FUSION PROTEINS
The present invention relates to fusion proteins comprising an insulin receptor agonist fused to a human IgG Fc region through the use of a peptide linker, and the use of such fusion proteins in the treatment of diabetes. The fusion protein of the present invention has an extended time action profile and is useful for providing basal glucose control for an extended period of time.
1 . A fusion protein comprising:
a) an insulin receptor agonist having the general formula Z 1 -Z 2 -Z 3 , wherein:
i) Z 1 is an insulin B-chain analog, comprising the amino acid sequence:
X 1 X 2 X 3 QHLCGSHLVEALX 4 LVCGERGFX 5 YX 6 X 7 X 8 X 9
wherein X 1 is F, Q or A; X 2 is V or G; X 3 is N, K, D, G, Q, A or E; X 4 is E, Y, Q, or H; X 5 is H or F; X 6 is G, T, S, H, V or is absent; X 7 is G, E, P, K, D, S, H or is absent; X 8 is G, E, K, P, Q, D, H or is absent; X 9 is G, T, S, E, K, A or is absent, provided that the insulin B-chain analog includes at least one modification from the amino acid sequence of the B-chain of a molecule of human insulin at X 4 , X 5 , X 6 , X 7 , X 8 , or X 9 (SEQ ID NO:1);
ii) Z 2 is a first peptide linker comprising 5 to 10 amino acids, wherein at least 5 of said amino acids are G residues; and
iii) Z 3 is an insulin A-chain analog comprising the amino acid sequence:
GIVEQCCTSX 1 CSLX 2 QLENYCX 3 X 4
wherein X 1 is T or I; X 2 is D, Y, Q or E; X 3 is G, N, S or A; and X 4 is any naturally occurring amino acid, or is absent, provided that if X 3 is N, then X 4 must be an amino acid other than G or N (SEQ ID NO:2);
b) a second peptide linker; and
c) a human IgG Fc region;
wherein the C-terminal residue of the insulin receptor agonist is directly fused to the N-terminal residue of the second peptide linker, and the C-terminal residue of the second peptide linker is directly fused to the N-terminal residue of the human IgG Fc region.
2 . The fusion protein of claim 1 , wherein:
the insulin B-chain analog includes at least one modification from the amino acid sequence of the human insulin B-chain at X 4 or X 5 of SEQ ID NO:1; and
and the insulin A-chain analog includes at least one modification from the amino acid sequence of the human insulin A-chain at X 1 or X 2 of SEQ ID NO:2.
3 . The fusion protein of claim 2 , wherein:
the insulin B-chain analog comprises the sequence of SEQ ID NO:1, wherein: X 1 is F;
X 2 is V; X 3 is N or D; X 4 is E; X 5 is H; and
the insulin A-chain analog comprises the sequence of SEQ ID NO:2, wherein: X 1 is I or T; X 2 is D; X 3 is G; and X 4 is absent.
4 . The fusion protein of claim 3 , wherein the insulin B-chain analog comprises the sequence of SEQ ID NO:1, wherein X 6 -X 9 are each G.
5 . The fusion protein of claim 1 , wherein the first peptide linker comprises the following amino acid sequence:
X 1 GX 2 GGGG
wherein X 1 is G or is absent; and X 2 is G, S or is absent (SEQ ID NO:3).
6 . The fusion protein of claim 5 , wherein X 1 and X 2 of SEQ ID NO:3 are G and S, respectively.
7 . The fusion protein of claim 1 , wherein the insulin receptor agonist has the following amino acid sequence:
(SEQ ID NO: 5)
FVNQHLCGSHLVEALELVCGERGFHYGGGGGGSGGGGGIVEQCCTSTCSL
DQLENYCG.
8 . The fusion protein of claim 1 , wherein the second peptide linker is a peptide having between 10 and 25 amino acids, wherein at least 50% of said amino acids are G residues.
9 . The fusion protein of claim 8 , wherein the second peptide linker comprises a peptide having the sequence [GGGGX] n
wherein X is Q, E or S; and wherein n is 2-5.
10 . The fusion protein of claim 9 , wherein the second peptide linker comprises the following amino acid sequence:
GGGGX 1 GGGGX 2 GGGGX 3 GGGGX 4 X 5 X 6
X 1 is Q or E
X 2 is Q or E
X 3 is Q or E
X 4 is G, E, Q or is absent
X 5 is G or absent; and
X 6 is G or is absent
(SEQ ID NO:6).
11 . The fusion protein of claim 1 , wherein the second peptide linker has the following amino acid sequence:
(SEQ ID NO: 7)
GGGGQGGGGQGGGGQGGGGG.
12 . The fusion protein of claim 1 , wherein the human IgG Fc region is an Fc region from an IgG1, IgG2 or IgG4.
13 . The fusion protein of claim 1 , wherein the human IgG Fc region comprises an amino acid sequence selected from the group consisting of SEQ ID NO:8, SEQ ID NO:9 and SEQ ID NO:10.
14 . A fusion protein having the amino acid sequence of SEQ ID NO:12.
15 . A homodimer of two fusion proteins of claim 1 .
16 . A homodimer of two fusion proteins of claim 14 .
17 . A pharmaceutical composition comprising a fusion protein of claim 1 and further comprising one or more buffering agents, one or more surfactants, and one or more isotonicity agents.
18 . The pharmaceutical composition of claim 17 wherein the pH ranges from about 5.5 to about 8.0.
19 . The pharmaceutical composition of claim 17 , further comprising an additional active ingredient.
20 . The pharmaceutical composition of claim 19 , wherein the additional active ingredient is a GLP-1R agonist.
21 . The pharmaceutical composition of claim 20 , wherein the GLP-1R agonist is dulaglutide.
22 . A pharmaceutical composition comprising a homodimer of claim 16 and dulaglutide.
23 . A method of treating a patient with diabetes mellitus comprising administering to a patient in need thereof a therapeutically effective amount of the fusion protein of claim 1 .
24 . The method of claim 23 , wherein the fusion protein of claim 1 is administered in combination with a GLP-IR agonist.
25 . The method of claim 24 , wherein the GLP-1R agonist is dulaglutide.
26 . A method of treating a patient with diabetes mellitus comprising administering to a patient in need thereof a homodimer of claim 16 in combination with dulaglutide.