Compositions and methods of use for recombinant human secretoglobins

Abstract

Methods of synthetically producing, formulating and using secretoglobins SCGB1A1, SCGB3A2, and SCGB3A1 are provided. Methods of using secretoglobins SCGB1A1, SCGB3A2, and SCGB3A1 as therapeutic agents to affect long term patient outcomes, such as preventing severe respiratory exacerbations of underlying conditions that require medical intervention, including hospitalization are provided. Methods of producing recombinant human secretoglobins, analytical methods, pharmaceutical compositions, and methods of use to prevent the long term sequelae of acute and chronic respiratory conditions are provided.

Claims

1. A method of preventing hospitalization due to a severe respiratory exacerbation in a patient with acute lung injury comprising the steps of: administering recombinant human SCGB3A2 (rhSCGB3A2) protein, wherein the rhSCGB3A2 protein consists of the amino acid sequence set forth in SEQ ID NO: 3, to a patient having an acute lung injury, wherein the patient is not re-hospitalized for at least ten months after administration of rhSCGB3A2, wherein the severe respiratory exacerbation is caused by an environmental trigger, influenza virus, respiratory syncytial virus, (RSV), or any bacteria or other microbe.

2. A method of preventing hospitalization due to a severe respiratory exacerbation in a patient who experiences frequent respiratory exacerbations comprising the steps of: administering recombinant human SCGB3A2 (rhSCGB3A2) protein, wherein the rhSCGB3A2 protein consists of the amino acid sequence set forth in SEQ ID NO. 3, to a patient having frequent respiratory exacerbations, wherein the patient is not re-hospitalized for at least two months after administration of rhSCGB3A2, wherein the severe respiratory exacerbation is caused by an environmental trigger, influenza virus, respiratory syncytial virus, (RSV), or any bacteria or other microbe.

3. A method of preventing hospitalization due to a severe respiratory exacerbation in a patient with a chronic respiratory condition comprising the steps of: administering recombinant human SCGB3A2 (rhSCGB3A2) protein, wherein the rhSCGB3A2 protein consists of the amino acid sequence set forth in SEQ ID NO. 3, to a patient having a chronic respiratory condition, wherein the patient is not re-hospitalized for at least one month after administration of rhSCGB3A2, wherein the severe respiratory exacerbation is caused by an environmental trigger, influenza virus, respiratory syncytial virus, (RSV), or any bacteria or other microbe.

4. The method of claim 3 wherein the chronic respiratory condition is pulmonary fibrosis, bronchiectasis, or COPD.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

(1) FIG. 1: Human SCGB3A2 amino acid sequences, alignment of human SCGB3A2 amino acid sequences with comparison of predicted and actual N-termini

(2) FIG. 2: SDS-PAGE of purified rhSCGB3A2, SDS-PAGE of purified rhSCGB3A2. Samples containing 5 micrograms each with and without 1 mM DTT were mixed with SDS Sample Buffer, boiled 5 minutes and loaded on a 10-20% tricine gel. The gel was run and stained with Coomassie R250. The gel was de-stained and imaged with a digital camera.

(3) FIG. 3: Isoelectric focusing of purified rhSCGB3A2, Isoelectric focusing of purified rhSCGB3A2, compared to rhCC10 and UBL and Den-1. Samples containing 5 micrograms each were loaded on a Novex IEF gel. The gel was run and stained with Coomassie R250. The gel was de-stained and imaged with a digital camera. Arrows represent major and minor isoforms of rhSCGB3A2 with ATA N-terminus.

(4) FIG. 4: In vitro inhibition of sPLA.sub.2-1B with rhSCGB3A2 Panel A: UNIBIPY substrate; no PLA.sub.2; no rhSCGB3A2. Panel B: UNIBIPY substrate plus PLA.sub.2; no rhSCGB3A2. Panel C: UNIBIPY substrate plus PLA2 plus rhSCGB3A2. Peak #1 is the UNIBIPY phospholipid substrate, peak #2 is the product after cleavage by sPLA.sub.2.

(5) FIG. 5: Western blot of SCGB3A2 in human TAF. Western blot of tracheal aspirate fluids from human infants compared to purified rhSCGB3A2 using anti-rhSCGB3A2 rabbit polyclonal antibody. Samples containing 20 microliters of each TAF were loaded on a Novex 10-20% tricine gel; rhSCGB3A2 is in lane 1 (5 nanograms) and lane 8 (1 nanogram). The gel was de-stained and imaged with a digital camera.

(6) FIG. 6: A standard curve of an ELISA for rhSCGB3A2 is depicted.

DETAILED DESCRIPTION

(7) Three pieces of evidence were combined to conceive the invention; including 1) the long term protection from severe respiratory exacerbations and re-hospitalization by a single dose of rhCC10 observed in premature infants, 2) the airway epithelial phenotypes of CC10 KO mice, and 3) the “growth factor” properties of SCGB3A2 (Guha, 2012; Kurotani, 2008; Kurotani, 2008a; Inoue, 2008; Niimi, 2001). Despite many years of research, there is no public consensus concerning the role of CC10 in the respiratory epithelium, other than that it mediates anti-inflammatory effects. A recent clinical trial failure in a nasal allergen challenge model of allergic rhinitis demonstrated that the even its anti-inflammatory effects in vivo are not consistent against all types of inflammatory disease (Widegren, 2009). And, despite a complete CC10 deficiency, Clara cells are still found in the airways of both strains of CC10 KO mice. Although CC10 and SCGB3A2 are structurally similar, and, therefore, believed to share some functions, there are no reports pertaining to the stimulation of growth or development of airway epithelial cells by CC10, and rhCC10 is, in fact, well-known to suppress the growth of tumor cells of epithelial origin (Kundu, 1996; Leyton, 1994), including an airway epithelial cell line, A549 (Szabo, 1998).

(8) We nevertheless believe that the rhCC10 administered to premature infants on the day of birth stimulated the development of CC10-secreting cells, which, in turn, produced native CC10, which stimulated development of more CC10-secreting cells, and so on. The end result was a more normal and resilient respiratory epithelium in the rhCC10-treated infants who were more resistant to all environmental challenges (dust, smoke, allergens, RSV infection, influenza infection, etc.) compared to the placebo-treated infants. A single dose of rhCC10 on the day of birth conferred 100% protection from re-hospitalization due to severe respiratory exacerbation, contrasting the 50% re-hospitalization rate observed in the placebo-treated infants.

(9) We further believe that the use of CC10 to stimulate development of CC10-secreting cells in the respiratory epithelium will also work in adults with chronic respiratory diseases in which airway remodeling has resulted in loss of Clara cells. A course of treatment with rhCC10 may not cure the disease, but, we believe, would restore, to some extent, Clara cells and associated structures, resulting in a more normal epithelium that is then more resistant to subsequent environmental challenges. The clinical outcome of a course of rhCC10 treatment would then be an increase in the time interval to the next severe exacerbation.

(10) We further believe that the airway epithelial phenotype of Clara cell deficiency in CC10 KO mice suggests that CC10 is an autocrine and paracrine factor required for the development of Clara cells, associated structures, and other normal cell populations of the airway epithelium. We believe that CC10 is an autocrine and paracrine factor required for the development and maintenance of CC10-secreting cells outside of the respiratory tract, including the gastrointestinal tract and urogenital tract. There is much speculation that because secretoglobins share structural similarities that they will also share similar function, however, no biological activity has ever been previously shown to be shared between any two secretoglobins either in vitro or in vivo. Herein, we report that rhSCGB3A2 shares with CC10, the ability to inhibit porcine pancreatic phospholipase A2 in vitro. This is the first report that any other secretoglobin, besides CC10, actually inhibits any phospholipase A2 enzyme or possesses any type of anti-inflammatory activity. Based on these results, we infer that other secretoglobins, including respiratory secretoglobins, which share structural similarities with rhCC10, can stimulate the development and maintenance of the cells that secrete them to effect long-term clinical benefits such as increased time to next exacerbation, decreased severity of next exacerbation, and prevention of severe exacerbations following acute injury.

EXAMPLES

Example 1: Long Term Protection by rhCC10 in Premature Infants with RDS

(11) The safety, pharmacokinetics, and anti-inflammatory properties of rhCC10 were evaluated in a randomized, placebo-controlled, double-blinded, multicenter trial of 22 premature infants with respiratory distress syndrome (RDS) with mean birth weight of 932 g and mean gestational age of 26.9 wks, who received one intratracheal (IT) dose of placebo (n=7), 1.5 mg/kg (n=8) or 5.0 mg/kg (n=7) of rhCC10 following surfactant treatment (Levine, 2005). rhCC10-treated infants showed significant reductions in TAF total cell counts (P<0.001), neutrophil counts (P<0.001), and total protein concentrations (P<0.01) and decreased IL-6 (P<0.07) over the first 3 days of life. The rhCC10 was safe and well tolerated.

(12) Remarkably, and despite small numbers, follow-up of 17 infants at 6 months corrected gestational age (CGA) found that 0/11 who received rhCC10 were re-admitted to the hospital for respiratory causes compared to 3/6 receiving placebo as shown in Table 2 (P<0.05 Fisher's Exact Test, two tailed).

(13) TABLE-US-00002 TABLE 2 Re-hospitalizations for severe respiratory exacerbations 6 months CGA Placebo (7 enrolled) 3/6 1.5 mg/kg (8 enrolled) 0/6   5 mg/kg (7 enrolled) 0/5

(14) This result is even more remarkable when considering that 6 months CGA, in this context, means a time period corresponding to 6 months after the infant would have been 40 weeks gestation, and that some infants in the study were 24 weeks post-menstrual age (PMA) at birth, so that the 6 month CGA follow up timepoint occurred as many as 10 months after a single dose of rhCC10 administered on the day of birth. From a statistical standpoint, the results demonstrate at least a 57% incidence of re-hospitalization in the placebo group versus at least a 27% in the rhCC10 group. This is a very powerful long-term effect and these data illustrate a significant and unprecedented long-term benefit for administration of rhCC10.

(15) It is even more remarkable to find such a profound long term benefit when pharmacokinetic analyses showed that the excess CC10 was eliminated within 48 hours of administration, with a serum half-life of 9-11 hours (Levine, 2005). A significant amount of rhCC10 was observed in the tracheal aspirate fluids for nearly 2 days, and reached the serum by 6 h, but was then filtered by the kidney and excreted in urine by 12 h. The rhCC10 followed the natural physiological distribution path from lung to blood to urine and demonstrated long-term benefits, despite the rapid elimination.

Example 2: Cloning and Expression of rhSCGB3A2

(16) FIG. 1, SEQ. ID. NO. 3 shows the amino acid sequence of rhSCGB3A2 (ATAFLINKVPLPVDKLAPLPLDNILPFMDPLKLLLKTLGISVELVEGLRKCVNELGPEASE AVKKLLEAL) that was prepared for these studies. The sequence was extracted from Genebank locus AAQ89338 (Table 1). As a result of the recombinant product method that utilized an ubiquitin-like (UBL) fusion system and released the rhSCGB3A2 product (SEQ. ID. NO. 3) from the UBL using a UBL-protease, the N-terminus differs from the N-termini predicted for the native protein using consensus single peptide cleavage sites for mammalian secreted proteins. It also differs from the N-termini of actual peptides isolated from human fluid samples. This is the first description of the synthesis of human SCGB3A2 without a histidine purification tag and the effects of the N-terminus on the stability and activity of the protein could not be predicted. The amino acid sequence of rhSCGB3A2 was shown FIG. 1, SEQ ID NO. 3 and has predicted molecular weight of 8147.82 Daltons and a predicted isoelectric point of 6.1.

(17) A synthetic DNA coding sequence for rhSCGB3A2 was designed using jcat (www.jcat.de), with codon usage optimized for expression in E. coli bacteria K12 strain. Once the DNA sequence was generated, restriction sites were added to the ends to facilitate directional cloning of the gene into the bacterial expression vector, pTXB1, already containing the UBL. SCGB3A2 was cloned as a C-terminal extension of the UBL, which ends in LRGG and is the required sequence for cleavage of the C-terminal protein, in this case rhSCGB3A2. An AfIII site was placed at the 5′ end and a BamHI site was placed at the 3′ end for directional cloning.

(18) The new gene for rhSCGB3A2 was synthesized from overlapping oligonucleotides using PCR and is in Italic in SEQ ID NO 1 below. The DNA sequence used to clone the rhSCGB3A2 gene into the UBL expression vector is SEQ ID NO 1:

(19) TABLE-US-00003 CTTAAGAGGTGGTGCTACCGCTTTCCTGATCAACAAAGTTCCGCTGCCG GTTGACAAACTGGCTCCGCTGCCGCTGGACAACATCCTGCCGTTCATGG ACCCGCTGAAACTGCTGCTGAAAACCCTGGGTATCTCTGTTGAACACCT GGTTGAAGGTCTGCGTAAATGCGTTAACGAACTGGGTCCGGAAGCTTCT GAAGCTGTTAAAAAACTGCTGGAAGCTCTGTCTCACCTGGTTTAGTAAG GATCC

(20) The pTXB1 plasmid containing the UBL-rhSCGB3A2 fusion was transformed into E. coli strain HMS174/DE3 which contains a DE3 prophage encoding the T7 RNA polymerase that enables inducible expression of the fusion protein. Colonies were screened for expression of the fusion protein and the rhSCGB3A2 gene was reconfirmed by DNA sequencing in high expressers.

(21) A four liter fermentation culture containing SuperBroth media with ampicillin was inoculated from a 120 ml overnight culture of the highest-expressing clone and grown at 37° C. The culture was induced to overexpress the UBL-rhSCGB3A2 fusion protein at an OD.sub.600 of 8.75 using 0.3 mM IPTG, then allowed to grow for another 2 hours. Cell paste was harvested by centrifugation and the wet cell paste yield was 67 grams. The cell paste was then used for purification of rhSCGb3A2.

Example 3: Purification of rhSCGB3A2

(22) The cell paste was resuspended in 20 mM NaH.sub.2PO.sub.4, 0.5 M NaCl, pH 7.2, then the cells were ruptured by freeze-thaw to generate a crude lysate. The crude lysate was clarified by centrifugation at 19,800×g for 20′ at 4° C. DNA, endotoxin, and other bacterial contaminants were precipitated out of the clarified lysate supernatant using polyethylimine (PEI) at a concentration of 0.025% and a second centrifugation at 19,800×g for 10′ at 4° C. The PEI supernatant was then filtered through a 0.22 micron filter and 10 mM imidazole was added to the filtrate. Both the UBL and the UBL protease contain a histidine tag so that they bind to an immobilized metal affinity chromatography column. The filtrate containing the UBL-rhSCGB3A2 fusion protein was then passed over an IMAC column (nickel chelating sepharose fast flow) previously equilibrated in 20 mM NaH.sub.2PO.sub.4, 0.5 M NaCl, 10 mM imidazole, pH 7.2, the column was washed with the same buffer, then the UBL-rhSCGB3A2 fusion protein was eluted with 20 mM NaH.sub.2PO.sub.4, 100 mM NaCl, 300 mM imidazole, pH 7.2. The IMAC eluate was then concentrated and buffer exchanged using tangential flow filtration with a 5 kDa NMWCO filter in 15 mM Tris, 15 mM BisTris, 40 mM NaCl, pH 7.0. The UBL-rhSCGB3A2 was further purified over a Macro Prep High Q column (BioRad) in which contaminants were bound and the UBL-rhSCGB3A2 flowed through. The rhSCGB3A2 was then separated from the UBL by digestion with UBL protease Den-1 (1:100 molar ratio) in 5 mM DTT, with pH adjusted to 6.5 with HCl, at 37° C. for 2 hours. The rhSCGB3A2 was then purified from the digestion mixture using cation exchange chromatography (GE Sepharose SP High Performance). The SP column was equilibrated with 15 mM Tris, 15 mM BisTris, 40 mM NaCl, pH 6.5, the digestion mixture loaded, and contaminants bound to the column while rhSCGB3A2 flowed through. The SP flow through was then extensively dialyzed against 0.9% NaCl using a 3.5 kDa MWCO regenerated cellulose membrane. The sample was concentrated using centrifugal concentrators (3.5 kDa MWCO), then filtered through a 0.22 micron filter. The filtrate was purified rhSCGB3A2. FIG. 2 shows SDS-PAGE analysis of the final purified protein. It is >97% pure by densitometry of SDS-PAGE, and roughly 95% dimer and 5% monomer. As with rhCC10, it is difficult to completely reduce the dimer to monomer with reducing agents.

Example 4: Isoelectric Point of rhSCGB3A2

(23) The isoelectric point (pI) of a protein is a measure of the total surface charge of that protein. pI is measured using standard isoelectric focusing (IEF) methods. Approximately 5 micrograms of rhSCGB3A2, rhCC10, UBL, and Den-1 were loaded onto an IEF gel (Novex) in order to determine the pI of rhSCGB3A2 as shown in FIG. 3. When a protein migrates as a single band on SDS-PAGE and multiple bands are observed in the IEF gel, alternate isoforms of the protein are likely present. In contrast to rhCC10, which shows a single band at pI 4.8, rhSCGB3A2 shows two bands at pI 6.7 and 6.3. The predicted pI of our rhSCGB3A2 sequence is 6.1 (www.expasy.edu; Protein tool “Compute MW/pI”), yet the vast majority of the protein migrates at a position corresponding to a pI of 6.7. Not even the minor band at 6.3 corresponds to the predicted pI of 6.1. That there are two rhSCGB3A2 IEF bands means that either alternatively folded isoforms are present or that they represent monomers and dimers, as visualized in non-reducing SDS-PAGE. These pIs further show that this preparation is an unknown and unpredicted isoform of rhSCGB3A2 that is unique. The unique folding pattern of a recombinant protein is often determined by the synthetic process, in this case, the selection of N-terminus, expression of the protein as a C-terminal fusion with an ubiquitin-like protein, IMAC purification of the fusion protein, cleavage of the SCGB3A2 from the UBL, and separation of the SCGB3A2 from the UBL and UBL-protease. Thus, the uniqueness of this preparation may be due to the synthetic process, the non-native N-terminus, or a combination of these or other unknown factors.

Example 5: Inhibition of PLA.SUB.2 .by rhSCGB3A2

(24) The biological activity of rhSCGB3A2 was evaluated in a fluorescent and quantitative HPLC assay that evaluates inhibition of porcine pancreatic secretory PLA.sub.2enzyme (sPLA.sub.2) that was developed to evaluate the potency of different batches of rhCC10. Inhibition of PLA2 enzymes is thought to be a major anti-inflammatory mechanism of action for CC10. Many have speculated that other secretoglobins may also inhibit PLA.sub.2 enzymes, due to their structural similarities with CC10. The rhSCGB3A2 (5.5 micrograms) was mixed with of 100 nanograms porcine sPLA.sub.2 1B (0.1 microgram) and incubated at 37° C. The reaction was started through the addition of the fluorescent phospholipid analogue 2-decanoyl-1-(O-(11-(4,4-difluoro-5,7-dimethyl-4-bora-3a,4a-diaza-s-indacene-3-propionyl)amino)undecyl)-sn-glycero-3-phosphocholine (aka UNIBIPY; 47.6 nanograms). After 15 minutes the reaction was terminated by the addition of 2-propanol/n-hexane. The cleavage product was separated from the substrate on a Waters Spherisorb silica HPLC column. The separation was followed with a G1321A fluorescence detector.

(25) Results of the assay are shown in FIG. 4. Panel A shows the UNIBIPY substrate without sPLA.sub.2 or rhSCGB3A2; panel B shows the UNIBIPY substrate plus sPLA.sub.2, and panel C shows the UNIBIPY substrate plus sPLA.sub.2 plus rhSCGB3A2. The sPLA.sub.2 cleaves the substrate (peak #1), giving rise to a product (peak #2). In the presence of rhSCGB3A2, the product peak is significantly reduced. Each reaction set was run in duplicate. The rhSCGB3A2 showed 83% inhibition of sPLA.sub.2-1B activity in the assay, which is comparable to rhCC10 protein (data not shown).

(26) Percent inhibition is calculated as follows:
% inhibition={1−(average of the cleaved area with rhSCGB3A2/(average of the cleaved area without rhSCGB3A2)}×100

(27) It was concluded that the rhSCGB3A2 does inhibit porcine pancreatic sPLA.sub.2 and the level of activity is comparable to rhCC10.

Example 6: Comparison of rhSCGB3A2 to Native SCGB3A2 in Human Fluids

(28) Purified rhSCGB3A2 was used to immunize two New Zealand white rabbits, using a standard immunization protocol. The protein was conjugated to KLH, mixed with Freund's adjuvant, and injected into the animals. Both animals produced excellent antibody responses with very high titers. IgG was purified from each set of animal sera using a Pierce Protein A IgG Purification Kit and the purified IgGs were dialyzed into PBS, pH 7.2, aliquoted and stored at −80° C.

(29) The antibodies were qualified by Western blot using tracheal aspirate fluids (TAF) obtained from premature human infants. Samples containing 20 microliters of TAF from 6 infants were run on non-reducing SDS-PAGE and compared to rhSCGB3A2 (5 nanograms). The gel was electro-blotted to PVDF membrane, blocked with 4% non-fat milk, then the highest titer rabbit anti-rhSCGB3A2 IgG (1:5000 dilution) was incubated with the blot, followed by a goat anti-rabbit-HRP conjugate (1:20,000 dilution). The blot was developed using enhanced chemiluminescence (41PBA-ECL—100 mM Tris/HCl pH 8.8, 1.25 mM luminol, 5.3 mM hydrogen peroxide and 2 mM 41PBA). Immunoreactive bands appeared in 5/6 of the TAF samples. Two of the samples, (lane 3 and lane 6) contained bands that migrated at the same size as the rhSCGB3A2 homodimer, indicating that the rhSCGB3A2 preparation resembled native human SCGB3A2 in some patients. Heterologous expression of recombinant proteins, especially hydrophobic proteins, for use in animal or human studies often yields misfolded, inactive, immunogenic, or otherwise unusable preparations. Given that the actual N-terminus of native SCGB3A2 is not known and that the pI of rhSCGB3A2 was not as predicted, the observation that at least some human samples contained similar proteins validated our synthetic approach and rhSCGB3A2 preparation. All 5 reactive samples contained high molecular weight species, on the order of 200 kDa and all contained multiple discrete bands in the 8-13 kDa size range, some of which may correspond to monomers, dimers, and alternative isoforms. Two samples (lanes 3 and 7) also contained immunoreactive smears below 3.5 kDa, which likely represent SCGB3A2 degradation products. This is the first time that native SCGB3A2 has been visualized by Western blot. The anti-rhSCGB3A2 antibody used in the Western blot was then used to develop an ELISA for human SCGB3A2.

Example 7: Development of ELISA for rhSCGB3A2

(30) A competitive ELISA was developed using standard methods. In the competitive assay format, the antibody that captures the target is coated onto the wells of the microtiter plate, then an enzyme-conjugated target molecule (labeled target) is used to compete with unconjugated target in the sample for binding to available sites in the well. As the concentration of target in the sample increases, the amount of labeled target that binds to the wells decreases. The rabbit anti-rhSCGB3A2 antibody was coated onto 96 well Maxisorb plates (200 ng/well) then the wells were blocked with 5% sucrose, 2.5% BSA in PBS, then plates are dried and stored at 4° C. A conjugate of horse radish peroxidase (HRP) and rhSCGB3A2 was made (Pierce kit-EZ-Link Maleimide Activated HRP kit, Cat #31494) and was used in the assay diluted 1:130,000. Calibrators (1-500 ng) were made using rhSCGB3A2 and the standard curve was generated as shown in FIG. 6. Native SCGB3A2 was then quantitated in human TAF samples as shown in Table 3.

(31) TABLE-US-00004 TABLE 3 Native SCGB3A2 in human TAF [SCGB3A2] Lane Sample (ng/ml)* 1 RK-SCGB3A2 (5 ng) 2 Infant TAF; Pt. 6 774 3 Infant TAF; Pt. 7 804 4 infant TAF; Pt. 12 ND 5 Infant TAF; Pt. 15 540 6 Infant TAF; Pt. 17 462 7 Infant TAF; Pt. 19 395 8 Rh-SCGB3A2 (1 ng)

(32) SCGB3A2 was also measured in 3 adult human serum samples; returning values of 0, 29, and 32 ng/ml. SCGB3A2 could not be detected in unconcentrated human urine, or urine concentrated 10×. The limit of detection of the assay was 5 ng/ml.

Example 8

(33) a) A method of use of rhCC10 to prevent hospitalization due to a severe respiratory exacerbation in a patient with acute lung injury for a period of up to ten months after administration. b) A method of use of rhCC10 to prevent a severe respiratory exacerbation in a patient who experiences frequent exacerbations for at least one month after administration. c) A method of use of rhCC10 to prevent hospitalization due to severe respiratory exacerbations in a patient with a chronic respiratory condition for a period of at least one month after administration. d) The method of example a-c wherein the chronic respiratory condition is COPD. e) The method of example a-c wherein the chronic respiratory condition is asthma. f) The method of use of rhSCGB3A2 to prevent hospitalization due to a severe respiratory exacerbation in a patient with acute lung injury for a period of up to ten months after administration. g) The method of use of rhSCGB3A2 to prevent a severe respiratory exacerbation in a patient who experiences frequent exacerbations for at least two months after administration. h) The method of use of rhSCGB3A2 to prevent hospitalization due to severe respiratory exacerbations in a patient with a chronic respiratory condition for a period of at least one month after administration. i) The method of use of rhSCGB3A2 to prevent hospitalization due to severe respiratory exacerbations in a patient with a chronic respiratory condition for a period of at least 2 months after administration. j) The method of examples g-i wherein the chronic respiratory condition is pulmonary fibrosis. k) The method of examples g-i wherein the chronic respiratory condition is bronchiectasis. SCGB3A2: l) A composition of matter for recombinant human SCGB3A2 protein with N-terminus ATA, comprising seq ID 3. m) A process for synthesizing recombinant human SCGB3A2 using a UBL fusion protein and UBL protease that recognizes the fusion partner and cleaves between the fusion partner and SCGB3A2, to release the intact SCGB3A2 protein according to seq ID 3. n) A pharmaceutical composition of rhSCGB3A2 that inhibits PLA.sub.2enzymes. o) A pharmaceutical composition of rhSCGB3A2 that migrates in an isoelectric focusing gel corresponding to isoelectric point at or between 6.3-6.7. p) A pharmaceutical composition of rhSCGB3A2 comprising a homodimer. q) A pharmaceutical composition of rhSCGB3A2 comprising a homodimer with pI of 6.7 that inhibits PLA.sub.2enzymes.

(34) While the invention has been described in connection with what is presently considered to be the most practical and preferred embodiments, it is to be understood that the invention is not to be limited to the disclosed embodiments but, on the contrary, is intended to cover various modifications and equivalent arrangements included within the spirit and scope of the appended claims.

Abbreviations and Definitions

(35) CC10: Clara cell 10 kDa protein,

(36) CCSP: Clara cell secretory protein

(37) CC16: Clara cell 16 kDa protein

(38) SCGB1A1: protein encoded by the SCGB1A1 gene, same as CC10, CCSP, CC16, uteroglobin

(39) SCGB3A1: protein encoded by the SCGB3A1 gene, same as HIN-1 and UGRP2

(40) SCGB3A2: protein encoded by the SCGB3A2 gene, same as HIN-2 and UGRP1

(41) HIN-1: high-in-normal protein 1

(42) HIN-2: high-in normal protein 2

(43) UGRP1: uteroglobin gene related protein 1

(44) UGRP2: uteroglobin gene related protein 2

(45) Secretoglobin: Protein from the family of structurally related proteins characterized by four helical bundle monomers connected by disulfide bonds.

(46) Respiratory secretoglobins: Secretoglobins that are highly expressed and abundant in the respiratory tract, including SCGB1A1, SCGB3A1, and SCGB3A2.