Methods, compositions, and kits for the treatment of matrix mineralization disorders
The present invention provides methods, compositions, and kits for the treatment of matrix mineralization disorders such as hypophosphatasia. In particular, the present invention provides polypeptides having a soluble alkaline phosphatase fused to an Fc domain of an immunoglobulin. Such polypeptides can be administered to patients, e.g., subcutaneously, to treat hypophosphatasia using enzyme replacement therapy. The invention also features nucleic acids encoding such polypeptides and the use of the nucleic acids for treating matrix mineralization disorders.
1. A method of treating hypophosphatasia (HPP) in a subject, said method comprising administering to said subject a therapeutically effective amount of a pharmaceutical composition comprising:
(a) a polypeptide comprising the structure Z-sALP-Y-Fc-X or the structure Z-Fc-Y-sALP-X; and
(b) a pharmaceutically acceptable excipient,
wherein sALP is the extracellular domain of an alkaline phosphatase comprising an amino acid sequence having at least 85% sequence identity to any one of SEQ ID NOs: 5-14; each of X and Z is absent and Y is an amino acid sequence of from one to twenty amino acids; and said polypeptide does not comprise a polyaspartic acid or polyglutamic acid region longer than three consecutive aspartic acid or glutamic acid residues.
2. The method of claim 1 , wherein
(a) said polypeptide comprises the structure Z-sALP-Y-Fc-X.
3. The method of claim 1 , wherein
(a) the amino acid sequence of said sALP comprises an amino acid sequence having
at least 95% sequence identity to SEQ ID NO: 5.
4. The method of claim 1 , wherein said Fc comprises a CH2 domain, a CH3 domain, and a hinge region.
5. The method of claim 1 , wherein Y is two amino acid residues.
6. The method of claim 1 , wherein the amino acid sequence of said polypeptide comprises an amino acid sequence having
(a) at least 85% sequence identity to SEQ ID NO: 4,
(b) at least 95% sequence identity to SEQ ID NO: 4, or
(c) at least 99% sequence identity to SEQ ID NO: 4.
7. The method of claim 6 , wherein the amino acid sequence of said polypeptide comprises the sequence of SEQ ID NO: 4.
8. The method of claim 1 , wherein
(a) said polypeptide is pegylated,
(b) said polypeptide is glycosylated,
(c) said pharmaceutical composition comprises a dimer of said polypeptide,
(d) said pharmaceutically acceptable excipient comprises saline, or
(e) said pharmaceutical composition is lyophilized.
9. The method of claim 1 , wherein said pharmaceutical composition is administered subcutaneously, intravenously, orally, nasally, intramuscularly, sublingually, intrathecally, or intradermally.
10. The method of claim 1 , wherein said HPP is infantile HPP, childhood HPP, perinatal HPP, adult HPP, or odontohypophosphatasia.
11. The method of claim 1 , wherein said pharmaceutical composition is administered in an amount that is therapeutically effective to treat a hypophosphatasia (HPP) phenotype selected from the group consisting of HPP-related seizure, premature loss of deciduous teeth, incomplete bone mineralization, elevated blood and/or urine levels of inorganic pyrophosphate (PP i ), elevated blood and/or urine levels of phosphoethanolamine (PEA), elevated blood and/or urine levels of pyridoxal 5′-phosphate (PLP), inadequate weight gain, rickets, bone pain, calcium pyrophosphate dihydrate crystal deposition, aplasia, hypoplasia, and dysplasia of the dental cementum.
12. The method of claim 1 , wherein said subject is human.
13. The method of claim 1 , wherein said polypeptide does not comprise a polyaspartic acid or polyglutamic acid region longer than two consecutive aspartic acid or glutamic acid residues.
14. The method of claim 1 , wherein said Fc is a constant domain of an immunoglobulin selected from the group consisting of IgG-1, IgG-2, IgG-3, and IgG-4.
15. The method of claim 14 , wherein the amino acid sequence of said Fc comprises an amino acid sequence having:
(i) at least 85% sequence identity to SEQ ID NO: 3,
(ii) at least 95% sequence identity to SEQ ID NO: 3, or
(iii) at least 99% sequence identity to SEQ ID NO: 3.
16. The method of claim 14 , wherein the amino acid sequence of said Fc comprises the sequence of SEQ ID NO: 3.
17. The method of claim 5 , wherein Y is leucine-lysine.
18. The method of claim 9 , wherein said pharmaceutical composition is administered subcutaneously to said subject in a dosage of about 0.5 mg/kg/day to about 10 mg/kg/day.
19. The method of claim 18 , wherein said pharmaceutical composition is administered subcutaneously to said subject in a dosage of about 2 mg/kg/day to about 3 mg/kg/day.
20. The method of claim 9 , wherein said pharmaceutical composition is administered subcutaneously to said subject between one and seven times a week.
21. The method of claim 20 , wherein said pharmaceutical composition is administered subcutaneously to said subject three times a week.
22. The method of claim 11 , wherein said incomplete bone mineralization is incomplete femoral bone mineralization, incomplete tibial bone mineralization, incomplete metatarsal bone mineralization, or incomplete rib bone mineralization.
23. The method of claim 7 , wherein the amino acid sequence of said polypeptide consists of the sequence of SEQ ID NO: 4.
24. The method of claim 10 , wherein said HPP is infantile HPP.
25. The method of claim 10 , wherein said HPP is perinatal HPP.
26. The method of claim 10 , wherein said HPP is childhood HPP.
27. The method of claim 10 , wherein said HPP is adult HPP.
28. The method of claim 16 , wherein the amino acid sequence of said Fc consists of the sequence of SEQ ID NO: 3.
29. The method of claim 3 , wherein the amino acid sequence of said sALP comprises an amino acid sequence having at least 99% sequence identity to SEQ ID NO: 5.
30. The method of claim 29 , wherein the amino acid sequence of said sALP comprises the sequence of SEQ ID NO: 5.
31. The method of claim 30 , wherein the amino acid sequence of said sALP consists of the sequence of SEQ ID NO: 5.