PEPTIDES FOR TREATMENT OF DIABETES

Abstract

The present disclosure concerns agents and their use in the treatment of endocrine, nutritional and/or metabolic diseases in a mammal. The disclosure furthermore concerns novel peptides.

Claims

1. An agent comprising: a) a peptide or peptide analog comprising or consisting of the amino acid sequence KPLAEIDSIELSYGIK (SEQ ID NO: 136), KCLAECDSIELSYGIK (SEQ ID NO: 141), KPLAEDISIELSYGIK (SEQ ID NO: 145), KPLAEIGDIELSYGIK (SEQ ID NO: 146), KPLAEIDSIELTYGIK (SEQ ID NO: 149), KPLAEIDGIELSYGIK (SEQ ID NO: 150), KPLAEIDGIELTYGIK (SEQ ID NO: 151), KPLAEIGSIELSYGIK (SEQ ID NO: 152), KGLAEIDSIELSYGIK (SEQ ID NO: 153) and KPLAGIDSIGLSYGIK (SEQ ID NO: 154); CLAEIDSC (SEQ ID NO: 142), CFKPLAEIDSIECSYGIK (SEQ ID NO: 143), KPLAEGDIELSYGIK (SEQ ID NO: 147), KPLAEIELSYGIK (SEQ ID NO: 148), KCLAEIDSCELSYGIK (SEQ ID NO: 155), or CFKPLAEIDSIEC (SEQ ID NO: 156); b) a polynucleotide encoding upon expression, the peptide of a); c) a vector comprising the polynucleotide of b); or d) a cell comprising the polynucleotide of b), or the vector of c).

2. The agent according to claim 1, wherein the peptide or peptide analog comprises an amino acid sequence of the general formula: TABLE-US-00056 (SEQIDNO:162) KX.sub.2LAX.sub.5X.sub.6X.sub.7X.sub.8IX.sub.10LSYGIK wherein: X.sub.2 is C, P or G; X.sub.5 is E or G; X.sub.5 is C, I or absent; X.sub.7 is D, G or absent; X.sub.8 is S, G or absent; X.sub.10 is E or G.

3. The agent according to claim 1, wherein the agent comprises no more than 85, such as no more than 80, such as no more than 75, such as no more than 70, such as no more than 65, such as no more than 60, such as nor more than 55, such as no more than 50, such as no more than 55, such as no more than 40 amino acids, such as no more than 35, such as no more than 30, such as no more than 28, such as no more than 26, such as no more than 24, such as no more than 22, such as no more than 20, such as no more than 19, such as no more than 18, such as no more than 17, such as no more than 16, such as no more than 15, such as no more than 14, such as no more than 13, such as no more than 12, such as no more than 11, such as no more than 10 amino acids.

4. The agent according to claim 1, wherein the agent comprises at least 2 additional amino acids, such as at least 3, such as at least 4, such as at least 5, such as at least 6, such as at least 7, such as at least 8, such as at least 9, such as at least 10, such as at least 15 or such as at least 20 amino acids conjugated to the N- or C-terminus of the peptide.

5. The agent according to claim 1, wherein the agent is non-naturally occurring.

6. The agent according to claim 1, wherein the agent is conjugated to a moiety.

7. The agent according to claim 1, wherein the agent is further modified such as being glycosylated or by PEGylation, amidation, esterification, acylation, acetylation and/or alkylation.

8. The agent according to claim 1, wherein the agent comprises or consists of tandem repeats.

9. The agent according to claim 1, wherein the agent is fused to another polypeptide.

10. The agent according to claim 9, wherein the said polypeptide is selected from the group consisting of glutathione-S-transferase (GST) and protein A.

11. The agent according to claim 1, wherein the agent is fused to a tag.

12. The agent according to claim 1, wherein the agent is cyclic.

13. The agent according to claim 1, wherein the peptide or peptide analog comprises or consists of the amino acid sequence KPLAEIDSIELSYGIK (SEQ ID NO: 136), or a variant or fragment thereof.

14. The agent according to claim 1, wherein one or more amino acids are conservatively substituted.

15. The agent according to claim 1, wherein the peptide or peptide analog comprises or consists of one or more additional amino acids, inserted at the N- and/or C-terminus and/or internally within the sequence.

16. The agent according to claim 1, wherein the agent further comprises a detectable moiety.

17. An agent comprising: c) a peptide or peptide analog comprising or consisting of the amino acid sequence GDPNDGRGDSVVYGLR (SEQ ID NO: 137), VDTYDGGISVVYGLR (SEQ ID NO: 138), and VDTYDGDGSVVYGLR (SEQ ID NO: 139). VDVPEGDISLAYGLR (SEQ ID NO: 157), LDGLVRAYDNISPVG (SEQ ID NO: 158), GDPNGDISVVYGLR (SEQ ID NO: 159), VDVPNGDISLAYRLR (SEQ ID NO: 160) VDVPEGDISLAYRLR (SEQ ID NO: 161), V(beta-D)TYDGDISVVYGLR (SEQ ID NO:167), VDTY(beta-D)GDISVVYGLR (SEQ ID NO: 168), or VDTYDG(beta-D)ISVVYGLR (SEQ ID NO:169); b) a polynucleotide encoding upon expression, the peptide of a); c) a vector comprising the polynucleotide of b); or d) a cell comprising the polynucleotide of b), or the vector of c).

18. The agent according to claim 17, wherein the peptide or peptide analog comprises or consists of the amino acid sequence VDTYDGGISVVYGLR (SEQ ID NO: 138), or a variant or fragment thereof.

19. A method of treating an endocrine disease and/or a metabolic disease, the method comprising administering to a subject in need thereof a therapeutically effective amount of an agent comprising: a) a peptide or a peptide analog selected from the group consisting of: (i) a peptide comprising or consisting of an amino acid sequence of the general formula: TABLE-US-00057 (SEQIDNO:140) KX.sub.2LAX.sub.5X.sub.6X.sub.7X.sub.8IX.sub.10LX.sub.12YGIK wherein: X.sub.2 is C, P or G; X.sub.5 is E or G; X.sub.6 is C, D or I; X.sub.7 is D, I, S or G; X.sub.8 is S, D or G; X.sub.10 is E or G; X.sub.12 is S or T; with the proviso that if X.sub.12 is T, the peptide comprises no more than 25 amino acid residues; (ii) a peptide comprising or consisting of an amino acid sequence of the general formula: TABLE-US-00058 (SEQIDNO:68) VDZ.sub.3Z4Z.sub.5GZ.sub.7Z.sub.8SZ.sub.10Z.sub.11YGLR wherein: Z.sub.3 is T or V; Z.sub.4 is Y or P; Z.sub.5 is D or N; Z.sub.7 is D or G; Z.sub.8 is I or G; Z.sub.10 is V or L; Z.sub.11 is V or A; wherein the peptide is selected from the group consisting of VDTYDGDISVVYGLR (SEQ ID NO: 1), VDTYDGDISVVYGL (SEQ ID NO: 3), VDTYDGDISVVYG (SEQ ID NO: 6), GDISVVYGLR (SEQ ID NO: 26), VDTYDGDIS (SEQ ID NO: 28), VDTYDGRGDSVVYGLR (SEQ ID NO: 67), VDVPNGDISLAYGLR (SEQ ID NO: 69), VDVPNGDISLAYGL (SEQ ID NO: 71) DVPNGDISLAYGLR(SEQ ID NO: 72), VDVPNGDISLAYG (SEQ ID NO: 74), PNGDISLAYGLR (SEQ ID NO: 81), VDVPNGDISLA (SEQ ID NO: 83), GDISLAYGLR( (iii) a peptide comprising or consists of an amino acid sequence selected from the group consisting of KCLAECDSIELSYGIK (SEQ ID NO: 141), CLAEIDSC (SEQ ID NO: 142), CFKPLAEIDSIECSYGIK (SEQ ID NO: 143), KPLAEGDIELSYGIK (SEQ ID NO: 147), KPLAEIELSYGIK (SEQ ID NO: 148), KCLAEIDSCELSYGIK (SEQ ID NO: 155) or CFKPLAEIDSIEC (SEQ ID NO: 156); b) a polynucleotide encoding upon expression, the peptide of a); c) a vector comprising the polynucleotide of b); or d) a cell comprising the polynucleotide of b), or the vector of c).

20. The method according claim 19, wherein said agent comprises a second or further active ingredient.

21. The method according to claim 20, wherein the second or further active ingredient is selected from the group consisting of insulin, glucagon-like peptide-1 (GLP-1), sulfonylurea, a dipeptidyl peptidase-4 (DPP4) inhibitor, an alpha-glucosidase inhibitor, a thiazolidinedione, a meglitidine and a sodium-glucose cotransporter-2 (SGLT2) inhibitor.

22. The method according to claim 19, wherein the endocrine disease and/or metabolic disease are selected from the group consisting of diabetes mellitus, type 1 diabetes mellitus, type 2 diabetes mellitus, malnutrition-related diabetes mellitus, disorders of glucose regulation and pancreatic internal secretion, insulin resistance syndrome, impaired glucose tolerance, hyperglycemia, hyperinsulinemia, and any combinations thereof.

23. The method according to claim 19, wherein the endocrine disease and/or metabolic disease are selected from the group consisting of diabetes mellitus, disorders of the thyroid gland, disorders of glucose regulation and pancreatic internal secretion, disorders of endocrine glands, malnutrition, nutritional deficiencies, obesity, hyperalimentation, and metabolic disorders.

24. The method according to claim 19, wherein the endocrine disease and/or a metabolic disease is diabetes mellitus selected from the group consisting of type 1 diabetes mellitus, type 2 diabetes mellitus, malnutrition-related diabetes mellitus, specified diabetes mellitus, and unspecified diabetes mellitus.

25. The method according to claim 19, wherein the endocrine disease and/or a metabolic disease is a disorder of glucose regulation and pancreatic internal secretion selected from the group consisting of nondiabetic hypoglycaemic coma and disorders of pancreatic internal secretion.

26. The method according to claim 19, wherein the endocrine disease and/or a metabolic disease is a disorder of obesity and hyperalimentation selected from the group consisting of localized adiposity, hyperalimentation, and sequelae of hyperalimentation.

27. A method for delaying onset of diabetes and/or a diabetes associated disorder or disease, the method comprising administering a therapeutically effective amount of an agent according to claim 1, to an individual in need thereof.

28. The method according to claim 27, wherein insulin secretion is increased.

29. The method according to claim 27, wherein cellular uptake of glucose is increased.

Description

DESCRIPTION OF DRAWINGS

[0062] FIG. 1. FOL-005 and FOL-014 induced proliferation of -cells

[0063] Addition of increasing concentrations of FOL-005 in solution induced increasing proliferation of INS-1 cells after 48 hours (FIG. 1A). Wells coated with FOL-005 and blocked with Bovine Serum Albumin (BSA) induced more proliferation of -cells compared to only BSA coated control (ctrl) wells (FIG. 1B). Wells pre-coated with FOL-014 and blocked with BSA induced more proliferation compared to only BSA coated wells (FIG. 10). Data is presented as counts per minute (CPM) relative unstimulated control (ctrl) cells. MeanSD are presented for 10-12 different observations in each group.

[0064] FIG. 2. FOL-005 protected -cells against glucotoxicity

[0065] INS-1 cells incubated during 48 h in 20 mM glucose displayed more apoptotic cells (Annexin V positive) compared to cells incubated at 5 mM glucose. Addition of FOL-005 to cells incubated with 20 mM glucose reduced the level of apoptotic cells compared to 20 mM glucose alone (FIG. 2A). Apoptosis measured by caspase-3 activity was increased in INS-1 cells at 20 mM compared to 5 mM glucose. Addition of FOL-005 diminished the rate of glucotoxicity-induced caspse-3 activity (FIG. 2B). MeanSD are presented for 4-8 different observations in each group.

[0066] FIG. 3. Insulin secretion was increased from islets and -cells following FOL-005 stimulation

[0067] FOL-005 stimulated -cell and islet insulin secretion. Insulin release from INS-1 cells was increased after FOL-005 (6 M) stimulation in-non glucose containing media compared to non-stimulated control (ctrl) and to a scrambled control peptide (FOL-015) (FIG. 3A). FOL-005 stimulated insulin release from INS-1 at both low (5 mM) and high (20 mM) glucose (FIG. 3B). Isolated mouse pancreatic islets stimulated with FOL-005 (6 M) or GLP-1 (100 nM) secreted more insulin compared to unstimulated control islets (FIG. 3C). MeanSD are presented for 5-6 different observations in each group.

[0068] FIG. 4. Insulin secretion was increased from islets and -cells following FOL-014 stimulation

[0069] FOL-014 stimulated insulin secretion from -cells and pancreatic islets. INS-1 cells stimulated with FOL-014 (6 M) secreted more insulin compared to unstimulated control cells (FIG. 4A). Isolated mouse pancreatic islets stimulated with FOL-014 (6 M) secreted more insulin compared to control islets (FIG. 4B). Addition of GLP-1 (100 nM) or FOL-014 (0.6 M) had no effect on insulin secretion. MeanSD are presented for 5-6 different observations in each group.

[0070] FIG. 5. The effect of FOL-014 on insulin secretion was dose dependent. Stimulation of INS-1 cells by increasing doses of FOL-014 resulted in a significant increase in insulin secretion for all concentrations tested. The insulin secretion increased in a linear fashion in the presence of FOL-014 ranging from 0.6 nM to 60 nM. Higher concentrations appeared to result in a less pronounced effect on insulin secretion. Furthermore, FOL-014 induced insulin secretion was comparable to the effect of 100 nM GLP-1. Bars represent mean values and standard error of the mean (SEM).

[0071] FIG. 6. The effect on insulin secretion of FOL-014 was glucose concentration dependent. The insulin secretion from untreated or FOL-014 exposed INS-1 cells was measured in the presence of increasing glucose concentrations. At glucose levels 5.5 mM or higher, the insulin secretion was significantly higher in the FOL-014 treated cells, as compared to untreated control cells. Bars represent mean values and standard error of the mean (SEM).

[0072] FIG. 7. FOL-005 and FOL-014 dosed together with native GLP-1 elicited an additive effect on insulin secretion. The insulin release from INS-1 cells was measured following combination treatment of GLP-1 together with FOL-005 and FOL-014 (all three peptides in a concentration of 100 nM), respectively and compared with the effect of each peptide alone. The combination of GLP-1 and FOL-014 significantly increased the insulin secretion as compared with each peptide alone. An increase was also observed for the combination of FOL-005 and GLP-1. Bars represent mean values and standard error of the mean (SEM).

[0073] FIG. 8. FOL-014 affected insulin and glucagon secretion in pancreatic islets. Two different concentrations of FOL-014 were tested and compared with the effect of 100 nM GLP-1 on isolated mouse islets in low (2.8 mM) (A, C) and high (16.7 mM) (B, D) concentrations of glucose. In the low glucose samples, the presence of FOL-014 did not increase insulin secretion, but reduced glucagon secretion as compared with control and GLP-1. In the high glucose samples, 600 nM FOL-014 and GLP-1, but not 6 M FOL-014, significantly increased insulin secretion (B), and GLP-1 as well as both concentrations of FOL-014 efficiently reduced glucagon secretion (D). Bars represent mean values and standard error of the mean (SEM).

[0074] FIG. 9. FOL-014 lowered plasma glucose levels in vivo following a glucose injection. An intraperitoneal glucose tolerance test (IPGTT) was performed on wild type C57bl/6 mice. FOL-014 dosed at 200 nmol/kg significantly lowered the plasma glucose levels as compared to the control at 15 minutes, 30 minutes and 45 minutes (P=0.0027). At the 30 nmol/kg dose, FOL-014 lowered the glucose levels with a significant effect at 45 minutes after the glucose injection. The dotted line corresponds to mean non-fasting glucose levels. Data represents mean values and standard error of the mean (SEM). Statistical analysis was performed using student's t-test.

[0075] FIG. 10. FOL-014 delayed the onset of type-1 diabetes in BB lyp/lyp rats. BB lyp/lyp rats treated with FOL-014 showed a significant delay in the onset of diabetes defined as plasma glucose<11.1 mmol/l. Age of onset of diabetes for each rat was depicted in (A) with a significant difference between untreated and treated groups. The percentage of animals developing type 1 diabetes each day was depicted in (B) with a significant difference between groups. Error bars in (A) represent standard error of the mean (SEM).

[0076] FIG. 11. The effect on insulin secretion of peptide analogues derived from FOL-005 or FOL-014. Novel peptide analogues were tested in two separate INS-1 cell lines (A and B) for their ability to induce insulin secretion under high glucose (16.7 mM) conditions. The effect was compared with that of native GLP-1, FOL-005 and FOL-014 as well as the effect of high glucose alone. Analogues inducing insulin release below the average of the high glucose control were considered non-functional (not shown). The level of insulin secretion is depicted in black, filled bars for the novel analogues, and in contrasting patterns for the comparators. Bars represent mean values and standard error of the mean (SEM).

[0077] FIG. 12. FOL-005 and FOL-014 displayed specific distribution patterns following injection in mouse. Following subcutaneous administration of .sup.3H-FOL-005, the highest overall levels of radioactivity were present in pancreas and at the injection site, 1 hour (A) and 2 hours (B) after injection. Accumulation of the .sup.3H-FOL-005 is also visible in liver, kidney, salivary glands. Using Pearl Trilogy Small Animal Imaging System in vivo bio-distribution and tissue localization of Cy7.5 labelled FOL-005 (C) and FOL-014 (D) in NMRI nude mice via subcutaneous injection was investigated. Following initial control imaging, a dose of 10 nmol per mouse was administered and live imaging was performed at 5 min, 20 min, 50 min, 60 min, 2 hrs, 4 hrs, 6 hrs, 24 hrs and 48 hrs. High accumulation of both peptides was evident in the pancreatic region as well as at the injection site.

DETAILED DESCRIPTION

[0078] The disclosure is as defined in the claims.

[0079] In one aspect, the present disclosure concerns a peptide or a peptide analog comprising an amino acid sequence of the general formula:

TABLE-US-00003 a) (SEQIDNO:140) KX.sub.2LAX.sub.5X.sub.6X.sub.7X.sub.8IX.sub.10LX.sub.12YGIK [0080] wherein: [0081] X.sub.2 is C, P or G; [0082] X.sub.5 is E or G; [0083] X.sub.6 is C, D or I; [0084] X.sub.7 is D, I, S or G; [0085] X.sub.8 is S, D or G; [0086] X.sub.10 is E or G; [0087] X.sub.12 is S or T;
with the proviso that if X.sub.12 is T, the peptide comprises no more than 25 amino acids; and
with the proviso that if X.sub.2 is P, X.sub.5 is E, X.sub.6 is I, X.sub.7 is D, X.sub.8 is S, X.sub.10 is E and X.sub.12 is S, the peptide comprises no more than 85 amino acid residues;

[0088] b) a polynucleotide encoding upon expression, the peptide of a);

[0089] c) a vector comprising the polynucleotide of b); and

[0090] d) a cell comprising the polynucleotide of b), or the vector of c).

[0091] In one embodiment, the present disclosure concerns a peptide or a peptide analog comprising an amino acid sequence of the general formula:

TABLE-US-00004 (SEQIDNO:162) KX.sub.2LAX.sub.5X.sub.6X.sub.7X.sub.8IX.sub.10LSYGIK
wherein: [0092] X.sub.2 is C, P or G; [0093] X.sub.5 is E or G; [0094] X.sub.6 is C, I or absent; [0095] X.sub.7 is D, G or absent; [0096] X.sub.8 is S, G or absent; [0097] X.sub.10 is E or G; [0098] wherein absent means that the amino acid X.sub.5 is coupled to the amino acid X.sub.10

[0099] In one embodiment, the present disclosure concerns a peptide comprising an amino acid sequence of the general formula:

TABLE-US-00005 (SEQIDNO:163) KX.sub.2LAX.sub.5IX.sub.10LSYGIK
wherein: [0100] X.sub.2 is C, P or G; [0101] X.sub.5 is E or G; [0102] X.sub.10 is E or G.

[0103] In one embodiment, the present disclosure concerns an agent comprising: [0104] a) a peptide, wherein the peptide is selected from the group consisting of: [0105] i) a peptide comprising or consisting of the amino acid sequence of SEQ ID NO: 136, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, and 156; [0106] ii) a biologically active sequence variant of any one of the peptides of i), wherein any one amino acid has been altered for another proteinogenic or non-proteinogenic amino acid, with the proviso that no more than five amino acids are so altered; [0107] iii) a biologically active fragment of the peptide of any one of i) or ii), wherein the fragment comprises at least 10 consecutive amino acids of any one of i) or ii); [0108] b) a polynucleotide encoding upon expression, the peptide of a); [0109] c) a vector comprising the polynucleotide of b); and [0110] d) a cell comprising the polynucleotide of b), or the vector of c).

[0111] In one embodiment, the present disclosure concerns an agent comprising: [0112] a) a peptide, wherein the peptide comprises or consists of an amino acid sequence selected from the group consisting of GDPNDGRGDSVVYGLR (SEQ ID NO: 137), VDTYDGGISVVYGLR (SEQ ID NO: 138), and VDTYDGDGSVVYGLR (SEQ ID NO: 139). VDVPEGDISLAYGLR (SEQ ID NO: 157), LDGLVRAYDNISPVG (SEQ ID NO: 158), GDPNGDISVVYGLR (SEQ ID NO: 159), VDVPNGDISLAYRLR (SEQ ID NO: 160) VDVPEGDISLAYRLR (SEQ ID NO: 161); [0113] b) a polynucleotide encoding upon expression, the peptide of a); [0114] c) a vector comprising the polynucleotide of b); and [0115] d) a cell comprising the polynucleotide of b), or the vector of c).

[0116] In one embodiment, the present disclosure concerns a peptide comprising an amino acid sequence of the general formula:

TABLE-US-00006 (SEQIDNO:164) VDVPZ.sub.5GDISLAYZ.sub.13LR [0117] wherein: [0118] Z.sub.5 is E or N; [0119] Z.sub.13 is R or G.

[0120] In one embodiment, the present disclosure concerns a peptide comprising an amino acid sequence of the general formula:

TABLE-US-00007 (SEQIDNO:165) VDTYDGZ.sub.7Z.sub.8SVVYGLR [0121] wherein: [0122] Z.sub.7 is D or G; [0123] Z.sub.8 is I or G.

[0124] In one embodiment, the present disclosure concerns a peptide comprising an amino acid sequence of the general formula:

TABLE-US-00008 (SEQIDNO:166) GDPNZ.sub.5Z.sub.6Z.sub.7Z.sub.8Z.sub.9SVVYGLR [0125] wherein: [0126] Z.sub.5 is D or G; [0127] Z.sub.6 is D or G [0128] Z.sub.7 is I or R; [0129] Z.sub.8 is G or absent; [0130] Z.sub.9 is D or absent.

[0131] The term absent as used herein, e.g. X.sub.6 is C, I or absent is to be understood as that the amino acid residues directly adjacent to the absent amino acid are directly linked to each other by a conventional amide bond.

[0132] The term peptide analog described herein refers to a peptide comprising or consisting of a non-naturally occurring peptide.

[0133] The term amino acid as used herein includes the standard twenty genetically-encoded amino acids and their corresponding stereoisomers in the D form (as compared to the natural 1 form), omega-amino acids and other naturally-occurring amino acids, unconventional amino acids (e.g., ,-disubstituted amino acids, N-alkyl amino acids, etc.) and chemically derivatized amino acids (see below).

[0134] When an amino acid is being specifically enumerated, such as alanine or Ala or A, the term refers to both L-alanine and D-alanine unless explicitly stated otherwise. Other unconventional amino acids may also be suitable components for peptides of the present disclosure, as long as the desired functional property is retained by the peptide. For the peptides shown, each encoded amino acid residue, where appropriate, is represented by a single letter designation, corresponding to the trivial name of the conventional amino acid.

[0135] Chemical derivatives of one or more amino acids may be achieved by reaction with a functional side group. Such derivatives include, for example, those molecules in which free amino groups have been derivatized to form amine hydrochlorides, p-toluene sulphonyl groups, carboxybenzoxy groups, t-butyloxycarbonyl groups, chloroacetyl groups or formyl groups. Free carboxyl groups may be derivatized to form salts, methyl and ethyl esters or other types of esters and hydrazides. Free hydroxyl groups may be derivatized to form O-acyl or O-alkyl derivatives. Also included as chemical derivatives are those peptides which contain naturally occurring amino acid derivatives of the twenty standard amino acids. For example: 4-hydroxyproline may be substituted for proline; 5-hydroxylysine may be substituted for lysine; 3-methylhistidine may be substituted for histidine; homoserine may be substituted for serine and ornithine for lysine. Derivatives also include peptides containing one or more additions or deletions as long as the requisite activity is maintained. Other included modifications are amidation, amino terminal acylation (e.g. acetylation or thioglycolic acid amidation), terminal carboxylamidation (e.g. with ammonia or methylamine), and the like terminal modifications.

[0136] Some of the peptides of the disclosure shares amino acid sequence similarity with a sub-region of naturally occurring osteopontin proteins. In some embodiments, said peptide may be regarded as an active fragment of a naturally-occurring osteopontin protein or a variant of such as a fragment.

[0137] Some of the peptides of the disclosure shares amino acid sequence similarity with a sub-region of naturally occurring tenascin proteins. In some embodiments, said peptide may be regarded as an active fragment of a naturally-occurring tenascin protein or a variant of such as a fragment.

[0138] By fragment, at least 5 contiguous amino acids of the amino acid sequence are included, for example at least 6, 7, 8, 9, 10, 11, 12, 13, 14 or 15 contiguous amino acids of the amino acid sequence. Thus, the fragment may be 15 or fewer amino acids in length, for example 14, 13, 12, 11, 10, 9, 8, 7, 6 or 5 amino acids in length

[0139] In one embodiment, said peptide is of no more than no more than 85, such as no more than 80, such as no more than 75, such as no more than 70, such as no more than 65, such as no more than 60, such as nor more than 55, such as no more than 50, such as no more than 55, such as no more than 40 amino acids, such as no more than 35, such as no more than 30, such as no more than 28, such as no more than 26, such as no more than 24, such as no more than 22, such as no more than 20, such as no more than 19, such as no more than 18, such as no more than 17, such as no more than 16, such as no more than 15, such as no more than 14, such as no more than 13, such as no more than 12, such as no more than 11, such as no more than 10 amino acids in length.

[0140] In another embodiment, said peptide is between 5 and 30 amino acids in length, such as between 5 and 20, such as between 8 and 20, such as between 8 and 16, such as between 10 and 15 amino acids in length.

[0141] In yet another embodiment, said fragment comprises 15 or fewer amino acids in length, such as fewer than 14 amino acids, such as fewer than 13 amino acids, such as fewer than 12 amino acids, such as fewer than 11 amino acids, such as fewer than 10 amino acids, such as fewer than 9 amino acids, such as fewer than 8 amino acids, such as fewer than 7 amino acids, such as fewer than 6 amino acids, such as fewer than 5 amino acids in length.

[0142] The term variant refers to a peptide that does not share 100% amino acid sequence identity with the parent peptide, i.e. one or more amino acids must be mutated.

[0143] Mutated refers to altering an amino acid at a specified position in the parent peptide. For example, an amino acid at a specified position may be deleted, altered, substituted or may be the site of an insertion/addition of one or more amino acids. It will be appreciated by persons skilled in the art that the substitutions may be conservative or non-conservative.

[0144] In one embodiment, said peptide variant comprises or consists of a sequence wherein no more than five amino acids are altered for another proteinogenic or non-proteinogenic amino acid, such as no more than 4 amino acids, such as no more than 3 amino acids, such as no more than 2 amino acids, such as no more than 1 amino acid is altered. In one embodiment, one or more amino acids are conservatively substituted. Conservatively substituted refers to a substitution of one amino acid with another with similar properties (size, hydrophobicity, etc), such that the function of the peptide is not significantly altered. Thus, by conservative substitutions is intended combinations such as Gly, Ala; Val, Ile, Leu; Asp, Glu; Asn, Gln; Ser, Thr; Lys, Arg; and Phe, Tyr.

[0145] In another embodiment, said peptide comprises or consists of one or more additional amino acids, inserted at the N- and/or C-terminus and/or internally within the sequence. In one embodiment, at least 2 additional amino acids, such as at least 3, such as at least 4, such as at least 5, such as at least 6, such as at least 7, such as at least 8, such as at least 9, such as at least 10, such as at least 15 or such as at least 20 additional amino acids are inserted. The additional amino acids may be the amino acids from the corresponding positions of the wildtype human osteopontin (SEQ ID NO: 66) or from the corresponding positions of the wildtype murine osteopontin (SEQ ID NO: 134). The term corresponding positions of the wildtype osteopontin we mean that the additional amino acids are the same as those present in the equivalent position in the above wildtype osteopontin (if one imagines that the amino acid sequence of SEQ ID NO:1 replaces the sequence underlined in italics in SEQ ID NO:66 In another embodiment, the peptide is selected from the group consisting of SEQ ID NO: 1, 136, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 67, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127, 128, 129, 130, 131, 132, 133, 135, 137, 138, 139, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 158, 159, 160, 161, 167, 168 and 169;

[0146] i. 15-Amino Acid Peptides:

TABLE-US-00009 SEQIDNO:1 VDTYDGDISVVYGLR SEQIDNO:2 VDTYDGDISVVYGLS

[0147] ii. 14-Amino Acid Peptides:

TABLE-US-00010 SEQIDNO:3 VDTYDGDISVVYGL SEQIDNO:4 DTYDGDISVVYGLR SEQIDNO:5 TYDGDISVVYGLRS

[0148] iii. 13-Amino Acid Peptides:

TABLE-US-00011 SEQIDNO:6 VDTYDGDISVVYG SEQIDNO:7 DTYDGDISVVYGL SEQIDNO:8 TYDGDISVVYGLR SEQIDNO:9 YDGDISVVYGLRS

[0149] iv. 12-Amino Acid Peptides:

TABLE-US-00012 SEQIDNO:10 VDTYDGDISVVY SEQIDNO:11 DTYDGDISVVYG SEQIDNO:12 TYDGDISVVYGL SEQIDNO:13 YDGDISVVYGLR SEQIDNO:14 DGDISVVYGLRS

[0150] v. 11-Amino Acid Peptides:

TABLE-US-00013 SEQIDNO:15 VDTYDGDISVV SEQIDNO:16 DTYDGDISVVY SEQIDNO:17 TYDGDISVVYG SEQIDNO:18 YDGDISVVYGL SEQIDNO:19 DGDISVVYGLR SEQIDNO:20 GDISVVYGLRS

[0151] vi. 10-Amino Acid Peptides:

TABLE-US-00014 SEQIDNO:21 VDTYDGDISV SEQIDNO:22 DTYDGDISVV SEQIDNO:23 TYDGDISVVY SEQIDNO:24 YDGDISVVYG SEQIDNO:25 DGDISVVYGL SEQIDNO:26 GDISVVYGLR SEQIDNO:27 DISVVYGLRS

[0152] vii. 9-Amino Acid Peptides:

TABLE-US-00015 SEQIDNO:28 VDTYDGDIS SEQIDNO:29 DTYDGDISV SEQIDNO:30 TYDGDISVV SEQIDNO:31 YDGDISVVY SEQIDNO:32 DGDISVVYG SEQIDNO:33 GDISVVYGL SEQIDNO:34 DISDVVYGLR SEQIDNO:35 ISDVVYGLRS

[0153] viii. 8-Amino Acid Peptides:

TABLE-US-00016 SEQIDNO:36 VDTYDGDI SEQIDNO:37 DTYDGDIS SEQIDNO:38 TYDGDISV SEQIDNO:39 YDGDISVV SEQIDNO:40 DGDISVVY SEQIDNO:41 GDISVVYG SEQIDNO:42 DISVVYGL SEQIDNO:43 ISVVYGLR

[0154] ix. 7-Amino Acid Peptides:

TABLE-US-00017 SEQIDNO:44 VDTYDGD SEQIDNO:45 DTYDGDI SEQIDNO:46 TYDGDIS SEQIDNO:47 YDGDISV SEQIDNO:48 DGDISVV SEQIDNO:49 GDISVVY SEQIDNO:50 DISVVYG SEQIDNO:51 ISVVYGL

[0155] x. 6-Amino Acid Peptides:

TABLE-US-00018 SEQIDNO:52 DTYDGD SEQIDNO:53 TYDGDI SEQIDNO:54 YDGDIS SEQIDNO:55 DGDISV SEQIDNO:56 GDISVV SEQIDNO:57 DISVVY SEQIDNO:58 ISVVYG

[0156] xi. 5-Amino Acid Peptides:

TABLE-US-00019 SEQIDNO:59 TYDGD SEQIDNO:60 YDGDI SEQIDNO:61 DGDIS SEQIDNO:62 GDISV SEQIDNO:63 DISVV SEQIDNO:64 ISVVY SEQIDNO:65 SVVYG

[0157] xii. 16-Amino Acid Peptide:

TABLE-US-00020 SEQIDNO:67 VDTYDGRGDSVVYGLR

[0158] xiii. 15-Amino Acid Peptides:

TABLE-US-00021 SEQIDNO:69 VDVPNGDISLAYGLR SEQIDNO:70 DVPNGDISLAYGLRS

[0159] xiv. 14-Amino Acid Peptides:

TABLE-US-00022 SEQIDNO:71 VDVPNGDISLAYGL SEQIDNO:72 DVPNGDISLAYGLR SEQIDNO:73 VPNGDISLAYGLRS

[0160] xv. 13-Amino Acid Peptides:

TABLE-US-00023 SEQIDNO:74 VDVPNGDISLAYG SEQIDNO:75 DVPNGDISLAYGL SEQIDNO:76 VPNGDISLAYGLR SEQIDNO:77 PNGDISLAYGLRS

[0161] xvi. 12-Amino Acid Peptides:

TABLE-US-00024 SEQIDNO:78 VDVPNGDISLAY SEQIDNO:79 DVPNGDISLAYG SEQIDNO:80 VPNGDISLAYGL SEQIDNO:81 PNGDISLAYGLR SEQIDNO:82 NGDISLAYGLRS

[0162] xvii. 11-Amino Acid Peptides:

TABLE-US-00025 SEQIDNO:83 VDVPNGDISLA SEQIDNO:84 DVPNGDISLAY SEQIDNO:85 VPNGDISLAYG SEQIDNO:86 PNGDISLAYGL SEQIDNO:87 NGDISLAYGLR SEQIDNO:88 GDISLAYGLRS

[0163] xviii. 10-Amino Acid Peptides:

TABLE-US-00026 SEQIDNO:89 VDVPNGDISL SEQIDNO:90 DVPNGDISLA SEQIDNO:91 VPNGDISLAY SEQIDNO:92 PNGDISLAYG SEQIDNO:93 NGDISLAYGL SEQIDNO:94 GDISLAYGLR SEQIDNO:95 DISLAYGLRS

[0164] xix. 9-Amino Acid Peptides:

TABLE-US-00027 SEQIDNO:96 VDVPNGDIS SEQIDNO:97 DVPNGDISL SEQIDNO:98 VPNGDISLA SEQIDNO:99 PNGDISLAY SEQIDNO:100 NGDISLAYG SEQIDNO:101 GDISLAYGL SEQIDNO:102 DISLAYGLR SEQIDNO:103 ISLAYGLRS

[0165] xx. 8-Amino Acid Peptides:

TABLE-US-00028 SEQIDNO:104 VDVPNGDI SEQIDNO:105 DVPNGDIS SEQIDNO:106 VPNGDISL SEQIDNO:107 PNGDISLA SEQIDNO:108 NGDISLAY SEQIDNO:109 GDISLAYG SEQIDNO:110 DISLAYGL SEQIDNO:111 ISLAYGLR

[0166] xxi. 7-Amino Acid Peptides:

TABLE-US-00029 SEQIDNO:112 VDVPNGD SEQIDNO:113 DVPNGDI SEQIDNO:114 VPNGDIS SEQIDNO:115 PNGDISL SEQIDNO:116 NGDISLA SEQIDNO:117 GDISLAY SEQIDNO:118 DISLAYG SEQIDNO:119 ISLAYGL

[0167] xxii. 6-Amino Acid Peptides:

TABLE-US-00030 SEQIDNO:120 DVPNGD SEQIDNO:121 VPNGDI SEQIDNO:122 PNGDIS SEQIDNO:123 NGDISL SEQIDNO:124 GDISLA SEQIDNO:125 DISLAY SEQIDNO:126 ISLAYG

[0168] xxiii. 5-amino acid peptides:

TABLE-US-00031 SEQIDNO:127 VPNGD SEQIDNO:128 PNGDI SEQIDNO:129 NGDIS SEQIDNO:130 GDISL SEQIDNO:131 DISLA SEQIDNO:132 ISLAY SEQIDNO:133 SLAYG

[0169] xxiv. 16-Amino Acid Peptides:

TABLE-US-00032 SEQIDNO:136 KPLAEIDSIELSYGIK SEQIDNO:137 GDPNDGRGDSVVYGLR

[0170] xxv. 15-Amino Acid Peptides:

TABLE-US-00033 SEQIDNO:138 VDTYDGGISVVYGLR SEQIDNO:139 VDTYDGDGSVVYGLR

[0171] xxvi. 16-Amino Acid Peptides:

TABLE-US-00034 SEQIDNO:141 KCLAECDSIELSYGIK

[0172] xxvii. 8-Amino Acid Peptides:

TABLE-US-00035 SEQIDNO:142 CLAEIDSC

[0173] xxviii. 18-Amino Acid Peptides:

TABLE-US-00036 SEQIDNO:143 CFKPLAEIDSIECSYGIK

[0174] xxix. 16-Amino Acid Peptides:

TABLE-US-00037 SEQIDNO:144 KPLAEDISIELSYGIK SEQIDNO:145 KPLAEISDIELSYGIK SEQIDNO:146 KPLAEIGDIELSYGIK

[0175] xxx. 15-amino acid peptides:

TABLE-US-00038 SEQIDNO:147 KPLAEGDIELSYGIK

[0176] xxxi. 13-Amino Acid Peptides:

TABLE-US-00039 SEQIDNO:148 KPLAEIELSYGIK

[0177] xxxii. 16-Amino Acid Peptides:

TABLE-US-00040 SEQIDNO:149 KPLAEIDSIELTYGIK SEQIDNO:150 KPLAEIDGIELSYGIK SEQIDNO:151 KPLAEIDGIELTYGIK SEQIDNO:152 KPLAEIGSIELSYGIK SEQIDNO:153 KGLAEIDSIELSYGIK SEQIDNO:154 KPLAGIDSIGLSYGIK SEQIDNO:155 KCLAEIDSCELSYGIK

[0178] xxxiii. 13-amino acid peptides:

TABLE-US-00041 SEQIDNO:156 CFKPLAEIDSIEC

[0179] xxxiv. 15-Amino Acid Peptides:

TABLE-US-00042 SEQIDNO:157 VDVPEGDISLAYGLR SEQIDNO:158 LDGLVRAYDNISPVG

[0180] xxxv. 14-Amino Acid Peptides:

TABLE-US-00043 SEQIDNO:159 GDPNGDISVVYGLR

[0181] xxxvi. 15-Amino Acid Peptides:

TABLE-US-00044 SEQIDNO:160 VDVPNGDISLAYRLR SEQIDNO:161 VDVPEGDISLAYRLR SEQIDNO:167 V(beta-D)TYDGDISVVYGLR SEQIDNO:168 VDTY(beta-D)GDISVVYGLR SEQIDNO:169 VDTYDG(beta-D)ISVVYGLR

[0182] In one embodiment said peptide is derived from osteopontin, such as a mammalian osteopontin variant and/or fragment.

[0183] In one embodiment, said peptide is non-naturally occurring, such as a peptide comprising non-proteinogenic amino acid residues.

[0184] In some embodiments, said peptide is further conjugated to a moiety, which may be selected from the group consisting of PEG, monosaccharides, fluorophores, chromophores, radioactive compounds, and cell-penetrating peptides. In one embodiment, the fluorophore is selected from the group consisting of Lucifer yellow, biotin, 5,6-carboxyltetramethylrhodamine (TAMRA), indodicarbocyanine (C5) Alexa Fluor 488, Alexa Fluor 532, Alexa Fluor 647, ATTO 488, ATTO 532, 6-carboxyfluorescein (6-FAM), Alexa Fluor 350, DY-415, ATTO 425, ATTO 465, Bodipy FL, fluorescein isothiocyanate, Oregon Green 488, Oregon Green 514, Rhodamine Green, 5-Tetrachloro-Fluorescein, ATTO 520, 6-carboxy-4,5-dichloro-2,7-dimethoxyfluoresceine, Yakima Yellow dyes, Bodipy 530/550, hexachloro-fluorescein, Alexa Fluor 555, DY-549, Bodipy TMR-X, cyanine phosphoramidites (cyanine 3, cyanine 3.5, cyanine 5, cyanine 5.5, cyanine 7.5), ATTO 550, Rhodamine Red, ATTO 565, Carboxy-X-Rhodamine, Texas Red (Sulforhodamine 101 acid chloride), LightCycler Red 610, ATTO 594, DY-480-XL, DY-610, ATTO 610, LightCycler Red 640, Bodipy 630/650, ATTO 633, Bodipy 650/665, ATTO 647N, DY-649, LightCycler Red 670, ATTO 680, LightCycler Red 705, DY-682, ATTO 700, ATTO 740, DY-782, IRD 700, IRD 800, CAL Fluor Gold 540 nm, CAL Fluor Gold 522 nm, CAL Fluor Gold 544 nm, CAL Fluor Orange 560 nm, CAL Fluor Orange 538 nm, CAL Fluor Orange 559 nm, CAL Fluor Red 590 nm, CAL Fluor Red 569 nm, CAL Fluor Red 591 nm, CAL Fluor Red 610 nm, CAL Fluor Red 590 nm, CAL Fluor Red 610 nm, CAL Fluor Red 635 nm, Quasar 570 nm, Quasar 548 nm, Quasar 566 nm (Cy 3), Quasar 670 nm, Quasar 647 nm, Quasar 670 nm, Quasar 705 nm, Quasar 690 nm, Quasar 705 nm (Cy 5.5), Pulsar 650 Dyes, SuperRox Dyes.).

[0185] In another embodiment, said peptide is further modified such as being glycosylated or by PEGylation, amidation, esterification, acylation, acetylation and/or alkylation.

[0186] In one embodiment, said peptide comprises or consists of tandem repeats, which may comprise or consist of the amino acid sequence of any one or more of the sequences as described herein.

[0187] In one embodiment, said peptide is cyclic. The cyclic structure may be achieved by any suitable method of synthesis. Thus, heterodetic linkages may include, but are not limited to formation via disulphide, cysteine, alkylene or sulphide bridges.

[0188] In a further embodiment, the peptide comprises or consists of a fusion. For example, the peptide may comprise a fusion of the amino acid sequence of SEQ ID NO: 1 or 136.

[0189] The term fusion of a peptide relates to an amino acid sequence corresponding to, for example, SEQ ID NO: 1 or 136 (or a fragment or variant thereof) fused to any other peptide. For example, the said peptide may be fused to a polypeptide such as glutathione-S-transferase (GST) or protein A in order to facilitate purification of said peptide. Examples of such fusions are well known to those skilled in the art. Similarly, the said peptide may be fused to an oligo-histidine tag such as His6 or to an epitope recognised by an antibody such as the well-known Myc tag epitope. Fusions to any variant or derivative of said peptide are also included in the scope of the disclosure.

[0190] Alternatively, the fused portion may be a lipophilic molecule or peptide domain that is capable of promoting cellular uptake of the polypeptide, as known to those skilled in the art.

Novel Peptides

[0191] In one embodiment, the present disclosure relates to a peptide comprising or consisting of an amino acid sequence selected from the group consisting of KPLAEIDSIELSYGIK (SEQ ID NO: 136), GDPNDGRGDSVVYGLR (SEQ ID NO: 137), VDTYDGGISVVYGLR (SEQ ID NO: 138), and VDTYDGDGSVVYGLR (SEQ ID NO: 139), VDVPEGDISLAYGLR (SEQ ID NO: 157), LDGLVRAYDNISPVG (SEQ ID NO: 158), GDPNGDISVVYGLR (SEQ ID NO: 159), VDVPNGDISLAYRLR (SEQ ID NO: 160) VDVPEGDISLAYRLR (SEQ ID NO: 161), or a variant or fragment thereof.

[0192] In another embodiment, the present disclosure relates to a peptide comprising or consisting of an amino acid sequence selected from the group consisting of KCLAECDSIELSYGIK (SEQ ID NO: 141), CLAEIDSC (SEQ ID NO: 142), CFKPLAEIDSIECSYGIK (SEQ ID NO: 143), KPLAEDISIELSYGIK (SEQ ID NO: 145), KPLAEIGDIELSYGIK (SEQ ID NO: 146), KPLAEGDIELSYGIK (SEQ ID NO: 147), KPLAEIELSYGIK (SEQ ID NO: 148), KPLAEIDSIELTYGIK (SEQ ID NO: 149), KPLAEIDGIELSYGIK (SEQ ID NO: 150), KPLAEIDGIELTYGIK (SEQ ID NO: 151), KPLAEIGSIELSYGIK (SEQ ID NO: 152), KGLAEIDSIELSYGIK (SEQ ID NO: 153), KPLAGIDSIGLSYGIK (SEQ ID NO: 154), KCLAEIDSCELSYGIK (SEQ ID NO: 155) and CFKPLAEIDSIEC (SEQ ID NO: 156), or a variant or fragment thereof.

[0193] In one embodiment, the present disclosure relates to the agent comprising a peptide, wherein the peptide comprises or consists of the amino acid sequence KPLAEIDSIELSYGIK (SEQ ID NO: 136), or a variant or fragment thereof.

[0194] In one embodiment, the present disclosure relates to the agent comprising a peptide, wherein the peptide comprises or consists of the amino acid sequence KPLAGIDSIGLSYGIK (SEQ ID NO: 154), or a variant or fragment thereof.

[0195] In one embodiment, the present disclosure relates to the agent comprising a peptide, wherein the peptide comprises or consists of the amino acid sequence KGLAEIDSIELSYGIK (SEQ ID NO: 153), or a variant or fragment thereof.

[0196] In one embodiment, the present disclosure relates to the agent comprising a peptide, wherein the peptide comprises or consists of the amino acid sequence KCLAECDSIELSYGIK (SEQ ID NO: 141), or a variant or fragment thereof.

[0197] In one embodiment, the present disclosure relates to the agent comprising a peptide, wherein the peptide comprises or consists of the amino acid sequence KPLAEIDGIELTYGIK (SEQ ID NO: 151), or a variant or fragment thereof.

[0198] In one embodiment, the present disclosure relates to the agent comprising a peptide, wherein the peptide comprises or consists of the amino acid sequence

[0199] KPLAEIGSIELSYGIK (SEQ ID NO: 152), or a variant or fragment thereof.

[0200] In one embodiment, the present disclosure relates to the agent comprising a peptide, wherein the peptide comprises or consists of the amino acid sequence KPLAEIELSYGIK (SEQ ID NO: 148), or a variant or fragment thereof.

[0201] In one embodiment, the present disclosure relates to an agent comprising: [0202] b) a peptide or peptide analog comprising or consisting of the amino acid sequence GDPNDGRGDSVVYGLR (SEQ ID NO: 137), VDTYDGGISVVYGLR (SEQ ID NO: 138), and VDTYDGDGSVVYGLR (SEQ ID NO: 139). VDVPEGDISLAYGLR (SEQ ID NO: 157), LDGLVRAYDNISPVG (SEQ ID NO: 158), GDPNGDISVVYGLR (SEQ ID NO: 159), VDVPNGDISLAYRLR (SEQ ID NO: 160) VDVPEGDISLAYRLR (SEQ ID NO: 161), V(beta-D)TYDGDISVVYGLR (SEQ ID NO:167), VDTY(beta-D)GDISVVYGLR (SEQ ID NO: 168), VDTYDG(beta-D)ISVVYGLR (SEQ ID NO:169); [0203] b) a polynucleotide encoding upon expression, the peptide of a); [0204] c) a vector comprising the polynucleotide of b); and [0205] d) a cell comprising the polynucleotide of b), or the vector of c).

[0206] In some embodiments, said variant comprises or consists of a sequence wherein any one amino acid has been altered for another proteinogenic or non-proteinogenic amino acid, with the proviso that no more than five amino acids are so altered, such as no more than 4 amino acids, such as no more than 3 amino acids, such as no more than 2 amino acids, such as no more than 1 amino acid is altered. In some embodiments, one or more amino acids are conservatively substituted.

[0207] In some embodiments, said peptide comprises or consists of one or more additional amino acids, inserted at the N- and/or C-terminus and/or internally within the sequence. In one embodiment, at least 2 additional amino acids, such as at least 3, such as at least 4, such as at least 5, such as at least 6, such as at least 7, such as at least 8, such as at least 9, such as at least 10, such as at least 15 or such as at least 20 additional amino acids are inserted.

[0208] In some embodiments, said peptide is no more than 85, such as no more than 80, such as no more than 75, such as no more than 70, such as no more than 65, such as no more than 60, such as nor more than 55, such as no more than 50, such as no more than 55, such as no more than 40 amino acids, such as no more than 35, such as no more than 30, such as no more than 28, such as no more than 26, such as no more than 24, such as no more than 22, such as no more than 20, such as no more than 19, such as no more than 18, such as no more than 17, such as no more than 16, such as no more than 15, such as no more than 14, such as no more than 13, such as no more than 12, such as no more than 11, such as no more than 10 amino acids in length.

[0209] In some embodiments, said peptide is further conjugated to a moiety, which may be selected from the group consisting of PEG, monosaccharides, fluorophores, chromophores, radioactive compounds, and cell-penetrating peptides.

[0210] In one embodiment, said peptide is further modified such as being glycosylated or by PEGylation, amidation, esterification, acylation, acetylation and/or alkylation.

[0211] In some embodiments, said peptide comprises or consists of tandem repeats, which may comprise or consist of the amino acid sequence of any one or more of the sequences as described herein above.

[0212] In one embodiment, said peptide is cyclic. The cyclic structure may be achieved by any suitable method of synthesis. Thus, heterodetic linkages may include, but are not limited to formation via, cysteine, disulphide, alkylene or sulphide bridges.

Indications

[0213] The agents of the present disclosure are suitable for use in the treatment of endocrine, nutritional and metabolic diseases and disorders.

[0214] In one embodiment, the mammal in need of treatment of an endocrine disease, a nutritional disease and/or a metabolic disease is a human.

[0215] In some embodiments, the endocrine disease, nutritional disease and/or metabolic disease is selected from the group consisting of diabetes mellitus, type 1 diabetes mellitus, type 2 diabetes mellitus, malnutrition-related diabetes mellitus, disorders of glucose regulation and pancreatic internal secretion, insulin resistance syndrome, impaired glucose tolerance, hyperglycemia, hyperinsulinemia, and any combinations thereof.

[0216] In some embodiments, the endocrine disease, nutritional disease and/or metabolic disease is selected from the group consisting of diabetes mellitus, disorders of the thyroid gland, disorders of glucose regulation and pancreatic internal secretion, disorders of endocrine glands, malnutrition, nutritional deficiencies, obesity, hyperalimentation, and metabolic disorders.

[0217] In one embodiment, diabetes mellitus is selected from the group consisting of type 1 diabetes mellitus, type 2 diabetes mellitus, malnutrition-related diabetes mellitus, specified diabetes mellitus, and unspecified diabetes mellitus.

[0218] In one embodiment, disorders of glucose regulation and pancreatic internal secretion are selected from the group consisting of nondiabetic hypoglycaemic coma and disorders of pancreatic internal secretion.

[0219] In one embodiment, disorders of obesity and hyperalimentation are selected from the group consisting of localized adiposity, hyperalimentation, and sequelae of hyperalimentation.

[0220] In one embodiment, disorders of nutritional deficiencies are selected from the group consisting of disorders of aromatic amino-acid metabolism, disorders of branched-chain amino-acid metabolism and fatty-acid metabolism, disorders of amino-acid metabolism, lactose intolerance, disorders of carbohydrate metabolism, disorders of sphingolipid metabolism, disorders of lipid storage disorders, disorders of glycosaminoglycan metabolism, disorders of glycoprotein metabolism, disorders of lipoprotein metabolism, lipidaemias, disorders of purine and pyrimidine metabolism, disorders of porphyrin and bilirubin metabolism, disorders of mineral metabolism, cystic fibrosis, amyloidosis, volume depletion, disorders of fluid, electrolyte and acid-base balance, and postprocedural endocrine and metabolic disorders.

Compositions

[0221] In one aspect, the present disclosure relates to a composition comprising the agent described herein.

[0222] In one aspect, the present disclosure relates to an agent selected from the group consisting of: [0223] a) a peptide or a peptide analog selected from the group consisting of [0224] (i) a peptide comprising or consisting of an amino acid sequence of the general formula:

TABLE-US-00045 (SEQIDNO:140) KX.sub.2LAX.sub.5X.sub.6X.sub.7X.sub.8IX.sub.10LX.sub.12YGIK [0225] wherein: [0226] X.sub.2 is C, P or G; [0227] X.sub.5 is E or G; [0228] X.sub.6 is C, D or I; [0229] X.sub.7 is D, I, S or G; [0230] X.sub.8 is S, D or G; [0231] X.sub.10 is E or G; [0232] X.sub.12 is S or T [0233] with the proviso that if X.sub.12 is T, the peptide comprises no more than 25 amino acid residues; and [0234] (ii) a peptide comprising or consisting of an amino acid sequence of the general formula:

TABLE-US-00046 (SEQIDNO:68) VDZ.sub.3Z4Z.sub.5GZ.sub.7Z.sub.8SZ.sub.10Z.sub.11YGLR [0235] wherein: [0236] Z.sub.3 is T or V; [0237] Z.sub.4 is Y or P; [0238] Z.sub.5 is D or N; [0239] Z.sub.7 is D or G; [0240] Z.sub.8 is I or G; [0241] Z.sub.10 is V or L; [0242] Z.sub.11 is V or A; and [0243] (iii) a peptide comprising or consists of an amino acid sequence selected from the group consisting of KCLAECDSIELSYGIK (SEQ ID NO: 141), CLAEIDSC (SEQ ID NO: 142), CFKPLAEIDSIECSYGIK (SEQ ID NO: 143), KPLAEIELSYGIK (SEQ ID NO: 148), KCLAEIDSCELSYGIK (SEQ ID NO: 155) and CFKPLAEIDSIEC (SEQ ID NO: 156); [0244] b) a polynucleotide encoding upon expression, the peptide of a); [0245] c) a vector comprising the polynucleotide of b); and [0246] d) a cell comprising the polynucleotide of b), or the vector of c); [0247] for use in the treatment of an endocrine disease, a nutritional disease and/or a metabolic disease in a mammal.

[0248] In one aspect, the present disclosure relates to a composition for use in treatment of an endocrine disease, a nutritional disease and/or a metabolic disease, comprising an agent described herein. In one embodiment, said composition is a pharmaceutical composition.

[0249] In one embodiment, the agent further comprises a second active ingredient. Said second active ingredient may be selected from the group consisting of insulin, glucagon-like peptide-1 (GLP-1), biguanides, forskolin compounds, sulfonylurea, a dipeptidyl peptidase-4 (DPP4) inhibitor, an alpha-glucosidase inhibitor, a thiazolidinedione, a meglitidine and a sodium-glucose cotransporter-2 (SGLT2) inhibitor.

Other Methods

[0250] In one aspect, the present disclosure concerns a method of treating an endocrine disease, a nutritional disease and/or a metabolic disease, the method comprising administering an agent described herein to a subject in need thereof.

[0251] In one aspect, the present disclosure concerns the use of an agent for the manufacture of a medicament for use in treatment of an endocrine disease, a nutritional disease and/or a metabolic disease in a mammal.

[0252] In one aspect, the present disclosure concerns a polynucleotide encoding upon expression the peptide as described herein. In one aspect, the present disclosure concerns a vector comprising said polynucleotide encoding upon expression the peptide as described herein. In one aspect, the present disclosure concerns a cell comprising said polynucleotide or said vector encoding upon expression the peptide as described herein

[0253] In one aspect, the present disclosure concerns a method for increasing insulin secretion, the method comprising administering a therapeutically effective amount of a peptide described herein, to an individual in need thereof. In one embodiment, said method is an in vitro method.

[0254] In one aspect, the present disclosure concerns a method for decreasing blood glucose levels, the method comprising administering a therapeutically effective amount of a peptide described herein, to an individual in need thereof. In one embodiment, said method is an in vitro method. In one embodiment, insulin secretion is increased. In another embodiment, cellular uptake of glucose is increased. In yet another embodiment, insulin production is increased. In another embodiment glucagon production is decreased.

[0255] In one aspect, the present disclosure concerns a method, e.g. an in vitro method, for improving -cell morphology, the method comprising administering a therapeutically effective amount of a peptide described herein, to an individual in need thereof.

[0256] In one aspect, the present disclosure concerns a method for improving -cell viability, the method comprising administering a therapeutically effective amount of a peptide described herein, to an individual in need thereof.

[0257] In one aspect, the present disclosure concerns a method for delaying onset of diabetes and diabetes associated disorders and disease, the method comprising administering a therapeutically effective amount of a peptide described herein, to an individual in need thereof.

[0258] In one embodiment of the present disclosure, the agent may further comprise a detectable moiety. For example, a detectable moiety may comprise or consist of a radioisotope, such as a radioisotope selected from the group consisting of .sup.99mTc, .sup.111In, .sup.67Ga, .sup.68Ga, .sup.72As, .sup.89Zr, .sup.123I and .sup.201Tl. The binding moieties may thus be coupled to nanoparticles that have the capability of multi-imaging (for example, SPECT, PET, MRI, Optical, or Ultrasound). Alternatively, the detectable moiety may comprise or consist of a paramagnetic isotope, such as a paramagnetic isotope is selected from the group consisting of .sup.157Gd, .sup.55Mn, .sup.162Dy, .sup.52Cr and .sup.56Fe.

[0259] In the case that the agent comprises a detectable moiety, then the detectable moiety may be detectable by an imaging technique such as SPECT, PET, MRI, optical or ultrasound imaging.

[0260] In one aspect, the present disclosure concerns the use of agent described herein for the preparation of a diagnostic composition for the diagnosis of a disease, disorder or damage of the pancreas in an individual.

Items

[0261] 1. An agent comprising: [0262] a) a peptide, wherein the peptide or peptide analog comprises an amino acid sequence of the general formula:

TABLE-US-00047 (SEQIDNO:140) KX.sub.2LAX.sub.5X.sub.6X.sub.7X.sub.8IX.sub.10LX.sub.12YGIK [0263] wherein: [0264] X.sub.2 is C, P or G; [0265] X.sub.5 is E or G; [0266] X.sub.6 is C, D or I; [0267] X.sub.7 is D, I, S or G; [0268] X.sub.8 is S, D or G; [0269] X.sub.10 is E or G; [0270] X.sub.12 is S or T; [0271] with the proviso that if X.sub.12 is T, the peptide comprises no more than 25 amino acid residues; and [0272] with the proviso that if X.sub.2 is P, X.sub.5 is E, X.sub.5 is I, X.sub.7 is D, X.sub.5 is S, X.sub.10 is E and X.sub.12 is S, the peptide comprises no more than 85 amino acid residues; [0273] or a biologically active fragment and/or variant of SEQ ID NO: 140; [0274] b) a polynucleotide encoding upon expression, the peptide of a); [0275] c) a vector comprising the polynucleotide of b); and [0276] d) a cell comprising the polynucleotide of b), or the vector of c). [0277] 2. An agent comprising a peptide, wherein the peptide comprises an amino acid sequence of the general formula:

TABLE-US-00048 (SEQIDNO:164) VDVPZ.sub.5GDISLAYZ.sub.13LR [0278] wherein: [0279] Z.sub.5 is E or N; [0280] Z.sub.13 is R or G. [0281] 3. An agent comprising a peptide, wherein the peptide comprises an amino acid sequence of the general formula:

TABLE-US-00049 (SEQIDNO:165) VDTYDGZ.sub.7Z.sub.8SVVYGLR [0282] wherein: [0283] Z.sub.7 is D or G; [0284] Z.sub.8 is I or G. [0285] 4. An agent comprising a peptide, wherein the peptide comprises an amino acid sequence of the general formula:

TABLE-US-00050 (SEQIDNO:166) GDPNZ.sub.5Z.sub.6Z.sub.7Z.sub.8Z.sub.9SVVYGLR [0286] wherein: [0287] Z.sub.5 is D or G; [0288] Z.sub.6 is D or G [0289] Z.sub.7 is I or R; [0290] Z.sub.8 is G or absent; [0291] Z.sub.9 is D or absent. [0292] 5. The agent according to item 2 to 4, wherein the agent comprising: [0293] a) a peptide, wherein the peptide comprises or consists of an amino acid sequence selected from the group consisting of GDPNDGRGDSVVYGLR (SEQ ID NO: 137), VDTYDGGISVVYGLR (SEQ ID NO: 138), and VDTYDGDGSVVYGLR (SEQ ID NO: 139). VDVPEGDISLAYGLR (SEQ ID NO: 157), LDGLVRAYDNISPVG (SEQ ID NO: 158), GDPNGDISVVYGLR (SEQ ID NO: 159), VDVPNGDISLAYRLR (SEQ ID NO: 160) VDVPEGDISLAYRLR (SEQ ID NO: 161); [0294] b) a polynucleotide encoding upon expression, the peptide of a); [0295] c) a vector comprising the polynucleotide of b); and [0296] d) a cell comprising the polynucleotide of b), or the vector of c). [0297] 6. The agent according to item 1, wherein the peptide comprises or consists of an amino acid sequence of the general formula:

TABLE-US-00051 (SEQIDNO:162) KX.sub.2LAX.sub.5X.sub.8X.sub.7X.sub.8IX.sub.10LSYGIK [0298] wherein: [0299] X.sub.2 is C, P or G; [0300] X.sub.6 is C, I or absent; [0301] X.sub.7 is D, G or absent; [0302] X.sub.8 is S, G or absent; [0303] X.sub.10 is E or G. [0304] 7. The agent according to item 6, wherein the peptide comprises an amino acid sequence of the general formula:

TABLE-US-00052 (SEQIDNO:163) KX.sub.2LAX.sub.5IX.sub.10LSYGIK [0305] wherein: [0306] X.sub.2 is C, P or G; [0307] X.sub.5 is E or G; [0308] X.sub.10 is E or G. [0309] 8. An agent comprising: [0310] a) a peptide or peptide analog comprising or consisting of the amino acid sequence GDPNDGRGDSVVYGLR (SEQ ID NO: 137), VDTYDGGISVVYGLR (SEQ ID NO: 138), and VDTYDGDGSVVYGLR (SEQ ID NO: 139). VDVPEGDISLAYGLR (SEQ ID NO: 157), LDGLVRAYDNISPVG (SEQ ID NO: 158), GDPNGDISVVYGLR (SEQ ID NO: 159), VDVPNGDISLAYRLR (SEQ ID NO: 160) VDVPEGDISLAYRLR (SEQ ID NO: 161), V(beta-D)TYDGDISVVYGLR (SEQ ID NO:167), VDTY(beta-D)GDISVVYGLR (SEQ ID NO: 168), VDTYDG(beta-D)ISVVYGLR (SEQ ID NO:169); [0311] b) a polynucleotide encoding upon expression, the peptide of a); [0312] c) a vector comprising the polynucleotide of b); and [0313] d) a cell comprising the polynucleotide of b), or the vector of c). [0314] 9. The agent according to any one of the preceding items, wherein the agent comprises non-naturally occurring, e.g. non-proteinogenic, amino acid residues. [0315] 10. The agent according to any one of the preceding items, wherein the agent is conjugated to a moiety. [0316] 11. The agent according to any one of the preceding items, wherein the moiety is selected from the group consisting of polyethylene glycol (PEG), monosaccharides, fluorophores, chromophores, radioactive compounds, and cell-penetrating peptides. [0317] 12. The agent according to any one of the preceding items, wherein the agent is further modified such as being glycosylated or by PEGylation, amidation, esterification, acylation, acetylation and/or alkylation. [0318] 13. The agent according to any one of the preceding items, wherein the agent comprises or consists of tandem repeats. [0319] 14. The agent according to any one of the preceding items, wherein the tandem repeats comprise or consist of the amino acid sequence of any one or more of the sequences as described in the preceding items. [0320] 15. The agent according to any of the preceding items, wherein the agent is fused to another polypeptide. [0321] 16. The agent according to any one of the preceding items, wherein the said polypeptide is selected from the group consisting of glutathione-S-transferase (GST) and protein A. [0322] 17. The agent according to any of the preceding items, wherein the agent is fused to a tag. [0323] 18. The agent according to any one of the preceding items, wherein the said tag is an oligo-histidine tag. [0324] 19. The agent according to any of the preceding items, wherein the agent is cyclic, such as wherein the peptide is cyclic. [0325] 20. The agent according to any of the preceding items, wherein the peptide or peptide analog is capable of forming at least one intramolecular cysteine bridge, e.g. to form a cyclic or partially cyclic peptide. [0326] 21. The agent according to any of the preceding items, wherein the peptide or peptide analog comprises or consists of an amino acid sequence selected from the group consisting of KCLAECDSIELSYGIK (SEQ ID NO: 141), CLAEIDSC (SEQ ID NO: 142), CFKPLAEIDSIECSYGIK (SEQ ID NO: 143), KPLAEDISIELSYGIK (SEQ ID NO: 145), KPLAEIGDIELSYGIK (SEQ ID NO: 146), KPLAEGDIELSYGIK (SEQ ID NO: 147), KPLAEIELSYGIK (SEQ ID NO: 148), KPLAEIDSIELTYGIK (SEQ ID NO: 149), KPLAEIDGIELSYGIK (SEQ ID NO: 150), KPLAEIDGIELTYGIK (SEQ ID NO: 151), KPLAEIGSIELSYGIK (SEQ ID NO: 152), KGLAEIDSIELSYGIK (SEQ ID NO: 153), KPLAGIDSIGLSYGIK (SEQ ID NO: 154), KCLAEIDSCELSYGIK (SEQ ID NO: 155) and CFKPLAEIDSIEC (SEQ ID NO: 156), or a variant or fragment thereof. [0327] 22. The agent according to any of the preceding items, wherein the peptide or peptide analog comprises or consists of the amino acid sequence KPLAEIDSIELSYGIK (SEQ ID NO: 136), or a variant or fragment thereof. [0328] 23. The agent according to any of the preceding items, wherein the peptide or peptide analog comprises or consists of the amino acid sequence KPLAGIDSIGLSYGIK (SEQ ID NO: 154), or a variant or fragment thereof. [0329] 24. The agent according to any of the preceding items, wherein the peptide or peptide analog comprises or consists of the amino acid sequence KGLAEIDSIELSYGIK (SEQ ID NO: 153), or a variant or fragment thereof. [0330] 25. The agent according to any of the preceding items, wherein the peptide or peptide analog comprises or consists of the amino acid sequence KCLAECDSIELSYGIK (SEQ ID NO: 141), or a variant or fragment thereof. [0331] 26. The agent according to any of the preceding items, wherein the peptide or peptide analog comprises or consists of the amino acid sequence KPLAEIDGIELTYGIK (SEQ ID NO: 151), or a variant or fragment thereof. [0332] 27. The agent according to any of the preceding items, wherein the peptide or peptide analog comprises or consists of the amino acid sequence KPLAEIGSIELSYGIK (SEQ ID NO: 152), or a variant or fragment thereof. [0333] 28. The agent according to any of the preceding items, wherein the peptide or peptide analog comprises or consists of the amino acid sequence KPLAEIELSYGIK (SEQ ID NO: 148), or a variant or fragment thereof. [0334] 29. The agent according to any one of the preceding items, wherein the variant comprises or consists of a sequence wherein any one amino acid has been altered for another proteinogenic or non-proteinogenic amino acid, with the proviso that no more than five amino acids are so altered. [0335] 30. The agent according to any one of the preceding items, wherein the variant comprises or consists of a sequence wherein no more than five amino acids are altered for another proteinogenic or non-proteinogenic amino acid, such as no more than 4 amino acids, such as no more than 3 amino acids, such as no more than 2 amino acids, such as no more than 1 amino acid is altered. [0336] 31. The agent according to any one of the preceding items, wherein one or more amino acids are conservatively substituted. [0337] 32. The agent according to any one of the preceding items, wherein the peptide or peptide analog comprises or consists of one or more additional amino acids, inserted at the N- and/or C-terminus and/or internally within the sequence. [0338] 33. The agent according to any one of the preceding items, wherein the peptide or peptide analog comprises 1 additional amino acid conjugated to either N- or C-terminal. [0339] 34. The agent according to any of the preceding items, wherein the agent comprises no more than 85, such as no more than 80, such as no more than 75, such as no more than 70, such as no more than 65, such as no more than 60, such as nor more than 55, such as no more than 50, such as no more than 55, such as no more than 40 amino acids, such as no more than 35, such as no more than 30, such as no more than 28, such as no more than 26, such as no more than 24, such as no more than 22, such as no more than 20, such as no more than 19, such as no more than 18, such as no more than 17, such as no more than 16, such as no more than 15, such as no more than 14, such as no more than 13, such as no more than 12, such as no more than 11, such as no more than 10 amino acids. [0340] 35. The agent according to any one of the preceding items, wherein the agent comprises at least 2 additional amino acids, such as at least 3, such as at least 4, such as at least 5, such as at least 6, such as at least 7, such as at least 8, such as at least 9, such as at least 10, such as at least 15 or such as at least 20 amino acids conjugated to the N- or C-terminus of the peptide. [0341] 36. The agent according to any of the preceding items, wherein the agent further comprises a detectable moiety. [0342] 37. The agent according to any of the preceding items, wherein the detectable moiety comprises or consists of a radioisotope. [0343] 38. The agent according to any of the preceding items, wherein the radioisotope is selected from the group consisting of .sup.99mTc, .sup.111In, .sup.67Ga, .sup.68Ga, .sup.72As, .sup.89Zr, .sup.123I and .sup.201Tl. [0344] 39. The agent according to any of the preceding items, wherein the detectable moiety is detectable by an imaging technique such as SPECT, PET, MRI, optical or ultrasound imaging. [0345] 40. Use of the agent of any of the preceding items, for the preparation of a diagnostic composition for the diagnosis of a disease, disorder or damage of the pancreas in an individual. [0346] 41. A composition comprising the agent according to any of the preceding items. [0347] 42. The composition according to any one of the preceding items, wherein the composition is a pharmaceutical composition. [0348] 43. The agent or the composition according to any one of the preceding items, for use as a medicament. [0349] 44. An agent selected from the group consisting of: [0350] a) a peptide selected from the group consisting of [0351] (i) a peptide comprising or consisting of an amino acid sequence of the general formula:

TABLE-US-00053 (SEQIDNO:140) KX.sub.2LAX.sub.5X.sub.6X.sub.7X.sub.8IX.sub.10LX.sub.12YGIK [0352] wherein: X.sub.2 is C, P or G; X.sub.5 is E or G; X.sub.6 is C, D or I; X.sub.7 is D, I, S or G; X.sub.8 is S, D or G; X.sub.10 is E or G; X.sub.12 is S or T; [0353] with the proviso that if X.sub.12 is T, the peptide comprises no more than 25 amino acid residues; [0354] or a biologically active fragment and/or variant of SEQ ID NO: 140; [0355] (ii) a peptide comprising or consisting of an amino acid sequence of the general formula:

TABLE-US-00054 (SEQIDNO:68) VDZ.sub.3Z4Z.sub.5GZ.sub.7SZ.sub.10Z.sub.11YGLR [0356] wherein: [0357] Z.sub.3 is T or V; [0358] Z.sub.4 is Y or P; [0359] Z.sub.5 is D or N; [0360] Z.sub.7 is D or G; [0361] Z.sub.8 is I or G; [0362] Z.sub.10 is V or L; [0363] Z.sub.11 is V or A; and [0364] b) a polynucleotide encoding upon expression, the peptide of a); [0365] c) a vector comprising the polynucleotide of b); and [0366] d) a cell comprising the polynucleotide of b), or the vector of c); [0367] for use in the treatment of an endocrine disease, a nutritional disease and/or a metabolic disease in a mammal. [0368] 45. The agent or the composition for use according to item 44, wherein the peptide comprises or consists of an amino acid sequence selected from the group consisting of KCLAECDSIELSYGIK (SEQ ID NO: 141), CLAEIDSC (SEQ ID NO: 142), CFKPLAEIDSIECSYGIK (SEQ ID NO: 143), KPLAEIELSYGIK (SEQ ID NO: 148), KCLAEIDSCELSYGIK (SEQ ID NO: 155) and CFKPLAEIDSIEC (SEQ ID NO: 156); [0369] 46. The agent or the composition for use according to any one of the preceding items, wherein the peptide is selected from the group consisting of SEQ ID NO: 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155 and 156. [0370] 47. The agent or the composition for use according to any one of the preceding items, wherein the peptide is selected from the group consisting of SEQ ID NO: 1, 136, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 67, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127, 128, 129, 130, 131, 132, 133, 135, 137, 138, 139, 157, 158, 159, 160, 161, 167, 168 and 169. [0371] 48. The agent or the composition for use according to any one of the preceding items, wherein said agent comprises a second or further active ingredient. [0372] 49. The agent or the composition for use according to item 48, wherein the second or further active ingredient is selected from the group consisting of insulin, glucagon-like peptide-1 (GLP-1), sulfonylurea, a dipeptidyl peptidase-4 (DPP4) inhibitor, an alpha-glucosidase inhibitor, a thiazolidinedione, a meglitidine and a sodium-glucose cotransporter-2 (SGLT2) inhibitor. [0373] 50. The agent or the composition according to any of the preceding items for use in the treatment of an endocrine disease, a nutritional disease and/or a metabolic disease in a mammal. [0374] 51. The agent or the composition for use according to item 50, wherein the mammal is a human. [0375] 52. The agent or the composition for use according to any one of the preceding items, wherein the endocrine disease, nutritional disease and/or metabolic disease are selected from the group consisting of diabetes mellitus, type 1 diabetes mellitus, type 2 diabetes mellitus, malnutrition-related diabetes mellitus, disorders of glucose regulation and pancreatic internal secretion, insulin resistance syndrome, impaired glucose tolerance, hyperglycemia, hyperinsulinemia, and any combinations thereof. [0376] 53. The agent or the composition for use according to any one of the preceding items, wherein the endocrine disease, nutritional disease and/or metabolic disease are selected from the group consisting of diabetes mellitus, disorders of the thyroid gland, disorders of glucose regulation and pancreatic internal secretion, disorders of endocrine glands, malnutrition, nutritional deficiencies, obesity, hyperalimentation, and metabolic disorders. [0377] 54. The agent or the composition for use according to any one of the preceding items, wherein the diabetes mellitus is selected from the group consisting of type 1 diabetes mellitus, type 2 diabetes mellitus, malnutrition-related diabetes mellitus, specified diabetes mellitus, and unspecified diabetes mellitus. [0378] 55. The agent or the composition for use according to any one of the preceding items, wherein the disorder of glucose regulation and pancreatic internal secretion is selected from the group consisting of nondiabetic hypoglycaemic coma and disorders of pancreatic internal secretion. [0379] 56. The agent or the composition for use according to any one of the preceding items, wherein the disorder of obesity and hyperalimentation is selected from the group consisting of localized adiposity, hyperalimentation, and sequelae of hyperalimentation. [0380] 57. The agent or the composition for use according to any one of the preceding items, wherein the disorder of nutritional deficiencies is selected from the group consisting of disorders of aromatic amino-acid metabolism, disorders of branched-chain amino-acid metabolism and fatty-acid metabolism, disorders of amino-acid metabolism, lactose intolerance, disorders of carbohydrate metabolism, disorders of sphingolipid metabolism, disorders of lipid storage disorders, disorders of glycosaminoglycan metabolism, disorders of glycoprotein metabolism, disorders of lipoprotein metabolism, lipiemias, disorders of purine and pyrimidine metabolism, disorders of porphyrin and bilirubin metabolism, disorders of mineral metabolism, cystic fibrosis, amyloidosis, volume depletion, disorders of fluid, electrolyte and acid-base balance, and postprocedural endocrine and metabolic disorders. [0381] 58. A method of treating an endocrine disease, a nutritional disease and/or a metabolic disease, the method comprising administering an agent according to any one of the preceding items to a subject in need thereof. [0382] 59. Use of an agent according to any one of the preceding items for the manufacture of a medicament for use in treatment of an endocrine disease, a nutritional disease and/or a metabolic disease in a mammal. [0383] 60. A method for delaying onset of diabetes and diabetes associated disorders and diseases, the method comprising administering a therapeutically effective amount of the agent as defined in any one of the preceding items, to an individual in need thereof. [0384] 61. A method for decreasing blood glucose levels, the method comprising administering a therapeutically effective amount of an agent of any one of the preceding items, to an individual in need thereof. [0385] 62. The method according to item 61, wherein insulin secretion is increased. [0386] 63. The method according to item 61, wherein cellular uptake of glucose is increased. [0387] 64. The method according to item 61, wherein the insulin production is increased. [0388] 65. The method according to item 61, wherein the glucagon production is decreased. [0389] 66. A method for improving beta cell viability, the method comprising administering a therapeutically effective amount of an agent of any one of the preceding items, to an individual in need thereof. [0390] 67. A method for improving beta cell morphology, the method comprising administering a therapeutically effective amount of an agent of any one of the preceding items, to an individual in need thereof. [0391] 68. A method for stabilising or improving viability and/or morphology of pancreatic islets, the method comprising administering a therapeutically effective amount of an agent of any one of the preceding items, to an individual in need thereof.

EXAMPLES

[0392] The disclosure is further illustrated by the following examples, which however should not be construed as being limiting for the disclosure. These examples demonstrate that exemplary peptides of the present disclosure stimulate -cell proliferation, and have the ability to protect and rescue -cells from apoptosis induced by glucotoxic conditions. It is also demonstrated that the exemplary peptides have the ability to stimulate insulin secretion from rat -cells as well as isolated mouse pancreatic islets, where the peptides also are demonstrated to reduce glucagon levels. Furthermore, the examples demonstrate that the peptides reduce plasma glucose levels in vivo in a glucose tolerance test and that the peptides delay onset of type 1 diabetes in BB lyp/lyp rats

Example 1: Peptide Design

[0393] The novel peptides were designed following rational structure activity investigations. For FOL-005 (SEQ ID NO: 1) the peptides were designed around the RGD site but mutated in order to generate different structures that potentially could interact with different integrins. A sequence similar to FOL-005 was identified in the third fibronectin type III repeat domain (TNfn3) in tenascin-C and found to be reasonably similar to the mutated RGD site of FOL-005. A peptide was designed from this sequence denoted FOL-014. The X-ray crystal structure of the tenascin-3 TNfn3 domain (PDB code 1TEN, Leahy et al. (1992) Science 258(5084):987-91) was analyzed. The FOL-014 (SEQ ID NO: 136) sequence span the beta-turn before and the entire 3rd beta sheet. FOL-014 variants were designed to allow for structural modification and stabilization of the 3-dimensional molecular structure. Specifically, the peptides variants covered the beta-turn region with exposed side chains and some cyclized variants to maintain geometry.

[0394] All peptides were synthesized by solid phase peptide synthesis using several peptide manufacturers. Mainly, the peptide variants have been provided by Biopeptide Inc., California.

Example 2: FOL-005 and FOL-014 Induced Proliferation of INS-1 Cells

[0395] To investigate if FOL-005 and FOL-014 could induce proliferation of -cells we used INS-1 cells. Rat INS-1 cells were seeded in 96-well plates in RPMI medium with supplement and after 2 hours the medium was changed to RPMI without supplement. During the proliferation experiment the cells were incubated at different test conditions (FOL-005, FOL-014, coated or in solution, 48 h incubation) and during the last 20 hours of culture period the cells were pulsed with 1 Ci/well of [methyl-3H] thymidine. The cells were then harvested onto glass fiber filters using a FilterMate harvester. The filters were air dried, and the bound radioactivity was measured using a liquid scintillation counter. To study whether FOL-005 influenced -cell proliferation, INS-1 cells were treated with increasing amounts of soluble FOL-005 (0.06-6 M) during 48 hours and proliferation was measured with radiolabeled thymidine incorporation into newly synthesized DNA. FOL-005 stimulated INS-1 cell proliferation (FIG. 1A). Wells coated with either FOL-005 or FOL-014 and later blocked with bovine serum albumin (BSA) before addition of INS-1 cells also stimulated proliferation compared to control (ctrl) coated wells (FIG. 1B-C).

[0396] This demonstrated that FOL-005 and FOL-014 interacted with -cells and induced proliferation.

Example 3: FOL-005 Protected n-Cells from Glucotoxicity

[0397] Since glucotoxicity in pancreatic -cells is a well-established process in type 2 diabetes we next investigated the protective effects of FOL-005 on -cells during glucotoxic conditions. First we confirmed that 20 mM glucose induced cell apoptosis in INS cells after 48 h of exposure. High glucose (20 mM) containing RPMI medium induced more Annexin V positive cells and more caspase-3 activity in INS cells compared to cells incubated with medium containing 5 mM glucose (FIG. 2A-B). Exposure of INS-1 cells to 20 mM of glucose at the same time as FOL-005 decreased cell apoptosis as detected both by Annexin V staining and by caspase-3 activity (FIG. 2 A-B). The rate of apoptosis in INS-1 cells was measured with either Caspase-3 Assay Kit or stained with Annexin V Apoptosis Detection Kit with 7-AAD. Caspase-3 activity was measured with fluorescence at an excitation wavelength of 380 nm and an emission wavelength of 440 nm. Caspase-3 activity was then normalized to protein concentration in each well. Measurements of Annexin V stained cells were performed using a CyAn ADP flow cytometer and analyzed with Summit V4.3 software.

[0398] In conclusion, it is well known that glucotoxicity induces -cell apoptosis, however in the presence of FOL-005 glucotoxicity-induced apoptosis was diminished.

Example 4: FOL-005 Induced Insulin Secretion from INS-1 Cells

[0399] To investigate the stimulatory effect of FOL-005 on insulin secretion, INS-1 -cells were used in the following experiments. Cells were seeded overnight in cRPMI and then washed with PBS before pre-incubation for 60 min at 37 C. in Krebs-Ringer bicarbonate buffer (KRB), pH 7.4, supplemented with 10 mM HEPES, 0.1% bovine serum albumin. After pre-incubation, the buffer was changed and the INS-1 cells were incubated at different test conditions (0 mM, 5 mM or 20 mM glucose) and stimulated with peptide FOL-005 or FOL-015 (SEQ ID NO: 158) or left untreated during 60 min at 37 C. Immediately after incubation, an aliquot of the buffer was removed and frozen for subsequent assay of insulin with an insulin radioimmunoassay kit.

[0400] The results demonstrated that -cells stimulated with FOL-005 peptide secreted more insulin compared to unstimulated control cells or to cells stimulated with the FOL-015 control peptide (FIG. 3A) under conditions without glucose. INS-1 -cells subjected to glucose (5 mM or 20 mM) responded with insulin secretion after FOL-005 peptide (6 M) stimulation (FIG. 3B). INS-1 cells stimulated with 6 M FOL-005 peptide in the presence of 20 mM glucose responded with more insulin secretion compared to FOL-005 stimulated cells incubated with 5 mM glucose (FIG. 3B).

Example 5: FOL-005 Induced Insulin Secretion from Mouse Pancreatic Islets

[0401] Mouse pancreatic islets were isolated from 8-week old C57BL/6J male mice (Taconic). Mice were sacrificed by an overdose of isoflurane and cervical dislocation. 3 ml of 0.9 U/ml collagenase P was injected into the pancreatic duct to inflate the pancreas. The pancreas was then removed and collagen digested for 19 min at 37 C. The samples were vigorously shaken to disrupt the tissue. The digest was transferred into ice cold Hank's Balanced Salt Solution (HBSS) with Ca.sup.2+ and Mg.sup.2+. The suspension was allowed to sit for 10 min to allow the islet to sink, and the islets were washed in fresh HBSS four times. The islets were then hand-picked and sorted according to size. Islets (n=3 per well in a 96 well plate) were pre-incubated in KRB buffer during 10 min 37 C., pH 7.4, supplemented with 10 mM HEPES, 0.1%) bovine serum albumin. After pre-incubation, the buffer was changed and islets were incubated at different test conditions in new KRB buffer with 0.1%) bovine serum albumin (non-treated ctrl, FOL-005 peptide, or GLP-1) for 60 min at 37 C. Immediately after incubation, an aliquot of the buffer was removed and frozen for subsequent assay of insulin.

[0402] The results demonstrated that isolated mouse pancreatic islets stimulated with GLP-1 (100 nM) or FOL-005 (6 M) secreted more insulin compared to unstimulated control islets (FIG. 3C).

Example 6: FOL-014 Induced Insulin Secretion from INS-1 Cells

[0403] INS-1 -cells were used to investigate the stimulatory effect of FOL-014 on insulin secretion. Cells were seeded overnight and then washed with PBS before pre-incubation for 60 min at 37 C. in Krebs-Ringer bicarbonate buffer (KRB), pH 7.4, supplemented with 10 mM HEPES, 0.1% bovine serum albumin. After pre-incubation, the buffer was changed and the INS-1 cells were incubated in new KRB buffer supplemented with 10 mM HEPES, 0.1% bovine serum albumin and stimulated with peptide FOL-014 or left untreated during 60 min at 37 C. Immediately after incubation, an aliquot of the buffer was removed and frozen for subsequent assay of insulin.

[0404] The results demonstrated that -cells stimulated with FOL-014 peptide secreted more insulin compared to unstimulated control cells (FIG. 4A).

Example 7: FOL-014 Induced Insulin Secretion from Mouse Pancreatic Islets

[0405] Mouse pancreatic islets were isolated from 8-week old C57BL/6J male mice as described under example 5. The islets were then hand-picked and sorted according to size. Islets (n=5 per well in a 96 well plate) were pre-incubated in 200 l KRB buffer during 10 min 37 C., pH 7.4, supplemented with 10 mM HEPES, 0.1% bovine serum albumin. Following pre-incubation, the buffer was changed and islets were incubated in different test conditions in new KRB buffer with 0.1% bovine serum albumin (non-treated ctrl, FOL-014 peptide, and GLP-1) for 60 min at 37 C. Immediately after incubation, an aliquot of the buffer was removed and frozen for subsequent assay of insulin. The result show that mouse pancreatic islets stimulated with FOL-014 (6 M) secreted more insulin compared to unstimulated control islets (FIG. 4B). GLP-1 (100 nM) or FOL-014 (0.6 M) did not affect insulin secretion (FIG. 4B).

Example 8-11: Stimulation of Insulin Secretion from INS-1 Cell Lines by FOL-014, FOL-005 and Related Peptides

[0406] Materials and methods: Rat INS-1 -cells (passages 60-70) were cultured at 37 C. and 5% CO.sub.2 in cRPMI media (RPMI 1640 supplemented with 10% fetal bovine serum, 50 IU/mL penicillin, 50 mg/L streptomycin, 10 mM HEPES, 2 mM L-glutamine, 1 mM sodium pyruvate, and 50 M beta-mercaptoethanol) unless otherwise stated. INS-1 cells were seeded in 96-well plates (210.sup.3 cells/well) in cRPMI medium and following overnight incubation, the cells were washed in PBS before pre-incubation for 120 min at 37 C. in Krebs-Ringer bicarbonate buffer, pH 7.4, supplemented with 10 mM HEPES, 0.1% bovine serum albumin and 2.8 mM glucose. Following pre-incubation, the buffer was exchanged with fresh Krebs-Ringer buffer as described above and supplemented with specific glucose concentrations and peptides for the individual experiments as described below. Immediately after 60 minutes incubation at 37 C., an aliquot of the buffer was removed and frozen for subsequent insulin ELIZA assay.

Example 8. FOL-014 Induced Insulin Secretion is Dose-Dependent in a Non-Linear Manner

[0407] Insulin release from INS-1 cells were measured following exposure to increasing concentrations of FOL-014 and compared with the stimulatory effect of GLP-1 and untreated control during high glucose concentration (16.7 mM). All concentrations of FOL-014 tested elicited significantly higher insulin release as compared with the untreated control. At 6 nM or higher, FOL-014 triggered insulin release within the same range as 100 mM GLP-1. At concentrations ranging from 0.6-60 nM, insulin secretion increased in a linear fashion in relation to increasing FOL-014 concentrations. Exposure to FOL-014 concentrations 600 nM did not increase the insulin secretion (FIG. 5).

[0408] The results demonstrated that FOL-014 significantly increased insulin secretion from INS-1 -cells in vitro in a non-linear dose dependent fashion.

Example 9. The Capacity of FOL-014 to Induce Insulin Secretion is Glucose Dependent

[0409] Insulin release from INS-1 cells was measured following exposure to 60 nM FOL-014 at increasing concentrations of glucose. In untreated control samples, elevated glucose concentrations increased the insulin secretion at 11.1 mM glucose or higher. In the presence of FOL-014, insulin secretion increased significantly in a glucose dependent fashion already from 5.5 mM glucose. (FIG. 6).

[0410] The results demonstrated that the presence of FOL-014 significantly increased insulin secretion from INS-1 -cells in vitro in a glucose concentration dependent fashion and that FOL-014 was effective also at marginally elevated glucose levels.

Example 10. FOL-014 or FOL-005 in Combination with GLP-1 Increased Insulin Secretion as Compared with Either Peptide Alone

[0411] Insulin secretion from INS-1 cells was measured following exposure to FOL-005, FOL-014, GLP-1 or combinations of those, expressed as percentage of untreated control. The combined effect of GLP-1 and FOL-014 resulted in a significantly higher insulin release than GLP-1 or FOL-014 alone. The additive effect of the combination of FOL-005 and GLP-1 was less pronounced, but did however increase the insulin secretion as compared with GLP-1 alone. The experiments were performed in the presence of 16.7 mM glucose (FIG. 7).

[0412] The results demonstrated that the combination of GLP-1 and FOL-014 could further potentiate the insulin secretion from INS-1 cells in vitro as compared with each peptide alone. Furthermore, the combination of FOL-005 and GLP-1 tendentially increased insulin secretion.

Example 11. The Ability of Novel Peptide Analogues to Induce Insulin Secretion in Pancreatic -Cell-Lines was Investigated

[0413] Novel peptide analogues, derived from either FOL-005 or FOL-014 were tested concerning their ability to induce insulin secretion in two separate INS-1 cell lines in the presence of 16.7 mM glucose. FOL-005, FOL-014 and GLP-1 as well as a high glucose (16.7 mM) and a low glucose (2.8 mM) control (not shown) was included in each experiment and the peptide concentration was 100 nM. In order to correct for the variance between experiments, all values were normalized to, and expressed as percentage of the average value of the high glucose control in the individual experiments. The analogues were subsequently ranked according to performance (FIGS. 11A and 11B). Peptide analogues eliciting an insulin response below the high glucose control average value were considered non-functional and were hence excluded (not shown).

[0414] The results demonstrated the capacity of several novel peptide analogues to enhance insulin secretion from INS-1 -cells in vitro.

Example 12. FOL-014 Increase Insulin Secretion from Mouse-Derived Pancreatic Islets

[0415] Twelve-week-old male C57/bl6 mice were euthanized with isoflurane and cervical dislocation. After clamping the hepatic ducts, 3 ml of 0.9 U/ml collagenase P was injected into the bile duct to inflate the pancreas. The pancreas was then removed and digested for 19 min at 37 C. The samples were vigorously shaken to disrupt the tissue. The digest was quickly transferred into ice cold Hank's Balanced Salts Solution with Ca.sup.2+ and Mg.sup.2+. The suspension was allowed to sit for 8 min to allow the islet to sink, and the islets were washed in the same manner our times. The islets were then handpicked and sorted according to size.

[0416] Freshly isolated islets were seeded in groups of 5 in a 96-well plate and preincubated for 1 h at 37 C. in a Krebs-Ringer bicarbonate buffer (pH 7.4). The islets were incubated for 1 h at 37 C. in Krebs-Ringer buffered solution supplemented with 0.6 or 6 M FOL-014 or 100 nM GLP-1 or left unsupplemented for control. Immediately after incubation, the medium was removed for assays of insulin and glucagon using Mercodia's ELISA kits. The effect of FOL-014 on insulin (FIGS. 8A and B) and glucagon (FIGS. 8C and D) secretion from isolated mouse islets was measured in the presence of low glucose (2.8 mM; FIGS. 8A and C) or high glucose (16.7 mM; FIGS. 8B and D) concentrations. A significant effect of FOL-014 was observed in the presence of high glucose for insulin and in the presence of both high and low glucose for glucagon. The effect of FOL-014 differed from that of GLP-1, which enhanced insulin secretion also in low glucose samples but failed to inhibit glucagon secretion in low glucose conditions.

[0417] The results demonstrated that FOL-014 enhanced insulin secretion and inhibited glucagon secretion in pancreatic islets.

Example 13. FOL-014 Reduced Plasma Glucose Levels in an Intraperitoneal Glucose Tolerance Test (IPGTT) in Mice

[0418] Whole blood was collected for glucose and insulin measurements from 10-week-old wild type male C57bl/6 mice. After a 4 hour fast, the mice were divided into three groups and given an intraperitoneal injection (ip) of either saline, 30 nmol/kg peptide (FIG. 9A) or 200 nmol/kg peptide (FIG. 9B). 15 min after the FOL-014 or saline (control) injections, the mice were administered 2 g of glucose/kg ip. Blood glucose concentrations were measured at 5, 15, 30, 45 and 60 minutes after the glucose injection. Statistical calculations were performed using student's t-test. FOL-014 dosed at 200 nmol/kg significantly lowered the plasma glucose levels as compared to the control when measured as area under the curve. In addition, the difference was significant at 15, 30 and 45 minutes. At the 30 nmol/kg dose, FOL-014 lowered the plasma glucose levels with a significant effect at 45 minutes after the glucose injection.

[0419] The results demonstrated that FOL-014 could lower plasma glucose levels in a glucose tolerance test performed on healthy wild type mice.

Example 14. FOL-014 Delayed Onset of Type 1 Diabetes in BB Lyp/Lyp Rats

[0420] BB lyp/lyp rats were randomized for placebo (sodium chloride, 9 mg/ml) or FOL-014 treatment 3 times/week from day 40 until onset of type 1 diabetes, defined as plasma glucose levels 11.1 mM. The dose of 100 nmol/kg FOL-014 peptide in saline or placebo (saline) was administered subcutaneously and the animals were terminated immediately upon exceeding critical plasma glucose levels. The difference between FOL-014 treated animals and animals receiving placebo treatment was significant both when expressed as average age for onset of type 1 diabetes (FIG. 10A) and when described as percentage of animals developing type 1 diabetes per day (FIG. 10B).

[0421] The results demonstrated that FOL-014 treatment significantly delayed the onset of type-1 diabetes in BB lyp/lyp rats.

Example 15. FOL-005 and FOL-014 Displayed Organ Specific Distribution Patterns in Mice

[0422] 057BI/6 mice were injected subcutaneously with H.sup.3 labelled FOL-005 and euthanized at 1 h (FIG. 12A) or 2 h (FIG. 12B) after injection. Following whole body sectioning the distribution of the labelled peptide was visualised. Strong binding was evident in pancreas and at the site of injection. Using Pearl Trilogy Small Animal Imaging System, in vivo bio-distribution and tissue localization of two Cy7.5 labelled peptides, FOL-005 (FIG. 12C) and FOL-014 (FIG. 12D) in NMRI nude mice via subcutaneous injection was investigated. High accumulation of the peptide was evident in the pancreatic tissue area. The same distribution pattern was found after i.v. administrations (not shown). The dose of each peptide was 10 nmol per mouse. The mice were imaged before injection, at 5 min, 20 min, 50 min, 60 min, 2 hrs, 4 hrs, 6 hrs, 24 hrs and 48 hrs post administration of labelled peptide.

Example 16. Tissue Specific Imaging for Diagnostic Use

[0423] Agents prepared as defined herein above are labelled by conjugation to suitable imaging probe or moiety, using methods known by those of skill in the art. The conjugated peptide-probe agents are subsequently administered to a subject and biodistribution is subsequently monitored e.g. up to 48 h after administration. The conjugated agent is thus used as a diagnostic or prognostic tool for investigation of pancreatic status. As such, the conjugated agents are suitable for detecting, diagnosing, or monitoring disease, disease processes and progression, susceptibility, as well as to determine efficacy of a treatment. The agents are particularly suited for monitoring the diabetic status of a subject. The conjugated agents are also used for monitoring and/or predicting risk of developing a disease, specifically diabetes. The test is used alone or in combination with other tests known by those of skill in the art, such as blood tests, genetic testing, urine test, and biopsies.

TABLE-US-00055 Example17Sequenceoverview SEQ ID NO Sequence Notes 1 VDTYDGDISVVYGLR FOL-005 2 VDTYDGDISVVYGLS 3 VDTYDGDISVVYGL FOL-025 4 DTYDGDISVVYGLR 5 TYDGDISVVYGLRS 6 VDTYDGDISVVYG FOL-024 7 DTYDGDISVVYGL 8 TYDGDISVVYGLR 9 YDGDISVVYGLRS 10 VDTYDGDISVVY 11 DTYDGDISVVYG 12 TYDGDISVVYGL 13 YDGDISVVYGLR 14 DGDISVVYGLRS 15 VDTYDGDISVV 16 DTYDGDISVVY 17 TYDGDISVVYG 18 YDGDISVVYGL 19 DGDISVVYGLR 20 GDISVVYGLRS 21 VDTYDGDISV 22 DTYDGDISVV 23 TYDGDISVVY 24 YDGDISVVYG 25 DGDISVVYGL 26 GDISVVYGLR FOL-009h 27 DISVVYGLRS 28 VDTYDGDIS FOL-019h 29 DTYDGDISV 30 TYDGDISVV 31 YDGDISVVY 32 DGDISVVYG 33 GDISVVYGL 34 DISVVYGLR 35 ISVVYGLRS 36 VDTYDGDI 37 DTYDGDIS 38 TYDGDISV 39 YDGDISVV 40 DGDISVVY 41 GDISVVYG 42 DISVVYGL 43 ISVVYGLR 44 VDTYDGD 45 DTYDGDI 46 TYDGDIS 47 YDGDISV 48 DGDISVV 49 GDISVVY 50 DISVVYG 51 ISVVYGL 52 DTYDGD 53 TYDGDI 54 YDGDIS 55 DGDISV 56 GDISVV 57 DISVVY 58 ISVVYG 59 TYDGD 60 YDGDI 61 DGDIS 62 GDISV 63 DISVV 64 ISVVY 65 SVVYG 66 MRIAVICFCLLGITCA Wildtypehuman IPVKQADSGSSEEKQL osteopontin,i.e. YNKYPDAVATWLNPDP GenBank: SQKQNLLAPQTLPSKS AAA59974.1 NESHDHMDDMDDEDDD DHVDSQDSIDSNDSDD VDDTDDSHQSDESHHS DESDELVTDFPTDLPA TEVFTPVVPTVDTYDG RGDSVVYGLRSKSKKF RRPDIQYPDATDEDIT SHMESEELNGAYKAIP VAQDLNAPSDWDSRGK DSYETSQLDDQSAETH SHKQSRLYKRKANDES NEHSDVIDSQELSKVS REFHSHEFHSHEDMLV VDPKSKEEDKHLKFRI SHELDSASSEVN 67 VDTYDGRGDSVVYGLR FOL-002 68 VDZ.sub.3Z4Z.sub.5GZ.sub.7Z.sub.8S Z.sub.3isTorV; Z.sub.10Z.sub.11YGLR Z4isYorP; Z.sub.5isDorN; Z.sub.7isDorG; Z.sub.8isIorG; Z.sub.10isVorL; Z.sub.11isVorA 69 VDVPNGDISLAYGLR FOL-004 70 DVPNGDISLAYGLRS 71 VDVPNGDISLAYGL FOL-016 72 DVPNGDISLAYGLR FOL-007 73 VPNGDISLAYGLRS 74 VDVPNGDISLAYG FOL-017 75 DVPNGDISLAYGL 76 VPNGDISLAYGLR 77 PNGDISLAYGLRS 78 VDVPNGDISLAY 79 DVPNGDISLAYG 80 VPNGDISLAYGL 81 PNGDISLAYGLR FOL-008 82 NGDISLAYGLRS 83 VDVPNGDISLA FOL-018 84 DVPNGDISLAY 85 VPNGDISLAYG 86 PNGDISLAYGL 87 NGDISLAYGLR 88 GDISLAYGLRS 89 VDVPNGDISL 90 DVPNGDISLA 91 VPNGDISLAY 92 PNGDISLAYG 93 NGDISLAYGL 94 GDISLAYGLR FOL-009 95 DISLAYGLRS 96 VDVPNGDIS FOL-019 97 DVPNGDISL 98 VPNGDISLA 99 PNGDISLAY 100 NGDISLAYG 101 GDISLAYGL 102 DISLAYGLR 103 ISLAYGLRS 104 VDVPNGDI 105 DVPNGDIS 106 VPNGDISL 107 PNGDISLA 108 NGDISLAY 109 GDISLAYG 110 DISLAYGL 111 ISLAYGLR 112 VDVPNGD 113 DVPNGDI 114 VPNGDIS 115 PNGDISL 116 NGDISLA 117 GDISLAY 118 DISLAYG 119 ISLAYGL 120 DVPNGD 121 VPNGDI 122 PNGDIS 123 NGDISL 124 GDISLA 125 DISLAY 126 ISLAYG 127 VPNGD 128 PNGDI 129 NGDIS 130 GDISL 131 DISLA 132 ISLAY 133 SLAYG 134 MRLAVICFCLFGIASS Wildtypemurine LPVKVTDSGSSEEKLY osteopontin,i.e. SLHPDPIATWLVPDPS NCBIReference QKQNLLAPQNAVSSEE Sequence: KDDFKQETLPSNSNES NP_001191162.1 HDHMDDDDDDDDDDGD HAESEDSVDSDESDES HHSDESDETVTASTQA DTFTPIVPTVDVPNGR GDSLAYGLRSKSRSFQ VSDEQYPDATDEDLTS HMKSGESKESLDVIPV AQLLSMPSDQDNNGKG SHESSQLDEPSLETHR LEHSKESQESADQSDV IDSQASSKASLEHQSH KFHSHKDKLVLDPKSK EDDRYLKFRISHELES SSSEVN 135 VDVPNGRGDSLAYGLR FOL-001 136 KPLAEIDSIELSYGIK FOL-014 137 GDPNDGRGDSVVYGLR FOL-003 138 VDTYDGGISVVYGLR FOL-026 139 VDTYDGDGSVVYGLR FOL-027 140 KX.sub.2LAX.sub.5X.sub.6X.sub.7X.sub.8IX.sub.10 X.sub.2isC,PorG; LX.sub.12YGIK X.sub.5isEorG; X.sub.6isC,DorI; X.sub.7isD,I,SorG; X.sub.8isS,DorG; X.sub.10isEorG; X.sub.12iSSorT; 141 KCLAECDSIELSYGIK FOL-032 (Cyclic) 142 CLAEIDSC FOL-033 (Cyclic) 143 CFKPLAEIDSIECSYG FOL-036 IK(Cyclic) 144 KPLAEDISIELSYGIK FOL-037 145 KPLAEISDIELSYGIK FOL-038 146 KPLAEIGDIELSYGIK FOL-039 147 KPLAEGDIELSYGIK FOL-040 148 KPLAEIELSYGIK FOL-041 149 KPLAEIDSIELTYGIK FOL-042 150 KPLAEIDGIELSYGIK FOL-043 151 KPLAEIDGIELTYGIK FOL-044 152 KPLAEIGSIELSYGIK FOL-045 153 KGLAEIDSIELSYGIK FOL-046 154 KPLAGIDSIGLSYGIK FOL-047 155 Cyclic FOL-034 KCLAEIDSCELSYGIK 156 Cyclic FOL-035 CFKPLAEIDSIEC 157 VDVPEGDISLAYGLR FOL-010 158 LDGLVRAYDNISPVG FOL-015 159 GDPNGDISVVYGLR FOL-006 160 VDVPNGDISLAYRLR FOL-011 161 VDVPEGDISLAYRLR FOL-012 162 KX.sub.2LAX.sub.5X.sub.6X.sub.7X.sub.8IX.sub.10 X.sub.2isC,PorG; LSYGIK X.sub.5isEorG; X.sub.6isC,Iorabsent; X.sub.7isD,Gorabsent; X.sub.8isS,Gorabsent; X.sub.10isEorG; 163 KX.sub.2LAX.sub.5IX.sub.10LSYGIK X.sub.2iSC,PorG; X.sub.5isEorG; X.sub.10isEorG. 164 VDVPZ.sub.5GDISLAYZ.sub.13 Z.sub.5isEorN; LR Z.sub.13isRorG. 165 VDTYDGZ.sub.7Z.sub.8SVVYGLR Z.sub.7isDorG; Z.sub.8isIorG. 166 GDPNZ.sub.5Z6Z.sub.7Z.sub.8Z.sub.9SV Z.sub.5isDorG; VYGLR Z6isDorG Z.sub.7isIorR; Z.sub.8isGorabsent; Z.sub.9isDorabsent. 167 VZ.sub.2TYDGDISVVYGLR Z.sub.2isbetaD FOL-005(2betaAsp) 168 VDTY Z.sub.5isbetaD Z.sub.5GDISVVYGLR FOL-005(5betaAsp) 169 VDTYDG FOL-005(7betaAsp) Z.sub.7ISVVYGLR Z.sub.7isbetaD