COMPOSITIONS AND METHODS FOR THE PREVENTION OF TYPE I HYPERSENSITIVITY REACTIONS

Abstract

The present invention provides compositions and methods for preventing an anaphylactoid hypersensitivity reaction in a subject by providing to that subject a combination of antigen-binding IgG and an anti-IgE antibody.

Claims

1. A composition for allergy treatment, the composition comprising: an IgG antibody that binds to an epitope on an allergen; and an anti-IgE antibody in an amount sufficient to inhibit IgE binding to a high affinity FcεRI receptor but that does not eliminate circulating IgE.

2. The composition of claim 1, wherein the allergy treated is a hypersensitivity reaction.

3. The composition of claim 1, wherein the allergy treated is an anaphylactoid Type I hypersensitivity reaction.

4. The composition of claim 1, wherein the allergy treated is anaphylaxis due to exposure to a food, animal, or environmental allergen.

5. The composition of claim 1, wherein the anti-IgE antibody is omalizumab.

6. The composition of claim 1, wherein the anti-IgE antibody reduces circulating IgE by at least 25%.

7. The composition of claim 1, wherein the anti-IgE antibody reduces circulating IgE by at least 50%.

8. The composition of claim 1, wherein the anti-IgE antibody reduces circulating IgE by at least 75%.

9. The composition of claim 1, wherein the IgG antibody and anti-IgE antibody are contained within one dosage form.

10. The composition of claim 1, wherein the IgG antibody and anti-IgE antibody are provided to the subject in separate dosage forms.

11. A method of treating a condition in a subject, the method comprising providing to a subject a composition for allergy treatment comprising an IgG antibody that binds to an epitope on an allergen; and an anti-IgE antibody in an amount sufficient to inhibit IgE binding to a high affinity FcεRI receptor but that does not eliminate circulating IgE.

12. The method of claim 11, wherein the allergy treated is a hypersensitivity reaction.

13. The method of claim 11, wherein the allergy treated is an anaphylactoid Type I hypersensitivity reaction.

14. The method of claim 11, wherein the allergy treated is anaphylaxis due to exposure to a food, animal, or environmental allergen.

15. The method of claim 11, wherein the anti-IgE antibody is omalizumab.

16. The method of claim 11, wherein the anti-IgE antibody reduces circulating IgE by at least 25%.

17. The method of claim 11, wherein the anti-IgE antibody reduces circulating IgE by at least 50%.

18. The method of claim 11, wherein the anti-IgE antibody reduces circulating IgE by at least 75%.

19. The method of claim 11, wherein the IgG antibody and anti-IgE antibody are contained within one dosage form.

20. The method of claim 11, wherein the IgG antibody and anti-IgE antibody are provided to the subject in separate dosage forms.

Description

DETAILED DESCRIPTION

[0014] The invention discloses compositions and methods for the prevention of a Type I hypersensitivity reaction in a subject. The composition is a combination of an IgG antibody that binds to an epitope on an allergen and an anti-IgE antibody in an amount sufficient to inhibit IgE binding to a high affinity FcεRI receptor but that does not eliminate circulating IgE.

[0015] Hypersensitivity reactions occur when the immune system has dysfunctional response disproportionate to the antigen presented to the body. Some are immediate anaphylactic reactions while others more slowly develop into other disease states. The invention can be used to prevent the hypersensitivity reaction wherein a subject or a sample from the subject responds with a hypersensitive, or abnormally sudden and severe, response to the stimulus.

[0016] Some foods such as peanuts (a legume), nuts, seafood and shellfish are the cause of serious Type I hypersensitivity reactions in many people. Officially, the United States Food and Drug Administration recognizes eight foods as being common for allergic reactions in a large segment of the sensitive population. These include peanuts, tree nuts, eggs, milk, shellfish, fish, wheat and their 20 derivatives, and soy and their derivatives, as well as sulfites (chemical-based, often found in flavors and colors in foods).

[0017] An allergic reaction can be caused by any form of direct contact with the allergen-consuming food or drink one is sensitive to (ingestion), breathing in pollen, perfume or pet dander (inhalation), or brushing a body part against an allergy-causing plant (direct contact). The presently disclosed systems and methods can be used to prevent an allergic response in a subject due to ingestion, inhalation, and/or contact with an allergen or source of allergens.

[0018] There are five classes of immunoglobulin: IgA, IgD, IgE, IgG, and IgM. Immunoglobulins are antibodies. Whenever the term “antibody” is used in the disclosure it is intended to mean polyclonal antibodies, monoclonal antibodies, or antigen-binding portions or fragments of any of the foregoing. IgA is mainly present in secretions such as bowel fluid, nasal discharge, and saliva, to prevent bacterial invasion from a mucous membrane. It is also present in breast milk and protects the gastrointestinal tract of newborns from bacterial and viral infection. IgD is present on the surface of B cells and it is reported to play a role in the induction of antibody production and the prevention of respiratory tract infections. IgE is related to Type I hypersensitivity reactions. By binding to mast cells, IgE is believed to be involved in allergies such as pollinosis. IgG is the main antibody in blood and has a powerful ability to bind to bacteria and toxins, and thus it takes on an important role in the biological defense system. It is the only isotype that can pass through the placenta, and IgG transferred from the mother’s body protects a newborn. IgM is constructed of five units of basic Y-shaped structures and is mainly distributed to the blood. Produced first upon pathogen invasion by B cells, IgM has a key role in the initial immune system defense for protecting the body. Disclosures of the invention primarily focus on IgG and IgE antibodies.

[0019] An antibody or antigen-binding fragment thereof is capable of binding to a known non-tumor allergen. For example, the specific allergen may include, but is not limited to, a food allergen, a plant allergen, a fungal allergen, an animal allergen, a dust mite allergen, a drug allergen, a cosmetic allergen, or a latex allergen. In some embodiments, the antibody is an antibody that specifically binds to a food allergen, such as a milk allergen, an egg allergen, a nut allergen, a fish allergen, a shellfish allergen, a soy allergen, a legume allergen, a seed allergen, or a wheat allergen. In some embodiments, the antibody specifically binds to a peanut allergen.

[0020] IgG antibodies binds pathogens, toxins, and is associated with Type II and II hypersensitivity reactions. IgG also activates the complement system of the immune system, helping to clear pathogens and damaged cells, and plays a role in the inflammatory cascade. By binding to the epitope, or binding region, on allergens or pathogens, IgG helps to alert the immune system to the presence of the foreign object and activate the immune system to clear it from the body.

[0021] IgE antibodies mediate Type I hypersensitivity reactions by binding to specific receptors on inflammatory immune cells, such as mast cells in mucosal tissues lining body surfaces and cavities, as well as basophils in the circulation. Those cells mediate allergic responses triggered 20 by specific antigens (allergens) that are recognized by IgE through the release of inflammatory molecules, such as histamine. The inflammatory response leads to symptoms, such as sneezing, runny or stuffed nose, itchy eyes, breathing difficulties, and, in extreme cases, anaphylactic shock and even death.

[0022] The FcεRI receptor is also known as the high-affinity IgE receptor. It is present on mast cells, basophils, eosinophils, and epidermal Langerhans cells. FcεRI is a known promoter of histamine, among other immune mediators, and therefore can activate the inflammatory cascade. Blockade of high affinity FcεRI receptors is likely to slow the timing of and reduce the severity of the inflammatory response.

[0023] According to an embodiment of the invention, the anti-IgE antibody is omalizumab. Omalizumab is a recombinant DNA-derived humanized IgG1.sub.K monoclonal antibody that selectively binds to human immunoglobulin E (IgE). The antibody has a molecular weight of approximately 149 kiloDaltons. Omalizumab is an anti-IgE antibody indicated for: moderate to severe persistent asthma in adults and pediatric patients 6 years of age and older with a positive skin test or in vitro reactivity to a perennial aeroallergen and symptoms that are inadequately controlled with inhaled corticosteroids; nasal polyps in adult patients 18 years of age and older with inadequate response to nasal corticosteroids, as add-on maintenance treatment; and chronic spontaneous urticaria (CSU) in adults and adolescents 12 years of age and older who remain symptomatic despite H1 antihistamine treatment.

[0024] According to varying embodiments of the invention, the anti-IgE antibody reduces circulating IgE by at least 25%, by at least 50%, or by at least 75%. The goal of treating a subject with the composition is to reduce serum IgE levels so that a Type I hypersensitivity reaction is not as sudden or severe, allowing the subject more time before lifesaving emergency treatment can be provided.

[0025] Embodiments of the invention further provide a method of treating a condition in a subject, the method comprising providing to a subject the composition for allergy treatment comprising an IgG antibody that binds to an epitope on an allergen and an anti-IgE antibody in an amount sufficient to inhibit IgE binding to a high affinity FcεRI receptor but that does not eliminate circulating IgE. The method also comprises any of the varied embodiments of the composition discussed above.

[0026] In aspects of the invention, the antigen-binding function of an antibody or fragment of the invention may be performed by fragments of the full-length antibody comprising the binding portion of the antibody. Examples of binding portions of antibodies include a monovalent fragment consisting of the variable light chain, variable heavy chain, and CL and CH1 constant regions (Fab fragment). Examples also include bivalent fragments comprising two Fab fragments linked by a disulfide bridge at the hinge region (F(ab′)2 fragment), fragments consisting of the variable heavy chain and CH1 constant domain (Fd fragment), fragments consisting of the variable light chain and variable heavy chain domains of a single arm of an antibody (Fv fragment), fragments consisting of a variable heavy chain domain (dAb fragment), and isolated complementarity determining region.

[0027] According to varying embodiments of the invention, the IgG antibody and anti-IgE antibody are contained within one dosage form, whereas in another embodiment, the IgG antibody and anti-IgE antibody are provided to the subject in separate dosage forms. In some embodiments, antibodies of the invention are delivered directly in a prolonged release formulation. The antibody itself may be modified to include features that increase serum half-life. Antibodies may be pegylated, conjugated to other proteins (e.g., human serum albumin) or provided in a vehicle that causes delayed release of the antibody.

[0028] Embodiments of the present invention provide for the administration of a therapeutically effective amount of a pharmaceutical formulation to a subject for preventing or treating an allergic response in said subject. The formulation generally includes a composition comprising the vector and other components, such as, for example, one or more pharmaceutically acceptable carriers, adjuvants, and/or vehicles appropriate for the particular route of administration for which the composition is to be employed. In some embodiments, the carrier, adjuvant, and/or vehicle is suitable for injection (via a needle of the like) for intravenous, intramuscular, intraperitoneal, transdermal, or subcutaneous administration, as well as a consumable, or spray for related oral and inhalant administrations.

[0029] Therapeutic compositions of the invention may comprise an antibody, or antigen-binding portion thereof, formulated for delivery. Delivery may be in oral, subcutaneous, intravenous, aerosol or other appropriate formulations. Alternatively, therapeutic compositions of the invention may be delivered in the form of a nucleic acid encoding an appropriate antibody or antigen-binding portion thereof.

INCORPORATION BY REFERENCE

[0030] References and citations to other documents, such as patents, patent applications, patent publications, journals, books, papers, web contents, have been made throughout this disclosure. All such documents are hereby incorporated herein by reference in their entirety for all purposes.

EQUIVALENTS

[0031] Various modifications of the invention and many further embodiments thereof, in addition to those shown and described herein, will become apparent to those skilled in the art from the full contents of this document, including references to the scientific and patent literature cited herein. The subject matter herein contains important information, exemplification and guidance that can be adapted to the practice of this invention in its various embodiments and equivalents thereof.