Anti-transthyretin antibodies
The invention provides antibodies that specifically bind to transthyretin (TTR). The antibodies can be used for treating or effecting prophylaxis of diseases or disorders associated with TTR accumulation or accumulation of TTR deposits (e.g., TTR amyloidosis). The antibodies can also be used for diagnosing TTR amyloidosis and inhibiting or reducing aggregation of TTR, among other applications.
1. A method of treating a subject having or at risk of having a transthyretin-mediated amyloidosis associated with a condition selected from cardiomyopathy or hypertrophy, familial amyloid polyneuropathy, central nervous system selective amyloidosis (CNSA), senile systemic amyloidosis, senile cardiac amyloidosis, spinal stenosis, osteoarthritis, rheumatoid arthritis, juvenile idiopathic arthritis, age related macular degeneration, and a ligament or tendon disorder, the method comprising administering to the subject an effective regime of an antibody that specifically binds transthyretin comprising three heavy chain CDRs and three light chain CDRs from antibody 6C1.
2. A method of treating or delaying onset of or reducing severity of a transthyretin-mediated amyloidosis in a subject, comprising administering to the subject an effective regime of an antibody that specifically binds transthyretin comprising three heavy chain CDRs and three light chain CDRs from antibody 6C1.
3. The method of claim 2 , wherein the transthyretin-mediated amyloidosis is associated with a condition selected from cardiomyopathy or hypertrophy, familial amyloid polyneuropathy, central nervous system selective amyloidosis (CNSA), senile systemic amyloidosis, senile cardiac amyloidosis, spinal stenosis, osteoarthritis, rheumatoid arthritis, juvenile idiopathic arthritis, age related macular degeneration, and a ligament or tendon disorder.
4. The method of claim 2 , wherein administering the antibody delays the onset of a transthyretin-mediated amyloidosis in the subject.
5. The method of claim 2 , wherein administering the antibody inhibits or reduces aggregation of transthyretin in the subject.
6. The method of claim 2 , wherein administering the antibody inhibits or reduces transthyretin fibril formation in the subject.
7. The method of claim 2 , wherein administering the antibody reduces transthyretin deposits in the subject.
8. The method of claim 2 , wherein administering the antibody clears aggregated transthyretin in the subject relative to a subject with a transthyretin-mediated amyloidosis who has not received the antibody.
9. The method of claim 2 , wherein administering the antibody stabilizes a non-toxic conformation of transthyretin in the subject.
10. The method of claim 2 , wherein the antibody comprises three Kabat heavy chain CDRs designated SEQ ID NOS: 10-12, respectively and three light CDRs designated SEQ ID NOS: 18-20, respectively.
11. The method of claim 10 , wherein the antibody has a human IgG1 isotype.
12. The method of claim 10 , provided position H77 of the antibody is occupied by T.
13. The method of claim 12 , provided position H49 of the antibody is occupied by A.
14. The method of claim 12 , provided positions H76 and H82(a) of the antibody are occupied by S.
15. The method of claim 12 , provided positions H19, H44, H83, and H89 of the antibody are occupied by K, R, K, and M, respectively.
16. The method of claim 10 , provided position L45 of the antibody is occupied by K.
17. The method of claim 16 , provided position L2 of the antibody is occupied by V.
18. The method of claim 2 , wherein the antibody is a humanized or chimeric 6C1 antibody that specifically binds to transthyretin, wherein 6C1 is a mouse antibody characterized by a mature heavy chain variable region of SEQ ID NO:1 and a mature light chain variable region of SEQ ID NO:13.
19. The method of claim 2 , wherein the antibody comprises a humanized mature heavy chain variable region having an amino acid sequence at least 90% identical to SEQ ID NO:9 and a humanized mature light chain variable region having an amino acid sequence at least 90% identical to SEQ ID NO:17.
20. The method of claim 19 , wherein the antibody comprises a mature heavy chain variable region having an amino acid sequence at least 95% identical to SEQ ID NO:9 and a mature light chain variable region having an amino acid sequence at least 95% identical to SEQ ID NO:17.
21. The method of claim 20 , wherein the antibody comprises a mature heavy chain variable region having an amino acid sequence at least 98% identical to SEQ ID NO:9 and a mature light chain variable region having an amino acid sequence at least 98% identical to SEQ ID NO:17.
22. The method of claim 18 , wherein the mature heavy chain variable region of the antibody has the amino acid sequence of SEQ ID NO:4.
23. The method of claim 18 , wherein the mature heavy chain variable region of the antibody has the amino acid sequence of SEQ ID NO:5.
24. The method of claim 18 , wherein the mature heavy chain variable region of the antibody has the amino acid sequence of SEQ ID NO:6.
25. The method of claim 18 , wherein the mature heavy chain variable region of the antibody has the amino acid sequence of SEQ ID NO:7.
26. The method of claim 18 , wherein the mature heavy chain variable region of the antibody has the amino acid sequence of SEQ ID NO:8.
27. The method of claim 18 , wherein the mature heavy chain variable region of the antibody has the amino acid sequence of SEQ ID NO:9.
28. The method of any one of claims 22 - 27 , wherein the mature light chain variable region of the antibody has the amino acid sequence of SEQ ID NO:16 or SEQ ID NO:17.
29. The method of claim 2 , wherein the mature heavy chain has the amino acid sequence of SEQ ID NO: 9 and the mature light chain variable region of the antibody has an amino acid sequence of SEQ ID NO:17.
30. The method of claim 2 or 21 , wherein the antibody is a binding fragment.
31. The method of claim 30 , wherein the binding fragment is a single-chain antibody, Fab, or Fab′2 fragment.
32. The method of claim 2 or 21 , wherein the mature light chain variable region of the antibody is fused to a light chain constant region and the mature heavy chain variable region of the antibody is fused to a heavy chain constant region.
33. The method of claim 32 , wherein the heavy chain constant region is a mutant form of a natural human heavy chain constant region which has reduced binding to a Fcγ receptor relative to the natural human heavy chain constant region.
34. The method of claim 32 , wherein the mature heavy chain variable region is fused to a heavy chain constant region having the sequence of SEQ ID NO:26 and/or the mature light chain variable region is fused to a light chain constant region having the sequence of SEQ ID NO:28.