Patent
Compositions and methods for the treatment or prevention of Clostridium difficile infection in a subject are provided. The compositions comprise antibodies to Clostridium difficile toxin A. The methods provide for administering the antibodies to a subject in an amount effective to reduce or eliminate or prevent relapse from Clostridium difficile bacterial infection.
1. An isolated monoclonal antibody, or an antigen-binding portion thereof, comprising a heavy chain variable region and a light chain variable region,
wherein the heavy chain variable region comprises three complementarity determining regions (CDRs), CDR1, CDR2 and CDR3, having the amino acid sequences set forth in SEQ ID NOs: 29, 30 and 31, respectively,
wherein the light chain variable region comprises three CDRs, CDR1, CDR2 and CDR3, having the amino acid sequences set forth in SEQ ID NOs: 21, 22 and 23, respectively; and
wherein the antibody or antigen-binding portion thereof specifically binds to Clostridium difficile ( C. difficile ) toxin A.
2. The antibody or antigen-binding portion thereof of claim 1 , wherein the dissociation constant (K D ) of the antibody, or antigen-binding portion thereof, is less than about 8×10 −10 M.
3. The antibody or antigen-binding portion thereof of claim 1 , wherein the antibody or antigen-binding portion thereof is humanized or chimeric.
4. The antibody or antigen-binding portion thereof of claim 1 , wherein the heavy chain variable region comprises the amino acid sequence SEQ ID NO: 89 and wherein the light chain variable region comprises the amino acid sequence SEQ ID NO: 91.
5. The antibody or antigen-binding portion thereof of claim 1 , wherein the heavy chain variable region comprises the amino acid sequence SEQ ID NO: 93 and wherein the light chain variable region comprises the amino acid sequence SEQ ID NO: 95.
6. The antibody or antigen-binding portion thereof of claim 1 , wherein the antigen-binding portion thereof is selected from the group consisting of: (a) an scFv; (b) a Fab fragment; (c) an F(ab′)2; and (d) a disulfide linked Fv.
7. The antibody or antigen-binding portion thereof of claim 1 , wherein the antibody or antigen-binding portion thereof comprises at least one constant domain selected from the group consisting of: a) an IgG constant domain; and (b) an IgA constant domain.
8. The antibody or antigen-binding portion thereof of claim 1 , wherein the antibody or antigen-binding portion thereof binds to fragment 4 of C. difficile toxin A.
9. An isolated monoclonal antibody heavy chain variable region, wherein the heavy chain variable region comprises an amino acid sequence selected from the group consisting of SEQ ID NO: 28, 89, and 93,
wherein an antibody or antigen-binding portion thereof comprising the heavy chain variable region and a light chain variable region comprising the amino acid sequence SEQ ID NO: 20, 91, or 95, respectively, can specifically bind to C difficile toxin A.
10. An isolated monoclonal antibody light chain variable region, wherein the light chain variable region comprises an amino acid sequence selected from the group consisting of SEQ ID NO: 20, 91, and 95,
wherein an antibody or antigen-binding portion thereof comprising the light chain variable region and a heavy chain variable region comprising the amino acid sequence SEQ ID NO: 28, 89, or 93, respectively, can specifically bind to C difficile toxin A.
11. The antibody or an antigen-binding portion thereof of claim 1 , wherein the heavy chain variable region comprises the amino acid sequence SEQ ID NO: 28 and wherein the light chain variable region comprises the amino acid sequence SEQ ID NO: 20.
12. The antibody or antigen-binding portion thereof of claim 1 , wherein, in an in vivo toxin A challenge experiment, when the antibody, or an antigen-binding portion thereof, is administered to a mammal at a dosage ranging from about 8 mg/kg body weight to about 13 mg/kg body weight about 24 hours before the mammal is exposed to greater than about 100 ng of C. difficile toxin A, the chance of survival for the mammal is greater than about 80% within about 7 days.
13. The antibody or antigen-binding portion thereof of claim 1 , wherein the antibody, or antigen-binding portion thereof, at a concentration ranging from about 4 μM to about 17 μM, neutralizes greater than about 40% of about 150 ng/ml C. difficile toxin A in an in vitro neutralization assay.
14. A composition comprising the antibody or antigen-binding portion thereof of claim 1 , and at least one pharmaceutically acceptable carrier.
15. A method of preventing or treating C. difficile -associated disease comprising administering to a subject an effective amount of the antibody or antigen-binding portion thereof of claim 1 .
16. The method of claim 15 , wherein the antibody or antigen-binding portion thereof is administered intravenously, subcutaneously, intramuscularly or transdermally.
17. The method of claim 15 , further comprising the step of administering to the subject a second agent.
18. The method of claim 17 , wherein the second agent is a different antibody or fragment thereof.
19. The method of claim 17 , wherein the second agent is an antibiotic.
20. The method of claim 19 , wherein the antibiotic is vancomycin, metronidazole, or fidaxomicin.