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1. (WO2010081112) PREVENTION AND/OR TREATMENT OF MULTIPLE ORGAN DYSFUNCTION SYNDROME WITH INTERLEUKIN-22
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Use of Interleukin-22 for the prevention and/or treatment of multiple organ dysfunction syndrome (MODS)

FIELD OF INVENTION

[0001] This invention relates to the medical use of Interleukin-22 (IL-22).

BACKGROUND OF INVENTION

[0002] Multiple organ dysfunction syndrome (MODS), previously known as multiple organ failure (MOF), is altered organ function in an acutely ill patient such that homeostasis cannot be maintained without medical intervention. It is well established that Systemic Inflammatory Response Syndrome (SIRS) will lead to sepsis or severe sepsis and eventually lead to MODS. MODS usually results from uncontrolled inflammatory response which is triggered by infection, injury (accident or surgery), hypoperfusion and/or hypermetabolism. The uncontrolled inflammatory response will lead to SIRS or sepsis.

[0003] SIRS is an inflammatory state affecting the whole body. It is one of several conditions related to systemic inflammation, organ dysfunction, and organ failure. SIRS is a subset of cytokine storm, in which there is abnormal regulation of various cytokines. The cause of SIRS can be classified as infectious or noninfectious. SIRS is also closely related to sepsis. When SIRS is due to an infection, it is considered as sepsis. Noninfectious causes of SIRS include trauma, burns, pancreatitis, ischemia and hemorrhage. Sepsis is a serious medical condition characterized by a whole-body inflammatory state. Sepsis can lead to septic shock, multiple organ dysfunction syndrome and death. Both SIRS and sepsis could ultimately progress to MODS.

[0004] The underline mechanism of MODS is not well understood. At present there is no agent that can reverse the established organ failure. Therapy therefore is limited to supportive care. Prevention and treatment for MODS, MOF or sepsis are important to emergency medical service, for treatment of injury caused by traffic accident, burns, heart attacks, and severe infective diseases. Therefore, the development of an effective drug is in urgent need for patients.

SUMMARY OF INVENTION

[0005] It is therefore an object of the present invention to provide a therapeutic composition and method for MODS, MOF or sepsis.

[0006] Accordingly, the present invention, in one aspect, provides the use of interleukin-22 (IL-22) in manufacture of a composition for preventing and/or treating MODS, MOF, sepsis, or liver failure.

[0007] In another aspect, the present invention provides a method for the prevention and the treatment of MODS, MOF, sepsis, or liver failure in a subject, the method comprising administering a pharmaceutically effective amount of IL-22. In a further aspect, the present invention relates to the use of IL-22 in the manufacture of a medicament for preventing and treating MODS, MOF, sepsis, or liver failure. MODS, MOF or sepsis may be caused by, among other causes, trauma such as traffic accidents, burns, heart attack, and severe infective diseases.

[0008] In various aspects, IL-22 of the present invention includes but is not limited to mammal IL-22 and recombinant mammal IL-22. In a preferred embodiment, IL-22 is human IL-22.

BRIEF DESCRIPTION OF FIGURES

[0009] Figure 1 shows the Murine inter leukin-22 cDNA sequence.

[0010] Figure 2 shows the Human interleukin-22 cDNA sequence.

[0011] Figure 3 shows the Murine interleukin-22 amino acid sequence.

[0012] Figure 4 shows the Human interleukin-22 amino acid sequence.

[0013] Figure 5 shows that IL-22 increased animal survival in LPS-induced sepsis shock in mice.

[0014] Figure 6 shows that IL-22 protects LPS-induced multiple organ failure in rats caused by cachexia.

[0015] Figure 7 shows that IL-22 protected animal from death in LPS/GalN-induced acute liver failure in mice.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS [0016] Example 1: Human and murine IL-22 gene cloning

[0017] Cloning of human IL-22 gene: Human peripheral blood monocytes were stimulated with anti-human CD3 mAb and cultured for 24 h. Total RNA was extracted by ultracentrifugation, and cDNA was synthesized with the dT primers. Human IL-22 gene was amplified by PCR with the sense primer (5'-GCA GAA TCT TCA GAA CAG GTT C-3') and anti-sense primer (5'-GGC ATC TAA TTG TTA TTT CTA G-3'). The amplified DNA is cloned into E.coli expression vector.

[0018] Cloning of mouse IL-22 gene: C57BL/6 female mice were injected with LPS (5 mg/kg, sc). The spleen was obtained after 20 hours. Total RNA was extracted and cDNA was synthesized with the dT primers. Mouse IL-22 gene was amplified by PCR with the sense primer (5'-CTC TCA CTT ATC AAC TGT TGA C-3') and anti-sense primer (5'-GAT GAT GGA CGT TAG CTT CTC AC-3'). The amplified cDNA was cloned into E.coli expression vector pET21(+)

[0019] Both human IL-22 and murine IL-22 were verified by DNA sequencing, as shown in Fig. 1 and Fig.2.

[0020] Example 2: human IL-22 and mouse IL-22 gene expression

[0021] E. coli strain BL21(+) was used to express the recombinant protein. The E.coli cells were homogenized under high pressure. IL-22 inclusion bodies were obtained by centrifugation and washed with buffers (Tris-HCl 50 mM, NaCl 100 mM, EDTA 1 mM, DTT 1 mM, and sodium deoxycholate 0.5%) completely. Inclusion bodies were solubilized in 8M urea, 50 mM Mes, 10 mM EDTA, and 0.1 mM DTT, pH 6.5. Inclusion bodies was refolded 4 times for 20 hours in 100 mM Tris-HCl, 2 mM EDTA, 0.5 M L-arginine, 1 mM reduced glutathion, and 0.ImM oxidized glutathion, pH 8. The mixture was then concentrated and purified using a Superdex75 (Amersham) column chromatography. The protein was eluted with 20 mM Tris-HCl, 50 mM NaCl, pH 7. The purity of IL-22 was determined by SDS-PAGE (>95%) as shown in Fig.3 and Fig.4. IL-22 protein aliquot was stored at -80 0C.

[0022] Example 3: Protective Effect of IL-22 on Endotoxin-induced sepsis in mice

[0023] Female Balb/c mice, at 6 to 8 weeks, were treated with lipopolysacchride (LPS, salmonella abortus-equi (L-5886, Sigma) prepared at 1.0 mg/mL saline. 0.2 mL LPS solution was injected by i.p. to mice at dose of 10 mg/kg. Animals were divided to different treatment groups and survival was monitored for 7 days. Single dose of LPS at >12.0 mg/kg could result in 100% animal death at 48 to 72 hrs. LPS dosed at 10 mg/kg single dose resulted in 20 to 30% animal survival by day 7.

[0024] Treatment of mice started with daily subcutaneous injection of recombinant mouse IL-22, at 100 ug/kg, and 500 ug/kg. Control mice were treated with carrier, 0.5% BSA and saline. Results are shown in Fig 5. Control mice (carrier, n=10) had 20% survival by day 7. Treatment of IL-22 at 100 ug/kg and 500 ug/kg resulted in significant animal survival. These results show that IL-22 significantly protect mice from death in LPS-induced sepsis shock model.

[0025] Example 4: Protective Effect of IL-22 on Endotoxin-induced multiple organ failure in rats.

[0026] Animal model of multiple organ failure was established by daily injection of endotoxin (LPS-E-coli; 10 mg/kg/day, Difco) to 6 weeks old male Wister rats. Animals were divided into different treatment groups (n=8). Recombinant mouse IL-22 was administered subcutaneously at 100, 300, and 1000 ug/kg/day daily for 7 days. Control animals were injected with carrier solution only, 0.5% BSA PBS, pH7.0. Serum protein and albumin levels were measured at the end of 7 day treatment.

[0027] Results are shown in Fig 6. Serum levels of total proteins, albumin were decreased in control group, indicating that these rats were suffering from cachexia. Animals treated with rmIL-22 had significantly improved blood chemistry parameters. These data shows that IL-22 was effective in protect multiple organ failure in rats caused by endotoxin-induced cachexia.

[0028] Example 5: Protective Effect of IL-22 on LPS/GalN-induced acute liver failure in mice.

[0029] Lippolysaccharides (LPS, 100 ng/mL, Sigma, Cat: L2630) and D-galactosamine (D-GaIN, 130 mg/mL, Sigma, Cat: G1639) were prepared in pyrogen-free saline. Female BALB/c mice, 6-8 weeks, were injected introperitoneally (i.p.) with 0.2mL solution containing 0.ImL of LPS and 0.1 mL D-GaIN. The injection of LPS/GalN into mice induced acute liver failure evidenced by rapid elevation of liver enzymes (> 20-fold increase compared to control group) including a greater than 20-fold increase of alanine aminotransferase (ALT) and a greater than 40-fold increase of aspartate aminotransferase (AST) in the serum at 8 hrs. Less than 20% mice were viable at 24 hrs after LPS/GalN challenge.

[0030] Treatment of mice started with subcutaneous injection of recombinant mouse IL-22, at 100 ug/kg, and 300 ug/kg. Control mice were treated with carrier, 0.5% BSA and saline. Results are shown in Fig 7. Control mice (carrier, n=10) had 12.5% survival at 16 hrs. Treatment of IL-22 at 100 ug/kg and 300 ug/kg resulted 37.5% and 62.5% (n=10) survival, respectively. These results show that IL-22 significantly protect mice from LPS/GalN induced death mainly resulted from acute liver failure.