Biomaterial-based scaffolds are increasingly being applied as 3D culture systems in vitro and as molecular and cellular delivery vehicles in vivo. To support cellular survival, activation and differentiation, cells need to be provided with biomolecular cues that trigger specific signaling pathways. For instance, to facilitate survival and expansion of primary T lymphocytes, biomolecules that trigger T-cell receptor signaling and provide co-stimulatory cues are required. Therefore, biomolecules such as activating antibodies, protein complexes and polysaccharides need to be integrated into biomaterial-based scaffolds. These can be incorporated in various ways, e.g., through physical entrapment or ionic interaction but these strategies do not result in stable or controlled presentation of biomolecules. Instead, covalent attachment is favored to ensure sustained availability of these signals in a controlled manner.
Many biomaterial systems currently used to provide cells with a defined set of cues (e.g. expanding T cells with activating antibodies) are 2D systems, whereas repeatedly it has been shown that 3D systems resemble the natural cellular microenvironment and can improve cellular survival and behavior. Moreover, in vivo 3D systems can ensure localized and sustained availability of molecular cues and cells.
There is an increasing interest in using macroporous scaffolds as they can support cellular migration, infiltration and dispersion in contrast to many nanoporous 3D biomaterial-based scaffolds. Cryogelation is a technique that allows to create macroporous scaffolds with controllable pore sizes. Another major advantage of the polysaccharide-based (e.g., hyaluronic acid or alginate) cryogels described in this application in particular is their unique mechanical characteristics which allow for minimally invasive delivery of pre-formed constructs through injection, as opposed to many other pre-formed 3D polymer scaffolds that need to be surgically implanted. The use of pre-formed cryogels furthermore circumvents problems associated with injectable hydrogels that gel in situ including lack of control over the location of the gel, loss of cargo and a poorly defined macrostructure.
Biomolecules are mostly incorporated into biomaterial-based scaffolds in a non-covalent manner via adsorption, whereas covalent attachment provides more control, prevents (unwanted) release of the biomolecules and may enhance cellular responses. To create 3D biomaterial-based scaffolds that present signals in a spatiotemporally controlled manner, methods are required that support covalent attachment of biomolecules to scaffolds while preserving their biological activity. For these type of cryogels, methacrylation of biomolecules has been performed to allow covalent integration during cryopolymerization. This process may hamper bioactivity of biomolecules as they are exposed to free radicals but also may get buried within the polymer walls, preventing their presentation externally on the scaffolds.
In certain embodiments, the present invention provides a polymer comprising a moiety of formula (I):
wherein the hydrophilic polymer is crosslinked to one or more additional hydrophilic polymer molecules, and the linker is covalently attached to the hydrophilic polymer.
In certain aspects, the hydrophilic polymer is a polysaccharide. In certain aspects, the polysaccharide is hyaluronic acid or alginic acid.
In certain aspects, the biomolecule is capable of promoting cell expansion.
In further aspects, the present invention provides a cryogel comprising a polymer of the invention.
In certain embodiments, the present invention provides a method of making a cryogel, comprising crosslinking a hydrophilic polymer in an aqueous solvent to generate a crosslinked polymer. In certain embodiments, the hydrophilic polymer is an acrylated or methacrylated polysaccharide. In certain aspects, the acrylated or methacrylated polysaccharide is contacted with a radical initiator in the presence of an acrylate or methacrylate co-monomer.
In further aspects, the present invention provides a formulation comprising a cryogel of the invention and a pharmaceutically acceptable carrier.
The present invention also provides a method of delivering activated T-cells to a tissue, comprising contacting the tissue with a formulation or cryogel of the invention.
Disclosed is a highly modular platform to functionalize 3D cryogel scaffolds by attaching biomolecules in a covalent manner. Owing to their syringe injectability, the cryogels can easily be applied in vivo.
Various biomaterial-based scaffold systems are available to present molecular cues to cells in a 3D environment, although almost all approaches do not apply covalent attachment of biomolecules. The advantage, for example, of using polysaccharide-based (e.g., hyaluronic acid or alginate) cryogels is that they are naturally non-immunogenic, biodegradable and have unique mechanical characteristics which allow for minimally invasive delivery of pre-formed constructs through injection, as opposed to many other pre-formed 3D polymer scaffolds that need to be surgically implanted. The use of pre-formed cryogels furthermore circumvents problems associated with injectable hydrogels that gel in situ including lack of control over the location of the gel, loss of cargo and a poorly defined macrostructure. So far, there are no alternative strategies reported for covalent attachment of biomolecules (e.g., antibodies, protein complexes, enzymes, DNA and polysaccharides) to these polysaccharide-based (e.g., hyaluronic acid or alginate) cryogels. As the presence of co-monomers during scaffold formation is critical to support biomolecule incorporation, this invention provides important insight to enable this approach.
Carboxylic acids are often used for bioconjugation with polymers (synthetic and natural), including hyaluronic acid and alginate. But so far this has not been performed on pre-formed 3D macroporous cryogels while preserving biofunctionality. The critical dependence on co-monomers during scaffold formation has not been reported and is unexpected.
This invention focuses on covalent attachment of a wide range of biomolecules onto pre-formed polymeric cryogels. For example, macroporous cryogels based on hyaluronic acid (HA) or alginate are formed by cryogenic polymerization of methacrylated HA or alginate polymers. The resulting scaffolds are biocompatible, non-immunogenic, support cell survival and display favorable mechanical properties (
The invention is exemplified using HA/alginate cryogels, and describes a new process that enables efficient covalent attachment of biomolecules externally onto the scaffold's walls of pre-formed cryogels (
The invention can be applied, for example, for the efficient expansion of multifunctional primary T cells for adoptive T cell therapy purposes, and for the delivery of T cell-loaded activating HAGM cryogels through needle-mediated injection (
U.S. Pat. No. 10,045,947 discloses injectable preformed macroscopic 3-dimensional scaffolds for minimally invasive administration (hereby incorporated by reference). U.S. Pat. No. 9,675,561 discloses injectable cryogel vaccine devices and methods of use thereof (hereby incorporated by reference).
The term “residue” as used herein means a portion of a chemical structure that may be truncated or bonded to another chemical moiety through any of its substitutable atoms. As an example, the structure of glycidyl methacrylate is depicted below:
Residues of glycidyl methacrylate include, but are not limited to, any of the following structures:
An “alkyl” group is a straight chained or branched non-aromatic hydrocarbon which is completely saturated. Typically, a straight chained or branched alkyl group has from 1 to about 20 carbon atoms, preferably from 1 to about 10 unless otherwise defined. Examples of straight chained and branched alkyl groups include methyl, ethyl, n-propyl, iso-propyl, n-butyl, sec-butyl, tert-butyl, pentyl, hexyl, pentyl and octyl. A C1-C6 straight chained or branched alkyl group is also referred to as a “lower alkyl” group.
The term “hydrophilic polymer” is used to mean repeating units of biological or chemical moieties that is compatible with a biological system or that mimics naturally occurring polymers. Bio-compatible polymers may be synthetic or naturally derived. Representative hydrophilic polymers include, but are not limited to oligonucleotides, polynucleotides, peptides, polypeptides, proteins, hormones, oligosaccharides, polysaccharides, lipids, glycolipids, lipopolysaccharides, phospholipids, synthetic analogues of the foregoing and combinations of the foregoing. More specifically, suitable polymers and monomers include naturally derived polymers (alginate, hyaluronic acid, chitosan, heparin, cellulose ethers (e.g. carboxymethyl cellulose, cellulose), elastin, gelatin, starch, carob gum, pectin, guar gum, carrageenan collagen, xanthan gum, fibronectin, elastin, albumin, etc.) and synthetic polymers (poly(ethylene glycol) (PEG), PEG-derivatives such as PEG-co-poly(glycolic acid; PGA) and PEG-co-poly(L-lactide; PLA), poly(2-hydroxyethyl methacrylate) (pHEMA), poly-2-hydroxyethylacrylate (polyHEA), PAAm, poly(N-isopropylacrylamide) (PNIPAAm), polyamines and polyethyleneimines, polyvinyl alcohol, polyacrylamides, polyacrylic acid, polymethacrylic acid, and so forth. Exemplary bio-compatible polymers useful in the invention include gelatin, gelatin-based bio-compatible polymers, hyaluronic acid, and hyaluronic acid-based bio-compatible polymers.
The term “crosslinking” or “crosslinked” refers to one or more chemical linkages between a compound and a polymer, two polymers (e.g., two polypeptides), or two different regions of the same polymer (e.g., two regions of one protein).
A “cryogel”, as used herein, refers to a hydrogel that has undergone cross-linking at a temperature below the solvent freezing point (e.g., 0° C. for water). As used herein, the term “hydrogel” refers to a network of polymer chains (e.g., recombinant proteins) in which water or a solvent acts as a dispersion medium. In some embodiments, hydrogels have tunable mechanical properties which are not possible to achieve with other compositions, such as biofilms. In some embodiments, a hydrogel may be self-healing, in that the hydrogel can be broken apart and put back together. In other words, dried pieces of a hydrogel can be rehydrated and assembled together using the re-hydrated gel as a “glue.”
When used in a polymeric linking moiety, polyethylene glycol can consist of 2 repeat units of ethylene glycol up to 500,000 repeat units of ethylene glycol. The average molecular weight of the PEG moiety may be about 100 Da to about 10,000 Da, about 500 Da to about 5000 Da, about 1000 Da to about 5000 Da, about 2000 Da to about 5000 Da, or about 3500 Da.
As used herein, the term “pharmaceutically acceptable” or “pharmacologically acceptable” refers to those compounds, materials, compositions, and/or dosage forms which are, within the scope of sound medical judgment, suitable for use in contact with the tissues of human beings and animals without excessive toxicity, irritation, allergic response, or other problem or complication, commensurate with a reasonable benefit/risk ratio. Moreover, for animal (e.g., human) administration, it will be understood that compositions should meet sterility, pyrogenicity, general safety and purity standards as required by the FDA Office of Biological Standards.
The formulations comprising a cryogel of the invention, which formulations are described hereinbelow, may optionally contain a pharmaceutically acceptable excipient.
As used herein, the term “pharmaceutically acceptable excipient” means a pharmaceutically-acceptable material, composition or vehicle, such as a liquid or solid filler, diluent, excipient, manufacturing aid (e.g., lubricant, talc magnesium, calcium or zinc stearate, or steric acid), or solvent encapsulating material, involved in carrying or transporting the subject compound from one organ, or portion of the body, to another organ, or portion of the body. Each carrier must be “acceptable” in the sense of being compatible with the other ingredients of the formulation and not injurious to the patient. Some examples of materials which can serve as pharmaceutically-acceptable excipients include: (1) sugars, such as lactose, glucose and sucrose; (2) starches, such as corn starch and potato starch; (3) cellulose, and its derivatives, such as sodium carboxymethyl cellulose, methylcellulose, ethyl cellulose, microcrystalline cellulose and cellulose acetate; (4) powdered tragacanth; (5) malt; (6) gelatin; (7) lubricating agents, such as magnesium stearate, sodium lauryl sulfate and talc; (8) excipients, such as cocoa butter and suppository waxes; (9) oils, such as peanut oil, cottonseed oil, safflower oil, sesame oil, olive oil, corn oil and soybean oil; (10) glycols, such as propylene glycol; (11) polyols, such as glycerin, sorbitol, mannitol and polyethylene glycol (PEG); (12) esters, such as ethyl oleate and ethyl laurate; (13) agar; (14) buffering agents, such as magnesium hydroxide and aluminum hydroxide; (15) alginic acid; (16) pyrogen-free water; (17) isotonic saline; (18) Ringer's solution; (19) ethyl alcohol; (20) pH buffered solutions; (21) polyesters, polycarbonates and/or polyanhydrides; (22) bulking agents, such as polypeptides and amino acids (23) serum component, such as serum albumin, HDL and LDL; (22) C2-C12 alcohols, such as ethanol; and (23) other non-toxic compatible substances employed in pharmaceutical formulations. Wetting agents, coloring agents, release agents, coating agents, disintegrating agents, binders, sweetening agents, flavoring agents, perfuming agents, protease inhibitors, plasticizers, emulsifiers, stabilizing agents, viscosity increasing agents, film forming agents, solubilizing agents, surfactants, preservative and antioxidants can also be present in the formulation. The terms such as “excipient”, “carrier”, “pharmaceutically acceptable excipient” or the like are used interchangeably herein.
The present invention also contemplates pharmaceutically acceptable salts of the compounds of the invention. In certain embodiments, contemplated salts of the invention include, but are not limited to, alkyl, dialkyl, trialkyl or tetra-alkyl ammonium salts. In certain embodiments, contemplated salts of the invention include, but are not limited to, L-arginine, benenthamine, benzathine, betaine, calcium hydroxide, choline, deanol, diethanolamine, diethylamine, 2-(diethylamino)ethanol, ethanolamine, ethylenediamine, N-methylglucamine, hydrabamine, 1H-imidazole, lithium, L-lysine, magnesium, 4-(2-hydroxyethyl)morpholine, piperazine, potassium, 1-(2-hydroxyethyl)pyrrolidine, sodium, triethanolamine, tromethamine, and zinc salts. In certain embodiments, contemplated salts of the invention include, but are not limited to, Na, Ca, K, Mg, Zn or other metal salts.
The pharmaceutically acceptable acid addition salts can also exist as various solvates, such as with water, methanol, ethanol, dimethylformamide, and the like. Mixtures of such solvates can also be prepared. The source of such solvate can be from the solvent of crystallization, inherent in the solvent of preparation or crystallization, or adventitious to such solvent.
In certain embodiments, the present invention provides a polymer comprising a moiety of formula (I):
wherein the hydrophilic polymer is crosslinked to one or more additional hydrophilic polymer molecules, and the linker is covalently attached to the hydrophilic polymer.
In certain embodiments, the hydrophilic polymer is a synthetic polymer or a polysaccharide, protein or peptide. In certain embodiments, the hydrophilic polymer is a polysaccharide. In certain embodiments, the polysaccharide is selected from hyaluronic acid, alginic acid, chitosan, dextran, heparin and hydroxyethylcellulose. In certain embodiments, the polysaccharide is a polyuronic acid. In certain embodiments, the polysaccharide is hyaluronic acid or alginic acid.
In certain embodiments, the crosslinks are covalent. In certain embodiments, the polymer is crosslinked via acrylate or methacrylate residues. In certain embodiments, the crosslinks are derived from glycidyl methacrylate residues.
In certain embodiments, the linker is covalently attached to the hydrophilic polymer via a carboxyl group. In certain embodiments, the linker comprises one or more groups selected from alkyl, amide, triazole and polyether. In certain embodiments, the linker comprises a residue derived from dibenzocyclooctyne (DBCO). In certain embodiments, the linker comprises a hydrophilic polymer. In certain embodiments, the linker comprises a polyethylene glycol (PEG) group. In certain embodiments, the polyethylene glycol (PEG) group has a molecular weight of from about 0.5 to about 50 kDa. In certain embodiments, the polyethylene glycol (PEG) group has a molecular weight of about 3 kDa. In certain embodiments, the linker comprises a residue derived from azido-propylamine. In certain embodiments, the linker comprises a residue derived from dibenzocyclooctyne-PEG4-N-hydroxysuccinimidyl ester or dib enzocyclooctyne-PEG4-amine.
In certain embodiments, the biomolecule is selected from antibodies, protein complexes enzymes, DNA and polysaccharides. In certain embodiments, the biomolecule is capable of promoting cell expansion. In certain embodiments, the cells are non-immune cells. In certain embodiments, wherein the cells are stem cells. In certain embodiments, the cells are immune cells. In certain embodiments, the cells are selected from T cells, NK cells and dendritic cells. In certain embodiments, the cells are T cells. In certain embodiments, the biomolecule is selected from heparin, a CD3 antibody, a CD28 antibody and a peptide-major histocompatibility complex (pMHC).
In certain embodiments, the invention provides a cryogel comprising a polymer of any one of the preceding claims. In certain embodiments, the invention provides a method of expanding cells, comprising contacting one or more cells with a polymer or a cryogel of the invention. In certain embodiments, the cells are T cells.
In certain embodiments, the present invention provides a method of making a cryogel, comprising crosslinking a hydrophilic polymer in an aqueous solvent to generate a crosslinked polymer. In certain embodiments, the hydrophilic polymer is a polysaccharide. In certain embodiments, the polysaccharide is acrylated or methacrylated.
In certain embodiments, the acrylated or methacrylated polysaccharide is reacted with an acrylate or methacrylate co-monomer. In certain embodiments, the molar ratio of acrylate or methacrylate co-monomer to acrylate or methacrylate groups in the acrylated or methacrylated polysaccharide is at least about 0.1:1. In certain embodiments, the molar ratio of acrylate or methacrylate co-monomer to acrylate or methacrylate groups in the acrylated or methacrylated polysaccharide is from about 0.1:1 to about 30:1. In certain embodiments, the molar ratio of acrylate or methacrylate co-monomer to acrylate or methacrylate groups in the acrylated or methacrylated polysaccharide is about 1:1 to 20:1. In certain embodiments, the acrylate or methacrylate co-monomer is glycidyl methacrylate. In certain embodiments, the polysaccharide is selected from hyaluronic acid, alginic acid, chitosan, dextran, heparin and hydroxyethylcellulose. In certain embodiments, the acrylated or methacrylated polysaccharide is hyaluronic acid methacrylate (HAGM) or alginate methacrylate. In certain embodiments, the degree of methacrylation of the polysaccharide from about 1 to 90 mol %.
In certain embodiments, the acrylated or methacrylated polysaccharide is reacted with the acrylate or methacrylate co-monomer in the presence of a radical initiator. In certain embodiments, the aqueous solvent is frozen after the acrylated or methacrylated polysaccharide is contacted with the radical initiator (such as a redox initiator (e.g., ammonium persulfate/tetramethylethylenediamine (APS/TEMED)) or a photoinitiator (e.g., Irgacure 2959).
In certain embodiments, the cryogel is crosslinked by polycondensation, click-chemistry, Michael-type addition or enzymatically. In certain embodiments, the cryogel is crosslinked by click-chemistry. In certain embodiments, the cryogel is physically and/or non-covalently crosslinked by e.g., peptide-peptide, ionic and/or hydrophobic interactions.
In certain embodiments, the crosslinked polymer is reacted with a linker that comprises an azide, alkyne, alkene or thiol group. In certain embodiments, the crosslinked polymer is reacted with azido-terminated molecule such as azido-amine derivatives (azido-PEG-amine, azido, ethylamine, etc) or azido-alcohol derivatives (azido-PEG-amine, azido-propanol, etc) or with moieties that contain alkene, alkyne or thiol groups. In certain embodiments, the crosslinked polymer is reacted with an azido-propylamine in the presence of a coupling system. In certain embodiments, the coupling system comprises one or more aminium, phosphonium, carbodiimide or N-hydroxy reagents. In certain embodiments, the coupling system comprises N-hydroxysuccinimide and ethyl(dimethylaminopropyl) carbodiimide.
In certain embodiments, the crosslinked polymer is reacted with a biomolecule that is conjugated to a dibenzocyclooctyne (DBCO) moiety. In certain embodiments, the invention provides cryogel prepared according to the method of the invention.
In certain embodiments, the invention provides a method of expanding cells, comprising contacting one or more cells with a cryogel of the invention. In certain embodiments, the cells are non-immune cells. In certain embodiments, the cells are stem cells. In certain embodiments, the cells are immune cells. In certain embodiments, the cells are selected from T cells, NK cells and dendritic cells. In certain embodiments, the cells are T cells.
In certain embodiments, the invention provides a cryogel of the invention and a pharmaceutically acceptable carrier. In certain embodiments, the formulation is injectable.
In certain embodiments, the invention provides a method of delivering a biomolecule to a tissue, comprising contacting the tissue with the formulation of the invention. In certain embodiments, the invention provides a method of delivering activated T-cells to a tissue, comprising contacting the tissue with a formulation or cryogel of the invention.
The shape of the cryogel is dictated by a mold and can thus take on any shape desired by the fabricator, e.g., various sizes and shapes (disc, cylinders, squares, cubes, spheres, fibers, strings, foam, etc.) are prepared by cryogenic polymerization. Injectable cryogels can be prepared in the micrometer-scale to centimeter-scale. For instance, cube-shaped (i.e., cubiform) cryogels (4×4×1, 5×5×1, or 10×10×1 mm3) were fabricated and injected through a standard 16 G hypodermic needle.
The invention allows for covalent attachment of biomolecules that are presented externally on polymer's walls of 3D macroporous biomaterial-based scaffolds, instead of non-covalent methods of presenting biomolecules on these scaffolds (via ionic interactions, hydrophobic interactions, physical entrapment, etc.). The labelling method that is proposed is highly modular, efficient and is dependent on the presence of co-monomers during cryogel fabrication (
The cryogels of the invention may be useful as 3D culture systems to provide cells with stimulatory/survival cues; as tools to study ex vivo interaction of cells and molecular cues in a controlled context. Enhance immunotherapeutic approaches: e.g. ex vivo (T) cell expansion, in vivo (immune) cell stimulation.
The advantages of the materials disclosed herein include: high modularity; efficient and easy to work with; easy to wash away potential toxic molecules used for labelling; biomolecules attached in a covalent manner and presented externally on the scaffold's walls; bioavailability of molecules is retained as molecules are not exposed to freeze/thawing and free-radical polymerization during cryogel formation (which happens when molecules are physically entrapped); versatile platform for production of cryogels. Any water soluble polymers (synthetic and natural) and monomers can potentially be used.
HAGM cryogel. 30 pores of 3 different cryogels stained with rhodamine-labelled poly-L-lysine were measured. (D) Representative scanning electron microscopy images of a 4×4×1 mm [3% (wt/vol)] BMW HAGM cryogel. Scale bar equals 1 mm (left) and 100 μm (right). (E) Injectability of alginate cryogels with or without [0.4% (wt/vol)] RGD containing 50 μg of OVA/TLR NP. (F,G) The percentage of 7AAD−AnnexinV−viable human pan T cells
(F) or mouse BMDCs (G) after 24 (F) or 48 hours (F,G) culturing in medium, 3D collagen gels or cryogels. n=2-3 in 2-3 independent experiments. Values represent mean±SEM.
Fluorescence quantification of HAGM cryogels labelled with human αCD3-A488. n=3 for +linker, n=2 for −linker in 1 independent experiment. (C,D) Primary human pan T cells were stimulated with cryogels of batch LMW.1 (n=2 in 2 independent experiments), LMW.2 (n=3 in 3 independent experiments) or LMW.2 where HPMA was added as a co-monomer at [0.8% wt/vol)] (n=3 in 1 independent experiment). Cryogels were labelled with varying densities of αCD3-A488 and αCD28-A647, and the mean proliferation cycle (C) after 72 hours and IFNγ production (D) after 24 hours were determined. (E-F) Representative macroscopic image (E) and fluorescence quantification (F) of [4% (wt/vol)] HAGM LMW cryogels labelled with amine-Cy5 linker. n=5-10 in 2-3 independent experiments. Data was analyzed using a two-way ANOVA and Tukey's/Sidak's multiple comparisons test. Stars indicate significance compared to—, unless indicated otherwise. (G-H) Representative macroscopic image (G) and fluorescence quantification (H) of [3% (wt/vol)] HAGM HMW cryogels made with increasing amounts of GM and labelled with an amine-Cy5 linker. n=3-9 in 1-3 independent experiments. Statistical significance was tested on log-transformed data using a Kruskal Wallis test and Dunnett's multiple comparisons test. Stars indicate significance compared to [0% (wt/vol)] GM. (I) The injectability of [3% (wt/vol)] HAGM HMW cryogels through a 16 G needle was tested. Scale bar equals 4 mm. (J) Fluorescence quantification of [2.3% (wt/vol)] alginate cryogels labelled with amine-Cy5 linker. n=3 in 1 independent experiment.
(B-D, F, H, J) Values represent mean±SEM. Stars indicate significance compared to empty cryogels unless indicated otherwise. (B, H, J) Data were analyzed for statistical significance with a Kruskal Wallis test and Dunn's multiple comparisons test (B,H) or one-way anova (J) on log-transformed data (H,J). (C, D, F) Statistical significance was testing using a two-way anova and Dunnett's or Sidak's multiple comparison test.
All of the U.S. patents and U.S. and PCT published patent applications cited herein are hereby incorporated by reference.
The foregoing written specification is considered to be sufficient to enable one skilled in the art to practice the invention. The present invention is not to be limited in scope by examples provided, since the examples are intended as a single illustration of one aspect of the invention and other functionally equivalent embodiments are within the scope of the invention. Various modifications of the invention in addition to those shown and described herein will become apparent to those skilled in the art from the foregoing description and fall within the scope of the appended claims. The advantages and objects of the invention are not necessarily encompassed by each embodiment of the invention.
This application claims the benefit of priority to U.S. Provisional Patent Application No. 62/945,563, filed Dec. 9, 2019, which is incorporated herein by reference in its entirety.
Filing Document | Filing Date | Country | Kind |
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PCT/US20/64031 | 12/9/2020 | WO |
Number | Date | Country | |
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62945563 | Dec 2019 | US |