Methods providing a therapeutic macromolecule and synthetic nanocarriers comprising immunosuppressant locally and concomitantly to reduce both type I and type IV hypersensitivity

1. A method comprising:

providing a therapeutic dose of a therapeutic macromolecule, wherein the therapeutic macromolecule is not attached to synthetic nanocarriers;

providing a composition comprising synthetic nanocarriers that are attached to immunosuppressants; and

locally administering the composition and the therapeutic dose of the therapeutic macromolecule to a subject concomitantly,

wherein the subject is at risk of a local inflammatory reaction due to the administration of the therapeutic dose of the therapeutic macromolecule, and

wherein the local concomitant administration of the composition and the therapeutic dose of the therapeutic macromolecule reduces both Type 1 hypersensitivity and Type IV hypersensitivity in the subject.

2. The method of claim 1 , wherein the subject is a naïve subject.

3. The method of claim 1 , wherein the composition and the therapeutic dose of the therapeutic macromolecule are administered to the same location.

4. The method of claim 1 , wherein the composition and the therapeutic dose of the therapeutic macromolecule are administered to different locations.

5. The method of claim 1 , wherein the concomitant local administration is according to a protocol that has been demonstrated to result in a reduction of both Type 1 hypersensitivity and Type IV hypersensitivity with the composition and therapeutic dose of the therapeutic macromolecule, as compared to local administration of the therapeutic dose of the therapeutic macromolecule in the absence of concomitant local administration of the composition.

6. The method of claim 5 , wherein the method further comprises determining the protocol.

7. The method of claim 1 , wherein the method further comprises assessing a local inflammatory response in the subject prior to and/or after the administration.

8. The method of claim 7 , wherein the method further comprises assessing Type 1 hypersensitivity and Type IV hypersensitivity in the subject prior to and/or after the administration.

9. The method of claim 1 , wherein the method further comprises recording a reduction or prevention of a local inflammatory response.

10. The method of claim 9 , wherein the method further comprises recording a reduction in both Type 1 hypersensitivity and Type IV hypersensitivity.

11. The method of claim 1 , wherein the immunosuppressant comprises a statin, an mTOR inhibitor, a TGF-β signaling agent, a corticosteroid, an inhibitor of mitochondrial function, a P38 inhibitor, an NF-κB inhibitor, an adenosine receptor agonist, a prostaglandin E2agonist, a phosphodiesterase 4 inhibitor, an HDAC inhibitor or a proteasome inhibitor.

12. The method of claim 1 , wherein the therapeutic macromolecule is a therapeutic protein or a therapeutic polynucleotide.

13. The method of claim 1 , wherein the therapeutic protein is for protein replacement of protein supplementation therapy.

14. The method of claim 1 , wherein the therapeutic protein comprises a/an infusible or injectable therapeutic protein, enzyme, enzyme cofactor, hormone, blood or blood coagulation factor, cytokine, interferon, growth factor, monoclonal antibody, polyclonal antibody, or protein associated with Pompe's disease.

15. The method claim 14 , wherein the enzyme comprises an enzyme for enzyme replacement therapy for a lysosomal storage disorder.

16. The method of claim 14 , wherein the cytokine comprises a lymphokine, interleukin, chemokine, type 1 cytokine or a type 2 cytokine.

17. The method of claim 1 , wherein a load of immunosuppressant attached to the synthetic nanocarriers, on average across the synthetic nanocarriers, is between 0.1% and 50%.

18. The method of claim 1 , wherein the synthetic nanocarriers comprise lipid nanoparticles, polymeric nanoparticles, metallic nanoparticles, surfactant-based emulsions, dendrimers, buckyballs, nanowires, virus-like particles or peptide or protein particles.

19. The method of claim 1 , wherein the mean of a particle size distribution obtained using dynamic light scattering of the synthetic nanocarriers is a diameter greater than 100 nm.

20. The method of claim 1 , wherein an aspect ratio of the synthetic nanocarriers is greater than 1:1, 1:1.2, 1:1.5, 1:2, 1:3, 1:5, 1:7 or 1:10.