IL-18 binding protein (IL-18BP) and antibodies in inflammatory diseases
The present invention provides means and methods for treating Interleukin 18 (IL-18)-associated diseases and disorders. In particular, the present invention discloses antibodies specific for free IL-18 and IL-18 Binding Protein (IL-18BP) for use in such treatments and for the diagnosis of the diseases and disorders.
1. A method for the treatment of a pediatric autoinflammatory disease or condition and/or symptoms associated with said disease or condition in a subject, said method comprising administering to said subject an IL-18 inhibitor, wherein the IL-18 inhibitor is an IL-18 binding protein (IL-18BP) or an active fragment thereof, wherein the IL-18BP or the active fragment thereof comprises N-terminal and/or C-terminal deletion variants of IL-18BP, which are present in an amount of less than 30%.
2. The method of claim 1 , wherein the body fluids of said subject have been quantified to have abnormal levels of free IL-18, which exceed the level of free IL-18 in body fluids of a healthy control subject by 5%, 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, 100%, or more than 100%.
3. The method of claim 2 , wherein the level of free IL-18 in the body fluids has been determined to be ≥5 pg/mL as compared to ≤4 pg/mL in the healthy control subject.
4. The method of claim 1 , wherein the IL18-BP is human IL-18BP.
5. The method of claim 4 , wherein said human IL-18BP is selected from isoforms a, b, c and d of human IL-18BP.
6. The method of claim 1 , wherein said deletion variants comprise deletions of between 1 and 5 amino acid residues at the C-terminal end of the IL-18BP and/or between 1 and 30 amino acid residues at the N-terminal end of the IL-18BP.
7. The method of claim 1 , wherein the pediatric autoinflammatory disease or condition is a macrophage activation syndrome (MAS)-like pediatric disease or condition, including primary, secondary, and recurrent MAS.
8. The method of claim 7 , wherein the MAS-like pediatric disease or condition is an IL-18 associated, pediatric autoinflammatory disease or condition with severe systemic inflammation.
9. The method of claim 8 , wherein the pediatric autoinflammatory disease or condition with severe systemic inflammation is caused by an NLRC4 mutation.
10. The method of claim 8 , wherein the pediatric autoinflammatory disease or condition with severe systemic inflammation is associated with X-linked inhibitor of apoptosis protein (XIAP) deficiency.
11. The method of claim 10 , wherein the XIAP deficiency is caused by a mutation in XIAP/BIRC4.
12. The method of claim 11 , wherein the XIAP deficiency is X-linked lymphoproliferative syndrome 2 (XLP2.
13. The method of claim 10 , wherein the subject has an enhanced susceptibility to a viral infection.
14. The method of claim 13 , wherein the treatment reduces susceptibility to viral infections before the viral infection has occurred or after virus clearance through treatment with an antiviral agent.
15. The method of claim 14 , wherein the treatment reduces susceptibility to Epstein Barr virus (EBV) infection and/or cytomegalovirus (CMV) infection.
16. The method of claim 10 , wherein the subject has enterocolitis.
17. The method of claim 8 , wherein the pediatric autoinflammatory disease or condition with severe systemic inflammation is accompanied by high levels of IL-18 and free IL-18.
18. The method of claim 1 , wherein the IL-18 BP or the active fragment thereof is administered to the subject in need thereof in multiple doses/day, in multiple doses/week or in multiple doses/month.
19. The method of claim 1 , wherein the IL-18 BP or the active fragment thereof is administered in one dose per week, in two doses per week, three doses per week, or four doses per week.
20. The method of claim 1 , wherein the IL-18 BP or the active fragment thereof is administered every 24 hours to 48 hours.
21. The method of claim 19 , wherein a single dose comprises between 0.5 mg and 600 mg IL-18BP.
22. The method of claim 19 , wherein a single dose comprises between 0.5 mg of IL-18BP/kg body weight and 10 mg of IL-18BP/kg body weight.
23. The method of claim 19 , wherein a single dose of between 0.5 mg of IL-18BP/kg body weight and 5 mg of IL-18BP/kg body weight is administered every 24 or 48 hours.
24. The method of claim 1 , wherein the subject is a human.
25. The method of claim 1 , further comprising administering to the subject a glucocorticoid.
26. The method of claim 25 , wherein the glucocorticoid is dexamethasone.
27. The method of claim 1 , wherein the IL-18 inhibitor is administered to the subject subcutaneously.
28. The method of claim 19 , wherein a single dose of 2 mg of IL-18BP/kg body weight is administered every 48 hours.