Therapeutic pegylated growth hormone antagonists
11452763 · 2022-09-27
Inventors
- Richard S. Brody (Galena, OH, US)
- Thomas J. Zupancic (Powell, OH, US)
- John J. Kopchick (Athens, OH)
- Reetobrata Basu (Athens, OH, US)
Cpc classification
C07K19/00
CHEMISTRY; METALLURGY
A61K47/60
HUMAN NECESSITIES
International classification
C07K19/00
CHEMISTRY; METALLURGY
A61P35/00
HUMAN NECESSITIES
Abstract
Growth hormone receptor antagonists, comprising human growth hormone receptor antagonist G120K, wherein one amino acid of human growth hormone receptor antagonist G120K has been mutated to cysteine or wherein two amino acids of human growth hormone receptor antagonist G120K have been mutated to cysteine, and wherein the one amino acid mutated to cysteine is T142, and wherein the two amino acids mutated to cysteine are T142 and H151; and a polyethylene glycol molecule conjugated to each substituted cysteine in the human growth hormone receptor antagonist G120K mutant. These growth hormone receptor antagonists are useful in treating diseases or conditions, such as cancer and acromegaly, that are responsive to human growth hormone receptor antagonists.
Claims
1. A method for treating diseases or conditions responsive to human growth hormone receptor antagonists, comprising administering to the patient an effective amount of a human growth hormone receptor antagonist, comprising: (a) human growth hormone receptor antagonist G120K having a DNA sequence of SEQ ID NO: 3 and an amino acid sequence of SEQ ID NO: 4, wherein two amino acids of human growth hormone receptor antagonist G120K have been mutated to cysteine, wherein the two amino acids mutated to cysteine are T142 and H151; and (b) a polyethylene glycol molecule conjugated to each substituted cysteine in the human growth hormone receptor antagonist G120K mutant, wherein the polyethylene glycol molecules conjugated to the two amino acids mutated to cysteine are two 4.5 kDa branched polyethylene glycols each containing three carboxylate anions, wherein the polyethylene glycol molecule is prepared by step-wise organic chemistry and is a substantially pure single compound, and wherein the polyethylene glycol molecule is a branched structure.
2. The method of claim 1, wherein the diseases or conditions are cancers that express high levels of the growth hormone receptor; high levels of the prolactin receptor; or high levels of both the growth hormone receptor and the prolactin receptor.
3. The method of claim 2, wherein the cancers are breast cancer, central nervous system cancer, melanoma, non-small cell lung cancer, ovarian cancer, prostate cancer, and renal cancer.
4. The method of claim 1, wherein the following amino acids mutations have been made to the human growth hormone receptor antagonist: H18D, H21N, R167N, K168A, D171S, K172R, E174S, and I179T, and wherein these mutations are operative to prevent binding to a prolactin receptor.
5. The method of claim 1, wherein the polyethylene glycol molecule in the human growth hormone antagonist contains a maleimide group for conjugation to a free sulfhydryl group.
6. The method of claim 1, wherein the human growth hormone receptor antagonist is encoded by a DNA having the sequence consisting of SEQ ID NO: 23.
7. The method of claim 1, wherein the human growth hormone receptor antagonist has an amino acid sequence consisting of SEQ ID NO: 24.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
(1) The accompanying drawings, which are incorporated into and form a part of the specification, schematically illustrate one or more example implementations of the disclosed inventive subject matter and, together with the general description given above and detailed description given below, serve to explain the principles of the disclosed subject matter, and wherein:
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DETAILED DESCRIPTION
(27) Example implementations are now described with reference to the Figures. Reference numerals are used throughout the detailed description to refer to the various elements and structures. Although the following detailed description contains many specifics for the purposes of illustration, a person of ordinary skill in the art will appreciate that many variations and alterations to the following details are within the scope of the disclosed inventive subject matter. Accordingly, the following implementations are set forth without any loss of generality to, and without imposing limitations upon, the claimed subject matter.
(28) The present invention provides novel human growth hormone (hGH) antagonists for use primarily as therapeutics, particularly cancer therapeutics. U.S. patent application Ser. No. 16/216,230, (published as US2019/0099497) which is incorporated herein by reference in its entirety for all purposes, discloses the preparation of hGH antagonist molecules that are pegylated in predetermined positions. The hGH antagonists of this invention are typically made by mutating one or more selected amino acids of hGH G120K, a known hGH antagonist, to cysteines and then conjugating the cysteines to chemically activated polyethylene glycol molecules. The positions of the various substituted cysteines were selected for minimal loss in hGH receptor binding activity after conjugation with polyethylene glycol. The size and the number of PEGs added were selected to prevent filtration of these molecules in the kidneys, thereby prolonging in vivo half-lives.
(29) Two important variables in the preparation of the disclosed hGH antagonists include: (i) the amino acid position used for PEG attachment; and (ii) the size and type of the conjugated PEG. Initial research with similar compositions was done using random attachment of relatively small PEGs (e.g., about 5 kDa) to multiple lysines on the surfaces of proteins. This procedure successfully increased the in vivo half-lives of the proteins but resulted in large decreases in the affinity of the proteins for their receptors. More recent experimental approaches have added PEG molecules to specific amino acid sites on proteins. Two common methods used for site specific Pegylation are: (i) addition of PEG to the N-terminal amine of proteins by way of low pH reductive amination; and (ii) addition of PEG to the thiol groups of cysteines that are either native to the protein or engineered into specific positions. Other methods include PEG addition to unnatural amino acids; PEG addition to proteins C-termini by way of intein fusion proteins; and PEG addition to accessible glutamines by way of transaminase catalysis.
(30) Two different types or classes of polyethylene glycol (PEG) molecules are utilized with the present invention. The first class of PEGs was prepared by polymerization and is useful for modifying proteins to increase their in vivo half-lives. This type of PEG is by nature polydispersed, meaning that there is a distribution of molecular weight products around the average molecular weight. The PEGs include a 20 kDa linear PEG (Layson Bio, MPEG-MAL-20,000), a 40 kDa branched PEG (NOF, Sunbright GL2-400MA), and a linear 40 kDa PEG (NOF, Sunbright ME-400MA). These PEGS each contain a maleimide group for conjugation to the free sulfhydryl groups of the mutant proteins. The second class of polyethylene glycols are DPEGS® (discrete polyethylene glycols)(Quanta BioDesign). These DPEGS® (discrete polyethylene glycols) are pure single PEG molecules that are prepared using stepwise, organic chemistry so that each DPEGS® (discrete polyethylene glycols) species is a pure single compound with a specific structure and molecular weight. The DPEGS® (discrete polyethylene glycols) used in this invention, which typically contain a maleimide group for coupling to free thiols, may include the following: a tri-branched molecule with a molecular weight of 4473 Daltons and a carboxylate anion at the terminus of each branch (Quanta BioDesign #10451, MAL-DPEG®A); a neutral tri-branched molecule with a molecular weight of 4299 Daltons (Quanta BioDesign #4229, MAL-DPEG® B); a neutral 9-branched molecule with a molecular weight of 8324 (Quanta Biodesign #10484; MAL-DPEG®E); and a neutral 9-branched molecule with a molecular weight of 15,592 (Quanta Biodesign #11487; MAL-DPEG®F).
(31) Certain of these pegylated antagonists were tested with melanoma cells to determine the ability of these molecules to inhibit the activation of the hGH receptor by hGH; to sensitize these cells to chemotherapy treatment; to inhibit basement membrane invasion stimulated by hGH; and to inhibit hGH stimulated colony formation of non-adherent melanoma cells. Table I, below, includes names and abbreviations for specific human growth hormone (hGH) antagonists disclosed herein.
(32) TABLE-US-00001 TABLE I Designations for Mutant hGH Antagonists Letter SED ID Name Abbreviation Designation NOS: hGH-G120K G120K A 3-4 hGH-G120K-T142C-GL2- T142C-GL2 D 15-16 400MA hGH-G120K-H151C-GL2- H151C-GL2 — 17-18 400MA hGH-G120K-N99C-T142C- N99C-T142C- G 21-22 DPEG ®A.sub.2 DPEG ®A.sub.2 hGH-G120K-H151C-T142C- H151C-T142C- — 23-24 DPEG ®A.sub.2 DPEG ®A.sub.2
(33) All test samples contained the G120K mutation of hGH, which converts the hormone to a hormone antagonist. Single mutants containing either the T142C or H151C mutation were conjugated through their added cysteine to a 40 kDa two branched polyethylene glycol (GL2-400MA). Double mutants containing either N99C and T142C or H151C and T142C had both cysteine positions conjugated to a 4.5 kDa tri-branched polyethylene glycol with a carboxyl group at the end of each branch.
(34) Relative Affinity for the hGH Receptor Determined by Competition ELISA Assays
(35) The amino acid positions of G120K that were mutated to cysteine and subsequently pegylated were selected on the basis of amino acid accessibility and structural energy criteria (see U.S. patent application Ser. No. 16/216,230). Despite the fact that the pegylated mutants were all selected by the same method, there are differences in the affinities of the pegylated mutants for the hGH receptor (see U.S. patent application Ser. No. 16/216,230; Table 2, which is also reproduced herein as TABLE 2). The relative binding affinities of the single mutants substituted with DPEG®A varied between 20% and 100% of the affinity of hGH.
(36) Within a series of similar DPEG®s, the size of the PEG substituent makes a difference in receptor binding affinity (see TABLE 2, below), with the larger DPEG®E (8.3 kDa) and DPEG®F (15.6 kDa) binding more poorly than the smaller DPEG®A (4.5 kDa) or DPEG®B (4.3 kDa). However, PEG size is not the only predictor of hGH receptor binding affinity; the structure of the PEG is also important. Mutants substituted at positions N99C, T142C, and H151C with the 15.6 kDa DPEG®F, which contains nine branches, bind to the hGH receptor with relative affinities of 4%, 20%, and 4% respectively. In contrast, the same three mutants conjugated to a 40 kDa PEG (GL2-MA; 2 branches) all bound to the receptor with 50% of the affinity of hGH.
(37) TABLE-US-00002 TABLE 2 Receptor Binding Activity of hGH 120K Mutants.sup.1 Percent Receptor Binding Activities hGH Mutant Relative to that of hGH Determined from All Mutants Contain the Concentration of Each Sample that the G120K Mutation Yields 50% Inhibition (I.sub.50) DPEG ® Substitution dPEGA.sup.2 dPEGB.sup.2 dPEGE.sup.2 dPEGF.sup.2 G120K-T3C-DPEG ®X 70 70 NT NT G120K-E39C-DPEG ®X 20 NT NT NT G120K-P48C-DPEG ®X 20 NT NT NT G120K-Q69C-DPEG ®X 20 NT NT NT G120K-N99C-DPEG ®X 90 70 40 4 G120K-T142C-DPEG ®X 50 90 50 20 G120K-H151C-DPEG ®X 100 60 40 4 G120K-N99C-DPEG ®X- 20 40 20 —.sup.3 H151C-DPEG ®X G120K-T142C-DPEG ®X- 50 80 30 —.sup.3 N99C-DPEG ®X G120K-T142C-DPEG ®X- 50 40 10 —.sup.3 H151C-DPEG ®X .sup.1The receptor binding activities were determined using a competitive ELISA where the recombinant receptor was bound to a plate and the concentration of each sample needed to inhibit the binding of biotin-hGH to the coated plate by 50% (I50) was determined. The Table entries show the I.sub.50s relative to that of hGH, which is defined as 100%, and are rounded to a single significant figure. Only a single competitive ELISA was run for most of the mutants and the estimated relative standard deviation is 25%. Entries marked NT were not tested in this assay. .sup.2DPEG ®A is a tri-branched molecule with a molecular weight of 4473 Daltons and a carboxylate anion at the terminus of each branch; DPEG ®B is a neutral tri-branched molecule with a molecular weight of 4299 Daltons, DPEG ®E is a neutral 9-branched molecule with a molecular weight of 8324; and DPEG ®F is a neutral 9-branched molecule with a molecular weight of 15,592. .sup.3These reactions did not proceed to the double PEGylated product.
Determination of the Abilities of Pegylated hGH Antagonists to Inhibit the Stimulation of Stat5 Phosphorylation by hGH
(38) Four pegylated mutant antagonists were selected and tested for their abilities to inhibit the hGH stimulation of Stat5 phosphorylation in three human cancer cell lines at a single antagonist concentration. As illustrated in TABLE 3, below, these mutants were all effective antagonists at 50 nM, with the exception of H151C-GL2 with the IM9 cell line.
(39) TABLE-US-00003 TABLE 3 Inhibition of hGH Stimulation of Stat5 Phosphorylation in Different Cell Lines.sup.1 CELL LINES.sup.2 IM9 PANC1 MALME3M TARGET % Inhibition % Inhibition % Inhibition T142C-GL2 70 80 60 H151C-GL2 1 50 60 N99C-T142C-PEG ®A.sub.2 70 100 90 H151C-T142C-DPEG ®A.sub.2 70 90 90 .sup.1Stat5 phosphorylation was measure by ELISA after the cells were incubated with 2.5 nM hGH + 50 nM of the antagonist sample. .sup.2The cell lines used are as follows IM9; human lymphoblast, transformed PANC1; human pancreatic adenocarcinoma MALME3M; melanoma
(40) Pegylated mutant hGH antagonists T142-GL2 (D) and H151C-T142C-DPEG®A.sub.2 (G) were selected for further testing with melanoma cells using non-pegylated mutant G120K (A) as a control.
(41) Behavior of Pegylated hGH Antagonists in In Vitro Assays that Correlate with Anti-Cancer Activity
(42) Cell Viability
(43) Melanoma cells were incubated with pegylated mutant hGH antagonists T142-GL2 (D) and H151C-T142C-DPEG®A.sub.2(G) with non-pegylated G120K mutant (A) as a control in the presence of and in the absence of hGH and the chemotherapy drug doxorubicin. As shown in
(44) Basement Membrane Migration
(45) A known characteristic of cancer cells is their ability to migrate through basement membranes. This migration may be inhibited by chemotherapeutic agents such as doxorubicin. A general method for measuring basement membrane migration of cells, such as cancer cells, is shown in
(46) Results of a basement membrane inhibition assay with melanoma cells and the hGH antagonists G120K (A), T142C-GL2 (D), and H151C-T142C-DPEG®A2(G) are shown in
(47) Colony Formation of Non Adherent Melanoma Cells
(48) The transition of epithelial cells to mesenchymal cells is associated with cancer metathesis. Non-adherence is a key marker of the epithelial-mesenchymal transition. Adherent melanoma cells were treated with either hGH or hGH plus hGH antagonist and non-adherent cells were assayed for their ability to form colonies (
(49) Binding to the Prolactin Receptor
(50) Both human prolactin and hGH bind to and activate the prolactin receptor. The activation of this receptor has been implicated in breast cancer pathogenesis and behavior [8]. Binding of pegylated hGH antagonists T142C-GL2, H151C-GL2, N99C-T142C-DPEG®A2, and H151C-T142C-DPEG®A.sub.2 to the soluble prolactin receptor in a competitive ELISA assay determined that hGH and the pegylated antagonists listed in TABLE 2 (see also, U.S. patent application Ser. No. 16/216,230, Table 2) bind to the prolactin receptor with the relative binding affinities shown in TABLE 4, below.
(51) TABLE-US-00004 TABLE 4 Relative Binding Affinities of Pegylated hGH Antagonists for the Prolactin Receptor Protein Compound Abbreviation hGH 100% T142C-GL2 50% H151C-GL2 40% N99C-T142C-DPEG ®A.sub.2 60% H151C-T142C-DPEG ®A.sub.2 70%
(52) These antagonists are therefore expected to inhibit any facilitation of cancer cell growth mediated by activation of the prolactin receptor by either hGH or prolactin. This is in contrast to the current therapeutic growth hormone antagonist (SOMAVERT®) (pegvisomant), which does not bind to the prolactin receptor [8]-[9].
(53) Growth Hormone Antagonists as Potential Acromegaly Therapeutics
(54) The pegylated growth hormone antagonist SOMAVERT® (pegvisomant) has been approved for treatment of acromegaly. This molecule, which comprises hGH-G120K and eight (8) additional mutations, has four to six 5 kDa linear PEG molecules attached to random lysine residues. The eight additional mutations increase drug affinity for the soluble growth hormone receptor and remove its affinity for the prolactin receptor. SOMAVERT® (pegvisomant) is an effective treatment for acromegaly even though its randomly conjugated PEG molecules reduce its affinity for the hGHR by about 20-fold [10]. The hGH antagonists disclosed herein, with one or two specifically substituted PEGS, only reduce the receptor affinity about 2-fold, making these compounds potentially more effective as acromegaly treatment. However, in order to prepare an acromegaly treatment, the disclosed pegylated antagonists will be modified to prevent off-target prolactin receptor binding, requiring the following mutations: H18D, H21N, R167N, K168A, D171S, K172R, E174S, and I179T [11].
(55) As indicated by the disclosure above, the compositions of the present invention provide novel human growth hormone receptor antagonists that are useful in therapeutic applications. For reference purposes, SEQ ID NO: 1 provides the DNA sequence for human growth hormone WThGH and SEQ ID NO: 2 and provides the amino acid sequence for human growth hormone WThGH (mature form), referred to herein as hGH. Human growth hormone receptor antagonist hGH-G120K, referred to herein as G120K, is the parent receptor antagonist for the compositions of the present invention, and for reference purposes, SEQ ID NO: 3 provides the DNA sequence for human growth hormone receptor antagonist G120K and SEQ ID NO: 4 provides the amino acid sequence for human growth hormone receptor antagonist G120K (mature form). The single letter amino acid abbreviations used herein follow the IUPAC format.
(56) A first example human growth hormone antagonist disclosed herein includes human growth hormone antagonist G120K, wherein amino acid T3 has been mutated to cysteine, and wherein a polyethylene glycol molecule has been conjugated to the cysteine mutation. SEQ ID NO: 5 provides the DNA sequence for human growth hormone antagonist G120K-T3C and SEQ ID NO: 6 provides the amino acid for sequence human growth hormone antagonist G120K-T3C.
(57) A second example human growth hormone antagonist disclosed herein includes human growth hormone antagonist G120K, wherein amino acid E39 has been mutated to cysteine, and wherein a polyethylene glycol molecule has been conjugated to the cysteine mutation. SEQ ID NO: 7 provides the DNA sequence for human growth hormone antagonist G120K-E39C and SEQ ID NO: 8 provides the amino acid sequence for human growth hormone antagonist G120K-E39C.
(58) A third example human growth hormone antagonist disclosed herein includes human growth hormone antagonist G120K, wherein amino acid P48 has been mutated to cysteine, and wherein a polyethylene glycol molecule has been conjugated to the cysteine mutation. SEQ ID NO: 9 provides the DNA sequence for human growth hormone antagonist G120K-P48C and SEQ ID NO: 10 provides the amino acid sequence for human growth hormone antagonist G120K-P48C.
(59) A fourth example human growth hormone antagonist disclosed herein includes human growth hormone antagonist G120K, wherein amino acid Q69 has been mutated to cysteine, and wherein a polyethylene glycol molecule has been conjugated to the cysteine mutation. SEQ ID NO: 11 provides the DNA sequence for human growth hormone antagonist G120K-Q69C and SEQ ID NO: 12 provides the amino acid sequence for human growth hormone antagonist G120K-Q69C.
(60) A fifth example human growth hormone antagonist disclosed herein includes human growth hormone antagonist G120K, wherein amino acid N99 has been mutated to cysteine, and wherein a polyethylene glycol molecule has been conjugated to the cysteine mutation. SEQ ID NO: 13 provides the DNA sequence for human growth hormone antagonist G120K-N99C and SEQ ID NO: 14 provides the amino acid sequence for human growth hormone antagonist G120K-N99C.
(61) A sixth example human growth hormone antagonist disclosed herein includes human growth hormone antagonist G120K, wherein amino acid T142 has been mutated to cysteine, and wherein a polyethylene glycol molecule has been conjugated to the cysteine mutation. SEQ ID NO: 15 provides the DNA sequence for human growth hormone antagonist G120K-T142C-GL2-400MA, referred to herein as T142C-GL2, and SEQ ID NO: 16 provides the amino acid sequence for human growth hormone antagonist G120K-T142C-GL2-400MA, referred to herein as T142C-GL2.
(62) A seventh example human growth hormone antagonist disclosed herein includes human growth hormone antagonist G120K, wherein amino acid H151 has been mutated to cysteine, and wherein a polyethylene glycol molecule has been conjugated to the cysteine mutation. SEQ ID NO: 17 provides the DNA sequence for human growth hormone antagonist G120K-H151C-GL2-400MA, referred to herein as H151C-GL2, and SEQ ID NO: 18 provides the amino acid sequence for human growth hormone antagonist G120K-H151C-GL2-400MA, referred to herein as H151C-GL2.
(63) An eighth example human growth hormone antagonist disclosed herein includes human growth hormone antagonist G120K, wherein amino acids N99 and H151 have been mutated to cysteine, and wherein a polyethylene glycol molecule has been conjugated to each cysteine mutation. SEQ ID NO: 19 provides the DNA sequence for human growth hormone antagonist G120K-N99C-H151C-DPEG®A.sub.2 and SEQ ID NO: 20 provides the amino acid sequence for human growth hormone antagonist G120K-N99C-H151C-DPEG®A2.
(64) A ninth example human growth hormone antagonist disclosed herein includes human growth hormone antagonist G120K, wherein amino acids T142 and N99 have been mutated to cysteine, and wherein a polyethylene glycol molecule has been conjugated to each cysteine mutation. SEQ ID NO: 21 provides the DNA sequence for human growth hormone antagonist G120K-N99C-T142-DPEG®A2, referred to herein as N99C-T142C-DPEG®A.sub.2 and SEQ ID NO: 22 provides the amino acid sequence for human growth hormone antagonist G120K-N99C-T142-DPEG®A2, referred to herein as N99C-T142C-DPEG®A2.
(65) A tenth example human growth hormone antagonist disclosed herein includes human growth hormone antagonist G120K, wherein amino acids T142 and H151 have been mutated to cysteine, and wherein a polyethylene glycol molecule has been conjugated to each cysteine mutation. SEQ ID NO: 23 provides the DNA sequence for human growth hormone antagonist G120K-H151C-T142C-DPEG®A.sub.2, referred to herein as H151C-T142C-DPEG®A2 and SEQ ID NO: 24 provides the amino acid sequence for human growth hormone antagonist G120K-H151C-T142C-DPEG®A2, referred to herein as H151C-T142C-DPEG®A2.
(66) All literature and similar material cited in this application, including, but not limited to, patents, patent applications, articles, books, treatises, and web pages, regardless of the format of such literature and similar materials, are expressly incorporated by reference in their entirety. In the event that one or more of the incorporated references and similar materials differs from or contradicts this application, including but not limited to defined terms, term usage, described techniques, or the like, this application controls.
(67) As previously stated and as used herein, the singular forms “a,” “an,” and “the,” refer to both the singular as well as plural, unless the context clearly indicates otherwise. The term “comprising” as used herein is synonymous with “including,” “containing,” or “characterized by,” and is inclusive or open-ended and does not exclude additional, unrecited elements or method steps. Although many methods and materials similar or equivalent to those described herein can be used, particular suitable methods and materials are described herein. Unless context indicates otherwise, the recitations of numerical ranges by endpoints include all numbers subsumed within that range. Furthermore, references to “one implementation” are not intended to be interpreted as excluding the existence of additional implementations that also incorporate the recited features. Moreover, unless explicitly stated to the contrary, implementations “comprising” or “having” an element or a plurality of elements having a particular property may include additional elements whether or not they have that property.
(68) The terms “substantially” and “about” used throughout this specification are used to describe and account for small fluctuations, such as due to variations in processing. For example, these terms can refer to less than or equal to ±5%, such as less than or equal to ±2%, such as less than or equal to ±1%, such as less than or equal to ±0.5%, such as less than or equal to ±0.2%, such as less than or equal to ±0.1%, such as less than or equal to ±0.05%, and/or 0%.
(69) Underlined and/or italicized headings and subheadings are used for convenience only, do not limit the disclosed subject matter, and are not referred to in connection with the interpretation of the description of the disclosed subject matter. All structural and functional equivalents to the elements of the various implementations described throughout this disclosure that are known or later come to be known to those of ordinary skill in the art are expressly incorporated herein by reference and intended to be encompassed by the disclosed subject matter. Moreover, nothing disclosed herein is intended to be dedicated to the public regardless of whether such disclosure is explicitly recited in the above description.
(70) There may be many alternate ways to implement the disclosed inventive subject matter. Various functions and elements described herein may be partitioned differently from those shown without departing from the scope of the disclosed inventive subject matter. Generic principles defined herein may be applied to other implementations. Different numbers of a given module or unit may be employed, a different type or types of a given module or unit may be employed, a given module or unit may be added, or a given module or unit may be omitted.
(71) It should be appreciated that all combinations of the foregoing concepts and additional concepts discussed in greater detail herein (provided such concepts are not mutually inconsistent) are contemplated as being part of the disclosed inventive subject matter. In particular, all combinations of claimed subject matter appearing at the end of this disclosure are contemplated as being part of the inventive subject matter disclosed herein. While the disclosed inventive subject matter has been illustrated by the description of example implementations, and while the example implementations have been described in certain detail, there is no intention to restrict or in any way limit the scope of the appended claims to such detail. Additional advantages and modifications will readily appear to those skilled in the art. Therefore, the disclosed inventive subject matter in its broader aspects is not limited to any of the specific details, representative devices and methods, and/or illustrative examples shown and described. Accordingly, departures may be made from such details without departing from the spirit or scope of the general inventive concept.
(72) The following references form part of the specification of the present application and each reference is incorporated by reference herein, in its entirety, for all purposes. 1. Pasut, G. and Veronese, M. (2012) State of the Art in Pegylation: The Great Versatility Achieved After Forty Years of Research. J. Controlled Release 161, 461-472. 2. Parveen, S. and Sahoo, S. K. Nanomedicine: Clinical Applications of Polyethylene Glycol Conjugated to Proteins and Drugs Clin. Pharmacokinet. 45, 965-988. 3. Alconcel, S. N. S., Baas, A. S. and Maynard, H. D. (2011) FDA-Approved Poly(ethylene glycol)-Protein Conjugate Drugs. Polymer Chemistry 2, 1442-1448. 4. Kling, J. (2013) Pegylation of Biologics: A Multipurpose Solution. Bioprocess International 11, 35-43. 5. Sustarsic, E. G., Junnila, R. K., and Kopchick, J. J. (2013) “Human Metastatic Melanoma Cell Lines Express High Levels of Growth Hormone Receptor and Respond to GH Treatment” Biochem Biophys Res Commun. 441: 144-150. 6. Basu, R., Wu, S., and Kopchick, J. J. (2017-1) “Targeting Growth Hormone Receptor in Human Melanoma Cells Attenuates Tumor Progression and Epithelial Mesenchymal Transition Via Suppression of Multiple Oncogenic Pathways” Oncotarget 8, 21579-21598. 7. Basu, R., Baumgaertel, N., Wu, S., and Kopchick, J. J. (2017-2) “Growth Hormone Receptor Knockdown Sensitizes Human Melanoma Cells to Chemotherapy by Attenuating Expression of ABC Drug Efflux Pumps” Horm. Canc. 8, 143-156. 8. Xu, J., Sun, D., Jiang, J., Deng., L., Zhang, Y., Yu, H., Bahl, D., Langenheim, J. F., Chen, W. Y., Fuchs, S. Y., and Frank, S. J. (2013) “The Role of Prolactin Receptor in GH Signaling in Breast Cancer Cells” Mol. Endocrinol, 27, 266-279. 9. Goffin, V., Bernichtein, S., Carriere, O., Bennet, W. F., Kopchick, J. J., and Kelly, P. A. (1999) Endocrinology 140, 3853-3856. 10. Kopchick, J. J., List, E. O., Kelder, B., Gosney, E. S., and Berryman, D. E. (2014) “Evaluation of growth hormone (GH) action in mice: Discovery of hGH receptor antagonists and clinical indications Molecular and Cellular Endocrinology 386, 34-45. 11. Pradhananga, S., Wilkinson, I., and Ross, R. J. M. (2002) “Pegvisomant: Structure and Function” Journal of Molecular Endocrinology 29, 11-14.