A method to prevent, inhibit the progression of, reduce the severity of, or treat cardiac, vascular or skeletal dysfunction or defect(s) in a human having lysosomal storage disorder, is provided.

An asymmetric fusion protein in which a fragment of an antibody binding to an insulin receptor, an iduronate-2-sulfatase (IDS) enzyme, and an Fc region are fused, and a use thereof are disclosed. The fusion protein can cross the blood-brain barrier (BBB) to deliver the IDS enzyme to the brain. Therefore, a pharmaceutical composition containing the fusion protein as an active ingredient can be used as a therapeutic agent for a central nervous system disease and particularly, is expected to prevent and treat various diseases caused by ribosome accumulation.

Provided herein are methods and compositions for treating a subject suffering from a deficiency in iduronate 2-sulfatase in the CNS. The methods include systemic administration of a bifunctional fusion antibody comprising an antibody that crosses the blood brain barrier (BBB) and an iduronate 2-sulfatase.

Lysosomal storage diseases can be successfully treated using intraventricular delivery of the enzyme which is etiologically deficient in the disease. The administration can be performed slowly to achieve maximum effect. Surprisingly, effects are seen on both sides of the blood-brain barrier, making this an ideal delivery means for lysosomal storage diseases which affect both brain and visceral organs.

Disclosed herein are a modified iduronate 2-sulfatase, a composition comprising a modified iduronate 2-sulfatase, as well as methods for preparing a modified iduronate 2-sulfatase and therapeutic use of such a iduronate 2-sulfatase. In particular, the present disclosure relates to a modified iduronate 2-sulfatase sulfatase comprising substantially no epitopes for glycan recognition receptors, wherein said iduronate 2-sulfatase has a catalytic activity of at least 50% of that of unmodified iduronate 2-sulfatase in vitro.

Disclosed herein are a modified lysosomal protein, methods for preparing a modified lysosomal protein and therapeutic use of such a modified protein. Further disclosed herein is a method of treating a mammal afflicted with a lysosomal storage disease. In particular, the present disclosure relates to a method of preparing a modified lysosomal protein, said method comprising reacting a glycosylated lysosomal protein with an alkali metal periodate and reacting said lysosomal protein with an alkali metal borohydride for a time period of no more than 2 h, thereby modifying glycan moieties of the lysosomal protein and reducing the activity of the lysosomal protein with respect to glycan recognition receptors.

Provided herein are methods and compositions for treating a subject suffering from a deficiency in iduronate 2-sulfatase in the CNS. The methods include systemic administration of a bifunctional fusion antibody comprising an antibody that crosses the blood brain barrier (BBB) and an iduronate 2-sulfatase.

A delivery (transport) of therapeutic enzymes, which is applicable in medicine, is disclosed. A compound containing a therapeutic enzyme and a transport element that are coupled to one another directly or by a linker is described, the transport element being a Fab fragment of immunoglobulin IgG specific to an insulin receptor epitope, and to the use of said compound to produce a pharmaceutical composition for treating diseases, as well as to the use of said compound for the treatment and prophylaxis of diseases, in particular lysosomal storage diseases, inter alia, for the treatment and prophylaxis of the enzyme deficiency characteristic of the respective lysosomal storage disease, such as mucopolysaccharidosis, in particular mucopolysaccharidosis types I and II.

The present invention provides, among other things, compositions and methods for CNS delivery of lysosomal enzymes for effective treatment of lysosomal storage diseases. In some embodiments, the present invention includes a stable formulation for direct CNS intrathecal administration comprising an iduronate-2-sulfatase (I2S) protein, salt, and a polysorbate surfactant for the treatment of Hunters Syndrome.

The present invention provides pharmaceutical compositions comprising an a blood brain barrier peptide and a human peptide, such as an alpha-L-iduronidase (IDUA) protein, an iduronate-2-sulfatase protein (IDS) protein, or an a galactosidase A protein (-Gal A) protein. The invention further provides methods of use for treating Mucopolysaccharidosis type I (MPS I), including Hurler Syndrome, Hurler-Scheie Syndrome and Scheie Syndrome; methods of use for treating Hunter syndrome; and methods of use for treating Fabry disease.