Humanized tau antibodies in alzheimer's disease
The present invention is in the fields of biochemistry, molecular biology, and Alzheimer's disease diagnosis, prevention, and treatment. Provided herein are humanized antibodies against human tau that are capable of discriminating between normal (healthy) and pathological (disease-associated) tau.
1. A composition comprising a humanized anti-tau antibody, or a tau-binding fragment thereof, and a second therapeutic agent for ameliorating at least one symptom of Alzheimer's Disease or another tauopathy,
wherein the antibody or binding fragment comprises:
a heavy chain variable region comprising CDR-H1, CDR-H2, and CDR-H3 of SEQ ID NOs. 1, 2, and 3, respectively, and a framework from human immunoglobulin M65092 (SEQ ID NO. 71);
a light chain variable region comprising CDR-L1, CDR-L2, and CDR-L3 of SEQ ID NOs. 4, 5, and 6, respectively, and a framework from human immunoglobulin X72449 (SEQ ID NO. 65); and
heavy chain and light chain constant regions each from a human immunoglobulin;
wherein said heavy chain variable region framework has been substituted at one or more positions selected from 9, 21, 27, 28, 30, 38, 48, 67, 68, 70, and 95; said light chain variable region framework has either not been substituted or has been substituted at position 5; and wherein said positions are according to Kabat; and wherein
(i) the second therapeutic agent comprises one or more of gantenerumab, aducanumab, 3-amino-1-propanesulfonic acid (3APS), or any pharmaceutically acceptable salt thereof; or
(ii) the second therapeutic agent comprises one or more of donepezil, rivastigmine, galantamine, memantine, or any pharmaceutically acceptable salt thereof.
2. The composition of claim 1 , wherein heavy chain variable region framework position 9 is occupied by P, heavy chain variable region framework position 21 is occupied by P, heavy chain variable region framework position 27 is occupied by Y, heavy chain variable region framework position 28 is occupied by I, heavy chain variable region framework position 30 is occupied by T, heavy chain variable region framework position 38 is occupied by K, heavy chain variable region framework position 48 is occupied by I, heavy chain variable region framework position 67 is occupied by K, heavy chain variable region framework position 68 is occupied by A, heavy chain variable region framework position 70 is occupied by L, and/or heavy chain variable region framework position 95 is occupied by F; wherein said positions are according to Kabat.
3. The composition of claim 1 , wherein heavy chain variable region framework position 9 is occupied by A, heavy chain variable region framework position 21 is occupied by S, heavy chain variable region framework position 27 is occupied by Y, heavy chain variable region framework position 28 is occupied by T, heavy chain variable region framework position 30 is occupied by S, heavy chain variable region framework position 38 is occupied by R, heavy chain variable region framework position 48 is occupied by M, heavy chain variable region framework position 67 is occupied by R, heavy chain variable region framework position 68 is occupied by V, heavy chain variable region framework position 70 is occupied by I, and/or heavy chain variable region framework position 95 is occupied by Y; wherein said positions are according to Kabat.
4. The composition of claim 1 , wherein light chain variable region framework position 5 is occupied by S; wherein said position is according to Kabat.
5. The composition of claim 1 , wherein the sequence of the heavy chain variable region comprises any one of SEQ ID NOs. 14-25 (RHB through RHM); and the sequence of the light chain variable region comprises SEQ ID NO. 26 (RKA).
6. The composition of claim 1 , wherein the sequence of the heavy chain variable region comprises any one of SEQ ID NOs. 14-25 (RHB through RHM); and the sequence of the light chain variable region comprises SEQ ID NO. 27 (RKB).
7. The composition of claim 1 , wherein the antibody is of an IgG1 or IgG4 isotype.
8. The composition of claim 1 , wherein the light chain comprises a human kappa constant region.
9. A method of ameliorating the symptoms of Alzheimer's Disease or another tauopathy in a subject having Alzheimer's Disease or another tauopathy, comprising administering to the subject a therapeutically effective amount of the composition of claim 1 .
10. The method of claim 9 , wherein the humanized anti-tau antibody, or tau-binding fragment thereof, and the second therapeutic agent are administered sequentially.
11. The method of claim 9 , wherein the humanized anti-tau antibody, or tau-binding fragment thereof, and the second therapeutic agent are administered simultaneously.
12. The method of claim 9 , wherein the composition is effective to decrease behavioral, functional, and/or cognitive deterioration over time.
13. The method of claim 9 , wherein the composition is effective to improve and/or reduce the rate of deterioration in at least one disease assessment selected from the group consisting of the Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog), the Clinical Dementia Rating Sum of Boxes (CDR-sb), the Alzheimer's Disease Cooperative Study Activities of Daily Living Scale (ADCS-ADL), the Neuropsychiatric Inventory (NPI), and the Mini-Mental State Evaluation (MMSE).
14. The method of claim 13 , wherein administering the composition results in a median reduction in the rate of deterioration of ADAS-cog scores of two to five points.
15. A composition comprising a humanized anti-tau antibody, or a tau-binding fragment thereof, and a second therapeutic agent for ameliorating at least one symptom of Alzheimer's Disease or another tauopathy, wherein the antibody or binding fragment comprises a heavy chain variable region comprising SEQ ID NO. 16 and a light chain variable region comprising SEQ ID NO. 26; and wherein
(i) the second therapeutic agent comprises one or more of gantenerumab, aducanumab, 3-amino-1-propanesulfonic acid (3APS), or any pharmaceutically acceptable salt thereof; or
(ii) the second therapeutic agent comprises one or more of donepezil, rivastigmine, galantamine, memantine, or any pharmaceutically acceptable salt thereof.
16. The composition of claim 15 , wherein the antibody or binding fragment comprises a heavy chain comprising SEQ ID NO. 31 and a light chain comprising SEQ ID NO. 57.
17. The composition of claim 15 , wherein the antibody or binding fragment comprises a heavy chain comprising SEQ ID NO. 46 and a light chain comprising SEQ ID NO. 57.
18. A method of ameliorating the symptoms of Alzheimer's Disease or another tauopathy in a subject having Alzheimer's Disease or another tauopathy, comprising administering to the subject a therapeutically effective amount of the composition of claim 15 .
19. The method of claim 18 , wherein the humanized anti-tau antibody, or tau-binding fragment thereof, and the second therapeutic agent are administered sequentially.
20. The method of claim 18 , wherein the humanized anti-tau antibody, or tau-binding fragment thereof, and the second therapeutic agent are administered simultaneously.
21. The method of claim 18 , wherein the composition is effective to decrease or prevent behavioral, functional, and/or cognitive deterioration over time.
22. The method of claim 18 , wherein the composition is effective to improve and/or reduce the rate of deterioration in at least one disease assessment selected from the group consisting of the Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog), the Clinical Dementia Rating Sum of Boxes (CDR-sb), the Alzheimer's Disease Cooperative Study Activities of Daily Living Scale (ADCS-ADL), the Neuropsychiatric Inventory (NPI), and the Mini-Mental State Evaluation (MMSE).
23. The method of claim 22 , wherein administering the composition results in a median reduction in the rate of deterioration of ADAS-cog scores of two to five points.