Humanized Anti-AGR2 antibody

Abstract

The present invention relates to the field of immunotherapy. In particular, the present invention relates to an antibody, or binding fragment thereof, that specifically binds Anterior Gradient 2 protein (AGR2). The present invention further relates to the use of said antibody, or binding fragment thereof, in therapy.

Description

HUMANIZED ANTI-AGR2 ANTIBODYFIELD OF INVENTION

[0001] The present invention relates to the field of immunotherapy. In particular, the present invention relates to an antibody, or a binding fragment thereof, that specifically binds Anterior Gradient 2 protein (AGR2). The present invention further relates to the use of said antibody, or binding fragment thereof, in therapy.BACKGROUND OF INVENTION

[0002] Anterior gradient-2 (AGR2) is an endoplasmic reticulum (ER)-resident protein that belongs to the protein disulfide isomerase superfamily. AGR2 shows two localizations: intracellular and extracellular. In healthy cells that express AGR2, the predominant form is the intracellular form, which resides in the endoplasmic reticulum. In contrast, cancer cells express AGR2 on the cell surface and secrete it in the extracellular environment. Thus, AGR2 is not only found in the ER, but also in other locations such as the nucleus, cytoplasm, plasma membrane and extracellular space.

[0003] It has been shown that AGR2 exists not only as a monomer, but it can also form homodimers. Indeed, AGR2 forms dimers through residues E60 and C81.

[0004] AGR2 protein has a relatively unique property for a chaperone in that it can bind sequence-specifically to a specific peptide motif (TTIYY - SEQ ID NO: 40). Additionally, AGR2 harbors an ER retention signal sequence (KTEL - SEQ ID NO: 41). In normal tissues, AGR proteins could contribute to the regulation of the total protein load in the cell. AGR2 is also involved in pathways for ER stress, protein folding, transcription regulation, and exosome formation. Basal level of AGR2 expression was observed across different tissue types especially for tissues of epithelial origin. In adult human tissues, the highest level of AGR2 expression was observed in the gastrointestinal tract (from the stomach to rectum) and genitourinary tract (urinary bladder and female and male genitalia), as well as in respiratory epithelia of nasopharynx and bronchus (i.e.,all mucosal epithelium). In mammals, AGR2 is generally present in mucus secreting epithelial cells and is highly expressed in Paneth and goblet intestinal cells, with the highest levels in the ileum and colon.

[0005] AGR2 is a marker of tumor aggressiveness expressed by many solid tumor types. In prostate, AGR2 is overexpressed in cancer cells compared to normal luminal cells, and a majority of primary prostate tumors are AGR2 positive. This pattern is similarly found in pancreatic, oral, and breast cancers. AGR2 is also highly expressed in non-small cell lung cancer where high expression is associated with poor survival.

[0006] Studies in mammals revealed the role of AGR2 as a pro-metastatic protein essential to cancer progression and drug resistance. Recent data have highlighted an extracellular role for AGR2 in promoting cancer growth. Cancer-associated function of AGR2 seems to derive from its ability to promote cell adhesion, stimulate cell migration through an extracellular activity, and catalyze plasma membrane receptor trafficking through an intra-cellular function. Recently, specific protein-protein interaction of AGR2 with the oncogenic membrane receptor EpCAM has been shown.

[0007] The role of extracellular AGR2 (eAGR2) in the tumor development clearly shows that eAGR2 protein acts as an extracellular regulator, through gain of extracellular functions, on phenotypes associated with tumor morphogenesis, tumorigenicity, and inflammation. The deregulation of AGR2 localizations, intracellular (iAGR2) and extracellular (eAGR2), could exert different pro-oncogenic gain-of-functions.

[0008] Due to almost ubiquitous expression in solid tumors, expression in premalignant lesions and its involvement in metastatic disease, AGR2 protein represents a relevant target for cancer therapy.

[0009] Besides, AGR2 is also involved in other diseases such as asthma and inflammatory bowel disease. Indeed, studies in transgenic mice have shown that AGR2- null animals are defective in mucin production, have alterations in asthma incidence, and are primed to develop inflammatory bowel disease. Development of these pathologies in AGR2-null animals is due to the important role of intracellular AGR2, which acts as a chaperone in the folding and trafficking of mucin.

[0010] Several anti-AGR2 antibodies are commercially available. The epitopes recognized by the commercially available antibodies are not described. These antibodies are mostly sold for western blot or immunohistochemistry applications with no guarantee to function for ELISA or in vitro functional assays. Moreover, they are not described to cross react with other species preventing their use in animal models. Furthermore, these antibodies are poorly referenced in any publications.

[0011] The anti-AGR2 clone « 1C3 » is commercialized by Abnova (H00010551-M03) and was obtained by immunization of mouse using the AGR2 full-length recombinant protein with GST tag, but its epitope is unknown. This monoclonal antibody is a murine IgG2b kappa.

[0012] Liu et al. have produced two anti-human AGR2 antibodies, P1G4 and P3A5, intended for use as therapeutic treatment of cancer. The authors demonstrated in vivo an enhancement of Gemcitabine inhibition of tumor growth by P1G4 monoclonal antibody, but not with P3 A5.

[0013] A humanized anti-AGR2 antibody (18A4Hu) and its murine version (18A4) were reported to have inhibitory effect on AGR2+ ovarian cancer xenograft SK-OV-3.

[0014] It should be noted that all these monoclonal antibodies were developed for oncology indications only. When available, data obtained with these antibodies only exhibit inhibitory effect on tumors.

[0015] Besides, AGR2 has been shown to be involved in other diseases such as inflammatory diseases.

[0016] AGR2 expression is increased in biopsies taken from patients with active ulcerative colitis disease compared to patients in remission and to non IBD controls. AGR2 has also been found to be associated to homeostasis breakdown in pediatric ulcerative colitis disease. Moreover, in ulcerative colitis surgical specimen, AGR2 is highly expressed in colonic epithelium associated to histological fibrosis evidence, while AGR2 immunohistochemical signal is significantly lower in surgical normal margins isolated in non-IBD colons.

[0017] Moreover, immuno-histological staining of large-bowel sections from inflammatory bowel disease patients shows that AGR2 expression is highly upregulated compared to non-inflamed controls and localized to all epithelial surfaces (Al-Shaibi et al., Cell Mol Gastroenterol Hepatol, 2021;12(5):1809-1830).

[0018] In inflammatory bowel disease, and specifically in Crohn’s disease, the levels of AGR2 dimerization modulators are selectively deregulated, and this correlates with disease severity. AGR2 dimers act as sensors of ER homeostasis, which are disrupted upon ER stress and promote the secretion of AGR2 monomers. The latter might represent systemic alarm signals for pro-inflammatory responses (Maurel et al., EMBO Mol Med, 2019, l l(6):el0120).

[0019] AGR2 release in the extracellular environment enhances monocyte recruitment and pro-inflammatory phenotypes. Regulation of AGR2 dimerization is associated with pro-inflammatory responses and enrichment of macrophages in the colonic mucosa that could be observed in Crohn’s disease (Maurel et al., EMBO Mol Med, 2019, l l(6):el0120).

[0020] The secretion of AGR2 by epithelial cells can participate in the development of fibrosis in Crohn’s disease. In the ileum, there is a significant increase of AGR2 in tissues with a fibrotic compartment compared to pure inflammatory samples, highlighting that AGR2 is associated with a fibrostenosis process. AGR2 overexpression at the mRNA level is correlated to fibrosis grade in Crohn’s disease patients (Vieujean et al., J Crohns Colitis, 2021, 15(10): 1737-1750).

[0021] eAGR2, under its monomeric form, has been shown to selectively promote monocyte attraction, thereby linking eAGR2 to pro-inflammatory phenotypes and unraveling the extracellular gain-of-function of AGR2 as a pro-inflammatory chemokine (Maurel et al., EMBO Mol Med, 2019, 11(6): el0120). AGR2 blocking antibodies have been shown to impede monocytes migration and may thus inhibit a very early step of inflammation by blocking local monocyte recruitment.

[0022] Moreover, the differentiation of fibroblasts into myofibroblasts obtained when cultured in the presence of supernatant from intestinal epithelial cell pre-conditioned byER stress, as well as with recombinant AGR2, can be attenuated after blocking AGR2 with an anti-AGR2 antibody. Thus, AGR2 seems to have a pro-fibrotic role and to act as a paracrine inducer of intestinal fibroblast-to-myofibroblast differentiation (Vieujean et al., J Crohns Colitis, 2021, 15(10): 1737-1750.

[0023] By blocking fibroblast-to-myofibroblast differentiation, anti-AGR2 antibodies may block fibrosis installation preventing stricture in patients.

[0024] The etiology of chronic inflammatory bowel diseases such as Crohn's disease or ulcerative colitis is poorly understood. This results in a therapeutic strategy focused on the treatment of inflammatory symptoms without being able to act on the initial cause of the disease.

[0025] Less serious cases are treated with amino-salicylate compounds that have a local action on inflammation or corticosteroids. Patients with more severe forms of these diseases or who develop dependence on corticosteroids are treated with so-called biotherapies. The management of inflammatory bowel diseases often involves immunosuppressive treatments such as corticosteroids, immunomodulators, small molecules and biological agents that inhibit pro-inflammatory cytokine pathways (such as, e.g., anti-TNF antibodies).

[0026] Anti-TNF (Tumor Necrosis Factor) antibodies are the first-line treatments, but they are effective in only 30 to 40% of patients who go into remission. Moreover, 15% per year of patients responding to anti-TNF develop insensitivity to it, obliging gastroenterologists to use second-line treatments, anti-interleukins (usketinumab, STELARA®, Janssen) and anti-integrins (vedolizumab, ENTYVIO®, Takeda) antibodies.

[0027] The efficacy of these biotherapies is good but quickly decreases over time. Above all, the side effects of these treatments, which target the patient's immunity, are numerous: skin disorders, opportunistic infections, risk of cancer, etc. New therapeutic approaches are currently being developed, in particular small molecules targeting the ubiquitous JAK or SIP pathways, without having demonstrated their efficacy or safety for patients.

[0028] The use of more traditional immunosuppressants is becoming increasingly rare, given the high associated risks of cancer and serious infections. Surgery remains the most frequent outcome to avoid severe complications (notably colorectal cancer), causing serious alteration of patients' lives.

[0029] When patients experience inflammatory flare-ups, remission may be induced with current treatments. However, these treatments must be taken chronically, for life, to avoid relapses. However, a very significant and rapid therapeutic escape is observed in patients, and the serious side effects encourage the greatest caution during prolonged administrations.

[0030] Therefore, the discovery of a treatment that can maintain patients in long-term remission, while not presenting risks of side effects, would be a breakthrough in the field of inflammatory diseases of the mucous membranes.

[0031] AGR2 is a promising therapeutic target in the context of inflammatory diseases. However, no anti-AGR2 antibody has been developed for and shown to be effective in the prevention or treatment of inflammatory diseases.

[0032] Therefore, there is still a need for novel anti-AGR2 antibodies suitable to be used as a therapy, in particular in the context of inflammatory diseases.

[0033] Consequently, the inventors herein aimed at developing a novel tool to target AGR2 protein, in particular extracellular AGR2. More specifically, the inventors herein disclose a novel antibody, and binding fragments thereof, that specifically binds AGR2. The antibody, or binding fragment thereof, that specifically binds AGR2 of the present invention would be a valuable therapeutic tool for treating mucosal inflammatory diseases or cancer for example.

[0034] By targeting the pathologically abnormal secreted protein (eAGR2), the inventors aim at abrogating a unique mechanism of action: the early crosstalk between the epithelium and the immune system in mucosal inflammatory diseases, while having a much less aggressive secretive profile than competing immunotherapies.

[0035] Compared to the standard products currently used in the treatment of mucosal inflammatory diseases, anti-eAGR2 is the only one combining an anti-inflammatory action with an anti-fibrotic action, without risk of side effects, and with a targeted action on the affected tissue.

[0036] The inventors have identified several humanized monoclonal antibodies capable of specifically binding to human AGR2 with a high affinity. These humanized antibodies may be used in the prevention or treatment of inflammatory diseases and cancer.SUMMARY

[0037] The present invention relates to an isolated antibody, or binding fragment thereof, that specifically binds to Anterior Gradient 2 protein (AGR2), wherein said antibody, or binding fragment thereof, comprises: a heavy chain variable region (VH) comprising the following three complementary- determining regions (CDRs):- CDR1 : DYWMS (SEQ ID NO: 8);- CDR2: DIKFDGSFTNYAPSLKN (SEQ ID NO: 9);- CDR3 : EANYPGLTFD Y (SEQ ID NO : 10); and a light chain variable region (VL) comprising the following three CDRs:- CDR1 : XASEGISNYLA (SEQ ID NO: 11) wherein X is L or R;- CDR2: YASSLQD (SEQ ID NO: 14); and- CDR3 : QQSYKYPLT (SEQ ID NO: 15).

[0038] In some embodiments the isolated antibody, or binding fragment thereof, that specifically binds to AGR2 comprises: a heavy chain variable region (VH) comprising framework regions sharing at least 80% sequence identity with the framework regions of SEQ ID NO: 16; and a light chain variable region (VL) comprising framework regions sharing at least 80% sequence identity with the framework regions of SEQ ID NO: 19; or a heavy chain variable region (VH) comprising framework regions sharing at least 80% sequence identity with the framework regions of SEQ ID NO: 16; and a lightchain variable region (VL) comprising framework regions sharing at least 80% sequence identity with framework regions of SEQ ID NO: 20; or a heavy chain variable region (VH) comprising framework regions sharing at least 80% sequence identity with the framework regions of SEQ ID NO: 16; and a light chain variable region (VL) comprising framework regions sharing at least 80% sequence identity with the framework regions of SEQ ID NO: 21.

[0039] In some embodiments, the isolated antibody, or binding fragment thereof, that specifically binds to AGR2 comprises: a heavy chain variable region (VH) having a sequence consisting of sequence SEQ ID NO: 16; and a light chain variable region (VL) having a sequence consisting of sequence SEQ ID NO: 19; or a heavy chain variable region (VH) having a sequence consisting of sequence SEQ ID NO: 16; and a light chain variable region (VL) having a sequence consisting of sequence SEQ ID NO: 20; or a heavy chain variable region (VH) having a sequence consisting of sequence SEQ ID NO: 16; and a light chain variable region (VL) having a sequence consisting of sequence SEQ ID NO: 21.

[0040] In some embodiments, the isolated antibody, or binding fragment thereof, that specifically binds to AGR2 is an immunoconjugate.

[0041] The present invention also relates to a nucleic acid encoding said antibody, or binding fragment thereof, that specifically binds to AGR2.

[0042] The present invention also relates to an expression vector comprising said nucleic acid.

[0043] The present invention also relates to a cell comprising said nucleic acid or said expression vector.

[0044] The present invention also relates to a pharmaceutical composition comprising said isolated antibody, or binding fragment thereof, that specifically binds to AGR2, saidnucleic acid, said expression vector, or said cell, and at least one pharmaceutically acceptable excipient.

[0045] The present invention also relates to said isolated antibody, or binding fragment thereof, that specifically binds to AGR2, said nucleic acid, said expression vector, said cell, or said pharmaceutical composition, for use as a medicament.

[0046] The present invention also relates to said isolated antibody, or binding fragment thereof, that specifically binds to AGR2, said nucleic acid, said expression vector, said cell, or said pharmaceutical composition, for use in the treatment of a mucosal inflammatory disease, or a cancer, in a subject in need thereof.

[0047] In some embodiments, said isolated antibody, or binding fragment thereof, that specifically binds to AGR2, neutralizes the pro-inflammatory activity of eAGR2 and / or the pro-fibrotic activity of eAGR2.

[0048] In some embodiments, the mucosal inflammatory disease is selected from the group consisting of Crohn’s disease, ulcerative colitis, primary sclerosing cholangitis, chronic pancreatitis, microscopic colitis, inflammatory bowel disease (IBD), endometriosis, appendicitis, inflammatory bowel syndrome, idiopathic pulmonary fibrosis, systemic sclerosis, systemic sclerosis associated with interstitial lung disease, asthma and chronic obstructive pulmonary disease.

[0049] In some embodiments, said cancer is selected from the group consisting of colon cancer, gastrointestinal cancer, prostate cancer, pancreatic cancer, oral cancer, breast cancer, lung cancer, ovarian cancer, thyroid cancer, cholangiocarcinoma, head and neck squamous cell carcinoma, brain glioblastoma, adrenocortical carcinoma, bladder cancer, kidney cancer, penile cancer, renal cancer, testicular cancer, urethral cancer, colorectal cancer, cervical cancer, uterine cancer, endometrial cancer, vaginal cancer, vulvar cancer, gestational trophoblastic disease (GTD), and primary peritoneal cancer.

[0050] The present invention also relates to an in vitro method for detecting or quantifying AGR2 expression in a biological sample, comprising contacting saidbiological sample with the isolated antibody, or binding fragment thereof, that specifically binds to AGR2, as described herein.

[0051] In some embodiments, said method is for diagnosing or monitoring an AGR2- related disease in a subject, or for selecting a subject suffering from an AGR2-related disease for treatment targeting said disease.DEFINITIONS

[0052] In the present invention, the following terms have the following meanings:

[0053] “Affinity” is used to define the strength of an antibody-antigen complex. Affinity measures the strength of interaction between an epitope and an antigen binding site on an antibody. It may be expressed by an affinity constant KA or by a dissociation constant KD.

[0054] “Antibody” as used herein, refers to a protein, or polypeptide sequence derived from an immunoglobulin (IgG) molecule which specifically bind s with an antigen. Antibodies can be polyclonal or monoclonal, multiple or single chain, or intact immunoglobulins, and may be derived from natural sources or from recombinant sources. The term “antibody” also includes multispecific antibodies (e.g., bispecific antibodies), and antibody fragments, so long as they exhibit the desired biological activity. Antibodies can be multimers of immunoglobulin molecules, such as tetramers of immunoglobulin molecules. The basic four-chain antibody unit is a heterotetrameric glycoprotein composed of two identical light (L) chains and two identical heavy (H) chains. The L chain from any vertebrate species can be assigned to one of two clearly distinct types, called kappa (K) and lambda (X), based on the amino acid sequences of their constant domains (CL). Depending on the amino acid sequence of the constant domain of their heavy chains (CH), immunoglobulins can be assigned to different classes or isotypes. There are five classes of immunoglobulins: IgA, IgD, IgE, IgG, and IgM, having heavy chains designated alpha ([a]), delta ([8]), epsilon ([a]), gamma ([y]) and mu ([p]), respectively. The [y] and [a] classes are further divided into subclasses based on relatively minor differences in CH sequence and function, e.g., humans express the following subclasses: IgGl, IgG2, IgG3, IgG4, IgAl, and IgA2. Each L chain is linked to an H chainby one covalent disulfide bond, while the two H chains are linked to each other by one or more disulfide bonds depending on the H chain isotype. Each H and L chain also has regularly spaced intrachain disulfide bridges. Each H chain has at the N-terminus, a variable domain (VH) followed by three constant domains (CH) for each of the [a] and [y] chains and four CH domains for [p] and [a] isotypes. Each L chain has at the N- terminus, a variable domain (VL) followed by a constant domain (CL) at its other end. The VL is aligned with the VH, and the CL is aligned with the first constant domain of the heavy chain (CHI). Particular amino acid residues are believed to form an interface between the light chain and heavy chain variable domains. The pairing of a VH and a VL together forms a single antigen-binding site. An IgM antibody consists of five of the basic heterotetramer units along with an additional polypeptide called a J chain, and therefore, contains ten antigen-binding sites, while secreted IgA antibodies can polymerize to form polyvalent assemblages comprising 2-5 of the basic 4-chain units along with J chain. In the case of IgGs, the 4-chain unit is generally about 150,000 Daltons.

[0055] As used herein, the term “antibody fragment” refers to at least one portion of an intact antibody, preferably the antigen binding region or variable region of the intact antibody, that retains the ability to specifically interact with (e.g., by binding, steric hindrance, stabilizing / destabilizing, spatial distribution) an epitope of an antigen. Examples of antibody fragments include, but are not limited to, Fab, Fab', F(ab')2, Fv fragments, scFv antibody fragments, disulfide-linked Fvs (sdFv), a Fd fragment consisting of the VH and CHI domains, linear antibodies, single domain antibodies such as sdAb (either VL or VH), camelid VHH domains, multi-specific antibodies formed from antibody fragments such as a bivalent fragment comprising two Fab fragments linked by a disulfide bridge at the hinge region, and an isolated CDR or other epitope binding fragments of an antibody. An antigen binding fragment can also be incorporated into single domain antibodies, maxibodies, minibodies, nanobodies, intrabodies, diabodies, triabodies, tetrabodies, a v-NAR and a bis-scFv. Antigen binding fragments can also be grafted into scaffolds based on polypeptides such as a fibronectin type III. Papain digestion of antibodies produces two identical antigen-binding fragments, called “Fab” fragments, and a residual “Fc” fragment, a designation reflecting the ability to crystallize readily. The Fab fragment consists of an entire L chain along with the variableregion domain of the H chain (VH), and the first constant domain of one heavy chain (CHI). Each Fab fragment is monovalent with respect to antigen binding, z.e., it has a single antigen-binding site. Pepsin treatment of an antibody yields a single large F(ab')2 fragment that roughly corresponds to two disulfide linked Fab fragments having divalent antigen-binding activity and is still capable of crosslinking antigen. Fab' fragments differ from Fab fragments by having additional few residues at the carboxy terminus of the CHI domain including one or more cysteines from the antibody hinge region. Fab'-SH is the designation herein for Fab' in which the cysteine residue(s) of the constant domains bear a free thiol group. F(ab')2 antibody fragments originally were produced as pairs of Fab' fragments that have hinge cysteines between them. Other chemical couplings of antibody fragments are also known.

[0056] As used herein, the term “binding fragment”, refers to a part or region of the antibody according to the present invention, which comprises fewer amino acid residues than the whole antibody. A “binding fragment” binds antigen and / or competes with the whole antibody from which it was derived for antigen binding. Antibody binding fragments encompasses, without any limitation, single chain antibodies, Fv, Fab, Fab', Fab'-SH, F(ab)’2, Fd, defucosylated antibodies, diabodies, triabodies and tetrabodies.

[0057] “Antigen” or “Ag” refers to a molecule that provokes an immune response. This immune response may involve either antibody production, and / or the activation of specific immunologically-competent cells, or both.

[0058] "Cancer" generally refers to a disease caused by an uncontrolled division of abnormal cells. The term "cancer" in particular refers to any disease associated with tumorigenesis. The term "cancer" encompasses solid tumors and blood cancers, and encompasses both primary and metastatic cancers.

[0059] “CDR” or “complementarity determining region” means the non-contiguous antigen combining sites found within the variable region of both heavy and light chain polypeptides. The precise amino acid sequence boundaries of a given CDR can be determined using any of several well-known schemes, including those described by Kabat et al. (1991), “Sequences of Proteins of Immunological Interest” 5th Ed. Public HealthService, National Institutes of Health, Bethesda, MD (“Kabaf ’ numbering scheme), Al- Lazikani et al., (1997) JMB 273,927-948 (“Chothia” numbering scheme), or a combination thereof. More recently, a universal numbering system has been developed and widely adopted, ImMunoGeneTics (IMGT) Information System® (Lefranc et al., Nucleic Acids Res. 27: 209-212 1999). Herein, the CDRs are referred to in terms of both the amino acid sequence and the location within the light or heavy chain. As the "location" of the CDRs within the structure of the immunoglobulin variable domain is conserved between species and present in structures called loops, by using numbering systems that align variable domain sequences according to structural features, CDR and framework residues may be readily identified. This information can be used in grafting and replacement of CDR residues from immunoglobulins of one species into an acceptor framework from, typically, a human antibody. In some embodiments, by CDR regions or CDR, it is intended to indicate the hypervariable regions of the heavy and light chains of the immunoglobulins as defined by Kabat et al. (1991), (“Kabat” numbering scheme).

[0060] “Epitope” refers to a specific arrangement of amino acids located on a protein or proteins to which an antibody binds. Epitopes often consist of a chemically active surface grouping of molecules such as amino acids or sugar side chains and have specific three- dimensional structural characteristics as well as specific charge characteristics. Epitopes can be linear (or sequential) or conformational, ie., involving two or more sequences of amino acids in various regions of the antigen that may not necessarily be contiguous.

[0061] “Framework region” or “FR region” includes the amino acid residues of an antibody, or binding fragment thereof, that are part of the variable region but are not part of the CDRs. In naturally occurring antibodies, the six CDRs present on each monomeric antibody are short, non-contiguous sequences of amino acids that are specifically positioned to form the antigen binding site as the antibody assumes its three-dimensional configuration in an aqueous environment. The remainders of the heavy and light variable domains show less inter-molecular variability in amino acid sequence and are termed the framework regions.

[0062] “Fc domain,” “Fc portion,” and “Fc region” refer to a C-terminal fragment of an antibody heavy chain, e.g., from about amino acid (aa) 230 to about aa 450 of humangamma heavy chain or its counterpart sequence in other types of antibody heavy chains (e.g., a, 5, a and p for human antibodies), or a naturally occurring allotype thereof.

[0063] “Heavy chain region” includes amino acid sequences derived from the constant domains of an immunoglobulin heavy chain. A protein comprising a heavy chain region comprises at least one of a CHI domain, a hinge (e.g., upper, middle, and / or lower hinge region) domain, a CH2 domain, a CH3 domain, or a variant or fragment thereof. In an embodiment, the antibody according to the present invention may comprise the Fc region of an immunoglobulin heavy chain (e.g., a hinge portion, a CH2 domain, and a CH3 domain). In some embodiments, the antibody according to the present invention may comprise a heavy chain region comprising all of the constant domains derived from a human immunoglobulin 1 (IgGl) heavy chain. In some embodiments, the constant domains of the heavy chain region may be modified such that they vary in amino acid sequence from the naturally occurring (wild-type) immunoglobulin molecule. That is, the antibody according to the present invention may comprise alterations or modifications to one or more of the heavy chain constant domains (CHI, hinge, CH2 or CH3) and / or to the light chain constant domain (CL). Exemplary modifications include additions, deletions or substitutions of one or more amino acids in one or more domains.

[0064] Within an antibody, the term “hinge region” includes the region of a heavy chain molecule that joins the CHI domain to the CH2 domain. This hinge region comprises approximately 25 residues and is flexible, thus allowing the two N-terminal antigen binding regions to move independently. Hinge regions can be subdivided into three distinct domains: upper, middle, and lower hinge domains.

[0065] “Identity” or “identical”, when used herein in a relationship between the sequences of two or more amino acid sequences, or of two or more nucleic acid sequences, refers to the degree of sequence relatedness between amino acid sequences or nucleic acid sequences, as determined by the number of matches between strings of two or more amino acid residues or nucleic acid residues. “Identity” measures the percent of identical matches between the smaller of two or more sequences with gap alignments (if any) addressed by a particular mathematical model or computer program (i.e., “algorithms”). Identity of related amino acid sequences or nucleic acid sequences can bereadily calculated by known methods. Preferred methods for determining identity are designed to give the largest match between the sequences tested. Methods of determining identity are described in publicly available computer programs. Preferred computer program methods for determining identity between two sequences include the GCG program package, including GAP (Genetics Computer Group, University of Wisconsin, Madison, WI; Devereux et al., 1984. Nucleic Acids Res. 12(1 Pt 1):387-95), BLASTP, BLASTN, and FASTA (Altschul et al., 1990. J Mol Biol. 215(3):403-10). The BLASTX program is publicly available from the National Center for Biotechnology Information (NCBI) and other sources (BLAST Manual, Altschul et al. NCB / NLM / NH4 Bethesda, Md. 20894). The well-known Smith Waterman algorithm may also be used to determine identity.

[0066] As used herein, the term “immune cells” generally includes white blood cells (leukocytes) that are derived from hematopoietic stem cells (HSC) produced in the bone marrow. Examples of immune cells include, but are not limited to, lymphocytes (T cells, B cells, and natural killer (NK) cells) and myeloid-derived cells (neutrophil, eosinophil, basophil, monocyte, macrophage, dendritic cells).

[0067] As used herein, the term "isolated" or "non-naturally occurring" with reference to a biological component (such as a nucleic acid molecule, a protein or a cell), refers to a biological component altered or removed from the natural state. For example, a nucleic acid or a peptide naturally present in a living animal is not "isolated" but the same nucleic acid or peptide partially or completely separated from the coexisting materials of its natural state is “isolated”. An isolated nucleic acid or peptide can exist in substantially purified form, or can exist in a non-native environment such as, for example, a host cell. Typically, a preparation of isolated nucleic acid or peptide contains the nucleic acid or peptide at least about 80% pure, at least about 85% pure, at least about 90% pure, at least about 95% pure, greater than 95% pure, greater than about 96% pure, greater than about 97% pure, greater than about 98% pure, or greater than about 99% pure. Nucleic acids and proteins that are "non-naturally occurring" or have been "isolated" include nucleic acids and proteins purified by standard purification methods. The term also embraces nucleic acids and proteins prepared by recombinant expression in a host cell as well aschemically synthesized nucleic acids. An "isolated polypeptide" is one that has been identified and separated and / or recovered from a component of its natural environment.

[0068] As used herein, the term “monoclonal antibody” refers to an antibody obtained from a population of substantially homogeneous antibodies, ie., the individual antibodies comprised in the population are identical except for possible naturally occurring mutations that may be present in minor amounts. Monoclonal antibodies are highly specific, being directed against a single antigenic site. Furthermore, in contrast to polyclonal antibody preparations that include different antibodies directed against different determinants (epitopes), each monoclonal antibody is directed against a single determinant on the antigen. In addition to their specificity, the monoclonal antibodies are advantageous in that they may be synthesized uncontaminated by other antibodies. The modifier “monoclonal” is not to be construed as requiring production of the antibody by any particular method. For example, the monoclonal antibodies or binding fragment thereof according to the present invention may be prepared by the hybridoma methodology first described by Kohler et aL, 1975. Nature. 256(5517):495-7, or may be made using recombinant DNA methods in bacterial, eukaryotic animal or plant cells (Patent US4,816,567). The “monoclonal antibodies” may also be isolated from phage antibody libraries using the techniques described in Clackson et al., 1991. Nature. 352(6336):624-8 and Marks et al., 1991. J Mol Biol. 222(3):581-97, for example.

[0069] As used herein, the term “nucleic acid” or “polynucleotide” refers to a polymer of nucleotides covalently linked by phosphodiester bonds, such as deoxyribonucleic acids (DNA) or ribonucleic acids (RNA), in either single- or double-stranded form. Unless specifically limited, the term encompasses nucleic acids containing known analogues of natural nucleotides that have similar binding properties as the reference nucleic acid and are metabolized in a manner similar to naturally occurring nucleotides. Unless otherwise indicated, a particular nucleic acid sequence also implicitly encompasses conservatively modified variants thereof (e.g., degenerate codon substitutions), alleles, orthologs, SNPs, and complementary sequences as well as the sequence explicitly indicated. Specifically, degenerate codon substitutions may be achieved by generating sequences in which thethird position of one or more selected (or all) codons is substituted with mixed-base and / or deoxyinosine residues.

[0070] As used herein, the terms “prevent”, “preventing” and “prevention” refer to prophylactic and preventative measures, wherein the object is to reduce the chances that a subject develop the pathologic condition or disorder over a given period of time. Such a reduction may be reflected, e.g., in a delayed onset of at least one symptom of the pathologic condition or disorder in the subject.

[0071] “Single-chain variable fragment”, also abbreviated as “sFv” or “scFv”, refers to a fusion protein comprising at least one antibody fragment comprising a variable region of a light chain and at least one antibody fragment comprising a variable region of a heavy chain, wherein the light and heavy chain variable regions are contiguously linked, e.g., via a synthetic linker, e.g., a short flexible polypeptide linker, and capable of being expressed as a single chain polypeptide, and wherein the scFv retains the specificity of the intact antibody from which it is derived. Unless specified, as used herein an scFv may have the VL and VH variable regions in either order, e.g., with respect to the N-terminal and C-terminal ends of the polypeptide, the scFv may comprise VL-linker-VH or may comprise VH-linker-VL. Divalent, trivalent and higher scFv, called tandem-di-scFv, tandem-tri-scFv, etc., can be engineered by linking two, three or more scFv together. Alternatively, two scFv can be forced to dimerize into a diabody by using a linker peptide that is too short (typically of about 5 to 10 amino acids) between the VH and the VL domains. Alternatively, an even shorter linker peptide (typically of about 1 to 2 amino acids) leads to the formation of scFv trimers, also called triabodies or tribodies.

[0072] “Subject” is intended to include living organisms in which an immune response can be elicited. Preferably, the term “subject” refers to a warm-blooded animal, more preferably a mammal. The term “mammal” refers here to any mammal, including humans, domestic and farm animals, and zoo, sports, or pet animals, such as dogs, cats, cattle, horses, sheep, pigs, goats, rabbits, etc. Preferably, the mammal is a primate, more preferably a human. In some embodiments, a subject may be a “patient”, who / which is awaiting the receipt of, or is receiving medical care or was / is / will be the object of a medical procedure, or is monitored for the development of the targeted disease orcondition, such as, for example, mucosal inflammatory diseases. In some embodiments, the subject is an adult (for example a subject above the age of 18). In some embodiments, the subject is a child (for example a subject below the age of 18). In some embodiments, the subject is a male. In some embodiments, the subject is a female. In some embodiments, the subject is affected, preferably is diagnosed, with a mucosal inflammatory disease. In some embodiments, the subject is at risk of developing a mucosal inflammatory disease. Examples of risks factor include, but are not limited to, genetic predisposition, or familial history of mucosal inflammatory diseases.

[0073] As used herein, the term “transfected” or “transformed” or “transduced” refers to a process by which exogenous nucleic acid is transferred or introduced into the host cell. A “transfected” or “transformed” or “transduced” cell is one which has been transfected, transformed or transduced with exogenous nucleic acid. The cell includes the primary subject cell and its progeny.

[0074] “Therapeutically effective amount” refers to the level or amount of an antibody, or binding fragment thereof, as described herein that is aimed at, without causing significant negative or adverse side effects to the target, (1) delaying or preventing the onset of a disease, disorder, or condition; (2) slowing down or stopping the progression, aggravation, or deterioration of one or more symptoms of the disease, disorder, or condition; (3) bringing about ameliorations of the symptoms of the disease, disorder, or condition; (4) reducing the severity or incidence of the disease, disorder, or condition; or (5) curing the disease, disorder, or condition. A therapeutically effective amount may be administered prior to the onset of the disease, disorder, or condition, for a prophylactic or preventive action. Alternatively, or additionally, the therapeutically effective amount may be administered after initiation of the disease, disorder, or condition, for a therapeutic action.

[0075] “Treating” or “treatment” or “alleviation” refers to both therapeutic treatment and prophylactic or preventative measures; wherein the object is to prevent or slow down (lessen) the targeted pathologic condition or disorder. Those in need of treatment include those already with the disorder as well as those prone to have the disorder or those in whom the disorder is to be prevented. In some embodiments, a subject is successfully"treated" for a disease or disorder if, after receiving a therapeutic amount of an antibody, or binding fragment thereof, according to the present invention, the subject shows at least one of the following: relief to some extent of one or more of the symptoms associated with the disease or disorder to be treated; reduced morbidity and mortality; and improvement in quality-of-life issues. The above parameters for assessing successful treatment and improvement in the disease are readily measurable by routine procedures familiar to a physician.

[0076] As used herein, the terms “variable”, “variable region” or “variable domain” refer to the fact that certain regions of the variable domains VH and VL differ extensively in sequence among antibodies and are used in the binding and specificity of each particular antibody for its target antigen. However, the variability is not evenly distributed throughout the variable domains of antibodies. It is concentrated in three segments called “complementarity determining region” or “CDR” in each of the VL domain and the VH domain which form part of the antigen binding site.DETAILED DESCRIPTION

[0077] Human AGR2 typically refers to the protein referenced as AAY84776.1 in the NCBI databases on January 19, 2007. In the NCBI databases(https: / / www.ncbi.nlm.nih.gov), the reference human AGR2 gene sequence corresponds to NCBI Gene ID: 10551, as updated on November 28, 2021. The human AGR2 gene consists of 8 exons on chromosome 7p21.1. AGR2 transcript encompasses 1697 nucleotides and encodes a 175 amino acid protein. The reference human AGR2 protein sequence corresponds to SEQ ID NO: 1.

[0078] Mouse AGR2 typically refers to the protein referenced as NP_035913.1 in the NCBI databases on December 4, 2021. In the NCBI databases, the reference mouse AGR2 gene sequence corresponds to NCBI Gene ID: 23795, as updated on November 30, 2021. The mouse AGR2 gene consists of 8 exons on chromosome 12;12A. AGR2 transcript encompasses 760 nucleotides and encodes a 175 amino acid protein. The reference mouse AGR2 protein sequence corresponds to SEQ ID NO: 2.

[0079] Rhesus monkey AGR2 typically refers to the protein referenced as NP_001181233.1 in the NCBI databases July 11, 2020. In the NCBI databases, the reference rhesus monkey AGR2 gene sequence corresponds to NCBI Gene ID: 709127, as updated on June 24, 2020. The rhesus monkey AGR2 gene consists of 8 exons on chromosome 3. AGR2 transcript encompasses 1808 nucleotides and encodes a 175 amino acid protein. The reference rhesus monkey AGR2 protein sequence corresponds to SEQ ID NO: 3.

[0080] Cynomolgus monkey AGR2 typically refers to the protein referenced as XP_005550106 in the NCBI databases on May 14, 2024. In the NCBI databases, the reference cynomolgus monkey AGR2 gene sequence corresponds to NCBI Gene ID: 102132135, as updated on May 14, 2024. The cynomolgus monkey AGR2 gene consists of 8 exons on chromosome 3. AGR2 transcript encompasses 12338 nucleotides and encodes a 175 amino acid protein. The reference cynomolgus monkey AGR2 protein sequence corresponds to SEQ ID NO: 43.

[0081] Chimpanzee AGR2 typically refers to the protein referenced as XP 003318381.1 in the NCBI databases March 20, 2018. In the NCBI databases, the reference chimpanzee AGR2 gene sequence corresponds to NCBI Gene ID: 463277, as updated on March 19, 2021. The chimpanzee AGR2 gene consists of 8 exons on chromosome 7. AGR2 transcript encompasses 2197 nucleotides and encodes a 175 amino acid protein. The reference chimpanzee AGR2 protein sequence corresponds to SEQ ID NO: 4.

[0082] Rat AGR2 typically refers to the protein referenced as NP_001100195.1 in the NCBI databases February 1, 2021. In the NCBI databases, the reference rat AGR2 gene sequence corresponds to NCBI Gene ID: 298961, as updated on December 15, 2021. The rat AGR2 gene consists of 9 exons on chromosome 6ql6. AGR2 transcript encompasses 961 nucleotides and encodes a 175 amino acid protein. The reference rat AGR2 protein sequence corresponds to SEQ ID NO: 5.

[0083] Dog AGR2 typically refers to the protein referenced as XP_038542570.1 in the NCBI database on January 7, 2021. In the NCBI databases, the reference dog AGR2 gene sequence corresponds to NCBI Gene ID: 482333, as updated on December 15, 2021. Thedog AGR2 gene consists of 9 exons on chromosome 14. AGR2 transcript encompasses 2657 nucleotides and encodes a 175 amino acid protein. The reference dog AGR2 protein sequence corresponds to SEQ ID NO: 6.

[0084] Alternatives names for AGR2 include “Anterior Gradient 2 Protein”, “AG-2”, “AG2”, “HPC8”, “GOB-4”, “HAG-2”, “XAG-2”, “PADIA17”, “HEL-S-116”, “Protein Disulfide Isomerase Family A Member 17”, and “Secreted cement gland protein XAG-2 homolog” as non-limiting examples. Herein, the expressions “Anterior Gradient 2 Protein” and “AGR2” and “AG-2” are used indifferently.

[0085] In the context of the invention, AGR2 refers to the human AGR2 as well as any homologous protein in any animal species. For instance, AGR2 refers to any homologous sequence corresponding to SEQ ID NO: 1, SEQ ID NO: 2, SEQ ID NO: 3, SEQ ID NO: 4, SEQ ID NO: 5, SEQ ID NO: 6 or SEQ ID NO: 43 in any other species.

[0086] AGR2 protein has an N-terminal signal peptide sequence, a catalytically active thioredoxin domain, and a C-terminal ER-retention sequence. AGR2 plays a role in cell migration, cellular transformation and metastasis and up-regulates DUSP10, which subsequently inhibits p38 MAPK and prevents p53 activation by phosphorylation. As an ER-localized molecular chaperone, it plays a role in the folding, trafficking, and assembly of cysteine-rich transmembrane receptors and the cysteine-rich intestinal glycoprotein mucin. Extracellular (or secreted) AGR2 also displays proinflammatory and profibrotic activities.

[0087] AGR2 protein can be found in different localizations: it may be intracellular or extracellular, either bound to the cell surface or in a circulating (secreted) form.

[0088] The present invention firstly relates to an isolated antibody, or to a binding fragment thereof, that specifically binds to Anterior Gradient 2 protein (AGR2).

[0089] An “isolated antibody”, as used herein, is intended to refer to an antibody that is modified or removed from its natural state. In particular, an isolated antibody may be substantially free of other antibodies having different antigenic specificities (e.g., an isolated antibody that specifically binds AGR2 is substantially free of antibodies thatspecifically bind antigens other than AGR2). An isolated antibody that specifically binds AGR2 may, however, have cross-reactivity to other antigens, such as AGR2 molecules from other species. Moreover, an isolated antibody may be substantially free of other cellular material and / or chemicals, in particular those that would interfere with therapeutic uses of the antibody, including without limitation, enzymes, hormones, and other proteinaceous or non-proteinaceous components.

[0090] Preferably, the isolated antibody, or binding fragment thereof, is purified. For instance, the isolated antibody, or binding fragment thereof, is purified to greater than 80%, 85%, 90%, 91%, 92%, 93%, 94%, 95% or more by weight of protein.

[0091] The isolated antibody, or binding fragment thereof, of the invention specifically binds to AGR2.

[0092] The isolated antibody, or binding fragment thereof, of the invention specifically binds to all forms of AGR2, in particular to intracellular AGR2, extracellular AGR2 (z.e., expressed on the cell surface) and circulating AGR2 (z.e., secreted in the extracellular environment).

[0093] In particular, the isolated antibody, or binding fragment thereof, of the invention does not specifically bind to AGR3.

[0094] The humanAGR2 and AGR3 genes map to chromosome band 7p21.3. The AGR2 and AGR3 proteins are clustered together by phylogenetic analysis and share 65% sequence identity. AGR3 is the closest family member to AGR2.As used herein, an antibody, or binding fragment thereof, is said to be “specific for”, “immunospecific for”, or to “specifically bind” an antigen if it reacts at a detectable level with said antigen (e.g., AGR2), preferably with an affinity constant (KA) greater than or equal to about 106M’1, preferably greater than or equal to about 107M-1, 108M’1, 5xl08M-1, 109M’1, 5xl09M'1or more. Affinity of an antibody, or binding fragment thereof, for its cognate antigen is also commonly expressed as an equilibrium dissociation constant (KD). An antibody, or binding fragment thereof, is said to be “specific for” or to “specifically bind” an antigen if it reacts at a detectable level with said antigen (e.g., AGR2), preferably with a KD of less than or equal to 10'6M, preferably less than or equal to 10'7M, 5x1 O'8M, 10'8M,5x1 O'9M, 10'9M or less. Affinities of antibodies, or binding fragment thereof, can be readily determined using conventional techniques, for example, those described by Scatchard, 1949. Ann NY Acad Sci. 51 :660-672. Binding properties of an antibody, or binding fragment thereof, to antigens, cells or tissues may generally be determined and assessed using immunodetection methods including, for example, ELISA, immunofluorescence-based assays, such as immuno-histochemistry (IHC) and / or fluorescence-activated cell sorting (FACS) or by surface plasmon resonance (SPR, e.g., using BIAcore®).

[0095] In some embodiments, the isolated antibody, or binding fragment thereof, that specifically binds to AGR2 of the invention recognizes and is capable to bind to a soluble (i.e., not membrane bound) AGR2 protein. In some embodiments, the isolated antibody, or binding fragment thereof, that specifically binds to AGR2 of the invention recognizes and is capable to bind to a membrane-bound AGR2 protein.

[0096] In some embodiments, the isolated antibody, or binding fragment thereof, that specifically binds to AGR2 of the invention recognizes and binds to monomeric AGR2. In some embodiments, the isolated antibody, or binding fragment thereof, of the invention recognizes and binds to human AGR2 of SEQ ID NO: 1 comprising a mutation consisting of the glutamic acid residue at position 60 being substituted by an alanine residue. In some embodiments the isolated antibody, or binding fragment thereof, that specifically binds to AGR2 of the invention recognizes and binds to dimeric AGR2. In some embodiments, the isolated antibody, or binding fragment thereof, that specifically binds to AGR2 of the invention recognizes and binds both monomeric and dimeric forms of the human AGR2 protein with the same affinity.

[0097] The isolated antibody, or binding fragment thereof, of the invention recognizes and binds to a human AGR2 protein. Preferably, the isolated antibody, or binding fragment thereof, that specifically binds to AGR2 also binds to one or more homologous AGR2 protein(s) from another species. For instance, the isolated antibody, or binding fragment thereof, that specifically binds to AGR2 may also bind to one or more AGR2 protein(s) selected from a mouse AGR2 protein, a rhesus monkey AGR2 protein, a chimpanzee AGR2 protein, a rat AGR2 protein or a dog AGR2 protein.

[0098] In some embodiments, the isolated antibody, or binding fragment thereof, that specifically binds to AGR2 of the invention recognizes and binds to a mouse AGR2 protein. In some embodiments, the isolated antibody, or binding fragment thereof, that specifically binds to AGR2 of the invention recognizes and binds to a rhesus monkey AGR2 protein. In some embodiments, the isolated antibody, or binding fragment thereof, that specifically binds to AGR2 of the invention recognizes and binds to a chimpanzee AGR2 protein. In some embodiments, the isolated antibody, or binding fragment thereof, that specifically binds to AGR2 of the invention recognizes and binds to a rat AGR2 protein. In some embodiments, the isolated antibody, or binding fragment thereof, that specifically binds to AGR2 of the invention recognizes and binds to a dog AGR2 protein.

[0099] The isolated antibody of the invention, or binding fragment thereof, recognizes and binds to the human AGR2 protein of sequence SEQ ID NO: 1. Preferably, the isolated antibody, or binding fragment thereof, that specifically binds to AGR2 also binds to one or more AGR2 protein(s) of sequence SEQ ID NO: 2, SEQ ID NO: 3, SEQ ID NO: 4, SEQ ID NO: 5, SEQ ID NO: 6 and / or SEQ ID NO: 43.

[0100] In some embodiments, the isolated antibody, or binding fragment thereof, that specifically binds to AGR2 of the invention recognizes and binds to a mouse AGR2 protein of SEQ ID NO: 2. In some embodiments, the isolated antibody, or binding fragment thereof, that specifically binds to AGR2 of the invention recognizes and binds to a rhesus monkey AGR2 protein of SEQ ID NO: 3. In some embodiments, the isolated antibody, or binding fragment thereof, that specifically binds to AGR2 of the invention recognizes and binds to a chimpanzee AGR2 protein of SEQ ID NO: 4. In some embodiments, the isolated antibody, or binding fragment thereof, that specifically binds to AGR2 of the invention recognizes and binds to a rat AGR2 protein of SEQ ID NO: 5. In some embodiments, the isolated antibody, or binding fragment thereof, that specifically binds to AGR2 of the invention recognizes and binds to a dog AGR2 protein of SEQ ID NO: 6. In some embodiments, the isolated antibody, or binding fragment thereof, that specifically binds to AGR2 of the invention recognizes and binds to a monomeric AGR2 protein of SEQ ID NO: 7. In some embodiments, the isolated antibody, or bindingfragment thereof, that specifically binds to AGR2 of the invention recognizes and binds to a monomeric AGR2 protein of SEQ ID NO: 43.

[0101] In some embodiments, the isolated antibody, or binding fragment thereof, that specifically binds to AGR2 of the invention recognizes and is capable to bind to an AGR2 variant, preferably a variant of a human AGR2 protein, a variant of a mouse AGR2 protein, a variant of a rhesus monkey AGR2 protein, a variant of a chimpanzee AGR2 protein, a variant of a rat AGR2 protein, and / or a variant of a dog AGR2 protein.

[0102] A "variant" or "derivative" protein is defined as having a sequence identical to at least 80%, preferably at least 85%, more preferably at least 90%, even at least 95%, 96%, 97%, 98% or 99% of the reference sequence.

[0103] These variant sequences may differ from the reference sequence by substitution, deletion and / or insertion of one or more amino acids. The substitutions may in particular correspond to conservative substitutions or to substitutions of natural amino acids by nonnatural amino acids or pseudo amino acids.

[0104] By "amino acid sequence having (for instance) at least 80% of identity with a reference sequence" is meant herein a sequence identical to the reference sequence but this sequence may comprise up to twenty mutations (substitutions, deletions and / or insertions) per each part of one hundred amino acids of the reference sequence. Therefore, for a reference sequence of 100 amino acids, a fragment of 80 amino acids and a sequence of 100 amino acids comprising 20 substitutions compared with the reference sequence are two examples of sequences having 80% sequence identity with the reference sequence.

[0105] Percentage of identity is generally determined using sequence analysis software (for example the Sequence Analysis Software Package of the Genetics Computer Group, University of Wisconsin Biotechnology Center, 1710 University Avenue, Madison, Wis. 53705). The amino acid sequences to be compared are aligned to obtain maximum percentage identity. For this purpose, it may be necessary to artificially add gaps in the sequence. The alignment can be performed manually or automatically. Automated alignment algorithms of nucleotide sequences are well known to persons skilled in the artand described for example in Altschul et al. (1997) Nucleic Acids Res. 25:3389 and implemented by softwares such as the Blast software. One algorithm which can be isolated is the Needleman-Wunsch algorithm for example (Needleman and Wunsch (1970) J Mol Biol. 48:443-53). Once optimal alignment has been achieved, the percentage identity is established by recording all the positions at which the amino acids of the two compared sequences are identical, compared with the total number of positions.

[0106] In particular embodiments, the sequence of the AGR2 protein differs from the reference sequence solely through the presence of conservative substitutions. Conservative substitutions are substitutions of amino acids of the same class, such as substitutions of amino acids with non-charged side chains (such as asparagine, glutamine, serine, cysteine, and tyrosine), of amino acids with basic side chains (such as lysine, arginine and histidine), of amino acids with acid side chains (such as aspartic acid and glutamic acid), of amino acids with non-polar side chains (such as alanine, valine, leucine, isoleucine, proline, phenylalanine, methionine and tryptophan).

[0107] Preferably, a variant of AGR2 refers to an AGR2 protein having a sequence wherein at most 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 15, 20, 25 or 35 amino acids are deleted, added, or substituted as compared to the original protein sequence. In some embodiments, a variant protein of AGR2 refers to an AGR2 protein having a sequence wherein at most 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 15, 20, 25 or 35 amino acids are deleted, added or substituted as compared to the sequence of SEQ ID NO: 1, SEQ ID NO: 2, SEQ ID NO: 3, SEQ ID NO: 4, SEQ ID NO: 5, SEQ ID NO: 6 or SEQ ID NO: 43.

[0108] According to the invention, the polypeptides may be modified chemically or enzymatically to improve their stability or bioavailability. Such chemical or enzymatic modifications are well known to those skilled in the art. Mention may be made of the following modifications, but they are not limited thereto:- modifications of the C-terminal or N-terminal end of the polypeptides such as N- terminal deamination or acylation (preferably acetylation) or such as C-terminal amidation or esterification;- modifications of the amide bond between two amino acids, such as acylation (preferably acetylation) or alkylation at the nitrogen or alpha carbon;- changes in chirality, such as the substitution of a natural amino acid (L- enantiomer) by the corresponding D-enantiomer; this modification may optionally be accompanied by inversion of the side chain (from the C-terminal end to the N-terminal end);- changes to azapeptides, in which one or more alpha carbons are replaced by nitrogen atoms; and / or- changes to betapeptides, in which one or more carbons are added on the N-alpha side or on the C-alpha side of the main chain.

[0109] In this respect, it is possible to modify one or more of the lysine amino acids (K) of the polypeptides, notably by:- amidation: this modification is simple to achieve, the positive charge of the lysine being substituted by hydrophobic groups (for example acetyl or phenylacetyl);- amination: by formation of secondary amide from the primary amine R = (CH2)4- NH3+, for example by forming N-methyl, N-allyl or N-benzyl groups; and- by formation of N-oxide, N-nitroso, N-dialkyl phosphoryl, N-sulfenyl, or N- glycoside groups.

[0110] It is also or alternatively possible to modify one or more threonine (T) and / or serine (S) amino acids of the polypeptides, notably by adding an ester or ether group at the OH group of the side chain of threonine and / or serine. Esterification, a simple operation, can be performed using a carboxylic acid, an anhydride, by bridging, etc., to form acetates or benzoates. Etherification, which gives more stable compounds, can be performed using an alcohol, a halide, etc. to form a methyl ether for example or an O- glycoside.

[0111] It is also or alternatively possible to modify one or more glutamine (Q) amino acids for example by amidation, by forming secondary or tertiary amines, in particular with groups of methyl, ethyl type, whether or not functionalized.

[0112] It is also or alternatively possible to modify one or more glutamate (E) and / or aspartate (D) amino acids, for example:- by esterification, to form methyl esters, whether or not substituted, ethyl esters, benzyl esters, thiols (activated esters); and- by amidation, notably to form N, N dimethyl groups, nitroanilides, pyrrolidinyls.

[0113] In some embodiments, the isolated antibody, or binding fragment thereof, of the invention comprises chemical modifications of one or more:- methionine (M) and / or tryptophan (W) by oxidation,- asparagine (N) by deamidation, and / or- aspartic acid (D) by isomerization.

[0114] On the other hand, it is preferable not to modify the proline amino acids, which take part in the secondary structure of the polypeptides.

[0115] In some embodiments, the isolated antibody, or binding fragment thereof, that specifically binds to AGR2 of the invention recognizes and is capable to bind to an AGR2 fragment, preferably a fragment of a human AGR2 protein, a fragment of a mouse AGR2 protein, a fragment of a rhesus monkey AGR2 protein, a fragment of a chimpanzee AGR2 protein, a fragment of a rat AGR2 protein, and / or a fragment of a dog AGR2 protein.

[0116] As used herein, the term “fragment” of an antigen refers to any subset of an antigen, as a shorter peptide. In some embodiments, a fragment of an antigen is a peptide of at least 6 amino acids in length. In some embodiments, a fragment of an antigen is a peptide of 6 to 50 amino acids in length, of 6 to 30 amino acids, or of 6 to 20 amino acids in length.

[0117] The isolated antibody, or binding fragment thereof, that specifically binds to AGR2 of the invention may be polyclonal or monoclonal.

[0118] Preferably, the isolated antibody, or binding fragment thereof, that specifically binds to AGR2 is monoclonal.

[0119] The isolated antibody that specifically binds to AGR2 of the invention may be a whole antibody or a binding fragment of an antibody. Preferably, the isolated antibody that specifically binds to AGR2 is a whole antibody.

[0120] The antigen-binding fragment that specifically binds to AGR2 of the invention may be a molecule selected from the group comprising or consisting of a single-chain antibody, a dimeric single chain antibody, a single-domain antibody, a Fv, a Fab, a Fab', a Fab'-SH, a F(ab)’2, a Fd, a defucosylated antibody, a bi-specific antibody, a diabody, a triabody and a tetrabody.

[0121] The antigen-binding fragment that specifically binds to AGR2 of the invention may be a single-chain antibody. In some embodiments, the single-chain antibody is selected from the group comprising or consisting of a single-chain variable fragment (scFv), a tandem-di-scFv, a tandem-tri-scFv, a scFv-Fc, a (scFv-CH3)2 (also termed minibody), a (scFv-CH2-CH3)2 (also termed maxibody), a diabody, and a triabody.

[0122] The term “binding fragment”, as used herein, refers to a part or region of the antibody according to the present invention, which comprises fewer amino acid residues than the whole antibody. A “binding fragment” binds antigen and / or competes with the whole antibody from which it was derived for antigen binding (e.g., specific binding to AGR2). Antibody binding fragments encompasses, without any limitation, single chain antibodies, Fv, Fab, Fab', Fab'-SH, F(ab)’2, Fd, defucosylated antibodies, diabodies, triabodies and tetrabodies.

[0123] “Single chain antibody”, as used herein, refers to any antibody or fragment thereof that is a protein having a primary structure comprising or consisting of one uninterrupted sequence of contiguous amino acid residues, including without limitation (1) single-chain Fv molecules (scFv); (2) single chain proteins containing only one light chain variable domain, or a fragment thereof that contains the three CDRs of the light chain variable domain, without an associated heavy chain moiety; and (3) single chain proteins containing only one heavy chain variable region, or a fragment thereof containing the three CDRs of the heavy chain variable region, without an associated light chain moiety.

[0124] “Single-chain Fv”, also abbreviated as “sFv” or “scFv”, refers to antibody fragments that comprise the VH and VL antibody domains connected into a single amino acid chain. Preferably, the scFv amino acid sequence further comprises a peptide linker between the VH and VL domains that enables the scFv to form the desired structure for antigen binding.

[0125] “Fv”, as used herein, refers to the minimum antibody fragment that contains a complete antigen-recognition and -binding site. This fragment consists of a dimer of one HCVR and one LCVR in tight, non-covalent association. From the folding of these two domains emanate six hypervariable loops (three loops each from the heavy and light chain) that contribute to antigen binding and confer antigen binding specificity to the antibody. However, even a single variable domain (or half of an Fv comprising only three CDRs specific for an antigen) has the ability to recognize and bind antigen, although at a lower affinity than the entire binding site.

[0126] “Diabodies”, as used herein, refers to small antibody fragments prepared by constructing scFv fragments with short linkers (about 5-10 residues) between the HCVR and LCVR such that inter-chain but not intra-chain pairing of the variable domains is achieved, resulting in a bivalent fragment, z.e., fragment having two antigen-binding sites. Bispecific diabodies are heterodimers of two “crossover” scFv fragments in which the HCVR and LCVR of the two antibodies are present on different polypeptide chains.

[0127] Antibody binding fragments can be obtained using standard methods. For instance, Fab or F(ab')2 fragments may be produced by protease digestion of the isolated antibodies, according to conventional techniques.

[0128] In some embodiments, the antibody or binding fragment thereof according to the present invention is a molecule selected from the group comprising or consisting of a unibody, a domain antibody, and a nanobody.

[0129] “Unibodies” refer to antibody fragments lacking the hinge region of IgG4 antibodies. The deletion of the hinge region results in a molecule that is essentially half the size of traditional IgG4 antibodies and has a univalent binding region rather than the bivalent biding region of IgG4 antibodies.

[0130] “Domain antibodies” refer to the smallest functional binding units of antibodies, corresponding to the variable regions of either the heavy or light chains of antibodies.

[0131] “Single-domain antibodies” refer to antibody-derived proteins that contain the unique structural and functional properties of naturally-occurring heavy chain antibodies. These heavy chain antibodies may contain a single variable domain (VHH) - one such example is nanobodies®or a single variable domain (VHH) and two constant domains (CH2 and CH3) - such as camelid antibodies- or a single variable domain (VHH) and five constant domains (CHI, CH2, CH3, CH4 and CH5) - such as shark antibodies.

[0132] In one embodiment, the antibody or binding fragment thereof according to the present invention is a mimetic selected from the group comprising or consisting of an affibody, an affilin, an affitin, an adnectin, an atrimer, an evasin, a DARPin, an anticalin, an avimer, a fynomer, a versabody and a duocalin.

[0133] “Affibodies” refer to affinity proteins based on a 58 amino acid residue protein domain, derived from one of the IgG binding domain of staphylococcal protein A.

[0134] “DARPins” (Designed Ankyrin Repeat Proteins) refer to an antibody mimetic DRP (designed repeat protein) technology developed to exploit the binding abilities of non-antibody proteins.

[0135] “Anticalins” refer to another antibody mimetic technology, wherein the binding specificity is derived from lipocalins. Anticalins may also be formatted as dual targeting protein, called “duocalins”.

[0136] “Avimers” refer to another antibody mimetic technology.

[0137] “Versabodies” refer to another antibody mimetic technology. They are small proteins of 3-5 kDa with >15% cysteines, which form a high disulfide density scaffold, replacing the hydrophobic core the typical proteins have. The replacement of a large number of hydrophobic amino acids, comprising the hydrophobic core, with a small number of disulfides results in a protein that is smaller, more hydrophilic (less aggregation and non-specific binding), more resistant to proteases and heat, and has a lower density of T cell epitopes, because the residues that contribute most to MHCpresentation are hydrophobic. All four of these properties are well-known to affect immunogenicity, and together they are expected to cause a large decrease in immunogenicity.

[0138] In some embodiments, the antibody or binding fragment thereof according to the present invention also encompasses multispecific antibodies or binding fragments thereof, z.e., being immunospecific for more than one, such as at least two, different antigens, one of which being AGR2 according to the present invention.

[0139] In some embodiments, the antibody or binding fragment thereof according to the present invention also encompasses polymers of antibodies or binding fragments thereof, z.e., more than one, such as at least two, antibodies or binding fragments thereof, whether identical or different, being covalently linked together, directly or indirectly.

[0140] The isolated antibody, or binding fragment thereof, that specifically binds to AGR2 of the invention is humanized.

[0141] The complementary-determining regions (CDRs) are herein determined using the Kabat numbering system.

[0142] The isolated antibody, or binding fragment thereof, that specifically binds to AGR2 of the present invention comprises: a heavy chain variable region (abbreviated herein as VH) comprising the following three CDRs:VH CDR1: DYWMS (SEQ ID NO: 8);VH CDR2: DIKFDGSFTNYAPSLKN (SEQ ID NO: 9);VH CDR3: EANYPGLTFDY (SEQ ID NO: 10); and a light chain variable region (abbreviated herein as VL) comprising the following three CDRs:VL CDR1 : XASEGISNYLA (SEQ ID NO: 11) wherein X is L or R;VL CDR2: YASSLQD (SEQ ID NO: 14); andVL CDR3: QQSYKYPLT (SEQ ID NO: 15).

[0143] Preferably, the isolated antibody, or binding fragment thereof, that specifically binds to AGR2 comprises: a heavy chain variable region (abbreviated herein as VH) comprising the following three CDRs:VH CDR1: DYWMS (SEQ ID NO: 8);VH CDR2: DIKFDGSFTNYAPSLKN (SEQ ID NO: 9); andVH CDR3: EANYPGLTFDY (SEQ ID NO: 10); or a set of 3 CDRs having amino acid sequences at least 85%, 90% or 95% identical to SEQ ID NO: 8, 9 and 10; and a light chain variable region (abbreviated herein as VL) comprising the following three CDRs:VL CDR1 : LASEGISNYLA (SEQ ID NO: 12) or RASEGISNYLA (SEQ ID NO: 13);VL CDR2: YASSLQD (SEQ ID NO: 14);VL CDR3: QQSYKYPLT (SEQ ID NO: 15); or a set of 3 CDRs having amino acid sequences at least 85%, 90% or 95% identical to SEQ ID NO: 12 or 13, 14 and 15.

[0144] By “a set of 3 CDRs having amino acid sequences at least 85%, 90% or 95% identical to SEQ ID NO:” it is meant a set of 3 CDRs wherein:VH CDR1 as an amino acid sequence at least 85%, 90% or 95% identical to SEQ ID NO: 8;VH CDR2 as an amino acid sequence at least 85%, 90% or 95% identical to SEQ ID NO: 9; andVH CDR3 as an amino acid sequence at least 85%, 90% or 95% identical to SEQ ID NO: 10.

[0145] By “a set of 3 CDRs having amino acid sequences at least 85%, 90% or 95% identical to SEQ ID NO:” it is meant a set of 3 CDRs wherein:VL CDR1 as an amino acid sequence at least 85%, 90% or 95% identical to SEQ ID NO: 12 or 13;VL CDR2 as an amino acid sequence at least 85%, 90% or 95% identical to SEQID NO: 14; andVL CDR3 as an amino acid sequence at least 85%, 90% or 95% identical to SEQ ID NO: 15.

[0146] Preferably, the isolated antibody, or binding fragment thereof, that specifically binds to AGR2 comprises: a heavy chain variable region (abbreviated herein as VH) comprising the following three CDRs:VH CDR1: DYWMS (SEQ ID NO: 8);VH CDR2: DIKFDGSFTNYAPSLKN (SEQ ID NO: 9);VH CDR3: EANYPGLTFDY (SEQ ID NO: 10); and a light chain variable region (abbreviated herein as VL) comprising the following three CDRs:VL CDR1 : LASEGISNYLA (SEQ ID NO: 12) or RASEGISNYLA (SEQ IDNO: 13);VL CDR2: YASSLQD (SEQ ID NO: 14);VL CDR3: QQSYKYPLT (SEQ ID NO: 15).

[0147] Preferably, the isolated antibody, or binding fragment thereof, that specifically binds to AGR2 comprises: a heavy chain variable region (abbreviated herein as VH) comprising the following three CDRs:VH CDR1: DYWMS (SEQ ID NO: 8);VH CDR2: DIKFDGSFTNYAPSLKN (SEQ ID NO: 9);VH CDR3: EANYPGLTFDY (SEQ ID NO: 10); and a light chain variable region (abbreviated herein as VL) comprising the following three CDRs:VL CDR1 : LASEGISNYLA (SEQ ID NO: 12);VL CDR2: YASSLQD (SEQ ID NO: 14);VL CDR3: QQSYKYPLT (SEQ ID NO: 15).

[0148] Preferably, the isolated antibody, or binding fragment thereof, that specifically binds to AGR2 comprises: a heavy chain variable region (abbreviated herein as VH) comprising the following three CDRs:VH CDR1: DYWMS (SEQ ID NO: 8);VH CDR2: DIKFDGSFTNYAPSLKN (SEQ ID NO: 9);VH CDR3: EANYPGLTFDY (SEQ ID NO: 10); and a light chain variable region (abbreviated herein as VL) comprising the following three CDRs:VL CDR1 : RASEGISNYLA (SEQ ID NO: 13);VL CDR2: YASSLQD (SEQ ID NO: 14);VL CDR3: QQSYKYPLT (SEQ ID NO: 15).

[0149] The heavy chain and light chain variable domains (VH and VL) are herein determined using the Kabat numbering system.

[0150] In some embodiments, the isolated antibody, or binding fragment thereof, that specifically binds to AGR2 comprises: a VH comprising or consisting of a sequence at least 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99% identical to SEQ ID NO: 16; and a VL comprising or consisting of a sequence at least 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99% identical to SEQ ID NO: 19; or a VH comprising or consisting of a sequence at least 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99% identical to SEQ ID NO: 16; and a VL comprising or consisting of a sequence at least 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99% identical to SEQ ID NO: 20; or a VH comprising or consisting of a sequence at least 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99% identical to SEQ ID NO: 16; and a VL comprising or consisting of a sequence at least 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99% identical to SEQ ID NO: 21.

[0151] In some embodiments, the isolated antibody, or binding fragment thereof, that specifically binds to AGR2 comprises: a heavy chain variable region (VH) comprising framework regions sharing at least 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99% sequence identity with the framework regions of SEQ ID NO: 16; and a light chain variable region (VL) comprising framework regions sharing at least 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99% sequence identity with the framework regions of SEQ ID NO: 19; or a heavy chain variable region (VH) comprising framework regions sharing at least 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99% sequence identity with the framework regions of SEQ ID NO: 16; and a light chain variable region (VL) comprising framework regions sharing at least 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99% sequence identity with the framework regions of SEQ ID NO: 20; or a heavy chain variable region (VH) comprising framework regions sharing at least 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99% sequence identity with the framework regions of SEQ ID NO: 16; and a light chain variable region (VL) comprising framework regions sharing at least 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99% sequence identity with the framework regions of SEQ ID NO: 21.

[0152] Preferably, the isolated antibody, or binding fragment thereof, that specifically binds to AGR2 of the invention comprises: a VH comprising or consisting of the sequence SEQ ID NO: 16 and a VL comprising or consisting of the sequence SEQ ID NO: 19; or a VH comprising or consisting of the sequence SEQ ID NO: 16 and a VL comprising or consisting of the sequence SEQ ID NO: 20; or a VH comprising or consisting of the sequence SEQ ID NO: 16 and a VL comprising or consisting of the sequence SEQ ID NO: 21.

[0153] The fragment crystallizable (Fc) region of the isolated antibody that specifically binds to AGR2 may comprise at least one mutation reducing the antibody effector functions.

[0154] In some embodiments the isolated antibody that specifically binds to AGR2 is a Fc-silenced antibody.

[0155] As used herein “Fc-silenced antibody” refers to an antibody bearing a modification in the immunoglobulin Fc region in order to greatly reduce or eliminate the binding of immunoglobulin Fc to Fc gamma receptors (FcyR).

[0156] As used herein “EU numbering” refers to the numbering of the constant domains of the heavy and light chains of the human gamma G1 immunoglobulin (IgGl) as defined by Edelman et al. (Proc Natl Acad Sci USA, 63(1) :78-85, 1969). In this numbering, the first amino acid residue of the constant domain of the heavy chain is an alanine residue and is numbered at position 118, while the first amino acid residue of the constant domain of the light kappa chain is an arginine residue and is numbered at position 108.

[0157] In some embodiments, the isolated antibody that specifically binds to AGR2 of the present invention comprises a heavy chain constant region of an IgGl and a heavy chain constant region sequence comprising mutations consisting of the leucine residue at position 234 in the EU numbering (corresponding to position 117 of SEQ ID NO: 22) being substituted by an alanine residue, and the leucine residue at position 235 in the EU numbering (corresponding to position 118 of SEQ ID NO: 22) being substituted by an alanine residue (L234A and L235A).

[0158] In some embodiments, the isolated antibody that specifically binds to AGR2 of the present invention comprises a heavy chain constant region of an IgGl and a heavy chain constant region sequence comprising mutations consisting of the leucine residue at position 234 in the EU numbering (corresponding to position 117 of SEQ ID NO: 22) being substituted by a phenylalanine residue, the leucine residue at position 235 in the EU numbering (corresponding to position 118 of SEQ ID NO: 22) being substituted by a glutamic acid residue, and the proline residue at position 331 in the EU numbering(corresponding to position 214 of SEQ ID NO: 22) being substituted by a serine residue (L234F, L235E and P331S).

[0159] In some embodiments, the isolated antibody that specifically binds to AGR2 of the present invention comprises a heavy chain constant region of an IgG4.

[0160] In some embodiments, the isolated antibody that specifically binds to AGR2 of the invention comprises: a heavy chain constant region having a sequence comprising or consisting of sequence SEQ ID NO: 22, or a sequence at least 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99% identical to SEQ ID NO: 22; and a light chain constant region having a sequence comprising or consisting of sequence SEQ ID NO: 26, or a sequence at least 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99% identical to SEQ ID NO: 26.

[0161] In some embodiments, the isolated antibody that specifically binds to AGR2 of the invention comprises: a heavy chain constant region having a sequence comprising or consisting of sequence SEQ ID NO: 22; and a light chain constant region having a sequence comprising or consisting of sequence SEQ ID NO: 26.

[0162] In some embodiments, the isolated antibody that specifically binds to AGR2 of the invention comprises: a heavy chain constant region having a sequence comprising or consisting of sequence SEQ ID NO: 23, or a sequence at least 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99% identical to SEQ ID NO: 23; and a light chain constant region having a sequence comprising or consisting of sequence SEQ ID NO: 26, or a sequence at least 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99% identical to SEQ ID NO: 26.

[0163] In some embodiments, the isolated antibody that specifically binds to AGR2 of the invention comprises: a heavy chain constant region having a sequence comprising or consisting of sequence SEQ ID NO: 23; and a light chain constant region having a sequence comprising or consisting of sequence SEQ ID NO: 26.

[0164] In some embodiments, the isolated antibody that specifically binds to AGR2 of the invention comprises: a heavy chain constant region having a sequence comprising or consisting of sequence SEQ ID NO: 24, or a sequence at least 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99% identical to SEQ ID NO: 24; and a light chain constant region having a sequence comprising or consisting of sequence SEQ ID NO: 26, or a sequence at least 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99% identical to SEQ ID NO: 26.

[0165] In some embodiments, the isolated antibody that specifically binds to AGR2 of the invention comprises: a heavy chain constant region having a sequence comprising or consisting of sequence SEQ ID NO: 24; and a light chain constant region having a sequence comprising or consisting of sequence SEQ ID NO: 26.

[0166] In some embodiments, the isolated antibody that specifically binds to AGR2 of the invention comprises: a heavy chain constant region having a sequence comprising or consisting of sequence SEQ ID NO: 25, or a sequence at least 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99% identical to SEQ ID NO: 25; and a light chain constant region having a sequence comprising or consisting of sequence SEQ ID NO: 26, or a sequence at least 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99% identical to SEQ ID NO: 26.

[0167] In some embodiments, the isolated antibody that specifically binds to AGR2 of the invention comprises: a heavy chain constant region having a sequence comprising or consisting of sequence SEQ ID NO: 25; and a light chain constant region having a sequence comprising or consisting of sequence SEQ ID NO: 26.

[0168] In some embodiments, the isolated antibody that specifically binds to AGR2 comprises: a heavy chain having a sequence consisting of sequence SEQ ID NO: 27 or 30, or a sequence at least 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99% identical to SEQ ID NO: 27 or 30; and a light chain having a sequence consisting of anyone of sequence SEQ ID NO: 33-35, or a sequence at least 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99% identical to anyone of SEQ ID NO: 33-35.

[0169] In some embodiments, the isolated antibody that specifically binds to AGR2 comprises: a heavy chain having a sequence consisting of sequence SEQ ID NO: 27 or SEQ ID NO: 30; and a light chain having a sequence consisting of sequence SEQ ID NO: 33.

[0170] In some embodiments, the isolated antibody that specifically binds to AGR2 comprises: a heavy chain having a sequence consisting of sequence SEQ ID NO: 27 or SEQ ID NO: 30; and a light chain having a sequence consisting of sequence SEQ ID NO: 34.

[0171] In some embodiments, the isolated antibody that specifically binds to AGR2 comprises: a heavy chain having a sequence consisting of sequence SEQ ID NO: 27 or SEQ ID NO: 30; and a light chain having a sequence consisting of sequence SEQ ID NO: 35.

[0172] The isolated antibody, or binding fragment thereof, of the invention possesses anti-inflammatory functions. For instance, the isolated antibody, or binding fragment thereof, of the invention can inhibit the recruitment of monocytes induced by eAGR2.

[0173] The isolated antibody, or binding fragment thereof, of the invention possesses anti-fibrotic functions. In particular, the isolated antibody, or binding fragment thereof, of the invention can block the differentiation of fibroblasts into myofibroblasts.

[0174] The isolated antibody, or binding fragment thereof, of the invention possesses reduced effector functions. In particular, the isolated antibody, or binding fragment thereof, of the invention exhibits reduced binding to Fc receptors and / or reduced binding to complement components.

[0175] As used herein the term “reduced effector functions” for instance refers to reduced antibody-dependent cellular cytotoxicity (ADCC) and reduced complement dependent cytotoxicity (CDC).

[0176] Thus, the isolated antibody, or binding fragment thereof, of the invention has the following (non-exhaustive) advantages:- it specifically binds to AGR2 with a high affinity and does not cross-react with AGR3,- it specifically binds to AGR2 of various species (for instance human, mouse, dog, macaque, rat...),- it specifically binds to both soluble AGR2 protein, to membrane-bound AGR2 protein, as well as to intracellular AGR2 protein,- it specifically binds to both the monomeric form and the dimeric form of AGR2,- it displays anti-inflammatory and / or anti-fibrotic activities,- it displays anti-proliferative and / or anti-metastatic activities, and- it preserves the mucus-secreting cells and / or is involved in the regeneration of the epithelium.

[0177] In some embodiments, the isolated antibody, or binding fragment thereof, of the invention:- inhibits AGR2-dependent epithelial colonic cell line adhesion,- inhibits AGR2-dependent colonic fibroblast migration, and / or- abrogates the AGR2-dependent inhibition of fibrin formation, while Agtuzumab fails to do so.

[0178] The isolated antibody, or binding fragment thereof, of the invention also displays improved characteristics in comparison to other anti-AGR2 antibodies, in particular in comparison to Agtuzumab, including e.g. easier production and better yield (typically, higher than 200 mg / mL compared to 50 mg / mL for Agtuzumab);- better affinity (typically having a KD value under 85 pM compared to nanomolar range for Agtuzumab); lower Kdis (typically having 2.91E-04 or 3.05E-04 or 6.19E-04 compared to 8.46E-04 for Agtuzumab); and- better thermal stability (higher melting temperature) (typically, from 78.65°C to 79.91°C compared to 69.52°C for Agtuzumab).

[0179] Another object of the invention is an isolated nucleic acid encoding an isolated antibody, or binding fragment thereof, that specifically binds to AGR2 according to the present invention.

[0180] An “isolated nucleic acid”, as used herein, is intended to refer to a nucleic acid that is substantially separated from other genome DNA sequences as well as proteins or complexes such as ribosomes and polymerases, which naturally accompany a native sequence. The term embraces a nucleic acid sequence that has been removed from its naturally occurring environment and includes recombinant or cloned DNA isolates and chemically synthesized analogues or analogues biologically synthesized by heterologous systems. A substantially pure nucleic acid includes isolated forms of the nucleic acid. Of course, this refers to the nucleic acid as originally isolated and does not exclude genes or sequences later added to the isolated nucleic acid by the hand of man.

[0181] Preferably, the isolated nucleic acid is purified.

[0182] For instance, the isolated nucleic acid is purified to:(1) greater than 80%, 85%, 90%, 91%, 92%, 93%, 94%, 95% or more by weight of nucleic acid as determined by absorbance methods or fluorescence methods (such as, e.g., by measuring the ratio of absorbance at 260 and 280 nm (A260 / 280)), and most preferably greater than 96%, 97%, 98% or 99% by weight; or(2) homogeneity as shown by agarose gel electrophoresis and using an intercalating agent such as ethidium bromide, SYBR Green, GelGreen or the like.

[0183] In some embodiments, the nucleic acid or set of nucleic acids according to the present invention comprises or consists of: a sequence encoding the VH of the antibody, or binding fragment thereof, according to the present invention; and a sequence encoding the VL of the antibody, or binding fragment thereof, according to the present invention.

[0184] In some embodiments, the nucleic acid or set of nucleic acids according to the present invention comprises or consists of: a sequence encoding the heavy chain of the antibody according to the present invention; and a sequence encoding the light chain of the antibody according to the present invention.

[0185] In some embodiments, the nucleic acid or set of nucleic acids according to the present invention comprises or consists of: a sequence encoding the VH of the antibody, or binding fragment thereof, according to the present invention, said sequence being SEQ ID NO: 16 or any sequence sharing at least 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99% or more identity with SEQ ID NO: 16 and a sequence encoding the VL of the antibody, or binding fragment thereof, according to the present invention, said sequence being SEQ ID NO: 19 or any sequence sharing at least 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99% or more identity with SEQ ID NO: 19; ora sequence encoding the VH of the antibody, or binding fragment thereof, according to the present invention, said sequence being SEQ ID NO: 16 or any sequence sharing at least 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99% or more identity with SEQ ID NO: 16 and a sequence encoding the VL of the antibody, or binding fragment thereof, according to the present invention, said sequence being SEQ ID NO: 20 or any sequence sharing at least 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99% or more identity with SEQ ID NO: 20; or a sequence encoding the VH of the antibody, or binding fragment thereof, according to the present invention, said sequence being SEQ ID NO: 16 or any sequence sharing at least 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99% or more identity with SEQ ID NO: 16 and a sequence encoding the VL of the antibody, or binding fragment thereof, according to the present invention, said sequence being SEQ ID NO: 21 or any sequence sharing at least 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99% or more identity with SEQ ID NO: 21.

[0186] In some embodiments, the nucleic acid or set of nucleic acids according to the present invention comprises or consists of: a sequence encoding the heavy chain of the antibody according to the present invention, said sequence being SEQ ID NO: 36 or any sequence sharing at least 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99% or more identity with SEQ ID NO: 36; and a sequence encoding the light chain of the antibody according to the present invention, said sequence being SEQ ID NO: 37 or any sequence sharing at least 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99% or more identity with SEQ ID NO: 37; or a sequence encoding the heavy chain of the antibody according to the present invention, said sequence being SEQ ID NO: 36 or any sequence sharing at least 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99% or more identity with SEQ ID NO: 36; and a sequence encoding the light chain of the antibody according to the present invention, said sequence being SEQ ID NO: 38 or any sequence sharing at least 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99% or more identity with SEQ ID NO: 38; ora sequence encoding the heavy chain of the antibody according to the present invention, said sequence being SEQ ID NO: 36 or any sequence sharing at least 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99% or more identity with SEQ ID NO: 36; and a sequence encoding the light chain of the antibody according to the present invention, said sequence being SEQ ID NO: 39 or any sequence sharing at least 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99% or more identity with SEQ ID NO: 39.

[0187] In some embodiments, the nucleic acid or set of nucleic acids according to the present invention comprises or consists of: a sequence encoding the heavy chain of the antibody according to the present invention, said sequence being SEQ ID NO: 42 or any sequence sharing at least 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99% or more identity with SEQ ID NO: 42; and a sequence encoding the light chain of the antibody according to the present invention, said sequence being SEQ ID NO: 37 or any sequence sharing at least 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99% or more identity with SEQ ID NO: 37; or a sequence encoding the heavy chain of the antibody according to the present invention, said sequence being SEQ ID NO: 42 or any sequence sharing at least 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99% or more identity with SEQ ID NO: 42; and a sequence encoding the light chain of the antibody according to the present invention, said sequence being SEQ ID NO: 38 or any sequence sharing at least 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99% or more identity with SEQ ID NO: 38; or a sequence encoding the heavy chain of the antibody according to the present invention, said sequence being SEQ ID NO: 42 or any sequence sharing at least 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99% or more identity with SEQ ID NO: 42; and a sequence encoding the light chain of the antibody according to the present invention, said sequence being SEQ ID NO: 39 or any sequence sharing at least 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99% or more identity with SEQ ID NO: 39.

[0188] Another object of the present invention is an expression vector comprising the nucleic acid encoding the isolated antibody, or binding fragment thereof, that specifically binds to AGR2 according to the invention.

[0189] In some embodiments, the expression vector or set of expression vectors according to the present invention comprises: a sequence encoding the VH of the antibody, or binding fragment thereof, according to the present invention, preferably operably linked to regulatory elements; a sequence encoding the VL of the antibody, or binding fragment thereof, according to the present invention, preferably operably linked to regulatory elements.

[0190] In some embodiments, the expression vector according to the present invention comprises: a sequence encoding the VH of the antibody, or binding fragment thereof, according to the present invention, said sequence being SEQ ID NO: 16 or any sequence sharing at least 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99% or more identity with SEQ ID NO: 16 and a sequence encoding the VL of the antibody, or binding fragment thereof, according to the present invention, said sequence being SEQ ID NO: 19 or any sequence sharing at least 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99% or more identity with SEQ ID NO: 19; or a sequence encoding the VH of the antibody, or binding fragment thereof, according to the present invention, said sequence being SEQ ID NO: 16 or any sequence sharing at least 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99% or more identity with SEQ ID NO: 16 and a sequence encoding the VL of the antibody, or binding fragment thereof, according to the present invention, said sequence being SEQ ID NO: 20 or any sequence sharing at least 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99% or more identity with SEQ ID NO: 20; or a sequence encoding the VH of the antibody, or binding fragment thereof, according to the present invention, said sequence being SEQ ID NO: 16 or any sequence sharing at least 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99%or more identity with SEQ ID NO: 16 and a sequence encoding the VL of the antibody, or binding fragment thereof, according to the present invention, said sequence being SEQ ID NO: 21 or any sequence sharing at least 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99% or more identity with SEQ ID NO: 21.

[0191] In some embodiments, the expression vector or set of expression vectors according to the present invention comprises: a sequence encoding the heavy chain of the isolated antibody that specifically binds to AGR2 according to the invention, preferably operably linked to regulatory elements; and a sequence encoding the light chain of the isolated antibody that specifically binds to AGR2 according to the invention, preferably operably linked to regulatory elements.

[0192] In some embodiments, the expression vector according to the present invention comprises: a sequence encoding the heavy chain of the antibody according to the present invention, said sequence being SEQ ID NO: 36 or any sequence sharing at least 70%, 75%, 80%, 85% 90%, 95%, 96%, 97%, 98%, 99% or more identity with SEQ ID NO: 36, preferably operably linked to regulatory elements; and a sequence encoding the light chain of the antibody according to the present invention, said sequence being SEQ ID NO: 37 or any sequence sharing at least 70%, 75%, 80%, 85% 90%, 95%, 96%, 97%, 98%, 99% or more identity with SEQ ID NO: 37, preferably operably linked to regulatory elements; or a sequence encoding the heavy chain of the antibody according to the present invention, said sequence being SEQ ID NO: 36 or any sequence sharing at least 70%, 75%, 80%, 85% 90%, 95%, 96%, 97%, 98%, 99% or more identity with SEQ ID NO: 36, preferably operably linked to regulatory elements; and a sequence encoding the light chain of the antibody according to the present invention, said sequence being SEQ ID NO: 38 or any sequence sharing at least 70%, 75%, 80%, 85% 90%, 95%, 96%, 97%, 98%, 99% or more identity with SEQ ID NO: 38, preferably operably linked to regulatory elements; ora sequence encoding the heavy chain of the antibody according to the present invention, said sequence being SEQ ID NO: 36 or any sequence sharing at least 70%, 75%, 80%, 85% 90%, 95%, 96%, 97%, 98%, 99% or more identity with SEQ ID NO: 36, preferably operably linked to regulatory elements; and a sequence encoding the light chain of the antibody according to the present invention, said sequence being SEQ ID NO: 39 or any sequence sharing at least 70%, 75%, 80%, 85% 90%, 95%, 96%, 97%, 98%, 99% or more identity with SEQ ID NO: 39, preferably operably linked to regulatory elements.

[0193] In some embodiments, the expression vector according to the present invention comprises: a sequence encoding the heavy chain of the antibody according to the present invention, said sequence being SEQ ID NO: 42 or any sequence sharing at least 70%, 75%, 80%, 85% 90%, 95%, 96%, 97%, 98%, 99% or more identity with SEQ ID NO: 42, preferably operably linked to regulatory elements; and a sequence encoding the light chain of the antibody according to the present invention, said sequence being SEQ ID NO: 37 or any sequence sharing at least 70%, 75%, 80%, 85% 90%, 95%, 96%, 97%, 98%, 99% or more identity with SEQ ID NO: 37, preferably operably linked to regulatory elements; or a sequence encoding the heavy chain of the antibody according to the present invention, said sequence being SEQ ID NO: 42 or any sequence sharing at least 70%, 75%, 80%, 85% 90%, 95%, 96%, 97%, 98%, 99% or more identity with SEQ ID NO: 42, preferably operably linked to regulatory elements; and a sequence encoding the light chain of the antibody according to the present invention, said sequence being SEQ ID NO: 38 or any sequence sharing at least 70%, 75%, 80%, 85% 90%, 95%, 96%, 97%, 98%, 99% or more identity with SEQ ID NO: 38, preferably operably linked to regulatory elements; or a sequence encoding the heavy chain of the antibody according to the present invention, said sequence being SEQ ID NO: 42 or any sequence sharing at least 70%, 75%, 80%, 85% 90%, 95%, 96%, 97%, 98%, 99% or more identity with SEQ ID NO: 42, preferably operably linked to regulatory elements; and a sequence encoding the light chain of the antibody according to the presentinvention, said sequence being SEQ ID NO: 39 or any sequence sharing at least 70%, 75%, 80%, 85% 90%, 95%, 96%, 97%, 98%, 99% or more identity with SEQ ID NO: 39, preferably operably linked to regulatory elements.

[0194] In some embodiments, the expression vector according to the present invention is monocistronic.

[0195] By “monocistronic”, it is meant that a single nucleic acid encoding a single protein is expressed in a single expression vector.

[0196] In some embodiments, the expression vector according to the present invention is polycistronic.

[0197] By “polycistronic”, it is meant that at least two or more nucleic acids, each encoding a single protein, are expressed in a single expression vector.

[0198] Another obj ect of the invention is a cell comprising the nucleic acid encoding the isolated antibody, or binding fragment thereof, that specifically binds to AGR2 according to the invention, or the expression vector comprising the nucleic acid encoding the isolated antibody, or binding fragment thereof, that specifically binds to AGR2 according to the invention.

[0199] In some embodiments, the cell is an Escherichia coli (E. coli) cell. In other embodiments, the cell is a Chinese hamster ovary (CHO) cell.

[0200] Another object of the invention is a method of producing and purifying the isolated antibody, or binding fragment thereof, that specifically binds to AGR2 according to the invention.

[0201] In some embodiments, the method comprises:Culturing host cells transformed with the nucleic acid or expression vector according to the present invention, under conditions suitable for expression of the isolated antibody, or binding fragment thereof, that specifically binds to AGR2; Recovering the expressed antibody, or binding fragment thereof, that specifically binds to AGR2.

[0202] This recombinant process can be used for large scale production of antibodies or binding fragments thereof, including monoclonal antibodies intended for in vitro, ex vivo and / or in vivo therapeutic and / or diagnostic uses.

[0203] These processes are well-known in the art (Subramanian (Ed.), 2004. Antibodies (1st ed., Vol. 1 : Production and Purification). New York, NY: Springer US).

[0204] In some embodiments, the expressed antibody, or binding fragment thereof, is further purified.

[0205] Methods to purify the antibody, or binding fragment thereof, according to the present invention are well-known in the art (Subramanian (Ed.), 2004. Antibodies (1st ed., Vol. 1 : Production and Purification). New York, NY: Springer US), and include, without limitation, chromatography, preferably by affinity chromatography, more preferably by affinity chromatography on protein L agarose.

[0206] In some embodiments, the antibody, or binding fragment thereof, according to the present invention is an immunoconjugate.

[0207] In some embodiments, the immunoconjugate according to the present invention is an antibody, or binding fragment thereof, conjugated to a therapeutic moiety, i.e., a drug. In some embodiments, the therapeutic moiety is selected from a cytokine, an immunomodulator, an immunosuppressant, a cytotoxin, a chemotherapeutic agent, a lytic peptide and a radioisotope. Such conjugates are referred to herein as an "antibody drug conjugates" or "ADCs".

[0208] In some embodiments, the immunoconjugate according to the present invention is a labelled antibody, or binding fragment thereof.

[0209] By “labeled”, it is meant that the isolated antibody, or binding fragment thereof, has at least one element, isotope or chemical compound conjugated or attached to it, enabling for example the detection of said isolated antibody, or binding fragment thereof.

[0210] Examples of labels include, but are not limited to, luminescent dyes (also termed fluorophores or photodetectable labels), isotopic labels (also termed radioactive labels,radiolabels or heavy isotopes), contrast agents, magnetic labels, electric labels, thermal labels, and colored labels.

[0211] Another object of the present invention is a composition comprising, consisting essentially of or consisting of: at least one isolated antibody, or binding fragment thereof, that specifically binds to AGR2 of the present invention; at least one immunoconjugate as described herein; at least one nucleic acid encoding the isolated antibody, or binding fragment thereof, that specifically binds to AGR2 as described herein; at least one expression vector comprising such a nucleic acid; or at least one host cell comprising such an expression vector.

[0212] In some embodiments, said composition is a pharmaceutical composition and further comprises at least one pharmaceutically acceptable excipient.

[0213] Consequently, another object of the present invention is a pharmaceutical composition comprising, consisting essentially of or consisting of: at least one isolated antibody, or binding fragment thereof, that specifically binds to AGR2 of the present invention; at least one immunoconjugate as described herein; at least one nucleic acid encoding the isolated antibody, or binding fragment thereof, that specifically binds to AGR2 as described herein; at least one expression vector comprising such a nucleic acid; or at least one host cell comprising such an expression vector. and at least one pharmaceutically acceptable excipient.

[0214] As used herein, “consisting essentially of’, with reference to a composition of the invention, means that the at least one isolated anti-AGR2 antibody, or binding fragment thereof, is the only agent with a biologic or therapeutic activity within said composition.

[0215] The term “pharmaceutically acceptable excipient” includes any and all solvents, dispersion media, coatings, antibacterial and antifungal agents, isotonic andabsorption delaying agents and the like. Said excipient does not produce an adverse, allergic or other untoward reaction when administered to an animal, preferably a mammal, more preferably a human. For human administration, preparations should meet sterility, pyrogenicity, and general safety and purity standards as required by regulatory offices, such as, for example, FDA Office or EMA.

[0216] Examples of pharmaceutically acceptable excipients that may be used in the compositions of the present invention include, but are not limited to, ion exchangers, alumina, aluminum stearate, lecithin, serum proteins, such as human serum albumin, buffer substances such as phosphates, glycine, sorbic acid, potassium sorbate, partial glyceride mixtures of saturated vegetable fatty acids, water, salts or electrolytes, such as protamine sulfate, disodium hydrogen phosphate, potassium hydrogen phosphate, sodium chloride, zinc salts, colloidal silica, magnesium trisilicate, polyvinyl pyrrolidone, cellulose-based substances (for example sodium carboxymethylcellulose), polyethylene glycol, polyacrylates, waxes, polyethylene- polyoxypropylene- block polymers, polyethylene glycol and wool fat.

[0217] In some embodiments, the pharmaceutical compositions according to the present invention comprise vehicles which are pharmaceutically acceptable for a formulation capable of being injected to a subject. These may be in particular isotonic, sterile, saline solutions (monosodium or disodium phosphate, sodium, potassium, calcium or magnesium chloride and the like or mixtures of such salts), or dry, especially freeze-dried compositions which upon addition, depending on the case, of sterilized water or physiological saline, permit the constitution of injectable solutions.

[0218] Another object of the present invention is a medicament comprising, consisting essentially of or consisting of: at least one isolated antibody, or binding fragment thereof, that specifically binds to AGR2 of the present invention; at least one immunoconjugate as described herein; at least one nucleic acid encoding the isolated antibody, or binding fragment thereof, that specifically binds to AGR2 as described herein; at least one expression vector comprising such a nucleic acid; orat least one host cell comprising such an expression vector.

[0219] Another object of the invention is a kit comprising: at least one isolated antibody, or binding fragment thereof, that specifically binds to AGR2 according to the present invention; at least one immunoconjugate as described herein; at least one nucleic acid encoding the isolated antibody, or binding fragment thereof, that specifically binds to AGR2 as described herein; at least one expression vector comprising such a nucleic acid; or at least one host cell comprising such an expression vector. and instructions for use.

[0220] By “kit” is intended any manufacture (e.g., a package or a container) comprising at least isolated antibody, or binding fragment thereof, that specifically binds to AGR2 according to the present invention. The kit may be promoted, distributed, or sold as a unit for performing the methods of the present invention.

[0221] AGR2 has been shown to be overexpressed in mucosal inflammatory diseases. Moreover, secretion of AGR2 monomers have been observed in inflammatory bowel disease, and specifically in Crohn’s disease. Moreover, extracellular AGR2 displays pro- inflammatory and pro-fibrotic properties.

[0222] Therefore, AGR2 is a promising therapeutic target in the context of inflammatory diseases. Indeed, AGR2 blocking agents, such as e.g., anti-AGR2 antibodies, may act at two levels in the inflammatory process involved in mucosal inflammatory diseases: 1) by blocking local monocyte recruitment, and 2) by blocking fibroblast-to-myofibroblast differentiation and thus fibrosis installation.

[0223] The present invention further relates to an isolated antibody, or binding fragment thereof, that specifically binds to AGR2 as described herein, for use as a medicament.

[0224] Another object of the present invention is a nucleic acid encoding an isolated antibody, or binding fragment thereof, that specifically binds to AGR2 as describedherein, or an expression vector comprising such a nucleic acid molecule, or a host cell comprising such an expression vector, for use as a medicament.

[0225] The present invention further relates to an isolated antibody, or binding fragment thereof, that specifically binds to AGR2 as described herein for use for treating and / or preventing mucosal inflammatory diseases in a subject in need thereof.

[0226] Another object of the present invention is a nucleic acid encoding an isolated antibody, or binding fragment thereof, that specifically binds to AGR2 as described herein, or an expression vector comprising such a nucleic acid, or a host cell comprising such an expression vector, or a composition as described herein, or a pharmaceutical composition as described herein, for use for treating and / or preventing mucosal inflammatory diseases in a subject in need thereof.

[0227] As used herein the term “inflammatory diseases” refers to a vast array of disorders and conditions that are characterized by inflammation. Symptoms of inflammatory disease can include chronic pain, swelling, redness, joint and muscle stiffness, loss of function and movement in the affected area. Inflammatory disorders refer to many heterogeneous conditions that may have the following pathophysiological characteristics: an inflammatory response to an unidentified agent that involves different tissues and organs, a response depending on genetic variability in the response characteristics of immune cells such as antigen-presenting cells, B and T lymphocytes, production of autoantibodies (natural and pathogenic autoantibodies) to the exogenous or endogenous antigen, production of antigen-specific inflammatory cells, such as lymphocytes and T- cells, production and deposition of abnormal protein and other inflammatory products in different tissues eliciting further inflammatory and immune responses, these responses include inflammation of vessels in the surrounding tissue (i.e., vasculitis) and / or production of pro-inflammatory and anti-inflammatory mediators.

[0228] The persistence of the chronic inflammatory state is thought to reflect an imbalance between proinflammatory cytokines, such as TNF-alpha, IL-1, IL-6, and GM- CSF, and anti-inflammatory cytokines, including IL- 10, and TGF-beta, whereupon a deficiency of anti-inflammatory cytokines would be consistent with a failure of immunoregulatory mechanisms. Chronic inflammatory changes may occur as a result of failure of regulatory T-cells to down-regulate the inflammatory process. Non-limiting examples of inflammatory diseases include allergy, asthma, autoimmune diseases, coeliac disease, glomerulonephritis, hepatitis, inflammatory bowel disease, preperfusion injury and transplant rejection.

[0229] As used herein, the term “mucosa” refers to the moist tissue lining body cavities which secretes mucous and covered with epithelium. Examples of mucosa tissue include, but are not limited to: oral mucosa (e.g., buccal and sublingual), nasal mucosa, eye mucosa, genital mucosa, rectal mucosa, lung mucosa, bronchial mucosa, gastric mucosa, intestinal mucosa, olfactory mucosa, uterine mucosa and esophageal mucosa.

[0230] As used herein the term “mucosal inflammatory diseases” refers to particular inflammatory diseases involving mucosal inflammation. The pathogenesis is unknown and is likely multifactorial, involving genetic susceptibility, environmental factors, microbiota, and immune system. Mucosal inflammation is characterized by atrophy of the squamous epithelium, vascular damage, ulceration and inflammatory infiltration, leading to fibrosis. It usually affects the mucous lining of the mouth, the gastrointestinal tract or the respiratory system. Non-limiting examples of mucosal inflammatory diseases include Crohn’s disease, ulcerative colitis, primary sclerosing cholangitis, chronic pancreatitis, microscopic colitis, inflammatory bowel disease (IBD), irritable bowel syndrome, endometriosis, appendicitis, asthma, idiopathic pulmonary fibrosis, systemic sclerosis associated with interstitial lung disease and chronic obstructive pulmonary disease. For instance, inflammatory bowel diseases (IBD) comprise ulcerative colitis and Crohn's disease, which are characterized by idiopathic inflammation of the gastrointestinal tract.

[0231] “Crohn’s disease”, as used herein, refers to a condition involving chronic inflammation of the gastrointestinal tract. Crohn’ s-related inflammation usually affectsthe intestines but may occur anywhere from the mouth to the anus. Crohn’s disease differs from ulcerative colitis in that the inflammation extends through all layers of the intestinal wall and involves mesentery as well as lymph nodes. The disease is often discontinuous, i.e., severely diseased segments of bowel are separated from apparently disease-free areas. In Crohn’s disease, the bowel wall also thickens which can lead to obstructions, and the development of fistulas and fissures are not uncommon. Crohn’s disease may be one or more of several types of Crohn’s disease, including without limitation: ileocolitis (affects the ileum and the large intestine), ileitis (affects the ileum), gastroduodenal Crohn’s disease (inflammation in the stomach and the duodenum), jejunoileitis (spotty patches of inflammation in the jejunum), and Crohn’s (granulomatous) colitis (only affects the large intestine).

[0232] “Ulcerative colitis”, as used herein, refers to a condition involving inflammation of the large intestine and rectum. In patients with ulcerative colitis, there is an inflammatory reaction primarily involving the colonic mucosa. The inflammation is typically uniform and continuous with no intervening areas of normal mucosa. Surface mucosal cells as well as crypt epithelium and submucosa are involved in an inflammatory reaction with neutrophil infiltration. Ultimately, this reaction typically progresses to epithelial damage and loss of epithelial cells resulting in multiple ulcerations, fibrosis, dysplasia and longitudinal retraction of the colon.

[0233] AGR2 is a marker of tumor aggressiveness expressed by many solid tumor types. Due to almost ubiquitous expression in solid tumors, expression in premalignant lesions and its involvement in metastatic disease, AGR2 protein represents a relevant target for cancer therapy. AGR2, in particular extracellular AGR2, is also implicated in drug resistance to chemotherapy, mesenchymal transition (EMT), angiogenesis, metastasis, and in cancer cell proliferation, migration and invasion.

[0234] Therefore, the present invention further relates to an isolated antibody, or binding fragment thereof, that specifically binds to AGR2 as described herein, for use for treating and / or preventing cancer in a subject in need thereof.

[0235] Another object of the present invention is a nucleic acid encoding an isolated antibody, or binding fragment thereof, that specifically binds to AGR2 as described herein, or an expression vector comprising such a nucleic acid, or a host cell comprising such an expression vector, or a composition as described herein, or a pharmaceutical composition as described herein, for use for treating and / or preventing cancer in a subject in need thereof.

[0236] As used herein, the term "cancer" has its general meaning in the art and in particular refers to a disease caused by an uncontrolled division of abnormal cells. The term "cancer" encompasses solid tumors and blood cancers, and encompasses both primary and metastatic cancers.

[0237] Examples of cancers include, but are not limited to, cancer cells from the bladder, blood, bone, bone marrow, brain, breast, colon, esophagus, gastrointestinal, gum, head, kidney, liver, lung, nasopharynx, neck, ovary, prostate, pancreatic, skin, stomach, testis, tongue, or uterus.

[0238] In some embodiments, said cancer is a tumor, such as, for example, a solid tumor.

[0239] In some embodiments, said cancer is an epithelial cancer.

[0240] In some embodiments, said cancer is a urogenital cancer. Examples of urogenital cancers include without being limited to adrenocortical carcinoma, bladder cancer, kidney cancer, penile cancer, prostate cancer, renal cancer, testicular cancer, urethral cancer, colorectal cancer, cervical cancer, ovarian cancer, uterine cancer, endometrial cancer, vaginal cancer, vulvar cancer, gestational trophoblastic disease (GTD), primary peritoneal cancer.

[0241] In some embodiments, said cancer is a blood cancer. In some embodiments, said cancer is a hematologic malignancy. Examples of hematologic cancers include, but are not limited to, Hodgkin's disease, non-Hodgkin's lymphoma (malignant lymphoma) and blood cancers such as e.g., acute or chronic myeloid leukemia, acute lymphoblastic leukemia, chronic lymphocytic leukemia, myeloproliferative diseases, multiple myeloma, myelodysplastic syndrome.

[0242] Examples of cancers include, but are not limited to, acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), adenoid cystic carcinoma, adrenocortical, carcinoma, AIDS-related cancers, anal cancer, appendix cancer, astrocytomas, atypical teratoid / rhabdoid tumor, B-cell leukemia, lymphoma or other B cell malignancies, basal cell carcinoma, bile duct cancer, bladder cancer, bone cancer, osteosarcoma and malignant fibrous histiocytoma, brain stem glioma, brain tumors, breast cancer, bronchial tumors, Burkitt lymphoma, carcinoid tumors, central nervous system cancers, cervical cancer, chordoma, chronic lymphocytic leukemia (CLL), chronic myelogenous leukemia (CML), chronic myeloproliferative disorders, colon cancer, colorectal cancer, craniopharyngioma, cutaneous T cell lymphoma, embryonal tumors, endometrial cancer, ependymoblastoma, ependymoma, esophageal cancer, esthesioneuroblastoma, Ewing sarcoma family of tumors, extracranial germ cell tumor, extragonadal germ cell tumor, extrahepatic bile duct cancer, eye cancer fibrous histiocytoma of bone and osteosarcoma, gallbladder cancer, gastric (stomach) cancer, gastrointestinal carcinoid tumor, gastrointestinal stromal tumors (GIST), soft tissue sarcoma, germ cell tumor, gestational trophoblastic tumor, glioma, hairy cell leukemia, head and neck cancer, heart cancer, hepatocellular (liver) cancer, histiocytosis, Hodgkin lymphoma, hypopharyngeal cancer, intraocular melanoma, islet cell tumors (endocrine pancreas), Kaposi sarcoma, kidney cancer, Langerhans cell histiocytosis, laryngeal cancer, leukemia, lip and oral cavity cancer, liver cancer (primary), lobular carcinoma in situ (LCIS), lung cancer, lymphoma, macroglobulinemia, male breast cancer, malignant fibrous histiocytoma of bone, medulloblastoma, medulloepithelioma, melanoma, Merkel cell carcinoma, mesothelioma, metastatic squamous neck cancer with occult primary midline tract carcinoma involving NUT gene, mouth cancer, multiple endocrine neoplasia syndromes, multiple myeloma / plasma cell neoplasm, mycosis fungoides, myelodysplastic syndromes, myelodysplastic / myeloproliferative neoplasms, myelogenous leukemia, chronic (CML), myeloid leukemia, acute myeloid leukemia (AML), multiple myeloma, myeloproliferative disorders, nasal cavity and paranasal sinus cancer, nasopharyngeal cancer, neuroblastoma, non-Hodgkin lymphoma, non-small cell lung cancer, oral cancer, oral cavity cancer, oropharyngeal cancer, osteosarcoma, ovarian cancer, pancreatic cancer, papillomatosis, paraganglioma, paranasal sinus and nasal cavity cancer, parathyroid cancer, penile cancer, pharyngeal cancer, pheochromocytoma, pinealparenchymal tumors of intermediate differentiation, pineoblastoma and supratentorial primitive neuroectodermal tumors, pituitary tumor, plasma cell neoplasm / multiple myeloma, pleuropulmonary blastoma and breast cancer, primary central nervous system (CNS) lymphoma, prostate cancer, rectal cancer, renal cell (kidney) cancer, renal pelvis and ureter, transitional cell cancer, retinoblastoma, rhabdomyosarcoma, salivary gland cancer, sarcoma, Sezary syndrome, small cell lung cancer, small intestine cancer, soft tissue sarcoma, squamous cell carcinoma, squamous neck cancer, stomach (gastric) cancer, supratentorial primitive neuroectodermal tumors, T cell lymphoma, cutaneous cancer, testicular cancer, throat cancer, thymoma and thymic carcinoma, thyroid cancer, transitional cell cancer of the renal pelvis and ureter, trophoblastic tumor, ureter and renal pelvis cancer, urethral cancer, uterine cancer, uterine sarcoma, vaginal cancer, vulvar cancer, Waldenstrom macroglobulinemia, and Wilms Tumor, cholangiocarcinoma, head and neck squamous cell carcinoma, brain glioblastoma, adrenocortical carcinoma, bladder cancer, kidney cancer, renal cancer, colorectal cancer, cervical cancer, gestational trophoblastic disease (GTD), primary peritoneal cancer.

[0243] Preferably, the cancer to be prevented or treated with the isolated antibody, or binding fragment thereof, that specifically binds to AGR2 is selected from the group consisting of colon cancer, gastrointestinal cancer, prostate cancer, pancreatic cancer, oral cancer, breast cancer, lung cancer, ovarian cancer, thyroid cancer, cholangiocarcinoma, head and neck squamous cell carcinoma, brain glioblastoma, adrenocortical carcinoma, bladder cancer, kidney cancer, penile cancer, renal cancer, testicular cancer, urethral cancer, colorectal cancer, cervical cancer, uterine cancer, endometrial cancer, vaginal cancer, vulvar cancer, gestational trophoblastic disease (GTD), and primary peritoneal cancer.

[0244] The present invention further relates to a method for treating and / or preventing mucosal inflammatory diseases or cancers in a subject in need thereof, comprising administering to the subject an isolated antibody, or binding fragment thereof, that specifically binds to AGR2 as described herein, or a nucleic acid encoding an isolated antibody, or binding fragment thereof, that specifically binds to AGR2 as described herein, or an expression vector comprising such a nucleic acid, or a host cell comprisingsuch an expression vector, or a composition as described herein, or a pharmaceutical composition as described herein.

[0245] The present invention further relates to the use of an isolated antibody, or binding fragment thereof, that specifically binds to AGR2 as described herein, for the manufacture of a medicament for the treatment and / or prevention of mucosal inflammatory diseases or cancers in a subject in need thereof.

[0246] The present invention also relates to the use of a nucleic acid encoding an isolated antibody, or binding fragment thereof, that specifically binds to AGR2 as described herein, or an expression vector comprising such a nucleic acid, or a host cell comprising such an expression vector, or a composition as described herein, or a pharmaceutical composition as described herein, for the manufacture of a medicament for the treatment and / or prevention of mucosal inflammatory diseases or cancers in a subject in need thereof.

[0247] The present invention further relates to the use of the isolated antibody, or binding fragment thereof, that specifically binds to AGR2 as described herein, for treating and / or preventing mucosal inflammatory diseases or cancers in a subject in need thereof.

[0248] The present invention also relates to the use of the nucleic acid encoding the isolated antibody, or binding fragment thereof, that specifically binds to AGR2 as described herein, or the expression vector comprising such nucleic acid, or the host cell comprising such expression vector, or the composition as described herein, or the pharmaceutical composition as described herein, for treating and / or preventing mucosal inflammatory diseases or cancers in a subject in need thereof.

[0249] In some embodiments, the isolated antibody, or binding fragment thereof, that specifically binds to AGR2 according to the present invention, the nucleic acid encoding an isolated antibody, or binding fragment thereof, that specifically binds to AGR2 as described herein, the expression vector comprising such a nucleic acid, the host cell comprising such an expression vector, the composition as described herein, or the pharmaceutical composition as described herein, may be used for treating and / or preventing mucosal inflammatory diseases or cancers in a subject in need thereof.

[0250] The present invention further relates to a method for reducing mucosal inflammation in a subject in need thereof, comprising administering to the subject an isolated antibody, or binding fragment thereof, that specifically binds to AGR2 as described herein.

[0251] The present invention also relates to a method for reducing mucosal inflammation in a subject in need thereof, comprising administering to the subject a nucleic acid encoding an isolated antibody, or binding fragment thereof, that specifically binds to AGR2 as described herein, or an expression vector comprising such a nucleic acid, or a host cell comprising such an expression vector, or a composition as described herein, or a pharmaceutical composition as described herein.

[0252] Examples of mucosal inflammatory diseases include, but are not limited to Crohn’s disease, ulcerative colitis, primary sclerosing cholangitis, chronic pancreatitis, microscopic colitis, inflammatory bowel disease (IBD), endometriosis, appendicitis, inflammatory bowel syndrome, idiopathic pulmonary fibrosis, systemic sclerosis, in particular systemic sclerosis associated with interstitial lung disease, asthma and chronic obstructive pulmonary disease.

[0253] The present invention further relates to a method for reducing the pro- inflammatory activity and / or the pro-fibrotic activity of extracellular AGR2 in a subject in need thereof, said method comprising administering to said subject a therapeutically effective amount of an isolated antibody, or binding fragment thereof, that specifically binds to AGR2 of the invention.

[0254] The present invention also relates to a method for reducing the pro-inflammatory activity and / or the pro-fibrotic activity of extracellular AGR2 in a subject in need thereof, said method comprising administering to said subject a therapeutically effective amount of a nucleic acid encoding an isolated antibody, or binding fragment thereof, that specifically binds to AGR2 as described herein, or an expression vector comprising such a nucleic acid, or a host cell comprising such an expression vector, or a composition as described herein, or a pharmaceutical composition as described herein

[0255] For use in administration to a subject, the composition, pharmaceutical composition or medicament will be formulated.

[0256] In some embodiments, the composition, pharmaceutical composition or medicament according to the present invention is administered parenterally, orally, by inhalation, spray, rectally, nasally, or via an implanted reservoir.

[0257] In some embodiments, the composition, pharmaceutical composition or medicament is administered by injection, including, without limitation, subcutaneous, intravenous, intramuscular, intra-articular, intra-synovial, intra-stemal, intrathecal, intrahepatic, intralesional and intracranial injection or infusion techniques.

[0258] Examples of forms adapted for injection include, but are not limited to, solutions, such as, for example, sterile aqueous solutions, gels, dispersions, emulsions, suspensions, solid forms suitable for using to prepare solutions or suspensions upon the addition of a liquid prior to use, such as, for example, powder, liposomal forms and the like.

[0259] In some embodiments, the isolated anti-AGR2 antibody, or binding fragment thereof, composition, pharmaceutical composition or medicament according to the present invention, is to be administered to the subject in need thereof in a therapeutically effective amount.

[0260] It will be however understood that the total daily usage of the isolated anti-AGR2 antibody, or binding fragment thereof, composition, pharmaceutical composition or medicament according to the present invention will be decided by the attending physician within the scope of sound medical judgment. The specific therapeutically effective dose level for any particular patient will depend upon a variety of factors including the disease being treated and the severity of the disease; activity of the isolated antibody, or binding fragment thereof, that specifically binds to AGR2 employed; the age, body weight, general health, sex and diet of the subject; the time of administration, route of administration, and rate of excretion of the specific therapeutic agent employed; the duration of the treatment; drugs used in combination or coincidental with the specific therapeutic agent employed; and like factors well known in the medical arts. For example, it is well within the skill of the art to start doses of the compound at levels lower thanthose required to achieve the desired therapeutic effect and to gradually increase the dosage until the desired effect is achieved. The total dose required for each treatment may be administered by multiple doses or in a single dose.

[0261] In some embodiments, the daily dosage of the isolated antibody, or binding fragment thereof, that specifically binds to AGR2 may be varied over a wide range from 0.01 to 1000 mg per adult per day. Compositions may contain 0.01, 0.05, 0.1, 0.5, 1.0, 2.5, 5.0, 10.0, 15.0, 25.0, 50.0, 100, 250, and 500 mg of the active ingredient for the symptomatic adjustment of the dosage to the subject to be treated. A pharmaceutical composition or medicament typically contains from about 0.01 mg to about 500mg of active ingredient. A therapeutically effective amount of the drug is ordinarily supplied at a dosage level from 0.0002 mg / kg to about 20 mg / kg of body weight per day. For example, an antibody, or binding fragment thereof, present in a composition, pharmaceutical composition or medicament of this invention can be supplied at a concentration ranging from 1 mg / mL to about 100 mg / mL, such as, for example, at a concentration of 1 mg / mL, 5 mg / mL, 10 mg / mL, 50 mg / mL or 100 mg / mL. In some embodiments, the isolated antibody, or binding fragment thereof, that specifically binds to AGR2 is supplied at a concentration of about 10 mg / mL in either 100 mg (10 mL) or 500 mg (50 mL) single-use vials. It will be appreciated that these dosages are exemplary and that an optimal dosage can be adapted taking into account the affinity and tolerability of the particular therapeutic agent that must be determined in clinical trials.

[0262] In some embodiments, the isolated antibody, or binding fragment thereof, nucleic acid, expression vector, composition, pharmaceutical composition or medicament according to the present invention is to be administered before, concomitantly with or after a therapeutic drug.

[0263] Some examples of therapeutic drugs suitable for co-administration with the isolated antibody, or binding fragment thereof, nucleic acid, expression vector, composition, pharmaceutical composition or medicament according to the present invention include, without limitation, immunosuppressants, cytokines, immune modulators.

[0264] It will be understood by the one skilled in the art that the co-administration of the isolated antibody, or binding fragment thereof, nucleic acid, expression vector, composition, pharmaceutical composition or medicament according to the present invention with a particular therapeutic drug, which may be chosen among those recited herein but without being limited thereto, will depend on the disease or condition to be prevented and / or treated.

[0265] Examples of immunosuppressants include, without limitation, corticosteroids, mTOR inhibitors such as, e.g., sirolimus, everolimus, ridaforolimus, temsirolimus, umirolimus and zotarolimus; IL-1 receptor antagonists such as, e.g., anakinra; antimetabolites such as, e.g., azathioprine, leflunomide, methotrexate, mycophenolic acid and teriflunomide; IMiDs such as, e.g., apremilast, lenalidomide, pomalidomide and thalidomide; antibodies such as, e.g., vedolizumab, eculizumab, adalimumab, afelimomab, certolizumab pegol, golimumab, infliximab, nerelimomab, mepolizumab, omalizumab, faralimomab, elsilimomab, lebrikizumab, ustekinumab, secukinumab, muromonab-CD3, otelixizumab, teplizumab, visilizumab, clenoliximab, keliximab, zanolimumab, efalizumab, erlizumab, obinutuzumab, rituximab, ocrelizumab, pascolizumab, gomiliximab, lumiliximab, teneliximab, toralizumab, aselizumab, galiximab, gavilimomab, ruplizumab, belimumab, blisibimod, ipilimumab, tremelimumab, bertilimumab, lerdelimumab, metelimumab, natalizumab, tocilizumab, odulimomab, basiliximab, daclizumab, inolimomab, zolimomab aritox, atorolimumab, cedelizumab, fontolizumab, maslimomab, morolimumab, pexelizumab, reslizumab, rovelizumab, siplizumab, talizumab, telimomab aritox, vapaliximab, vepalimomab, abatacept, belatacept, etanercept, pegsunercept, aflibercept, alefacept and rilonacept, and small molecules targeting the ubiquitous JAK or SIP pathways.

[0266] Examples of cytokines include, without limitation, chemokines (such as, e.g., CCL1, CCL2 / MCP1, CCL3 / MIPla, CCL4 / MIP1P, CCL5 / RANTES, CCL6, CCL7, CCL8, CCL9, CCL11, CCL12, CCL13, CCL14, CCL15, CCL16, CCL17, CCL18 / PARC / DCCK1 / AMAC1 / MIP4, CCL19, CCL20, CCL21, CCL22, CCL23, CCL24, CCL25, CCL26, CCL27, CCL28, CXCL1 / KC, CXCL2, CXCL3, CXCL4, CXCL5, CXCL6, CXCL7, CXCL8 / IL8, CXCL9, CXCL10, CXCL11, CXCL12,CXCL13, CXCL14, CXCL15, CXCL16, CXCL17, CX3CL1, XCL1 and XCL2), tumor necrosis factors (such as, e.g., TNFA, Lymphotoxin, TNFSF4, TNFSF5 / CD40LG, TNFSF6, TNFSF7, TNFSF8, TNFSF9, TNFSF10, TNFSF11, TNFSF13, TNFSF13B and EDA) and interleukins (such as, e.g., IL-la, IL-10, IL-IRa, IL-2, IL-3, IL-4, IL-5, IL-6, IL-7, IL-9, IL-10, IL-11, IL-12, IL-13, IL-14, IL-15, IL-16, IL-17, IL-18, IL-19, IL-20, IL-21, IL-22, IL-23, IL-24, IL-25, IL-26, IL-27, IL-28, IL-29, IL-30, IL-31, IL-32, IL- 33, IL-34, IL-35, IL-36a, IL-36 , IL-36y, IL-36Ra, IL-37, IL-38, IFNa, IFN0, IFNK, IFNco and GM-CSF).

[0267] Examples of immune modulators include, without limitation, filgrastim, pegfilgrastim, lenograstim, molgramostim, sargramostim, ancestim, albinterferon, interferon alfa, peginterferon alfa, interferon beta, peginterferon beta, interferon gamma, aldesleukin, oprelvekin, growth hormone, immunocyanin, pegademase, prolactin, tasonermin, histamine dihydrochloride, poly ICLC, vitamin D, lentinan, plerixafor, roquinimex, mifamurtide, glatiramer acetate, thymopentin, thymosin al, thymulin, polyinosinic:polycytidylic acid, pidotimod, Bacillus Calmette-Guerin vaccine, melanoma vaccine and sipuleucel-T vaccine.

[0268] Other therapeutic drugs suitable for co-administration with the isolated antibody, or binding fragment thereof, nucleic acid, expression vector, composition, pharmaceutical composition or medicament according to the present invention include anti-cancer drugs. For instance, the therapeutic drug suitable for co-administration may be a cytotoxin, a chemotherapeutic agent, a lytic peptide or a radioisotope.

[0269] Examples of cytotoxins include, without limitation, radionuclides (e.g,35S,14C,32P,125I,131I,90Y,89Zr,2O1T1,186Re,188Re,57Cu,213Bi, and211At), conjugated radionuclides, and chemotherapeutic agents. Further examples of cytotoxins include, but are not limited to, antimetabolites (e.g, 5-fluorouricil (5-FU), methotrexate (MTX), fludarabine, etc.), anti -microtubule agents (e.g, vincristine, vinblastine, colchicine, taxanes (such as paclitaxel and docetaxel), etc.), alkylating agents (e.g, cyclophasphamide, melphalan, bischloroethylnitrosurea (BCNU), etc.), platinum agents (e.g, cisplatin (also termed cDDP), carboplatin, oxaliplatin, JM-216, CI-973, etc.), anthracy clines (e.g, doxorubicin, daunorubicin, etc.), antibiotic agents (e.g, mitomycin-C), topoisomerase inhibitors (e.g, etoposide, tenoposide, and camptothecins), or other cytotoxic agents such as ricin, diptheria toxin (DT), Pseudomonas exotoxin (PE) A, PE40, abrin, saporin, pokeweed viral protein, ethidium bromide, glucocorticoid, anthrax toxin and others.

[0270] Examples of chemotherapeutic agents include, without limitation, platinum coordination compounds (such as, e.g., cisplatin, carboplatin or oxalyplatin); taxane compounds (such as, e.g., paclitaxel or docetaxel); topoisomerase I inhibitors (such as, e.g., irinotecan or topotecan); topoisomerase II inhibitors (such as, e.g., etoposide or teniposide); vinca alkaloids (such as, e.g., vinblastine, vincristine or vinorelbine); antitumor nucleoside derivatives (such as, e.g., 5-fluorouracil, gemcitabine or capecitabine); alkylating agents (such as, e.g., nitrogen mustard or nitrosourea, cyclophosphamide, chlorambucil, carmustine or lomustine; anti-tumor anthracycline derivatives (sue has, e.g., daunorubicin, doxorubicin, idarubicin or mitoxantrone); anti-HER2 antibodies (such as, e.g., trastuzumab); estrogen receptor antagonists or selective estrogen receptor modulators (such as, e.g., tamoxifen, toremifene, droloxifene, faslodex or raloxifene); aromatase inhibitors (such as, e.g., exemestane, anastrozole, letrazole or vorozole); differentiating agents (such as, e.g., retinoids, vitamin D and retinoic acid metabolism blocking agents [RAMBA] such as accutane); DNA methyl transferase inhibitors (such as, e.g., azacytidine); kinase inhibitors (such as, e.g., flavoperidol, imatinib mesylate or gefitinib); famesyltransferase inhibitors; and HD AC inhibitors.

[0271] Examples of lytic peptides include, without limitation, toxins (such as, e.g., Diptheria toxin o Pseudomonas exotoxin).

[0272] Examples of radioisotopes include, without limitation, the radionuclides of technetium (e.g., Tc-99 and Tc-97), potassium e.g., K-40), rubidium (e.g., Rb-82), iodine (e.g., 1-123, 1-124, 1-125, 1-129, 1-131), cesium (e.g., Cs-135, Cs-137), cobalt (e.g., Co- 60), palladium (e.g., Pd-103, Pd-107), cadmium (e.g., Cd-113), strontium (e.g., Sr-89, Sr- 90), europium (e.g., Eu-55), tin (e.g., Sn-121, Sn-126), phosphorus (e.g., P-32, P-33), thallium (e.g., Tl-201), indium (e.g., In-111), gallium (e.g., Ga-67, Ga-68), yttrium (e.g., Y-90), iridium (e.g., Ir-192), bismuth (e.g., Bi-213), radium (e.g., Ra-223, Ra-225), and ruthenium (e.g., Ru-106).

[0273] The invention further relates to the use of the isolated antibody, or binding fragment thereof, according to the present invention, for detecting or quantifying AGR2 expression in a biological sample; and to methods for detecting or quantifying AGR2 expression in a biological sample comprising contacting said biological sample with the isolated antibody, or binding fragment thereof, of the present invention.

[0274] As used herein, a “biological sample” may for instance be a cell, tissue or organ. Examples of biological samples include, but are not limited to, bodily fluids (preferably blood, more preferably blood serum), plasma, urine, feces, synovial fluid, bronchoalveolar lavage fluid, sputum, lymph, ascitic fluids, urine, amniotic fluid, peritoneal fluid, cerebrospinal fluid, pleural fluid, pericardial fluid, and alveolar macrophages, tissue lysates, biopsies and extracts prepared from diseased tissues.

[0275] In some embodiments, the uses and methods for detecting or quantifying AGR2 may be in vitro or in vivo.

[0276] As used herein, the term “expression” may refer alternatively to the translation of AGR2 (i.e., expression of the protein), to the presence of AGR2 protein within a cell, at a cell surface, or to the presence of secreted or circulating AGR2 protein.

[0277] Assays suitable for detecting or quantifying a protein level in a sample are well- known in the art. Examples of such assays include, but are not limited to, mass spectrometry, immunohistochemistry, Multiplex methods (Luminex), western blot, enzyme-linked immunosorbent assay (ELISA), sandwich ELISA, fluorescent-linked immunosorbent assay (FLISA), enzyme immunoassay (EIA), radioimmunoassay (RIA), flow cytometry (FACS), immunofluorescence, immunoprecipitation, and the like.

[0278] In some embodiments, determining the expression level of AGR2 specifically corresponds to the detection and quantification of AGR2 protein within a cell. Methods for analyzing the presence of a protein in a cell are well-known to the skilled artisan and include, without limitation, FACS analysis, immunohistochemistry, mass spectrometry, western blot associated with cell fractionation, enzyme-linked immunosorbent assay (ELISA), sandwich ELISA, fluorescent-linked immunosorbent assay (FLISA), enzymeimmunoassay (EIA), radioimmunoassay (RIA) or image analysis, for example high content analysis and the like.

[0279] In some embodiments, the isolated antibody, or binding fragment thereof, according to the present invention is labeled, as described hereinabove, for detection or diagnostic purposes, or for patient monitoring purposes.

[0280] In some embodiments, the isolated antibody, or binding fragment thereof, according to the present invention is used in combination with one or several other antibodies. For instance, other anti-AGR2 antibodies may be used as a capture antibody, while the isolated antibody, or binding fragment thereof, according to the present invention may be used as a detection antibody, or vice versa. A non-limiting example of anti-AGR2 antibody includes, e.g., the antibody provided by Abeam under reference Ab244826.

[0281] In some embodiments, the sample is taken or retrieved from a subject prior to any analysis. Accordingly, in this embodiment, the uses and methods for detecting or quantifying AGR2 are in vitro uses and methods.

[0282] The invention further relates to the use of the isolated antibody, or binding fragment thereof, of the present invention, for diagnosing or monitoring an AGR2-related disease in a subject, and to methods of diagnosing or monitoring an AGR2 -related disease in a subject, comprising contacting a sample from said subject with the isolated antibody, or binding fragment thereof, of the present invention.

[0283] The invention further relates to the use of the isolated antibody, or binding fragment thereof, of the present invention, for selecting a subject suffering from an AGR2-related disease for treatment targeting said disease, and to methods of selecting a subject suffering from an AGR2-related disease for treatment targeting said disease, comprising contacting a sample from said subject with the isolated antibody, or binding fragment thereof, of the present invention.

[0284] The invention also relates to the use of the isolated antibody, or binding fragment thereof, of the present invention, for monitoring the response of a subject to a treatmenttargeting an AGR2-related disease, and to methods of monitoring the response of a subject to a treatment targeting an AGR2-related disease, comprising contacting a sample from said subject with the isolated antibody, or binding fragment thereof, of the present invention.

[0285] In some embodiments, the isolated antibody, or binding fragment thereof, of the present invention may be used within a companion diagnostic test. For instance, the isolated antibody, or binding fragment thereof, of the present invention may be used within a companion diagnostic test in association with a therapy targeting an AGR2- related disease.

[0286] As used herein the term “AGR2-related disease” refers to any disease in which AGR2 is involved. For instance, an “AGR2-related disease” may be a disease in which AGR2 is dysregulated, for instance overexpressed (up-regulated) or down-regulated, preferably overexpressed. An “AGR2-related disease” may also be a disease in which abnormal extracellular (membrane-bound or secreted) AGR2 can be detected. An “AGR2-related disease” may be a disease in which AGR2 monomer or dimer can be detected.

[0287] In particular, an “AGR2-related disease” may for instance be a mucosal inflammatory disease including, but not limited to, Crohn’s disease, inflammatory bowel disease and ulcerative colitis disease.

[0288] The uses and methods for diagnosing or monitoring an AGR2-related disease may be in vitro or in vivo, preferably in vitro. In some embodiments, the diagnosis method of the invention is an in vitro diagnosis method, i.e., the method of the invention is performed on a biological sample that was obtained from a patient prior to the implementation of the method of the invention. Consequently, in some embodiments, the method of the invention does not comprise obtaining a sample from the patient, i.e., the method of the invention is non-invasive.

[0289] In some embodiments, the AGR2-related diseases are AGR2hlgh-related diseases. According to this embodiment, the subject may be diagnosed as affected with or suffering from a AGR2-related disease if AGR2 is detected in a sample from said subject at a level,amount or concentration higher than in a reference subject (e.g., in a substantially healthy subject, or in a subject who is known not to be affected with or suffering from a AGR2- related disease).

[0290] The expression “monitoring the response of a subject to a treatment targeting an AGR2-related disease” may for instance mean adapting the treatment. Preferably, “monitoring the response of a subject to a treatment targeting an AGR2-related disease” means changing the drug used to treat the subject, or increasing or reducing the dose, the administration frequency, or changing the administration route of the treatment.

[0291] When the method is used to monitor the progression of an AGR2-related disease or to monitor the response of a subject to a treatment, it is repeated at least at two different points in time (e.g., before and after onset of a treatment).

[0292] In some embodiments, the uses and methods for diagnosing or monitoring an AGR2-related disease further comprise a step of treating the subject if said subject is diagnosed as being affected with or suffering from a AGR2 -related disease.

[0293] In some embodiments, the method of selecting a subject suffering from an AGR2-related disease for treatment targeting said disease, further comprises a step of submitting the subject to a treatment targeting said AGR2 -related disease, if said subject is selected to undergo treatment targeting said disease.BRIEF DESCRIPTION OF THE DRAWINGS

[0294] Figure 1 is a schematic of the 3-dimensional structure of the human AGR2 protein showing in dotted line circles the location of the epitope bound by Agtuzumab and of the epitope bound by TH- 10c humanized monoclonal antibodies of the invention.

[0295] Figure 2 is a schematic of the structure of the human AGR2 protein. Human AGR2 protein comprises from N-terminus to C-terminus: a cleavable signal peptide, an adhesion domain, a dimerization motif, a pseudo-thioredoxin motif, a peptide binding loop, and an endoplasmic reticulum retention signal.

[0296] Figures 3A-C is a set of graphs showing the cross-reactivity and specificity of the humanized anti-AGR2 monoclonal antibodies of the invention (i.e., TH-lOcl IgGl- LALA, TH-10c2 IgGl-LALA, TH-10c3 IgGl-LALA). Binding capacities of the antibodies towards human AGR2 WT, mouse AGR2, dog AGR2, macaque AGR2, human AGR3 and BSA were evaluated by ELISA. Antibodies were tested at an initial concentration of 10 pg / mL and serially diluted 1 / 10 as low as 0.00001 ng / mL.Figure 3A shows TH-lOcl IgGl-LALA humanized monoclonal antibody. Figure 3B shows TH-10c2 IgGl-LALA humanized monoclonal antibody. Figure 3C shows TH-10c3 IgGl-LALA humanized monoclonal antibody.

[0297] Figure 4 is a graph showing the potency of Agtuzumab IgGl-LALA, of TH-lOcl IgGl-LALA humanized monoclonal antibody and of the isotype control to inhibit cell adhesion in a PC-3 adhesion assay.

[0298] Figure 5 is a graph showing the binding of the optimized anti-AGR2 monoclonal antibodies of the invention to AGR2. Binding capacities of the antibodies (black), or of their isotype control (open dot), to bind recombinant human AGR2 (rec-huAGR2) was evaluated by ELISA. Antibodies were tested at an initial concentration of 10 pg / mL and serially diluted 1 / 2 as low as 0.08 pg / mL. The graph presents data from two experiments, with n=2-4 in each experiment. Values are expressed as the mean ± SEM.

[0299] Figure 6 is a graph showing the inhibition of AGR2-dependent cell adhesion by optimized anti-AGR2 monoclonal antibodies of the invention, in comparison with Agtuzumab, in a HT-29 cell adhesion assay. Differences in percentage of adhesion were compared with a one-way ANOVA test against the Agtuzumab (**=p < 0.01, ***=p < 0.001, ****=p < 0.0001). The graph presents two independent experiments, with n=2-3 in each experiment. Values are expressed as the mean ± SEM.

[0300] Figure 7 is a graph showing the inhibition of AGR2-dependent CCDI8-C0 (colonic fibroblasts) migration by optimized anti-AGR2 monoclonal antibodies of the invention, in comparison with Agtuzumab. The graph shows 2-9 experiments with triplicates. Values are expressed as the mean ± SEM, a one-way ANOVA was usedagainst the AGR2+Agtuzumab condition (*=p<0.05, **=p<0.01, ***=p<0.001, ****=p<0.0001).

[0301] Figure 8 is a graph showing the abrogation of AGR2-mediated fibrin formation inhibition by optimized anti-AGR2 monoclonal antibodies of the invention, in5 comparison with Agtuzumab. Values are expressed as the mean ± SEM, a one-way ANOVA test was used against the AGR2+Agtuzumab condition (n=2) (*=p<0.05, **=p<0.01, ***=p<0.001, ****=p<0.0001 ).TABLE OF SEQUENCES (IN PART)EXAMPLES

[0302] The present invention is further illustrated by the following examples. Table 1: Sequences of the antibodies in the Examples.Example 1: Development of rat monoclonal antibodies against human AGR2 by phage displayMaterial and Methods Antigens and adjuvants

[0303] Human AGR2 (230-30150) was used as recombinant target. Complete Freund’s adjuvant (CFA) and incomplete Freund’s adjuvant (IF A) were used for rat’s immunization. CFA was only used during the first injection and replaced by IF A duringsubsequent immune boosting of rats. Both CFA and IFA were purchased from Sigma- Aldrich (France) and were kept at +4°C until use.Immunization of rats

[0304] All animal handling work was approved by Animal Ethics Committees of Biotem and all experiments were conducted in accordance with the European Directive 2010 / 63 / UE as published in the French Official Journal of February 7th 2013. The recombinant Target proteins were emulsified separately in equal amounts of CFA and subcutaneously / intraperitoneally injected in 3 rats. Subsequent boosts were administered intraperitoneally. To enable production of the immune response, the rats were given an initial injection with 30 pg of antigen. For subsequent boosts, 30 pg of antigen were mixed with IFA and was then injected at 2-week intervals. To measure the humoral response of mice against both antigens, 0.2 mL blood sample was harvested at day 38. Serum was isolated to determine the reactivity against human AGR2, murine AGR2 and BSA by ELISA.ResultsImmunization of rats

[0305] The three rats immunized with protein human AGR2 showed good reactivity in ELISA with a higher sera reactivity against the targeted protein human AGR2 than with the murine AGR2. No reactivity against the negative control (BSA) was observed. Rat #1 was determined as the best candidate for phase 2 initiation according to the titers reached.Splenectomy from Rat #1 and B-cell isolation from the spleen

[0306] Splenectomy of Rat #1 was performed and spleen was treated in the molecular biology laboratory for RNA extraction. Total RNA was quantified (My spec, VWR) and controlled on agarose gel.Amplification by RT-PCR of the mRNA coding for the variable domains VLK, VL and VH

[0307] RNA coding variable domains of the y chain and K / light chains were retro- amplified with specific primer sets. The quality of the amplification was controlled byelectrophoresis, with a 1 % TBE / 0.8 % agarose-gel. VH and VL PCR products of amplification were separately pooled and cloned in a backup vector in order to generate two distinct sub-libraries (one for the heavy and one for the light chains).Construction of a scFv library and M13KO7 phage-based encapsidation

[0308] The first step of the library construction consisted of the VL fragments cloning in a phagemid vector, and then the VH fragments were inserted into the vector containing the VL repertoire.

[0309] A scFv library was built with success, which consisted of 2.3 x 107independent clones with a full-size insert rate of 79%, and was finally packaged in M13K07 phage.Example 2: Anti-AGR2 humanized monoclonal antibody productionMaterial and MethodsPlasmid Preparation

[0310] Target DNA sequence was designed, optimized and synthesized. The complete sequence was sub-cloned into GenScript’s proprietary vector. Transfection grade plasmid was maxi-prepared for TurboCHO-HT cell expression.Cell Culture and Transient Transfection

[0311] The cells were maintained at 37°C with 5% CO2 on an orbital shaker. One day before transfection, the cells were seeded at an appropriate density. On the day of transfection, DNA and Reagent were mixed at an optimal ratio and then added into cells ready for transfection. Approximately 24 hours post-transfection, feed was added to each sample.Purification and Analysis

[0312] Cell culture broth was centrifuged and followed by filtration. Filtered cell culture supernatant was loaded onto an affinity purification column at an appropriate flowrate. After washing and elution with appropriate buffers, the eluted fractions were pooled and buffer exchanged to the final formulation buffer. The purified protein was analyzed by SDS-PAGE and SEC-HPLC analysis to determine the molecular weight and purity. Theconcentration was determined by A280 method (i.e., absorbance of a protein solution at 280 nm).Results

[0313] TH-lOcl, TH-10c2 and TH-10c3 antibodies were produced. Additionally, all of TH-lOcl, TH-10c2 and TH-10c3 antibodies had a better yield than Agtuzumab (as shown on Table 2 below).Table 2: Production characteristics of Agtuzumab IgGl-LALA, TH-lOcl, TH-10c2 and TH- 10c 3 IgGl-LALA antibodies.Example 3: Epitope mappingMaterial and MethodsGeneration of DMS DNA libraries

[0314] DMS libraries of human AGR2 protein were generated by PCR, each mutated position carries a degenerated “NNS” or “NNK” codon encoding 20 amino acids / 32 codons.Construction of the expression plasmid of the antigen

[0315] The gene corresponding to human AGR2 WT (SEQ ID NO: 1) was synthesized and cloned into a plasmid allowing expression on the surface of galactose-inducible yeasts. In this construct, the expressed antigen (i.e., human AGR2 WT) carries a C-terminal HA tag. Expression plasmids are then transformed into the yeast strain S. cerevisiae EBY100.Induction of antigen expression in Yeast Surface Display

[0316] Induction of the transformed yeasts in SG-CAA induction medium (6.7 g / L yeast nitrogen base without casamino acids, 20 g / L, 5 g / L casamino acids, 100 mM sodium phosphate, pH 6.0) allows the expression of the antigen (i.e., human AGR2 WT) on the yeast surface.Flow cytometry sorting

[0317] 107induced cells were washed with ImL of PBSF (PBS with 0.1% BSA). The cells were then resuspended in an appropriate volume of solution containing 3 nM of Agtuzumab or 500 pM of TH- 10c humanized monoclonal antibody. After 2 hours of incubation at 20°C with agitation, the cells were washed with 1 mL of ice-cold PBSF (to avoid dissociation). Then, the cells were incubated with anti-human PE fluorescent reporter on ice for 15 minutes. The cells were then sorted on a BD FACSAria™!!! cytometer using the BD FACSDiva™ software.Next generation sequencing and data analysis

[0318] Plasmids from each sorted yeast population were extracted and prepared for sequencing. A two-step PCR was performed: a first step to amplify the region of interest and a second step to add the Illumina adapters needed for sequencing. Sequencing was performed on an Illumina iSeqlOO instrument (2x150 bp, 300 cycles) with at least 150,000 reads per population. The data were then processed through an analysis pipeline using dedicated proprietary scripts. Poor quality sequences (Q<30) were removed, then mono-mutants were detected and counted.Results

[0319] Deep Mutational Scanning (DMS) is a mutagenesis method that aims to perform all possible mono-substitutions on all selected residues within a given protein sequence. The DMS library is obtained in the form of DNA coding for the protein under study (i.e.,human AGR2 protein in this case). In this library, each DNA strand contains a codon that is mutated with respect to the parental sequence.

[0320] This DMS DNA library is integrated into an expression plasmid specifically designed to express recombinant proteins on the yeast surface. Yeasts are then transformed and induced to allow the expression of the mono-mutated proteins on their surface. This new library (called display library) is screened by flow cytometry using fluorescent reporters to reveal the expression of the protein (anti-tag fluorescent antibody) as well as the binding of the protein to its partner (fluorescent partner).

[0321] For epitope mapping, the ideal case is to have two antibodies with compatible epitopes that can bind together on the same antigen. In this way, each of the two antibodies acts as a conformational control of the mutated antigen for the other antibody. Indeed, mono-substitutions made on the antigen can have 4 types of effects:1. Loss of affinity for the first antibody, while retaining binding for the second: this is a mutation made within the epitope of the first antibody.2. Loss of affinity for the second antibody, while retaining binding for the first: this is a mutation in the epitope of the second antibody.3. Loss of affinity for both antibodies: this is a so-called "destructuring" mutation which affects the conformation of the antigen and thus prevents the binding of both antibodies.4. No effect: the mutation is not present in the epitope of one of the two antibodies and does not cause a significant change in the conformation of the antigen.

[0322] Following flow cytometry analysis, the yeast population that has lost affinity for the antibody of interest while retaining binding for the second antibody is sorted. The plasmids contained in this yeast population are extracted and sequenced by high- throughput sequencing. Analysis of the sequencing data allows the identification of mutations that have affected the binding of the antibody to its target. Thus, this analysis allows to identify the important positions on the antigen for the binding of the antibody of interest: i.e., its epitope.

[0323] The epitope bound by Agtuzumab and by TH-lOc humanized monoclonal antibody were identified using DMS. As shown on Figure 1, the epitope bound byAgtuzumab and the epitope bound by TH- 10c humanized monoclonal antibody are located in two distinct domains of the human AGR2 protein. Agtuzumab epitope contains as most important amino acid residues: the histidine residue at position 117 (Hl 17), the aspartic acid residue at position 121 (D121) and the tyrosine residue at position (124). On the other hand, the epitope bound by TH- 10c humanized monoclonal antibody contains as most important amino acid residues: the aspartic acid residue at position 140 (DI 40), the arginine residue at position 144 (R144), the proline residue at position 154 and the lysine residue at position 159 (LI 59).Example 4: Cross-reactivity and specificity of the anti-AGR2 humanized monoclonal antibodiesMaterial and MethodsELISA

[0324] ELISA optimized plates were coated with human AGR2 WT (SEQ ID NO: 1), mouse AGR2 (SEQ ID NO: 2), dog AGR2 (SEQ ID NO: 6), cynomolgus monkey AGR2 (SEQ ID NO: 43), human AGR3 or BSA at a concentration of 1 pg / mL in 50 pL per well and incubated overnight at 4°C. Then, plates were washed using 300 pL per well of PBS with 0.05% of Tween 20. Plates were blocked using 150pL per well of PBS with 2.5% milk during 1 hour at room temperature. Then, plates were washed using 300 pL per well of PBS with 0.05% of Tween 20. TH-lOcl, TH-10c2 and TH-10c3 antibodies were diluted at an initial concentration of 10 pg / mL and serially diluted at % down to 0.15 ng / mL. Antibodies were added to the plates and incubated for 2 hours at room temperature. Plates were washed three times using 300 pL per well of PBS with 0.05% of Tween 20. Anti-human IgGl conjugated to HRP (Sigma A0170-lmL, lot: 0000088179) secondary antibody diluted 1 / 2000 was added to the plates and incubated for 1 hour at room temperature. Detection was performed using TMB (KPL 52-00-01; lot 10602343). Reaction was stopped by H2SO4 solution and optical density (OD) was read at 450nm.Results

[0325] The binding capacity toward human AGR2 WT, mouse AGR2, dog AGR2, macaque AGR2, human AGR3 or BSA was evaluated for each of TH- 10c 1, TH-10c2 and TH-10c3 humanized monoclonal antibodies using ELISA.

[0326] As shown on Figures 3A-C, all antibodies were able to recognize and bind human AGR2 WT. Additionally, all antibodies were able to cross-react with mouse AGR2, dog AGR2 and macaque AGR2, while none of them was able to bind human AGR3 or BSA used as a control.

[0327] As shown on Table 3 below, Agtuzumab binds to human AGR2 with an affinity in the nanomolar range. All other antibodies (i.e., TH-lOcl, TH-10c2 and TH-10c3) show a very strong binding to AGR2 with a KD value under 85 pM.Table 3: Dissociation constant (KD), association rate constant (ka) and dissociation rate constant (Kdis) towards human AGR2 measured for Agtuzumab IgGl-LALA, TH-lOcl, TH-10c2 and TH- 10c 3 IgGl-LALA antibodies.Example 5: Thermal stability of the anti-AGR2 humanized monoclonal antibodiesMaterial and Methods

[0328] Thermal stability of Agtuzumab IgGl-LALA, TH-lOcl, TH-10c2 and TH-10c3 IgGl-LALA humanized monoclonal antibodies was evaluated by Differential Scanning Calorimetry (DSC).

[0329] Data were fitted using the MicroCai PEAQ DSC Analysis software to a non-two- state unfolding model and included buffer subtraction. Subsequently, the thermaltransition midpoint (Tm), representing the point at which there is an equal amount of folded / unfolded protein undergoing a transition, was determined. The calorimetric enthalpy (AHcal) was calculated from the integrated area under the peak of the transition and represented the total heat energy uptake by the sample undergoing the transition. This heat uptake depended on the concentration of sample in the sample cell of the instrument that was undergoing transition and was a model-free absolute measure of the enthalpy of the process involved.Results

[0330] As shown on Table 4, all humanized monoclonal antibodies of the invention displayed a better thermal stability than Agtuzumab.Table 4: Melting temperature (Tm) of the Fab fragments of Agtuzumab IgGl-LALA, and TH-lOcl, TH-10c2 and TH- 10c 3 IgGl-LALA humanized monoclonal antibodies.Example 6: Effect of the anti-AGR2 humanized monoclonal antibodies on myofibroblast differentiationMaterial and MethodsFibroblast to myofibroblast differentiation of the CCD-18Co

[0331] CCD-I8C0 cells were seeded in six-well plates (1 x 106cells / well) and grown for 48 hours before treatments. Endoplasmic reticulum (ER) stress was induced on CCD- I8C0 cells with 10 pg / mL Tunicamycin (Tm, Sigma, solubilized in DMSO) and DMSO was used as control condition (at the same final concentration) to monitor the response of CCD- 18 to Tm. The CCD-I8C0 cell differentiation-positive control was obtained usinga 48 hours treatment with 10 ng / mL of TGF-pi (R&D systems) added in the media of CCD-I8C0 cells (after 24 hours of serum starvation and addition of 1% FBS at the time of stimulation). The supernatants of HT-29 cells, pre-conditioned or not by Tm (thus, subject or not to a transient ER stress) and collected 8, 24, and 32 hours after the media change, were applied on CCD-18C0 cells, as inducing conditions, for further 48 hours of incubation. The HT-29 supernatant was used without any freezing cycle. The capacity of recombinant human AGR2 (rAGR2) to induce fibroblast to myofibroblast differentiation was investigated by application of 40 ng / mL of rhAGR2 in the media of CCD-I8C0 cells (after 24 hours of serum starvation and addition of 1% FBS at the time of stimulation), the control being the same condition without rhAGR2 supplementation. The impact of AGR2 blockade, using Agtuzumab or TH- 10c anti-AGR2 humanized monoclonal antibodies, supplemented to the conditions with rhAGR2 or to the HT-29 supernatant preconditioned by Tm, was evaluated. The HT-29 and CCD-I8C0 cells were harvested and treated for either total protein extracts [stored at -20°C] or for RNA extractions [stored at -80°C], HT-29 supernatants collected for analysis were stored at -20°C. Samples were used for immunofluorescence analyses, western blot, and RNA extraction and RT-qPCR.Example 7: Potency of anti-AGR2 humanized monoclonal antibodies to inhibit cell adhesionMaterial and MethodsPC-3 adhesion assay

[0332] Briefly, PC-3 cells were grown in F-12K Nut Mix medium supplemented with Fetal Bovine Serum and Penicillin / Streptomycin (ThermoFisher Scientific, Waltham, MA, USA). High binding plates were coated overnight with recombinant AGR2 (Thabor internal batch), washed with PBS, blocked with BSA (StemCell, Vancouver, BC, Canada), and incubated with or without anti-AGR2 antibodies and their isotype control for 2 hours. After a series of washes, the PC-3 cells were seeded and incubated for 1 hour. Cell adhesion was measured using CellTiter-Glo and the GloMax plate reader (Promega, Madison, WI, USA).Results

[0333] As shown on Figure 4, isotype control monoclonal antibody did not inhibit PC- 3 cell adhesion. Agtuzumab, like the isotype control, did not inhibit PC-3 cell adhesion. In contrast, TH-lOcl humanized monoclonal antibody successfully inhibited PC-3 cell adhesion with an IC50 of 4.291 pg / mL.Example 8: Binding of the anti-AGR2 humanized monoclonal antibodies to AGR2Material and MethodsELISA

[0334] ELISA optimized plates were coated with recombinant human AGR2 (rec- huAGR2) at a concentration of 1 pg / mL in 50 pL per well and incubated overnight at 4°C. Then, plates were washed using 300 pL per well of PBS with 0.05% of Tween 20. Plates were blocked using 150pL per well of PBS with 2.5% milk during 1 hour at room temperature. Then, plates were washed using 300 pL per well of PBS with 0.05% of Tween 20. All anti-AGR2 optimized monoclonal antibodies were diluted at an initial concentration of 10 pg / mL and serially diluted at 1 / 2 down to 0.08 ng / mL. Antibodies were added to the plates and incubated for 2 hours at room temperature. Plates were washed three times using 300 pL per well of PBS with 0.05% of Tween 20. Anti-human IgGl conjugated to HRP (Sigma A0170-lmL, lot: 0000088179) secondary antibody diluted 1 / 2000 was added to the plates and incubated for 1 hour at room temperature. Detection was performed using TMB (KPL 52-00-01; lot 10602343). Reaction was stopped by H2SO4 solution and optical density (OD) was read at 450nm, and relative fluorescence unit (RFU) was determined.Results

[0335] In order to demonstrate the ability of the optimized monoclonal antibodies of the invention to bind eAGR2, increasing concentrations of antibodies (namely TH-lOcl, TH- 10c2 and TH-10c3) were incubated on immobilized recombinant human AGR2 (rec- huAGR2). The amount of AGR2-bound antibodies was detected using a fluorophore-labeled secondary antibody and by fluorescence reading. The addition of increasing concentrations of all optimized monoclonal antibodies of the invention induced an increase of the measured fluorescence, showing the binding of all optimized monoclonal antibodies of the invention to AGR2 (Figure 5). On the contrary, as expected, no change in fluorescence was observed when using the isotype control.

[0336] In conclusion, the optimized monoclonal antibodies of the invention have the ability to bind AGR2.Example 9: Evaluating the efficacy of anti-AGR2 antibodies in in vitro assays in relation to the pathophysiology of Inflammatory Bowel Disease (IBD)

[0337] Inflammatory Bowel Disease, encompassing Crohn’s disease and ulcerative colitis, is characterized by persistent inflammation of the gastrointestinal tract. The pathophysiology of IBD is characterized by dysregulated immune responses, epithelial injury, and impaired tissue repair mechanisms. Emerging evidence indicates that the adhesion between epithelial cells and extracellular matrix proteins is crucial for maintaining epithelial integrity, promoting wound healing, and preventing excessive inflammation. Epithelial integrity in the gut is essential for sustaining a physical barrier against harmful pathogens, toxins, and commensal bacteria. In IBD, disruption of this barrier results in epithelial cell apoptosis, necrosis, and immune cell infiltration, thereby contributing to the chronic inflammatory response. eAGR2 has been recently shown by the inventors to be implicated in regulating epithelial cell adhesion by interacting with extracellular matrix components such as fibrinogen (data not shown), a key mediator in fibrin and clot formation and wound healing. This interaction is significant in the pathogenesis of IBD, as eAGR2-fibrinogen binding may facilitate the recruitment of inflammatory cells to damaged mucosa, exacerbate tissue injury, and impair mucosal healing.

[0338] Accordingly, in order to evaluate the therapeutic potential of optimized monoclonal antibodies of the invention in IBD, the inventors assessed the anti-eAGR2 antibody effect on AGR2-dependent cell adhesion, AGR2-dependent fibroblast migration and fibrin formation (see Examples 10-12 below).Example 10: Inhibition of AGR2-dependent cell adhesion by the anti-AGR2 humanized monoclonal antibodiesAssay description and aim

[0339] In the context of Crohn’s disease, dysregulation of eAGR2 expression or function could contribute to compromised epithelial cohesion, increased permeability, and impaired tissue repair, further aggravating the inflammatory process.

[0340] Cell adhesion molecules (CAMs), which mediate the interaction between epithelial cells and the extracellular matrix, are essential for maintaining epithelial integrity. AGR2 interacts with several adhesion molecules, including fibrinogen, which plays a role in modulating cell adhesion and recruitment of immune cells to sites of injury. In IBD, these interactions are upregulated, promoting inflammation and further destabilizing the epithelial barrier.

[0341] The inventors have demonstrated in vivo that, antibodies targeting eAGR2 have the potential to inhibit these interactions and restore epithelial integrity, probably by blocking the binding of eAGR2 to fibrinogen and other CAMs involved in cell adhesion. By preventing eAGR2 from facilitating immune cell adhesion and disrupting tight junctions between epithelial cells, anti-AGR2 antibodies may help preserve the structural integrity of the intestinal epithelium, reducing permeability and limiting inflammation.

[0342] An assay that measures antibody-mediated inhibition of cell adhesion enables assessing epithelial integrity in IBD. Testing the efficacy of anti-eAGR2 antibodies in inhibiting cell adhesion is a critical step in demonstrating and understanding their potential as effective therapeutic agents for IBD.Material and MethodsHT-29 adhesion assay

[0343] Briefly, HT-29 cells were grown in McCoy’s 5a medium modified supplemented with Fetal Bovine Serum and Penicillin / Streptomycin (ThermoFisher Scientific, Waltham, MA, USA). High binding plates were coated overnight with recombinant AGR2, washed with PBS, blocked with BSA (StemCell, Vancouver, BC, Canada), and incubated with or without anti-AGR2 antibodies and their isotype control for 2 hours.After a series of washes, HT-29 cells were seeded on rec-huAGR2-coated (20 pg / mL) plates, previously exposed (or not) to optimized monoclonal antibodies of the invention (black), to Agtuzumab (grey) or to the isotype control (open dot) (25 pg / mL). The quantity of attached cells (measured using CellTiter-Glo and a GloMax plate reader) is proportional to the luminescence (relative luminescence unit (RLU)). The percentage of adhesion was calculated by subtracting the RLU value of the no-cell control from all values, and subsequently dividing the resulting values by the value of cells not exposed to any antibodies (100% of adhesion) and multiplying by 100 (Figure 6). Differences in percentages of adhesion were compared with a one-way ANOVA test against the Agtuzumab condition (Figure 6 and Table 5) or the Isotype Control condition (Table 5) (**=p < 0.01, ***=p < 0.001, ****=p < 0.0001). Figure 6 and Table 5 present two independent experiments, with n=2-3 in each experiment. Values are expressed as the mean ± SEM.Results

[0344] The ability of the optimized monoclonal antibodies of the invention to inhibit the AGR2-dependent adhesion of colonic epithelial cells was assessed by measuring the adhesion of HT-29 cells to immobilized rec-huAGR2, pre-exposed or not to anti-AGR2 optimized monoclonal antibodies. The incubation of HT-29 cells on rec-huAGR2-coated wells increased the percentage of adhered cells in comparison with uncoated or BSA coated (irrelevant protein) wells. The addition of all anti-AGR2 antibodies significantly decreased the amount of AGR2-adhered cells in comparison with the isotype control condition (Figure 6 and Table 5). Moreover, all optimized monoclonal antibodies of the invention tended to decrease more the amount of adhered cells in comparison with Agtuzumab (Figure 6).Table 5: Statistical significance of differences in adhesion percentage determined with a one-way ANOVA test against the Agtuzumab condition or the Isotype Control condition

[0345] In conclusion, the optimized monoclonal antibodies of the invention significantly inhibit AGR2-dependent colonic cell line adhesion.Example 11: Inhibition of AGR2-dependent colonic fibroblast migration by the anti- AGR2 humanized monoclonal antibodiesAssay description and aim

[0346] In the context of Crohn’ s disease, dysregulation of eAGR2 expression or function could contribute to compromised epithelial cohesion, increased permeability, and impaired tissue repair, further aggravating the inflammatory process.

[0347] Cell adhesion molecules (CAMs), which mediate the interaction between epithelial cells and the extracellular matrix, are essential for maintaining epithelial integrity. AGR2 interacts with several adhesion molecules, including fibrinogen, which plays a role in modulating cell adhesion and recruitment of immune cells to sites of injury. In IBD, these interactions are upregulated, promoting inflammation and further destabilizing the epithelial barrier.

[0348] The inventors have demonstrated in vivo that, antibodies targeting eAGR2 have the potential to inhibit these interactions and restore epithelial integrity, probably by blocking the binding of eAGR2 to fibrinogen and other CAMs involved in cell adhesion. By preventing eAGR2 from facilitating immune cell adhesion and disrupting tight junctions between epithelial cells, anti-AGR2 antibodies may help preserve the structural integrity of the intestinal epithelium, reducing permeability and limiting inflammation.

[0349] An assay that measures antibody-mediated inhibition of cell adhesion enables assessing epithelial integrity in IBD. Testing the efficacy of anti-eAGR2 antibodies in inhibiting cell adhesion is a critical step in demonstrating and understanding their potential as effective therapeutic agents for IBD.Material and Methods

[0350] To study the effect of eAGR2 on fibrosis, the ability of human colonic fibroblasts to migrate upon eAGR2 stimulation was assessed in a model of scratch assay. For that purpose, CCDI8-C0 cells (human primary colonic fibroblasts) were seeded onto 96-well tissue culture treated plates and incubated at 37°C, 5% CO2 in order to obtain a monolayer of confluent CCDI8-C0. After 24 hours, cells were starved for 6 hours and scratched using the Incucyte® 96-well Woundmaker Tool (Sartorius, Gottingen, Germany). Rec- huAGR2 (100 pg / mL) or BS A (100 pg / mL; irrelevant protein) were added to the freshly scratched cell monolayer, in the presence or absence of optimized monoclonal antibodies of the invention, of Agtuzumab or of their isotype control (880 pg / mL; 1 : 1 eAGR2:mAb ratio). Cells were incubated at 37°C, 5% CO2, and fibroblast migration was recorded every hour for 24 hours using the Incucyte SX5 Live-Cell Analysis System (Sartorius). All experiments were conducted in starvation medium to avoid cell proliferation.

[0351] Figure 7 and Table 6 show 2-9 experiments with triplicates. Values are expressed as the mean ± SEM, and a one-way ANOVA was used against the AGR2+Agtuzumab condition (Figure 7 and Table 6) or the AGR2+Isotype Control condition (Table 6) (*=p<0.05, **=p<0.01, ***=p<0.001, ****=p<0.0001).Results

[0352] To study the effect of eAGR2 on fibrosis, the ability of human colonic fibroblasts to migrate upon eAGR2 stimulation was assessed in a model of scratch assay. The addition of rec-huAGR2 to a scratched monolayer of CCDI8-C0 (colonic fibroblasts) induced an increase of fibroblast migration, as seen by an increase of the relative scratch density.

[0353] Optimized monoclonal antibodies of the invention (TH-10-cl and TH-10-c3) significantly decreased the AGR2-dependent colonic fibroblast migration in comparison with the isotype control, while Agtuzumab showed no effect on AGR2-dependent colonic fibroblast migration (Table 6). Optimized monoclonal antibodies of the invention (TH- 10-cl and TH-10-c3) were also significantly more potent than Agtuzumab in reducing the AGR2-dependent colonic fibroblast migration (Figure 7 and Table 6).Table 6: Statistical significance of differences in cell migration inhibition determined with a one-way ANOVA test against the Agtuzumab condition or the Isotype Control condition

[0354] In conclusion, optimized monoclonal antibodies of the invention are more potent than Agtuzumab in inhibiting AGR2-dependent colonic fibroblast migration.Example 12: Abrogation of AGR2-mediated inhibition of fibrin formation by the anti-AGR2 humanized monoclonal antibodiesAssay description and aim

[0355] Wound healing within the gastrointestinal tract is a complex, multiphase process encompassing clot formation, inflammation, tissue repair, and remodeling. Fibrinogen, a crucial component of the extracellular matrix, plays a pivotal role in fibrin and clot formation and tissue repair. The protein eAGR2 has been recently shown by the inventors to be implicated in the regulation of the fibrinogen pathway, which is vital for both wound healing and the maintenance of the structural integrity of the gut epithelium. The inventors demonstrated that eAGR2 inhibits fibrin polymerization, which is a central stepin the coagulation cascade responsible for clot formation. By preventing fibrin polymerization, eAGR2 can suppress clot formation at the site of injury. A lack of clot formation could impair the formation of protective fibrin matrices, disrupt tissue repair, and exacerbate epithelial damage. The aberrant eAGR2 activity can contribute to a chronic inflammatory state, impede epithelial barrier repair, and disturb the coagulation response, all of which are central to IBD pathophysiology.

[0356] Impaired clotting and wound healing are characteristic of IBD pathology. Inflammatory responses in IBD disrupt normal wound healing, resulting in persistent ulcers and epithelial damage. Therefore, the inventors performed a fibrin assay to evaluate the role of eAGR2 in fibrinogen-mediated wound healing which is involved in inflammatory bowel disease (IBD). By assessing the impact of anti-eAGR2 antibodies on fibrinogen-induced fibrin formation, which reflects tissue repair, this assay provides valuable insights into how eAGR2 modulates the early stages of wound healing in IBD and facilitates the evaluation of the potency of anti-eAGR2 monoclonal antibodies.Material and Methods

[0357] To investigate the effect of eAGR2 on fibrin polymerization, an in vitro fibrin formation assay was established. Briefly, in a 96-well plate, purified native human fibrinogen was combined with recombinant human eAGR2 (rec-huAGR2) and an antibody (an optimized monoclonal antibody of the invention, or Agtuzumab, or their isotype control). The molar ratios employed were 50-fold molar excess of rec-huAGR2 relative to fibrinogen, and a 1 :2 molar ratio of antibody to rec-huAGR2. Fibrin polymerization was initiated by adding activated human thrombin and quantitatively monitored by measuring the absorbance at 405 nm, which correlates with turbidity, over a 2-hour period at 37°C using a Glomax plate reader (Promega, Madison, WI, USA). Background (fibrinogen without thrombin) was subtracted from the results. Values are expressed as the mean ± SEM, and a one-way ANOVA test was used against the AGR2+Agtuzumab condition (Figure 8 and Table 7) or the AGR2+Isotype Control condition (Table 7) (n=2) (*=p<0.05, **=p<0.01, ***=p<0.001, ****=p<0.0001 ).Results

[0358] Activated thrombin cleaves fibrinogen into fibrin, which may subsequently polymerize and participate in wound healing. However, when present, AGR2 binds fibrinogen, thus inhibiting fibrin polymerization.

[0359] Addition of activated thrombin to fibrinogen leads to fibrin formation and then polymerization that can be visualized through absorbance reading at 405 nm. Our in vitro assay clearly demonstrated that addition of AGR2 resulted in a marked decrease in fibrin formation, as directly observed through reduced turbidity compared to the control. The optimized monoclonal antibodies of the invention exhibited a significantly greater potency than Agtuzumab in counteracting this AGR2-dependent inhibition of fibrin formation (Figure 8 and Table 7). Importantly, the optimized monoclonal antibodies of the invention significantly abrogated the inhibitory effect of AGR2 on fibrin polymerization, while Agtuzumab did not (Table 7, versus AGR2+isotype control).Table 7: Statistical significance of differences in the abrogation of AGR2 -mediated inhibition of fibrin formation, determined with a one-way ANOVA test against the AGR2+ Agtuzumab condition or the AGR2+ Isotype Control condition

[0360] In conclusion, the optimized monoclonal antibodies of the invention significantly abrogate the AGR2-dependent inhibition of fibrin formation, while Agtuzumab fails to do so.ConclusionUse of the optimized monoclonal antibodies of the invention to inhibit eAGR2-fibrinogen interaction presents a promising strategy to modulate various aspects of IBD pathophysiology, including epithelial integrity, fibroblast migration, and wound healing. Cell adhesion, fibroblast migration and fibrin formation data provided herein show the potency of the optimized monoclonal antibodies of the invention, which are effective against the pathogenesis and progression of IBD. These data show the mechanisms by which eAGR2 contributes to IBD and demonstrate the therapeutic potential of targeting eAGR2 with the optimized monoclonal antibodies of the invention in IBD management.

Claims

CLAIMS1. An isolated antibody, or binding fragment thereof, that specifically binds to Anterior Gradient 2 protein (AGR2), wherein said antibody, or binding fragment thereof, comprises: a heavy chain variable region (VH) comprising the following three complementary- determining regions (CDRs):- CDR1 : DYWMS (SEQ ID NO: 8);- CDR2: DIKFDGSFTNYAPSLKN (SEQ ID NO: 9);- CDR3 : EANYPGLTFD Y (SEQ ID NO : 10); and a light chain variable region (VL) comprising the following three CDRs:- CDR1 : XASEGISNYLA (SEQ ID NO: 11) wherein X is L or R;- CDR2: YASSLQD (SEQ ID NO: 14); and- CDR3: QQSYKYPLT (SEQ ID NO: 15).

2. The isolated antibody, or binding fragment thereof, according to claim 1, wherein said antibody, or binding fragment thereof, comprises: a heavy chain variable region (VH) comprising framework regions sharing at least 80% sequence identity with the framework regions of SEQ ID NO: 16; and a light chain variable region (VL) comprising framework regions sharing at least 80% sequence identity with the framework regions of SEQ ID NO: 19; or a heavy chain variable region (VH) comprising framework regions sharing at least 80% sequence identity with the framework regions of SEQ ID NO: 16; and a light chain variable region (VL) comprising framework regions sharing at least 80% sequence identity with framework regions of SEQ ID NO: 20; or a heavy chain variable region (VH) comprising framework regions sharing at least 80% sequence identity with the framework regions of SEQ ID NO: 16; and a light chain variable region (VL) comprising framework regions sharing at least 80% sequence identity with the framework regions of SEQ ID NO: 21.

3. The isolated antibody, or binding fragment thereof, according to claim 1 or 2, wherein said antibody, or binding fragment thereof, comprises:a heavy chain variable region (VH) having a sequence consisting of sequence SEQ ID NO: 16; and a light chain variable region (VL) having a sequence consisting of sequence SEQ ID NO: 19; or a heavy chain variable region (VH) having a sequence consisting of sequence SEQ ID NO: 16; and a light chain variable region (VL) having a sequence consisting of sequence SEQ ID NO: 20; or a heavy chain variable region (VH) having a sequence consisting of sequence SEQ ID NO: 16; and a light chain variable region (VL) having a sequence consisting of sequence SEQ ID NO: 21.

4. The isolated antibody, or binding fragment thereof, according to any one of claims 1 to 3, wherein said antibody, or binding fragment thereof, is an immunoconjugate.

5. A nucleic acid encoding the antibody, or binding fragment thereof, according to any one of claims 1 to 4.

6. An expression vector comprising the nucleic acid according to claim 5.

7. A cell comprising the nucleic acid according to claim 5 or the expression vector according to claim 6.

8. A pharmaceutical composition comprising the isolated antibody, or binding fragment thereof, according to any one of claims 1 to 4, the nucleic acid according to claim 5, the expression vector according to claim 6, or the cell according to claim 7, and at least one pharmaceutically acceptable excipient.

9. The isolated antibody, or binding fragment thereof, according to any one of claims 1 to 4, the nucleic acid according to claim 5, the expression vector according to claim 6, the cell according to claim 7, or the pharmaceutical composition according to claim 8, for use as a medicament.

10. The isolated antibody, or binding fragment thereof, according to any one of claims 1 to 4, the nucleic acid according to claim 5, the expression vector according to claim 6, the cell according to claim 7, or the pharmaceutical composition accordingto claim 8, for use in the treatment of a mucosal inflammatory disease, or a cancer, in a subject in need thereof.

11. The isolated antibody, or binding fragment thereof, according to any one of claims 1 to 4, the nucleic acid according to claim 5, the expression vector according to claim 6, the cell according to claim 7, or the pharmaceutical composition according to claim 8, for use according to claim 10, wherein said isolated antibody, or binding fragment thereof, neutralizes the pro-inflammatory activity of eAGR2 and / or the pro-fibrotic activity of eAGR2.

12. The isolated antibody, or binding fragment thereof, according to any one of claims 1 to 4, the nucleic acid according to claim 5, the expression vector according to claim 6, the cell according to claim 7, or the pharmaceutical composition according to claim 8, for use according to claim 10 or 11, wherein the mucosal inflammatory disease is selected from the group consisting of Crohn’s disease, ulcerative colitis, primary sclerosing cholangitis, chronic pancreatitis, microscopic colitis, inflammatory bowel disease (IBD), endometriosis, appendicitis, inflammatory bowel syndrome, idiopathic pulmonary fibrosis, systemic sclerosis, systemic sclerosis associated with interstitial lung disease, asthma and chronic obstructive pulmonary disease.

13. The isolated antibody, or binding fragment thereof, according to any one of claims 1 to 4, the nucleic acid according to claim 5, the expression vector according to claim 6, the cell according to claim 7, or the pharmaceutical composition according to claim 8, for use according to claim 10 or 11, wherein said cancer is selected from the group consisting of colon cancer, gastrointestinal cancer, prostate cancer, pancreatic cancer, oral cancer, breast cancer, lung cancer, ovarian cancer, thyroid cancer, cholangiocarcinoma, head and neck squamous cell carcinoma, brain glioblastoma, adrenocortical carcinoma, bladder cancer, kidney cancer, penile cancer, renal cancer, testicular cancer, urethral cancer, colorectal cancer, cervical cancer, uterine cancer, endometrial cancer, vaginal cancer, vulvar cancer, gestational trophoblastic disease (GTD), and primary peritoneal cancer.

14. An in vitro method for detecting or quantifying AGR2 expression in a biological sample, comprising contacting said biological sample with the isolated antibody, or binding fragment thereof, according to any one of claim 1 to 4.

15. The in vitro method according to claim 14, wherein said method is for diagnosing or monitoring an AGR2-related disease in a subject, or for selecting a subject suffering from an AGR2-related disease for treatment targeting said disease.

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