Traditional treatment for leukemia has consisted of allogeneic transplants of bone marrow (BMT) where the recipient receives tissue grafts from a healthy donor. Although allogeneic BMT has met with some success, rejection of the graft by the recipient as well as the immune response of the grafted tissue attacking the host, known as Graft-Versus-Host-Disease (GVHD), occurs in many cases. GVHD is a significant cause of mortality in allogeneic bone marrow transplant (BMT) procedures. Similarly, attempts to repress the recipient's immune system prior to the transplant leave an already weakened patient susceptible to potentially fatal post-transplant procedures.
The SH2-domain-containing Inositol 5-Phosphatase (SHIP) is a hematopoietic cell-specific protein that is activated by various cytokines and growth factors. Numerous studies using SHIP deficient mice have shown that SHIP is a negative regulator of hematopoietic cell propagation, function and survival. In essence, SHIP helps control the reproduction of immune cells in the blood known as natural killers (NK) cells. When SHIP is downregulated, or repressed, the immune system of test SHIP-deficient mice were less likely to attack and reject transplanted bone marrow from mismatched, allogeneic donors. The reverse is also true, where the immune system cells present in the transplanted tissue were less likely to attack the new host.
Down regulation of SHIP in allogeneic BMT recipients prior to transplant has shown a decrease in the number of mice suffering from GVHD. However, allogeneic methods have many variables which affect its success. In addition to deficiencies already listed, i.e. GVHD and rejection by the host, allogeneic methods are complicated by the ability to find suitable donors and the potentially lethal complications resulting from graft rejection and GVHD.
For these reasons it is preferable to treat patients with autologous transplant methods, where the patient's own stem cells, depleted of leukemic or tumor cells (including leukemic stem cells clones or tumor cells), are encouraged to grow or are removed, cultured, and re-transplanted into the original host. This method provides the benefits of eliminating the chance of host rejection or GVHD since the cells are not foreign to the body. Currently, these hematopoietic stem cell (HSC) therapies fail with significant frequency. Many times the procedure is infeasible due to the inability to acquire viable HSC from the patient for transplant. Organ-specific stem cell transplants (e.g. neural stem cells, mesenchymal stem cells) are not yet widely used clinically due to the inability to acquire these cells or due to their inability to home efficiently and engraft after transplantation.
Therefore, what is needed is an efficacious therapy that provides a long-term benefit in a wide variety of genetic, oncologic and infectious diseases in the emerging field of stem cell transplantation.
The instant invention teaches the inhibition of SHIP expression, or function, for the increased efficacy of autologous transplants. In addition to cancer-related therapies BM stem cells are currently thought to be an effective therapy for cardiac repair. Other tissue or organ-specific stem cells, such as neural stem cells, might also be used to treat neurological diseases that occur due to the loss of neurons in the central nervous system.
In another embodiment, interference with SHIP function can be used to temporarily expand the hematopoietic stem cell compartment to assist with leukapheresis, to promote hematopoietic recovery after myeloablation treatments, to deplete target stem cell clones (such a leukemic stem cell clones and other tumor stem cell types), and to deplete, or damage, the repopulating ability of the endogenous hematopoietic stem cell pool in order to allow transplanted hematopoietic stem cells to better home and engraft and to increase mesenchymal stem cells number in vivo and ex vivo.
The method of increasing the yield of stem cells in a patient, in vivo, for autologous transplantation, comprises the steps of administering an effective amount of SHIP inhibitor to the patient and harvesting the stem cells from the patient for autologous transplantation. In one embodiment of this method, the SHIP inhibitor is selected from the group consisting of RNA interference compounds, antisense oligonucleotides, ribozymes, DNAzymes, nucleic acid modifiers, PNAs, nonstandard nucleic acids, aptamers, decoys, oligonucleotide based gene regulation, substrate mimics, molecular inhibitors and dominant/negative mutants. The stems cells harvested for transplantation are selected from the group consisting of hematopoietic stem cells, mammary stem cells, mesenchymal and other organ specific stem cells.
In another embodiment, the present invention provides a method of increasing the yield of stem cells from a patient, ex vivo, for autologous transplantation, comprising the steps of harvesting target stem cells from the patient and contacting the target stem cells with SHIP inhibitor. The SHIP inhibitor is selected from the group consisting of RNA interference compounds, antisense oligonucleotides, ribozymes, DNAzymes, nucleic acid modifiers, PNAs, nonstandard nucleic acids, aptamers, decoys, oligonucleotide based gene regulation, substrate mimics, molecular inhibitors and dominant/negative mutants. Stems cells harvested for transplantation are selected from the group consisting of hematopoietic stem cells, mammary stem cells, mesenchymal and other organ specific stem cells.
In yet another embodiment, the present invention provides a non-invasive method for harvesting stem cells from solid organ systems such as the CNS by mobilizing these cells to the blood, comprising the steps of administering SHIP inhibitor to a patient and then harvesting the stem cells from the volume of blood by leukopherisis. The stem cells can be either hematopoietic stem cells (HSC) or non hematopoietic (e.g., CNS, mesenchymal or other organ-specific stem cells).
In yet another embodiment the present invention provides a non-invasive method of promoting recovery of a stem cell population in a patient comprising the step of administering SHIP inhibitor to the patient, possibly a patient recovering from myeloablation therapy. The administration of SHIP inhibitor is conducted over a relatively short period, such as approximately one (1) and two (2) weeks. As mentioned, the target stem cell population can be either hematopoietic or non-hematopoietic stem cells.
In another embodiment, the present invention provides a method of reducing the population of target cells comprising the step of administering an effective amount of SHIP inhibitor to a patient. The administration of SHIP inhibitor is conducted over a more prolonged period, such as approximately nine (9) and twelve (12) weeks and can be used in conjunction with chemotherapeutic agents.
For a fuller understanding of the nature and objects of the invention, reference should be made to the following detailed description, taken in connection with the accompanying drawings, in which:
The present invention relates to the novel and unexpected finding that SHIP activity has a crucial role in regulating the number of hematoppietic, mammary and mesenchymal stem cells. Specifically, the present invention comprises methods for the increased efficacy of autologous stem cell transplants.
Terms: With regard to present disclosure above and below, the following terms are to be understood as follows.
SHIP—as used herein refers to the SH2-containing inositol-5-phosphatase-1. SHIP contains an amino-terminal src-homolgy domain (SH2), a 5′phosphoninositol phosphate domain, two phosphotyrosine binding consensus sequences, and a praline-rich region located in the carboxyl terminus.
Inhibition of SHIP function—as used herein refers to any genetic, or non-genetic, means for inhibiting SHIP function or expression. The term is meant to comprise any method of achieving this result known in the art. The term includes all methods known, as well as any substance which inhibits SHIP function or expression. Examples include, but are not limited to, RNA interference, antisense oligonucleotides, ribozymes, DNAzymes, nucleic acid modifiers, PNAs, nonstandard nucleic acids, aptamers, decoys, oligonucleotide based gene regulation, substrate mimics, molecular inhibitors and dominant/negative mutants.
Ex Vivo—as used herein refers to transfecting, contacting, or administering a substance to a cell outside of the body. As an example, a cell which shows expression of SHIP is removed from the host. The cell is then transfected, contacted, or administered with a substance that either inhibits SHIP expression or function. The cell is then either transplanted into the host, or allowed to propagate a new population of SHIP deficient cells, in the case of inhibition of SHIP expression, or cells in which SHIP function has been silenced (function).
Administering or Contacting—as used herein refers to the process of delivering to a cell, ex vivo, or a host, in vivo, a therapeutic substance, or a combination of several therapeutic substances. The process can include any method known in the art and is dependent on the type of substance or substances administered. Possible methods include, but are not limited to, parenteral (i.e. subcutaneously, intravenously, intramuscularly, intra-arterially, and direct injection into a tissue or organ), mucosal (i.e. intranasally), pulmonary (i.e. via inhalation), topical, via catheter (i.e. iontopheretically) or orally. Administration is usually achieved via a pharmaceutically acceptable carrier.
Gene Therapy—as used herein refers to a therapeutic method of delivery wherein the therapeutic agent is a polynucleotide capable of accomplishing a therapeutic goal when expressed as a transcript, an interfering RNA, an anti-sense polynucleotide or a polypeptide in the host or cell.
Therapeutically Effective Amount—as used herein is that amount of a substance necessary to achieve a desired therapeutic result. For example, if the therapeutic result desired is the enhanced yield of stem cells, the therapeutically effective amount is that amount that facilitates, or achieves, an increase in the total number of stem cells in a given population. The therapeutically effective amount can be a dosage administered in at least one amount and can include an administration protocol spanning several days or weeks.
Genetic Assembly—as used herein refers to any construct which is capable of modulating the expression of a target sequence or gene. Genetic assemblies can include transcriptional promoter/enhancers, locus defining elements, or any element that controls gene expression by any means (i.e. RNAi, alternate splicing, nuclear RNA export, post-translational modification of intermediaries or proteins). The genetic assembly optimally includes a sequence which is operably linked to the target sequence or gene, when expressed, and acts as a translation initiation sequence.
Autologous Transplantation
In one embodiment, the invention provides a method for increasing the yield of stem cells in a patient, in vivo, for autologous transplantation. Such a treatment is valuable for any disease, or genetic impairment, requiring treatment by bone marrow transplant (i.e. cancer, autoimmune deficiencies, HIV/AIDS), blood transplantation (e.g. mobilized stem cells), or stem cell transplant from any tissue source (stem cell transplants may come from non-BM stem cell populations, such as neural stem cells from the CNS, and therefore SHIP inhibition can increase these populations as well, as well as their mobilization to the blood (as it does for hematopoetic stem cells). The non-hematopoietic stem cells can be mobilized to the blood, which would greatly reduce the obstacles faced with collecting cells from bone marrow, brain, or other solid organs). It is known that current hematopoietic stem call therapies face significant obstacles due to the inability to acquire sufficient numbers of hematopoietic stem cells (HSC) from the patient for transplant. Accordingly, organ-specific stem cell transplants are not currently being done routinely in a clinical setting. In addition to the difficulty in acquiring these cells, efficacious treatments are hindered by the cells inability to efficiently home and engraft after infusion into circulation.
Therefore, in one embodiment, a substance that inhibits SHIP is administered to the patient prior to harvesting of the target stem cells. After treatment has been administered for a therapeutically effective time, stem cells are collected and transplanted back into the same host. This has the advantage of avoiding both rejection by the host and Graft Versus Host Disease, wherein the immune response of the grafted tissue attacks the host. Administration of the substance can take the form of genetic assembly or a pharmaceutical agent. These may include nucleic acids, or any substance, that inhibits SHIP function or expression, or leads to the expression of any antagonist of SHIP function. The genetic assembly can be linked to a promoter and other signals directing expression of a protein SHIP antagonist. Antisense oligonucleotides are also viable assemblies. Other possible genetic assemblies include, but are not limited to, RNA interference molecules (sRNA), enzymatic inhibitors, ribozymes, DNAzymes, nucleic acid modifiers, dominant/negative mutants, PNAs (or other nonstandard nucleic acids), aptamers, SHIP specific decoys and oligo based gene regulators.
In another embodiment, the efficiency of autologous tissue transplantation is greatly enhanced by removal of the threat of rejection or GVHD in a patient, ex vivo, through inhibition of SHIP function. Here, stem cells are collected prior to inhibition of SHIP activity. After the cells are collected they are contacted with an effective amount of a substance which inhibits SHIP activity. The cells are then allowed to propagate to increase their number in the presence of the SHIP inhibitor. When a therapeutically effective population of cells is achieved the cells are transplanted back to the host.
The number of hematopoietic stem cells (HSC), mammary stem cells (MSC) and mesenchymal stem cells (MeSC) is increased in vivo in SHIP-deficient mice. Thus, inhibition of SHIP expression or activity prior to harvest, or ex vivo after harvesting, allows greater numbers of organ-specific stem cells to be used for transplant and thus ensures that an adequate dose of stem cells is available for transplantation or gene modification. In addition to this quantitative effect, SHIP deficiency increases the proportion of actively dividing stem cells and thus SHIP-deficiency also has a beneficial qualitative effect on stem cell function. SHIP-deficiency also enhances the homing ability of stem cells to the tissue sites that are necessary for their engraftment (e.g. SCF, CXCR4). SHIP is known to increase the migration of differentiated hematopoietic cells to SCF and CXCR4, therefore SHIP inhibition enhances tissue homing of stem cells after their injection or transplantation.
Particularly, the increased cycling capacity of SHIP-deficient HSC enhances their ability to repopulate a damaged organ and their ability to be transduced by various gene delivery systems. Other features of stem cells are also enhanced by SHIP deficiency, such as homing to the damaged organ or cytokine-stimulated mobilization to the blood for stem cell collection. In a similar manner, inhibition of SHIP expression or activity can also be used to increase the number of organ-specific stem cells obtained from differentiation of pluripotent stem cells (ES cells). Thus, the development of a method to specifically inhibit SHIP expression or activity is a means to enhance stem cell harvesting, gene modification, homing and collection from the peripheral blood or lymph.
Included herein are thirteen (13) SHIP1 siRNA target sequences (Seq. ID. Nos. 1-13). These sequences are predicted to have strong specificity and strong knockdown against the human SHIP1 cDNA sequence. The cDNA is about 4800+ nt (Seq. ID. No. 14). Accordingly other target sequences are available, however, those listed (13) have a strong predictability factor in vivo.
Long Term Repopulation Modulation: In addition to the present inventions unexpected findings with regard to the enhancement of stem populations in a SHIP deficient environment, the present invention also relates to the novel and unexpected finding that SHIP deficient cells experience difficulty with regard to long-term repopulation of the blood system in comparison to wild-type hematopoietic stem cells.
Therefore, in another embodiment, interference with SHIP function can be used to temporarily expand the hematopoietic stem cell compartment to assist with leukapheresis, to promote hematopoietic recovery after myeloablation treatments, to deplete target stem cell clones (such a leukemic clones and other tumor stem cell types), and to deplete, or damage, the repopulating ability of the endogenous hematopoietic stem cell pool in order to allow transplanted hematopoietic stem cells to better home and engraft and to increase mesenchymal and stem cells number in vivo and ex vivo.
Alternatively, endogenous stem cells may not need to be harvested for subsequent return to the patient. The patient could be treated for a temporary period with SHIP inhibitors to increase the cycling of HSC to allow more rapid recovery of key blood cell populations (e.g. platelets, granulocytes, erythroid cells) after myeloablation. The same principle could also be applied to other stem cell populations in diseases where damage to tissues can be repaired by increasing the cycling and repopulation capacity of the stem cells for that tissue.
The ability of normal HSC to contribute to normal blood cell production is damaged by prolonged SHIP deficiency (9-12 weeks). This may occur by increasing the division rate of these cells and therefore prematurely “aging” these cells. Therefore, prolonged SHIP deficiency might also be used to burn out or “age” leukemic or tumor stem cell clones that must replenish cells of the leukemia or tumor. SHIP inhibitors might be combined with chemotherapeutic or other anti-cancer agents.
Treatment with SHIP inhibitors could also be used to age endogenous stem cell populations so that stem cell transplants (autologous or allogeneic) could compete more effectively for the tissues niches that support stem cell engraftment.
In
The statistical analysis was performed using the unpaired Student t test in Prism 4. Results were considered significant when p<0.005. *p<0.05.
In
Four (4) months after transplantation, the proportion of hematopoietic cells derived from the WT KTLS is significantly higher than the one derived from SHIP−/− KTLS cells. B) shows the level of reconstitution, 4 months after transplantation, in 3 different hematopoietic lineage to show that the cells are pluripotent. Again the level of reconstitution from the WTKTLS is significantly higher than from SHIP−/− KTLS. This is the result of 11 mice done in two different experiments. Statistical significance was established using Prism 4 software,
unpaired student t test. +p>0.05, * p<0.01, **p<0.005, ***p<0.05.
(A) Level of reconstitution of the hematopoietic system by the tested donor BM. WT BM level of reconstitution is significantly higher than for SHIP−/− BM. Student t test p<0.0001. (B) Number of competitive repopulation unit (CRU) was established following a method developed by D. E. Harrison, where donor CRU=(10×% donor)/(100−% donor). 10 is the number of of CRU present in the competing BM (Ly5.1). WT BM has a significantly higher number of CRU compared to SHIP−/− mice. Unpaired t test p=0.0005.
It will be seen that the objects set forth above, and those made apparent from the foregoing description, are efficiently attained and since certain changes may be made in the above construction without departing from the scope of the invention, it is intended that all matters contained in the foregoing description or shown in the accompanying drawings shall be interpreted as illustrative and not in a limiting sense.
It is also to be understood that the following claims are intended to cover all of the generic and specific features of the invention herein described, and all statements of the scope of the invention which, as a matter of language, might be the to fall therebetween. Now that the invention has been described,
Reference to Related Applications: This invention is based on priority document U.S. Provisional Application titled, “Inhibition of SHIP to Enhance Stem Cell Harvest and Transplantation,” Application Ser. No. 60/320,233 filed on May 28, 2003. This application claims the benefit under 35 U.S.C. §120, as a continuation-in-part (CIP) of the co-pending United States application listed below, and insofar as the subject matter of each of the claims of this application is not disclosed in the manner provided by the first paragraph of 35 U.S.C. §120,1 acknowledge the duty to disclose material information as defined in 37 C.F.R. §1.56(a), which occurred between the filing date of this application and the filing date of application Ser. No. 09/955,174, Filed Sep. 19, 2001.
Statement of Government Interest: The invention described herein may be manufactured and used by the Government of the United States of America for governmental purposes without payment of any royalties thereon.
Number | Date | Country | |
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60320233 | May 2003 | US |
Number | Date | Country | |
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Parent | 09955174 | Sep 2001 | US |
Child | 10709801 | May 2004 | US |