Methods and Treatment Involving Antibodies to IL-18
The present disclosure relates to methods of treating and/or detecting respiratory and inflammatory conditions associated with IL-18 by administering an anti-IL-18 antibody, optionally wherein the antibody comprises the six CDRs of SEQ ID NOS: 122, 123, 124, 126, 127, and 128, wherein 122-124 comprise the heavy chain CDRs and 126-128 comprise the light chain CDRs, to subjects aving elevated IL-18 levels. Conditions include acute respiratory distress syndrome (ARDS) and hemophagocytic lymphohistiocytosis HLH)/Macrophage activation syndrome (MAS), optionally wherein the ARDS and HLH/MAS are associated with viral infection, including coronavirus infection.
1 . A method of treating a condition associated with elevated IL-18, comprising administering to a subject in need thereof an effective amount of an anti-IL-18 antibody wherein the anti-IL-18 antibody comprises:
(a) a HCDR1 having an amino acid sequence of SEQ ID NO: 122;
(b) a HCDR2 having an amino acid sequence of SEQ ID NO: 123;
(c) a HCDR3 having an amino acid sequence of SEQ ID NO: 124;
(d) a LCDR1 having an amino acid sequence of SEQ ID NO: 126;
(e) a LCDR2 having an amino acid sequence of SEQ ID NO: 127; and
(f) a LCDR3 having an amino acid sequence of SEQ ID NO: 128 and, optionally wherein the condition associated with elevated IL-18 comprises any one or more of:
(a) inflammation, optionally wherein the inflammation is hyperinflammation;
(b) immune dysregulation that leads to multisystem organ failure;
(c) acute lung injury (ALI), optionally wherein the ALI is associated with a bacterial or viral infection, including coronavirus infection;
(d) acute respiratory distress syndrome (ARDS), optionally wherein the ARDS is associated with a bacterial or viral infection, including coronavirus infection;
(e) hemophagocytic lymphohistiocytosis (HLH), optionally where the HLH is associated with a bacterial or viral infection, including coronavirus infection;
(f) macrophage activation syndrome (MAS), optionally where the MAS is associated with a bacterial or viral infection, including coronavirus infection;
(g) cytokine storm that drives tissue injury and vascular permeability;
(h) post-infection pulmonary fibrosis;
(i) syndromes caused by NLRP3 overactivation/dysregulation due to viral infection; and
(j) pneumonia, optionally wherein the pneumonia is associated with a bacterial or viral infection, including coronavirus infection, thereby treating the condition.
2 . The method of claim 1 , wherein the method further comprises the following steps prior to administering the anti-IL-18 antibody:
(a) contacting a biological sample isolated from the subject with an anti-IL-18 antibody;
(b) incubating the biological sample to allow an anti-IL-18 antibody to bind to IL-18; and
(c) detecting the presence of complexes formed between an anti-IL-18 antibody and IL-18 in the biological sample.
3 . The method of claim 2 , wherein the detection of IL-18 indicates that treatment of the condition associated with elevated IL-18 with an anti-IL-18 antibody will be effective.
4 . A method of treating COVID-19 infection comprising administering an anti-IL-18 antibody to a subject in need thereof.
5 . A method of treating severe COVID-19 pneumonia comprising administering an anti-IL-18 antibody to a subject in need thereof.
6 . A method of treating acute inflammatory disease, optionally associated with COVID-19, comprising administering an anti-IL-18 antibody to a subject in need thereof.
7 . A method of treating respiratory failure associated with COVID-19 comprising administering an anti-IL-18 antibody to a subject in need thereof.
8 . A method of treating cytokine storm comprising administering an anti-IL-18 antibody to a subject in need thereof.
9 . A method of treating Acute Respiratory Distress Syndrome (ARDS), optionally associated with COVID-19, comprising administering an anti-IL-18 antibody to a subject in need thereof.
10 . A method of treating hemophagocytic lymphohistiocytosis (HLH), optionally associated with COVID-19, comprising administering an anti-IL-18 antibody to a subject in need thereof.
11 . A method of treating macrophage activation syndrome (MAS), optionally associated with COVID-19, comprising administering an anti-IL-18 antibody to a subject in need thereof.
12 . A method of preventing progression to ARDS in a subject, comprising administering an anti-IL-18 antibody to the subject not yet having ARDS and having a condition associated with elevated IL-18.
13 . A method of preventing the need for ventilation/intubation of a subject, comprising administering an anti-IL-18 antibody to the subject not yet intubated/ventilated and having a condition associated with elevated IL-18.
14 . The method of any one of claims 4 - 13 , wherein the anti-IL-18 antibody comprises:
(a) a HCDR1 having an amino acid sequence of SEQ ID NO: 122;
(b) a HCDR2 having an amino acid sequence of SEQ ID NO: 123;
(c) a HCDR3 having an amino acid sequence of SEQ ID NO: 124;
(d) a LCDR1 having an amino acid sequence of SEQ ID NO: 126;
(e) a LCDR2 having an amino acid sequence of SEQ ID NO: 127; and
(f) a LCDR3 having an amino acid sequence of SEQ ID NO: 128.
15 . The method of any one of the preceding claims, wherein the anti-IL-18 antibody comprises a VH domain having an amino acid sequence that is at least 90% identical to the full sequence of SEQ ID NO: 121.
16 . The method of any one of the preceding claims, wherein the anti-IL-18 antibody comprises a VH domain having an amino acid sequence that is identical to the full sequence of SEQ ID NO: 121.
17 . The method of any one of the preceding claims, wherein the anti-IL-18 antibody comprises a VL domain having an amino acid sequence that is at least 90% identical to the full sequence of SEQ ID NO: 125.
18 . The method of any one of the preceding claims, wherein the anti-IL-18 antibody comprises a VL domain having an amino acid sequence that is identical to the full sequence of SEQ ID NO: 125.
19 . The method of any one of the preceding claims, wherein the anti-IL-18 antibody comprises an antibody VH domain and an antibody VL domain, wherein the amino acid sequence of the antibody VH domain and the antibody VL domain are at least 90% identical to the full sequence of SEQ ID NOS: 121 and 125.
20 . The method of any one of claim 1 - 3 or 15 - 19 , wherein the condition associated with elevated IL-18 is secondary hemophagocytic lymphohistiocytosis (sHLH).
21 . The method of any one of claims 1 - 3 , wherein the condition associated with elevated IL-18 is a COVID-19 infection.
22 . The method of claim 20 , wherein the hemophagocytic lymphohistiocytosis (HLH) is secondary hemophagocytic lymphohistiocytosis (sHLH).
23 . The method of any of the preceding claims, wherein the anti-IL-18 antibody administered to the subject suppresses T cell activation.
24 . The method of any of the preceding claims, wherein the anti-IL-18 antibody administered to the subject suppresses increased expression of cytokines.
25 . The method of claim 24 , wherein the anti-IL-18 antibody administered to the subject suppresses increased expression of IFN-γ.
26 . The method of any of the preceding claims, wherein the anti-IL-18 antibody administered to the subject reduces the subject's risk of mortality or morbidity.
27 . The method of any one of the preceding claims, wherein the subject is human.
28 . The method of any one of claim 1 - 3 or 15 - 19 , wherein the subject has a respiratory disease, optionally caused by a coronavirus infection.
29 . The method of any one of claim 1 - 3 or 15 - 19 , wherein the subject has pneumonia.
30 . The method of any one of claim 1 - 3 or 15 - 19 , wherein the subject has acute lung injury (ALI).
31 . The method of any one of claim 1 - 3 or 15 - 19 , wherein the subject has acute respiratory distress syndrome (ARDS).
32 . The method of any one of claim 1 - 3 or 15 - 19 , wherein the subject has a mild coronavirus infection.
33 . The method of any one of claim 1 - 3 or 15 - 19 , wherein the subject has a moderate coronavirus infection.
34 . The method of any one of claim 1 - 3 or 15 - 19 , wherein the subject has a severe coronavirus infection.
35 . The method of any one of claim 1 - 3 or 15 - 19 , wherein the subject is at the Early Infection (Stage I) of a coronavirus infection.
36 . The method of any one of claim 1 - 3 or 15 - 19 , wherein the subject is at the Pulmonary Phase (Stage II) of a coronavirus infection.
37 . The method of any one of claim 1 - 3 or 15 - 19 , wherein the subject is at the Hyperinflammation Phase (Stage III) of a coronavirus infection.
38 . The method of any one of the preceding claims, wherein the subject is a pediatric subject.
39 . The method of any one of the preceding claims, wherein the subject is an adult.
40 . A kit for use in a method of any one of the preceding claims comprising an anti-IL-18 antibody and reagents for carrying out the method.