H268F, and S324T. In another preferred embodiment of the invention, the mutations excluded are G236R, S267E, H268F, and S324T. In another preferred embodiment of the invention, the mutations excluded are E233P, G236R, S267E, H268F, S324T, and L328F.In another preferred embodiment of the present invention, the excluded mutations are P238D, D265G, S267E, H268F, and S324T. In another preferred embodiment of the present invention, the excluded mutations are P238D, D265W, S267E, H268F, and S324T. In another preferred embodiment of the present invention, the excluded mutations are E233P, L234V, L235A, S267E, H268F, N297A, S324T, S328F, and a deletion of G236. In another preferred embodiment of the present invention, the excluded mutations are S267E, H268F, S324T, and L328F. In another preferred embodiment of the present invention, the excluded mutations are P238D, S267E, H268F, and S324T. In another preferred embodiment of the invention, the mutations excluded are P238D, S267E, H268F, S324T and N297A.

[0203] In some embodiments of the invention, the Fc multimer is not a stradomer. In some embodiments of the invention, the multimerization domain does not comprise an IgG2 hinge.

[0204] In some embodiments, the present invention relates to an Fc multimer for use in treating immune complex-mediated kidney damage, wherein the Fc multimer comprises two to six IgG Fc fusion monomers, wherein each Fc fusion monomer comprises two Fc fusion polypeptide chains, wherein each Fc fusion polypeptide chain comprises an IgG Fc polypeptide and a multimerization domain, and The multimerization domain does not comprise an IgG2 hinge. In some embodiments of the invention, the Fc multimer is not a stradomer.

[0205] In some embodiments, the present invention relates to an Fc multimer for use in treating immune complex-mediated kidney damage, wherein the Fc multimer comprises two to six IgG Fc fusion monomers, wherein each Fc fusion monomer comprises two Fc fusion polypeptide chains, wherein each Fc fusion polypeptide chain comprises an IgG Fc polypeptide and a multimerization domain; and wherein the Fc multimer is not a stradomer.

[0206] In some embodiments of the present invention, the Fc multimer is a hexamer comprising six IgG Fc fusion monomers.

[0207] In some embodiments of the present invention, the Fc multimer further comprises a linker sequence between the IgG Fc polypeptide and the multimerization domain.

[0208] In some embodiments of the invention, the multimerization domain comprises an IgM tail. In some embodiments of the invention, the IgM tail comprises 18 or fewer amino acids from an IgM tail domain. In some embodiments of the invention, the IgM tail comprises residues 233-250 of SEQ ID NO: 1. In some embodiments of the invention, the IgM tail is fused to the C-terminal 232 amino acid segment of an IgG Fc polypeptide.

[0209] In some embodiments of the invention, the IgG Fc polypeptide comprises an IgG1 Fc polypeptide. In some embodiments of the invention, the IgG1 Fc polypeptide comprises a truncated CH2 domain at the N-terminus and / or a truncated CH3 domain at the C-terminus.

[0210] In some embodiments of the invention, at least one Fc fusion polypeptide chain further comprises an immunoglobulin hinge region, a fragment thereof, a variant thereof, or a modified form thereof. In some embodiments of the invention, at least one Fc fusion polypeptide chain further comprises an IgG1 hinge region. In some embodiments of the invention, at least one Fc fusion polypeptide chain further comprises an immunoglobulin hinge region comprising residues 1-15 of SEQ ID NO: 1. In some embodiments of the invention, at least one Fc fusion polypeptide chain comprises SEQ ID NO: 1.

[0211] In some embodiments of the invention, at least one Fc fusion polypeptide chain comprises SEQ ID NO: 2, or residues 20-269 of SEQ ID NO: 2. In some embodiments of the invention, at least one Fc fusion polypeptide chain comprises SEQ ID NO: 3, with a leucine to cysteine ​​mutation at position 309 of the IgG Fc polypeptide of at least one Fc fusion polypeptide chain. In some embodiments of the invention, at least one Fc fusion polypeptide chain comprises SEQ ID NO: 4, or residues 20-269 of SEQ ID NO: 4, and with a leucine to cysteine ​​mutation at position 309 of the IgG Fc polypeptide of at least one Fc fusion polypeptide chain.

[0212] In some embodiments of the invention, at least one Fc fusion polypeptide chain has up to five conservative amino acid changes.

[0213] In some embodiments of the present invention, at least one Fc fusion polypeptide chain does not comprise a Fab polypeptide.

[0214] In some embodiments, the present invention provides a method for the treatment of immune complex-mediated kidney damage. a recombinant human Fc hexamer for use in a recombinant human Fc hexamer comprising six human IgG1 Fc fusion monomers, wherein each Fc fusion monomer comprises two human Fc fusion polypeptide chains, and each Fc fusion polypeptide chain comprises a human IgG1 Fc polypeptide and a human IgM tail, and further wherein the IgM tail in each Fc fusion polypeptide chain comprises 18 amino acids fused to 232 amino acids at the C-terminus of the constant region of the IgG1 Fc polypeptide.

[0215] In some embodiments of the present invention, the Fc hexamer lacks any mutations that increase the binding affinity of the Fc hexamer to complement system proteins. In some embodiments of the present invention, the excluded mutations are at least one of S267E, H268F, S324T, N297A, T299A, P238D, E233P, G236R, L234V, E233P, L234A, L235A, P238D, D265A, D265W, N297A, N297Q, T299A, and L328F in the IgG1 Fc domain of the Fc hexamer. In a preferred embodiment of the present invention, the excluded mutations are S267E, H268F, and S324T. In another preferred embodiment of the present invention, the excluded mutations are S267E, H268F, S324T, and N297A. In another preferred embodiment of the present invention, the mutations excluded are S267E, H268F, S324T, N297A, L234A, and L235A. In another preferred embodiment of the present invention, the mutations excluded are S267E, H268F, S324T, N297A, E233P, L234V, L235A, and the deletion of G236. In another preferred embodiment of the present invention, the mutations excluded are S267E, H268F, S324T, L234A, and L235A. In another preferred embodiment of the present invention, the mutations excluded are S267E, H268F, S324T, E233P, L234V, L235A, and the deletion of G236. In another preferred embodiment of the present invention, the mutations excluded are S267E, H268F, S324T, and D265A. In another preferred embodiment of the present invention, the excluded mutations are E233P, G236R, S267E, H268F, and S324T. In another preferred embodiment of the present invention, the excluded mutations are G236R, S267E, H268F, and S324T. In another preferred embodiment of the present invention, the excluded mutations are E233P, G236R, S267E, H268F, S324T, and L328F. In another preferred embodiment of the present invention, the excluded mutations are P238D, D265G, S267E, H268F, and S324T. In another preferred embodiment of the present invention, the excluded mutations are P238D, D265W, S267E, H268F, and S324T.In another preferred embodiment of the present invention, the excluded mutations are E233P, L234V, L235A, S267E, H268F, N297A, S324T, S328F, and deletion of G236. In another preferred embodiment of the present invention, the excluded mutations are S267E, H268F, S324T, and L328F. In another preferred embodiment of the present invention, the excluded mutations are P238D, S267E, H268F, and S324T. In another preferred embodiment of the present invention, the excluded mutations are P238D, S267E, H268F, S324T, and N297A.

[0216] In some embodiments of the invention, the Fc hexamer is not a stradomer.

[0217] In some embodiments of the present invention, each Fc fusion polypeptide chain of the Fc hexamer further comprises an IgG1 hinge region and does not comprise a Fab polypeptide.

[0218] In some embodiments of the invention, each IgG1 Fc polypeptide of the Fc hexamer comprises a leucine to cysteine ​​mutation at position 309.

[0219] In some embodiments, the present invention relates to an Fc multimer for use in treating immune complex-mediated kidney damage, wherein the Fc multimer comprises four polypeptides forming three Fc monomers, wherein the first polypeptide comprises a first Fc polypeptide, a first linker, and a second Fc polypeptide, wherein the second polypeptide comprises a third Fc polypeptide, a second linker and a fourth Fc polypeptide, wherein the third polypeptide comprises a fifth Fc polypeptide, wherein the fourth polypeptide comprises a sixth Fc polypeptide, wherein the first Fc polypeptide and the third Fc polypeptide form a first Fc monomer, wherein the fifth Fc polypeptide and the second Fc polypeptide form a second Fc monomer, and wherein the sixth Fc polypeptide and the fourth Fc polypeptide form a third Fc monomer.

[0220] In some embodiments of the present invention, the Fc multimer lacks any mutation that increases the binding affinity of the Fc multimer to complement system proteins. In some embodiments of the present invention, the excluded mutations are at least one of S267E, H268F, S324T, N297A, T299A, P238D, E233P, G236R, L234V, E233P, L234A, L235A, P238D, D265A, D265W, N297A, N297Q, T299A, and L328F in the IgG1 Fc domain of the Fc multimer. In a preferred embodiment of the present invention, the excluded mutations are S267E, H268F, and S324T. In another preferred embodiment of the present invention, the excluded mutations are S267E, H268F, S324T, and N297A. In another preferred embodiment of the present invention, the mutations excluded are S267E, H268F, S324T, N297A, L234A, and L235A. In another preferred embodiment of the present invention, the mutations excluded are S267E, H268F, S324T, N297A, E233P, L234V, L235A, and the deletion of G236. In another preferred embodiment of the present invention, the mutations excluded are S267E, H268F, S324T, L234A, and L235A. In another preferred embodiment of the present invention, the mutations excluded are S267E, H268F, S324T, E233P, L234V, L235A, and the deletion of G236. In another preferred embodiment of the present invention, the mutations excluded are S267E, H268F, S324T, and D265A. In another preferred embodiment of the present invention, the excluded mutations are E233P, G236R, S267E, H268F, and S324T. In another preferred embodiment of the present invention, the excluded mutations are G236R, S267E, H268F, and S324T. In another preferred embodiment of the present invention, the excluded mutations are E233P, G236R, S267E, H268F, S324T, and L328F. In another preferred embodiment of the present invention, the excluded mutations are P238D, D265G, S267E, H268F, and S324T. In another preferred embodiment of the present invention, the excluded mutations are P238D, D265W, S267E, H268F, and S324T.In another preferred embodiment of the present invention, the excluded mutations are E233P, L234V, L235A, S267E, H268F, N297A, S324T, S328F, and deletion of G236. In another preferred embodiment of the present invention, the excluded mutations are S267E, H268F, S324T, and L328F. In another preferred embodiment of the present invention, the excluded mutations are P238D, S267E, H268F, and S324T. In another preferred embodiment of the present invention, the excluded mutations are P238D, S267E, H268F, S324T, and N297A.

[0221] In some embodiments, the present invention relates to a method of treating immune complex-mediated kidney damage, comprising administering to a subject an Fc multimer, wherein the Fc multimer comprises two to six IgG Fc fusion monomers, wherein each Fc fusion monomer comprises two Fc fusion polypeptide chains, wherein each Fc fusion polypeptide chain comprises an IgG Fc polypeptide and a multimerization domain, and wherein the Fc multimer lacks any mutations that increase the binding affinity of the Fc multimer to the complement system. In some embodiments of the invention, the excluded mutations are at least one of S267E, H268F, S324T, N297A, T299A, P238D, E233P, G236R, L234V, E233P, L234A, L235A, P238D, D265A, D265W, N297A, N297Q, T299A, and L328F in the IgG1 Fc domain of the Fc multimer. In another preferred embodiment of the present invention, the mutations excluded are S267E, H268F, and S324T. In another preferred embodiment of the present invention, the mutations excluded are S267E, H268F, S324T, and N297A. In another preferred embodiment of the present invention, the mutations excluded are S267E, H268F, S324T, N297A, L234A, and L235A. In another preferred embodiment of the present invention, the mutations excluded are S267E, H268F, S324T, N297A, E233P, L234V, L235A, and a deletion of G236. In another preferred embodiment of the present invention, the mutations excluded are S267E, H268F, S324T, L234A, and L235A. In another preferred embodiment of the present invention, the excluded mutations are S267E, H268F, S324T, E233P, L234V, L235A, and G236 deletion. In another preferred embodiment of the present invention, the excluded mutations are S267E, H268F, S324T, and D265A. In another preferred embodiment of the present invention, the excluded mutations are E233P, G236R, S267E, H268F, and S324T. In another preferred embodiment of the present invention, the excluded mutations are G236R, S267E, H268F, and S324T. In another preferred embodiment of the present invention, the excluded mutations are E233P, G236R, S267E, H268F, S324T, and L328F. In another preferred embodiment of the present invention, the excluded mutations are P238D, D265G, S267E, H268F, and S324T. In another preferred embodiment of the present invention, the excluded mutations are P238D, D265W, S267E, H268F, and S324T. In another preferred embodiment of the present invention, the excluded mutations are E233P, L234V, L235A, S267E, H268F, N297A, S324T, S328F, and a deletion of G236. In another preferred embodiment of the present invention, the excluded mutations are S267E, H268F, S324T, and L328F. In another preferred embodiment of the present invention, the excluded mutations are P238D, S267E, H268F, and S324T. In another preferred embodiment of the invention, the mutations excluded are P238D, S267E, H268F, S324T and N297A.

[0222] In some embodiments of the invention, the Fc multimer is not a stradomer. In some embodiments of the invention, the multimerization domain does not comprise an IgG2 hinge.

[0223] In some embodiments, the present invention relates to a method of treating immune complex-mediated kidney damage, comprising administering to a subject an Fc multimer, wherein the Fc multimer comprises two to six IgG Fc fusion monomers, wherein each Fc fusion monomer comprises two Fc fusion polypeptide chains, wherein each Fc fusion polypeptide chain comprises an IgG Fc polypeptide and a multimerization domain, and wherein the multimerization domain does not comprise an IgG2 hinge. In some embodiments of the present invention, the Fc multimer is not a stradomer.

[0224] In some embodiments, the present invention relates to a method of treating immune complex-mediated kidney damage comprising administering to a subject an Fc multimer, wherein the Fc multimer comprises two to six IgG Fc fusion monomers, wherein each Fc fusion monomer comprises two Fc polypeptide chains, wherein each Fc fusion polypeptide chain comprises an IgG Fc polypeptide and a multimerization domain; and wherein the Fc multimer is not a stradomer.

[0225] In some embodiments of the present invention, the multimerization domain of the Fc multimer comprises an IgM tail. In some embodiments of the present invention, the IgM tail comprises residues 233-250 of SEQ ID NO:1.

[0226] In some embodiments of the present invention, at least one Fc fusion polypeptide chain of an Fc multimer comprises an IgG hinge region and does not comprise a Fab polypeptide. In some embodiments of the present invention, at least one Fc fusion polypeptide chain of an Fc multimer comprises an IgG1 hinge region and an IgG1 Fc polypeptide.

[0227] In some embodiments of the invention, at least one Fc fusion polypeptide chain of an Fc multimer comprises SEQ ID NO: 1 or SEQ ID NO: 3. In some embodiments of the invention, at least one Fc fusion polypeptide chain of an Fc multimer comprises SEQ ID NO: 3, and at position 309 of the IgG Fc polypeptide of at least one Fc fusion polypeptide chain is mutated from leucine to cysteine. In some embodiments of the invention, at least one Fc fusion polypeptide chain comprises SEQ ID NO: 4, and at position 309 of the IgG Fc polypeptide of at least one Fc fusion polypeptide chain is mutated from leucine to cysteine.

[0228] In some embodiments of the present invention, at least one Fc fusion polypeptide chain of the Fc multimer has up to five conservative amino acid changes.

[0229] In some embodiments of the present invention, the Fc multimer is a hexamer comprising six IgG Fc fusion monomers.

[0230] In some embodiments, the present invention relates to a method of treating immune complex-mediated kidney damage comprising administering to a subject a recombinant human Fc hexamer, wherein the recombinant human Fc hexamer comprises six human IgG1 Fc fusion monomers, wherein each Fc fusion monomer comprises two human Fc fusion polypeptide chains, and each Fc fusion polypeptide chain comprises a human IgG1 Fc polypeptide and a human IgM tail, and further wherein the IgM tail in each Fc fusion polypeptide chain comprises 18 amino acids fused to the C-terminal 232 amino acids of the constant region of the IgG1 Fc polypeptide.

[0231] In some embodiments of the present invention, the recombinant human Fc hexamer lacks any mutations that increase the binding affinity of the recombinant human Fc hexamer to complement system proteins. In some embodiments of the present invention, the excluded mutations are at least one of S267E, H268F, S324T, N297A, T299A, P238D, E233P, G236R, L234V, E233P, L234A, L235A, P238D, D265A, D265W, N297A, N297Q, T299A, and L328F in the IgG1 Fc domain of the Fc hexamer. In a preferred embodiment of the present invention, the excluded mutations are S267E, H268F, and S324T. In another preferred embodiment of the present invention, the excluded mutations are S267E, H268F, S324T, and N297A. In another preferred embodiment of the present invention, the mutations excluded are S267E, H268F, S324T, N297A, L234A, and L235A. In another preferred embodiment of the present invention, the mutations excluded are S267E, H268F, S324T, N297A, E233P, L234V, L235A, and the deletion of G236. In another preferred embodiment of the present invention, the mutations excluded are S267E, H268F, S324T, L234A, and L235A. In another preferred embodiment of the present invention, the mutations excluded are S267E, H268F, S324T, E233P, L234V, L235A, and the deletion of G236. In another preferred embodiment of the present invention, the mutations excluded are S267E, H268F, S324T, and D265A. In another preferred embodiment of the present invention, the excluded mutations are E233P, G236R, S267E, H268F, and S324T. In another preferred embodiment of the present invention, the excluded mutations are G236R, S267E, H268F, and S324T. In another preferred embodiment of the present invention, the excluded mutations are E233P, G236R, S267E, H268F, S324T, and L328F. In another preferred embodiment of the present invention, the excluded mutations are P238D, D265G, S267E, H268F, and S324T. In another preferred embodiment of the present invention, the excluded mutations are P238D, D265W, S267E, H268F, and S324T.In another preferred embodiment of the present invention, the excluded mutations are E233P, L234V, L235A, S267E. In another preferred embodiment of the present invention, the excluded mutations are S267E, H268F, S324T, and L328F. In another preferred embodiment of the present invention, the excluded mutations are P238D, S267E, H268F, and S324T. In another preferred embodiment of the present invention, the excluded mutations are P238D, S267E, H268F, S324T, and N297A.

[0232] In some embodiments of the invention, the Fc hexamer is not a stradomer.

[0233] In some embodiments of the present invention, each Fc fusion polypeptide chain of the Fc hexamer comprises an IgG1 hinge region and does not comprise a Fab polypeptide.

[0234] In some embodiments of the invention, each IgG1 Fc polypeptide of the fc hexamer comprises a leucine to cysteine ​​mutation at position 309.

[0235] In some embodiments, the present invention relates to a method of treating immune complex-mediated kidney damage comprising administering an Fc multimer to a subject, wherein the Fc multimer comprises four polypeptides forming three Fc monomers, wherein the first polypeptide comprises a first Fc polypeptide, a first linker, and a second Fc polypeptide, wherein the second polypeptide comprises a third Fc polypeptide, a second linker, and a fourth Fc polypeptide, wherein the third polypeptide comprises a fifth Fc polypeptide, wherein the fourth polypeptide comprises a sixth Fc polypeptide, wherein the first Fc polypeptide and the third Fc polypeptide together form the first Fc monomer, wherein the fifth Fc polypeptide and the second Fc polypeptide together form the second monomer, and wherein the sixth Fc polypeptide and the fourth Fc polypeptide form the third Fc monomer.

[0236] In some embodiments, the Fc multimer lacks any mutation that increases the binding affinity of the Fc multimer to complement system proteins. In some embodiments of the present invention, the excluded mutations are at least one of S267E, H268F, S324T, N297A, T299A, P238D, E233P, G236R, L234V, E233P, L234A, L235A, P238D, D265A, D265W, N297A, N297Q, T299A, and L328F in the IgG1 Fc domain of the Fc multimer. In a preferred embodiment of the present invention, the excluded mutations are S267E, H268F, and S324T. In another preferred embodiment of the present invention, the excluded mutations are S267E, H268F, S324T, and N297A. In another preferred embodiment of the present invention, the mutations excluded are S267E, H268F, S324T, N297A, L234A, and L235A. In another preferred embodiment of the present invention, the mutations excluded are S267E, H268F, S324T, N297A, E233P, L234V, L235A, and the deletion of G236. In another preferred embodiment of the present invention, the mutations excluded are S267E, H268F, S324T, L234A, and L235A. In another preferred embodiment of the present invention, the mutations excluded are S267E, H268F, S324T, E233P, L234V, L235A, and the deletion of G236. In another preferred embodiment of the present invention, the mutations excluded are S267E, H268F, S324T, and D265A. In another preferred embodiment of the present invention, the excluded mutations are E233P, G236R, S267E, H268F, and S324T. In another preferred embodiment of the present invention, the excluded mutations are G236R, S267E, H268F, S324T. In another preferred embodiment of the present invention, the excluded mutations are E233P, G236R, S267E, H268F, S324T, and L328F. In another preferred embodiment of the present invention, the excluded mutations are P238D, D265G, S267E, H268F, and S324T. In another preferred embodiment of the present invention, the excluded mutations are P238D, D265W, S267E, H268F, and L328F. In another preferred embodiment of the present invention, the excluded mutations are E233P, L234V, L235A, S267E, H268F, N297A, S324T, S328F, and a deletion of G236. In another preferred embodiment of the present invention, the excluded mutations are S267E, H268F, S324T, and L328F. In another preferred embodiment of the present invention, the excluded mutations are P238D, S267E, H268F, and S324T. In another preferred embodiment of the present invention, the excluded mutations are P238D, S267E, H268F, and S324T. In another preferred embodiment of the present invention, the excluded mutations are P238D, S267E, H268F, S324T, and N297A.

[0237] In some embodiments of the present invention, the Fc multimers or recombinant human Fc hexamers inhibit complement-dependent cytotoxicity and antibody-dependent cellular cytotoxicity in vitro.

[0238] In some embodiments of the present invention, the Fc multimers or recombinant human Fc hexamers inhibit activation of the classical or alternative complement pathway.

[0239] In some embodiments of the present invention, Fc multimers or recombinant human Fc hexamers inhibit pathogenesis in vivo in a mouse model of immune complex-mediated kidney injury.

[0240] In some embodiments of the invention, at least one Fc monomer or Fc fusion monomer of the Fc multimer or recombinant human Fc hexamer is capable of binding to an Fcγ receptor. In some embodiments of the invention, a first Fc monomer or Fc fusion monomer is capable of binding to a first Fcγ receptor and a second Fc monomer or second Fc fusion monomer is capable of binding to a second Fcγ receptor.

[0241] In some embodiments of the present invention, the Fc multimer or recombinant human Fc hexamer is used in the treatment of immune complex-mediated kidney damage, wherein the immune complex-mediated kidney damage is one of nephritis, glomerulonephritis, interstitial nephritis, anti-glomerular basement membrane (anti-GBM) disease, Goodpasture's syndrome, autoimmune kidney disease, lupus nephritis, membranous nephropathy, membranoproliferative glomerulonephritis (MPGN), or Bright's disease. In some embodiments of the present invention, the immune complex-mediated kidney damage is lupus nephritis.

[0242] In some embodiments of the present invention, the Fc multimer or recombinant human Fc hexamer is administered intravenously, subcutaneously, orally, intrathecally, or intrapulmonary by nebulization.

[0243] In some embodiments of the present invention, the Fc multimer or recombinant human Fc hexamer is administered to a subject in an amount ranging from about 3 mg / kg to 200 mg / kg, or in some embodiments of the present invention, the Fc multimer or recombinant human Fc hexamer is administered in an amount ranging from about 25 mg / kg to about 500 mg / kg. [Example]

[0244] Example 1: Production of IgG1 Fc multimers Fc-μTP was generated by fusing 18 amino acid residues of the human IgM tail (PTLYNVSLVMSDTAGTCY, SEQ ID NO: 9) to the C-terminus of the constant region of human IgG1 Fc fragment (amino acid residues 216-447, EU numbering; UniProtKB - P01857). Fc-μTP-L309C was generated by mutating Leu residue 309 (EU numbering) of Fc-μTP to Cys. DNA fragments encoding Fc-μTP and Fc-μTP-L309C were synthesized and codon-optimized for human cell expression by ThermoFisher Scientific (MA, USA). The DNA fragments were inserted into the ApaLI and XbaI sites of the pRhG4 mammalian cell expression vector using the InTag positive selection method (Chen, CG et al., (2014). Nucleic Acids Res 42(4):e26; Jost BGH was cloned using the Fc-μTP and Fc-μTP-L309C fragments (Bock T, et al. (2004). J. Immunol. Methods. 289:65-80). Briefly, the Fc-μTP and Fc-μTP-L309C fragments were isolated by ApaLI and AscI digestion. The CmR InTag adapter, which consists of a polyA addition site (BGHpA) and a chloramphenicol resistance gene (CmR), was also isolated by AscI and SpeI digestion (Chen, CG et al. (2014). Nucleic Acids Res 42(4):e26). The Fc molecule and CmR InTag adapter were cocloned into the ApaLI and XbaI sites of the pRhG4 vector using T4 DNA ligase. Positive clones were selected on agar plates containing 34 μg / ml chloramphenicol. Miniprep plasmid DNA was purified using a QIAprep Spin Miniprep Kit (QIAGEN, Hilden, Germany), and the sequence was confirmed by DNA sequencing analysis. Restriction enzymes and T4 DNA ligase were purchased from New England BioLabs (MA, USA).

[0245] Expi293 TM Transient transfection using the expression system (Life Technologies, NY, USA) was performed according to the manufacturer's instructions. Briefly, plasmid DNA (0.8 μg) was diluted in 0.4 ml Opti-MEM and gently mixed. Expifectamine 293 reagent (21.6 μL) was diluted in 0.4 ml Opti-MEM, gently mixed, and incubated at room temperature for 5 minutes. The diluted Expifectamine was then added to the diluted DNA, gently mixed, and incubated at room temperature for 20–30 minutes to allow the DNA-Expifectamine complex to form. The DNA-Expifectamine complex was then transferred to 6.8 ml (2 x 10 cells) of Expi293 cells. 7The cells were incubated at 37°C in an 8% CO2 incubator with shaking at 250 rpm for approximately 16-18 hours. 40 μl Enhancer 1 (Life Technologies, NY, USA), 400 μl Enhancer 2 (Life Technologies, NY, USA), and 200 μl LucraTone were added to a 50 ml bioreactor tube containing the cells. TM A master mix consisting of Lupin was prepared and added to each bioreactor tube. Cells were further incubated for 4 days at 37°C in an 8% CO2 incubator with shaking at 250 rpm. Protein was collected by centrifugation of the supernatant at 4000 rpm for 20 minutes and filtered into clean tubes using a 0.22 μm filter prior to HPLC quantification and purification.

[0246] To produce IgG1 Fc multimers, the C-terminus of recombinant human IgG1 Fc was fused to the 18-amino acid tail of IgM. The IgM tail (μTP) promotes the formation of pentamers and hexamers. Fc fusion proteins with a point mutation from leucine to cysteine ​​at residue 309 (Fc-μTP-L309C) were produced using either wild-type (WT) human IgG1 Fc peptide (Fc-μTP) or its variants. The point mutation from leucine 309 to cysteine ​​(Fc-μTP-L309C) was expected to result in a more stable structure than WT (Fc-μTP) due to the formation of covalent bonds between Fc molecules. This stabilization is achieved without the J chain.

[0247] The Fc-μTP and Fc-μTP-L309C fusion monomer subunits are derived from two peptides containing the following regions (residue numbers refer to the residue numbers in SEQ ID NOs: 2 and 4, respectively): Signal peptide residues 1-19 Human IgG1 hinge region residues 20-34 Human IgG1 Fc region residues 35-251 Human IgM tail residues 252-269 The amino acid sequences for the mature forms of the Fc-μTP and Fc-μTP-L309C peptides are provided as SEQ ID NO: 1 and SEQ ID NO: 3, respectively. The nucleic acid coding sequences are provided as SEQ ID NO: 95 (corresponding to SEQ ID NO: 9 of WO2017 / 129737) and SEQ ID NO: 96 (corresponding to SEQ ID NO: 10 of WO2017 / 129737), respectively.

[0248] During expression, the signal peptide is cleaved to form the mature Fc-μTP and Fc-μTP-L309C fusion peptides. The sequences of the immature fusion peptides are shown in SEQ ID NOs: 2 and 4, respectively.

[0249] SDS-PAGE of the multimeric Fc proteins showed a ladder-like pattern for each preparation, corresponding to the monomer, dimer, trimer, tetramer, pentamer, and hexamer forms of the Fc construct. Fc-μTP-L309C had a major band at the predicted hexamer position, whereas Fc-μTP did not, consistent with a more stable structure under the disruptive electrophoresis buffer conditions. A higher-order structure, most likely a dimer of hexamers, was also evident for Fc-μTP-L309C. For the following examples, the hexamer fraction of this material was purified.

[0250] Recombinant human IgG1 Fc monomer (residues 1-232 of SEQ ID NO: 1) was also produced and used as a control.

[0251] For the trivalent Fc construct used in Example 4, the Fc DNA sequence was derived from human IgG1 Fc. The bulge, gap, and charge mutations were substituted in the parent Fc sequence. DNA encoding a leader peptide from human immunoglobulin kappa light chain was attached to the 5' region. Of course, any one of a variety of leader peptides may be used in connection with the present invention. Leader peptides are typically excised in the lumen of the endoplasmic reticulum. An 11-nucleotide sequence containing a 5'-terminal EcoR1 site was added upstream of the ATG start codon. A 30-nucleotide sequence containing a 3'-terminal Xho1 site was added downstream of the 3'-terminal TGA translation stop codon. The DNA sequence was optimized for expression in mammalian cells and cloned into the pcDNA3.4 mammalian expression vector.

[0252] The amino acid sequence of the secreted polypeptide used in Example 4 is shown below.

[0253] SIF1 SEQ ID NO: 107 or 108 DKTHTCPPCPAPELLGGPSVFLFPPKPKDTLMISRTPEVTCVVVDVSHEDPEVKFNWYVDGVEVHNAKTKPREEQYNSTYRVVSVLTVLHQDWLNGKEYKCKVSNKALPAPIEK TISKAKGQPREPQVCTLPPSRDELTKNQVSLSCAVKGFYPSDIAVEWESNGQPENNYKTTPPVLDSDGSFFLVSKLTVDKSRWQQGNVFSCSVMHEALHNHYTQKSLSLSPG(K) SEQ ID NO: 113 or 114 DKTHTCPPCPAPELLGGPSVFLFPPKPKDTLMISRTPEVTCVVVDVSHEDPEVKFNWYVDGVEVHNAKTKPREEQYNSTYRVVSVLTVLHQDWLNGKEYKCKVSNKALPAPIEKTISKA KGQPREPQVYTLPPCRDELTKNQVSLWCLVKGFYPSDIAVEWESNGQPENNYKTTPPVLDSDGSFFLYSKLTVDKSRWQQGNVFSCSVMHEALHNHYTQKSLSLSPGKSGGGSGGGSGG GSGGGSGGGDKTHTCPPCPAPELLGGPSVFLFPPKPKDTLMISRTPEVTCVVVDVSHEDPEVKFNWYVDGVEVHNAKTKPREEQYNSTYRVVSVLTVLHQDWLNGKEYKCKVSNKALPA PIEKTISKAKGQPREPQVYTLPPSRDELTKNQVSLTCLVKGFYPSDIAVEWESNGQPENNYKTTPPVLKSDGSFFLYSDLTVDKSRWQQGNVFSCSVMHEALHNHYTQKSLSLSPG(K) CC SEQ ID NO: 124 DKTHTCPPCPAPELLGGPSVFLFPPKPKDTLMISRTPEVTCVVVDVSHEDPEVKFNWYVDGVEVHNAKTKPPEEQYNSTYRVVSVLTVLHQDWLNGKEYKCKVSNKALAPIE KTISKAKGQPREPQVCTLPPSRDELTKNQVSLSCAVDGFYPSDIAVEWESNGQPENNYKTTPPVLDSDGSFFLVSKLTVDKSRWQQGNVFSCSVMHEALHNHYTQKSLSLSPG SEQ ID NO: 125 DKTHTCPPCPAPELLGGPSVFLFPPKPKDTLMISRTPEVTCVVVDVSHEDPEVKFNWYVDGVEVHNAKTKPPEEQYNSTYRVVSVLTVLHQDWLNGKEYKCKVSNKALPAPIEKTISK AKGQPREPQVYTLPPCRDKLTKNQVSLWCLVKGFYPSDIAVEWESNGQPENNYKTTPPVLDSDGSFFLYSKLTVDKSRWQQGNVFSCSVMHEALHNHYTQKSLSLSPGKGGGGGGGGG GGGGGGGGGGGDKTHTCPPCPAPELLGGPSVFLFPPKPKDTLMISRTPEVTCVVVDVSHEDPEVKFNWYVDGVEVHNAKTKPPEEQYNSTYRVVSVLTVLHQDWLNGKEYKCKVSNKA LPAPIEKTISKAKGQPREPQVYTLPPSRDELTKNQVSLTCLVKGFYPSDIAVEWESNGQPENNYKTTPPVLKSDGSFFLYSDLTVDKSRWQQGNVFSCSVMHEALHNHYTQKSLSLSPG Q1 SEQ ID NO: 122 DKTHTCPPCPAPELLGGPSVFLFPPKPKDTLMASRTPEVTCVVVDVSHEDPEVKFNWYVDGVEVHNAKTKPPEEQYNSTYRVVSVLTVLHQDWLNGKEYKCKVSNKALAPIE KTISKAKGQPREPQVCTLPPSRDELTKNQVSLSCAVDGFYPSDIAVEWESNGQPENNYKTTPPVLDSDGSFFLVSKLTVDKSRWQQGNVFSCSVMHEALHNHYTQKSLSLSPG SEQ ID NO: 126 DKTHTCPPCPAPELLGGPSVFLFPPKPKDTLMASRTPEVTCVVVDVSHEDPEVKFNWYVDGVEVHNAKTKPPEEQYNSTYRVVSVLTVLHQDWLNGKEYKCKVSNKALPAPIEKTISK AKGQPREPQVYTLPPCRDKLTKNQVSLWCLVKGFYPSDIAVEWESNGQPENNYKTTPPVLDSDGSFFLYSKLTVDKSRWQQGNVFSCSVMHEALHNHYTQKSLSLSPGKGGGGGGGGG GGGGGGGGGGGDKTHTCPPCPAPELLGGPSVFLFPPKPKDTLMISRTPEVTCVVVDVSHEDPEVKFNWYVDGVEVHNAKTKPPEEQYNSTYRVVSVLTVLHQDWLNGKEYKCKVSNKA LPAPIEKTISKAKGQPREPQVYTLPPSRDELTKNQVSLTCLVKGFYPSDIAVEWESNGQPENNYKTTPPVLKSDGSFFLYSDLTVDKSRWQQGNVFSCSVMHEALHNHYTQKSLSLSPG

[0254] For protein expression of the Fc constructs, two of the DNA plasmid constructs expressing the polypeptide pairs shown above were transfected into EXPI293 cells (Life Technologies). Plasmid DNA was introduced into EXPI293 cells using liposome transfection. The total amount of transfected plasmid constructs was fixed, but the ratio of the different plasmid constructs was varied to maximize the yield of the desired construct.

[0255] After protein expression, the expressed constructs were purified from the cell culture supernatant by Protein A-based affinity column chromatography. The culture supernatant was loaded onto a Poros MabCapture A (LifeTechnologies) column using an AKTA Avant preparative chromatography system (GE Healthcare Life Sciences). The captured Fc constructs were then washed with phosphate-buffered saline (low salt wash) followed by phosphate-buffered saline supplemented with 500 mM NaCl (high salt wash). The Fc constructs were eluted with 100 mM glycine, 150 mM NaCl, pH 3 buffer. The protein solution emerging from the column was neutralized with 1 M TRIS pH 7.4 to a final concentration of 100 mM. The Fc constructs were further fractionated by ion-exchange chromatography using Poros® XS resin (Applied Biosciences catalog number 4404336). The column was pre-equilibrated with 10 mM MES, pH 6 (Buffer A) and the sample was eluted with a gradient to 10 mM MES, 500 mM sodium chloride, pH 6 (Buffer B).

[0256] The purified Fc constructs were analyzed by SDS-PAGE (sodium dodecyl sulfate polyacrylamide gel electrophoresis) under both reducing and non-reducing conditions, followed by Coomassie blue staining to confirm the presence of protein bands of the expected size.

[0257] Example 2: Fc-μTP-L309C(CHO) inhibits anti-GBM glomerulonephritis The efficacy of Fc-μTP-L309C produced from CHO cells [Fc-μTP-L309C(CHO)] was measured in an in vivo model of anti-glomerular basement membrane (GBM) glomerulonephritis.

[0258] Briefly, anti-GBM glomerulonephritis was induced in C57BL / 6 mice on day 0 using polyclonal antibody. Mice were induced by intravenous (i.v., tail vein) injection of 1 mg of monoclonal rabbit anti-GBM antibody, followed by intraperitoneal (i.p.) injection of 2 mg of mouse monoclonal anti-rabbit IgG (MsαRb IgG produced from hybridoma CRL-1753 (ATCC)) on day 6. Mice were injected i.p. with PBS or 50, 100, or 200 mg / kg of Fc-μTP-L309C on day 6, approximately 1 h before injection of MsαRb IgG mAb. After MsαRb injection, mice were individually placed in metabolic cages (Tecniplast) and urine was collected for 24 h. Urinary albumin levels were measured using an ELISA kit (Bethyl Laboratories), and albuminuria per mouse was plotted as μg per 24 h.

[0259] As shown in Figure 1, urinary albumin levels were significantly reduced in mice treated with Fc-μTP-L309C at all doses tested (PBS vs. 200 mg / kg Fc-μTP-L309C: p=0.0016; PBS vs. 100 mg / kg Fc-μTP-L309C: p=0.0036; PBS vs. 50 mg / kg Fc-μTP-L309C: p=0.0101). Table 1 shows the measured values.

[0260] [Table 1]

[0261] Example 3: Fc-μTP-L309C and its variants with reduced C1q binding ability inhibit anti-GBM glomerulonephritis The effects of Fc-μTP-L309C produced from CHO [Fc-μTP-L309C(CHO)] and HEK293 cells [Fc-μTP-L309C(HEK)] and its mutant with reduced C1q binding ability (K322A produced from HEK293 cells) were determined in an in vivo model of anti-GBM glomerulonephritis.

[0262] Briefly, anti-GBM glomerulonephritis was induced in C57BL / 6 mice by intravenous (i.v., tail vein) injection of 1 mg of polyclonal rabbit anti-GBM antibody on day 0, followed by intraperitoneal (i.p.) injection of 2 mg of mouse monoclonal anti-rabbit IgG (MsαRb IgG produced from hybridoma CRL-1753 (ATCC)) on day 6. Approximately 1 h before injection of MsαRb IgG mAb, mice were injected i.p. with PBS, 50 mg / kg of Fc-μTP-L309C (CHO), Fc-μTP-L309C (HEK), or K322A. After MsαRb injection, mice were individually placed in metabolic cages (Tecniplast) and urine was collected for 24 h. Urinary albumin levels were measured using an ELISA kit (Bethyl Laboratories), and albuminuria per mouse was plotted as μg per 24 h.

[0263] As shown in Figure 2, urinary albumin levels were significantly reduced in mice treated with all forms of Fc-μTP-L309C (PBS vs. CHO cell-derived Fc-μTP-L309C: p=0.0038; PBS vs. HEK293 cell-derived Fc-μTP-L309C: p=0.0038). Fc-μTP-L309C: p=0.0012; PBS vs. Fc-μTP-L309C K322A variant: p=0.0011). Table 2 shows the measured values.

[0264] [Table 2]

[0265] Example 4: Fc-μTP-L309C, CC SIF1, and Q1 inhibit anti-GBM glomerulonephritis The effects of Fc-μTP-L309C produced from HEK293 cells, i.e., Fc-μTP-L309C(HEK), and the trivalent Fc multimers CC, SIF1, and Q1 (as described in Example 1) were determined in an in vivo model of anti-GBM glomerulonephritis.

[0266] Briefly, anti-GBM glomerulonephritis was induced in C57BL / 6 mice by intravenous (i.v., tail vein) injection of 1 mg of polyclonal rabbit anti-GBM antibody on day 0, followed by intraperitoneal (i.p.) injection of 2 mg of mouse monoclonal anti-rabbit IgG (MsαRb IgG produced from hybridoma CRL-1753 (ATCC)) on day 6. Approximately 1 h before injection of MsαRb IgG mAb, mice were injected i.p. with 50 mg / kg of PBS, Fc-μTP-L309C (HEK), or one of three trivalent Fc multimers (CC, SIF1, and Q1). After MsαRb injection, mice were individually placed in metabolic cages (Tecniplast) and urine was collected for 24 h. Urinary albumin levels were measured using an ELISA kit (Bethyl Laboratories), and albuminuria per mouse was plotted as μg per 24 h.

[0267] As shown in Figure 3, urinary albumin levels were significantly reduced in mice treated with Fc-μTP-L309C or trivalent Fc multimers (PBS vs. Fc-μTP-L309C: p=0.0220; PBS vs. CC: p=0.0190; PBS vs. SIF1: p=0.0208; PBS vs. Q1: p=0.0119). Table 3 shows the measured values.

[0268] [Table 3]

[0269] Example 5: Fc-μTP-L309C inhibits anti-GBM glomerulonephritis in a dose-dependent manner The dose-response effect of Fc-μTP-L309C produced from HEK293 cells [Fc-μTP-L309C(HEK)] was determined in an in vivo model of anti-glomerular basement membrane (GBM) glomerulonephritis.

[0270] Briefly, C57BL / 6 mice were injected intravenously (i.v., tail vein) with 1 mg of polyclonal rabbit anti-GBM antibody on day 0, followed by mouse monoclonal anti-rabbit IgG (MsαRb produced from hybridoma CRL-1753 (ATCC)) on day 6. Anti-GBM glomerulonephritis was induced by intraperitoneal (ip) injection of 2 mg of Fc-μTP-L309C (IgG). On day 6, mice were intraperitoneally injected with PBS or 1, 5, 10, 20, or 50 mg / kg of Fc-μTP-L309C, approximately 1 h before injection of MsαRb IgG mAb. After injection of MsαRb, mice were individually placed in metabolic cages (Tecniplast) and urine was collected for 24 h. Urinary albumin levels were measured using an ELISA kit (Bethyl Laboratories), and albuminuria per mouse was plotted as μg per 24 h.

[0271] As shown in Figure 4, Fc-μTP-L309C inhibited anti-GBM antibody-induced glomerulonephritis in a dose-dependent manner (PBS vs. 50 mg / kg Fc-μTP-L309C: p=0.0194; PBS vs. 20 mg / kg Fc-μTP-L309C: p=0.0201; PBS vs. 10 mg / kg Fc-μTP-L309C: p=0.0286; PBS vs. 5 mg / kg Fc-μTP-L309C: p=0.2505; PBS vs. 1 mg / kg Fc-μTP-L309C: p=0.7875). Table 4 shows the measured values.

[0272] [Table 4]

Claims

1. 1. A pharmaceutical composition comprising an IgG Fc hexamer for use in the treatment of anti-glomerular basement membrane (anti-GBM) glomerulonephritis, wherein the Fc multimer lacks any mutation that increases the binding affinity of the Fc multimer to C1q; the deleted mutations are at least one of S267E, H268F, S324T, N297A, T299A, P238D, E233P, G236R, L234V, E233P, L234A, L235A, P238D, D265A, D265W, N297A, N297Q, T299A, and L328F in the IgG1 Fc domain of the Fc multimer; the Fc multimer comprises six human IgG1 Fc fusion monomers, wherein each Fc fusion monomer comprises two human Fc fusion polypeptide chains, and each Fc fusion polypeptide chain comprises a human IgG1 Fc polypeptide and a human IgM tail; the IgM tail in each Fc fusion polypeptide chain comprises 18 amino acids fused to 232 amino acids at the C-terminus of the constant region of an IgG1 Fc polypeptide, and each IgG1 Fc polypeptide comprises a leucine to cysteine ​​mutation at position 309; the Fc fusion polypeptide chain comprises either (i) the sequence of SEQ ID NO: 4, or (ii) the sequence of SEQ ID NO: 4 with a K322A mutation; The dosage of the Fc multimer is about 10 mg / kg body weight to about 200 mg / kg body weight. The above pharmaceutical composition.

2. The pharmaceutical composition of claim 1 , wherein the Fc multimerization domain does not comprise an IgG2 hinge.

3. 3. The pharmaceutical composition of claim 1 or 2, wherein the Fc multimer is not a stradomer.

4. The pharmaceutical composition according to any one of claims 1 to 3, wherein the Fc multimer inhibits complement-dependent cytotoxicity and / or antibody-dependent cellular cytotoxicity.

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