Methods and compositions with immune therapy for treatment of dementia

1. An isolated antibody, comprising a combination of (i) a heavy chain variable region, which comprises a heavy chain Complementarity Determining Regions (CDRs) CDR1 having the amino acid sequence of SEQ ID NO:9, a heavy chain CDR2 having the amino acid sequence of SEQ ID NO:10, and a heavy chain CDR3 having the amino acid sequence of SEQ ID NO:11, or variants of the heavy chain CDR amino acid sequences having 90% or greater, 95% or greater, 98% or greater, or 99% or greater sequence identity thereto, and (ii) a light chain variable region, which comprises a light chain CDR1 having the amino acid sequence of SEQ ID NO:12, a light chain CDR2 having the amino acid sequence of SEQ ID NO:13, and a light chain CDR3 having the amino acid sequence of SEQ ID NO:14, or variants of the light chain CDR amino acid sequences having 90% or greater, 95% or greater, 98% or greater, or 99% or greater sequence identity thereto; or

comprising a combination of (i) a heavy chain variable region, which comprises a heavy chain CDR1 having the amino acid sequence of SEQ ID NO:28, a heavy chain CDR2 having the amino acid sequence of SEQ ID NO:29, and a heavy chain CDR3 having the amino acid sequence of SEQ ID NO:30, or variants of the heavy chain CDR amino acid sequences having 90% or greater, 95% or greater, 98% or greater, or 99% or greater sequence identity thereto, and (ii) a light chain variable region, which comprises a light chain CDR1 having the amino acid sequence of SEQ ID NO:31, a light chain CDR2 having the amino acid sequence of SEQ ID NO:32, and a light chain CDR3 having the amino acid sequence of SEQ ID NO:33 or variants of the light chain CDR amino acid sequences having 90% or greater, 95% or greater, 98% or greater, or 99% or greater sequence identity thereto.

2. The antibody of claim 1 , which specifically binds to the peptide of SEQ ID NO:17 or SEQ ID NO:18.

3. The antibody of claim 1 , which is a humanized antibody.

4. The antibody of claim 3 , having an immunoglobulin heavy chain constant domain selected from the group consisting of IgG1, IgG2, IgG3 or IgG4, optionally comprising an S241P mutation IgG4 (Ser241Pro, Kabat numbering system), IgM, and variants thereof having unglycosylated Fc or Fc mutated in amino acid(s) to cause reduced binding to the Fc receptor.

5. The antibody of claim 3 , which is Fab, Fab′, F(ab) 2 , scFv, dsFv antibody, or an antibody fragment.

6. The antibody of claim 3 , comprising (i) a heavy chain variable region which comprises an amino acid sequence selected from the group consisting of SEQ ID NOs: 35, 37, 39, 41 and 43, and (ii) a light chain variable region which comprises an amino acid sequence selected from the group consisting of SEQ ID NOs: 45, 47, 49 and 51, and variants of (i) and (ii) in which the CDR amino acid sequences each or together have 90% or greater, 95% or greater, 98% or greater, or 99% or greater sequence identity thereto and the framework regions each or in total have 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 conservative amino acid substitutions.

7. The antibody of claim 1 , which is an antibody or a portion/derivative thereof that inhibits cleavage of APP by BACE.

8. The antibody of claim 1 , which is an isolated monoclonal antibody, or antigen-binding portion, or fragment thereof.

9. The antibody of claim 1 , wherein the antibody has an inhibitory effect on the proteolytic processing of APP by BACE, thereby reducing levels of intracellular or extracellular Aβ by at least 15%.

10. The antibody of claim 1 , which is an antibody that is de-immunized.

11. The antibody of claim 1 , which is an antibody that is a multi-specific antibody, such as a bispecific antibody further comprising a second antibody binding specificity which confers the ability of the bispecific antibody to cross the blood-brain barrier.

12. The antibody of claim 11 , wherein the first and second antibody binding specificities are provided by chemically linking a first antibody, or fragment thereof, to a second antibody, or fragment thereof.

13. The antibody of claim 12 , wherein the first and second antibodies are monoclonal antibodies.

14. The antibody of claim 13 , which is an F(ab′) 2 .

15. The antibody of claim 14 , which is a single chain Fv heterobispecific dimer.

16. An antibody complex, comprising an antibody of claim 1 , or an antibody fragment thereof, and a sialic acid-containing molecule conjugated thereto.

17. The antibody of claim 1 , which is a monoclonal antibody that inhibits cleavage of APP by BACE, wherein said antibody comprises the amino acid sequence of F5.100 or F5.87.

18. A pharmaceutical composition, comprising the antibody of claim 1 , or active fragment or complex thereof in a therapeutically effective amount, and a pharmaceutically acceptable carrier, a diluent, and/or an excipient.

19. The pharmaceutical composition of claim 18 suitable for administration, in a dosage suitable for treatment and/or delaying development of a disease that is susceptible to inhibiting of APP cleavage by BACE.

20. A method for treating a disease or condition associated with increased concentration of Aβ in the brain of a subject in need thereof, comprising administering the antibody of claim 1 in a therapeutically effective amount to the subject.

21. The method of claim 20 , wherein the disease or condition is Alzheimer's disease, mild cognitive impairment, Down's syndrome, or hereditary cerebral hemorrhage with amyloidosis (Dutch type).

22. A method of treating Alzheimer's disease, comprising administering to a patient having or suspected of having Alzheimer's disease the antibody of claim 1 .

23. A method of treating amyotrophic lateral sclerosis (ALS), comprising administering to a patient having or suspected of having ALS the antibody of claim 1 .

24. A method for reducing the plaque load in the brain of a subject suffering from a disease or condition associated with increased concentration of Aβ in the brain, comprising administering the antibody of claim 1 in a therapeutically effective amount to the subject.

25. A method of inhibiting deposition of Aβ, comprising administering the antibody of claim 1 or active fragment thereof in a therapeutically effective amount to the subject.

26. A method for decreasing the total amount of soluble Aβ in the brain of a subject suffering from a disease or condition associated with increased concentration of Aβ in the brain, comprising administering the antibody of claim 1 in a therapeutically effective amount to the subject.

27. A method for retaining or increasing cognitive memory capacity in a subject suffering from a disease or condition associated with increased concentration of Aβ in the brain, comprising administering the antibody of claim 1 in a therapeutically effective amount to the subject.

28. A method for treating and/or delay development of a disease that is susceptible to inhibiting APP cleavage by BACE, comprising administering to a patient in need thereof the antibody of claim 1 .

29. An isolated antibody, comprising a combination of a heavy chain variable region (VH) and a light chain variable region (VL) selected from the group consisting of:

VH1 of SEQ ID NO:35 and VL1 of SEQ ID NO:45;

VH1 of SEQ ID NO:35 and VL2 of SEQ ID NO: 47;

VH1 of SEQ ID NO:35 and VL3 of SEQ ID NO:49;

VH1 of SEQ ID NO:35 and VL4 of SEQ ID NO:51;

VH2 of SEQ ID NO:37 and VL1 of SEQ ID NO:45;

VH2 of SEQ ID NO:37 and VL2 of SEQ ID NO:47;

VH2 of SEQ ID NO:37 and VL3 of SEQ ID NO:49

VH2 of SEQ ID NO:37 and VL4 of SEQ ID NO:51;

VH3 of SEQ ID NO:39 and VL1 of SEQ ID NO:45;

VH3 of SEQ ID NO:39 and VL2 of SEQ ID NO:47;

VH3 of SEQ ID NO:39 and VL3 of SEQ ID NO:49;

VH3 of SEQ ID NO:39 and VL4 of SEQ ID NO:51;

VH4 of SEQ ID NO:41 and VL1 of SEQ ID NO:45;

VH4 of SEQ ID NO:41 and VL2 of SEQ ID NO:47;

VH4 of SEQ ID NO:41 and VL3 of SEQ ID NO:49;

VH4 of SEQ ID NO:41 and VL4 of SEQ ID NO:51;

VH5 of SEQ ID NO:43 and VL1 of SEQ ID NO:45;

VH5 of SEQ ID NO:43 and VL2 of SEQ ID NO:47;

VH5 of SEQ ID NO:43 and VL3 of SEQ ID NO:49; and

VH5 of SEQ ID NO:43 and VL4 of SEQ ID NO:51.