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1. WO2012065133 - IMMUNOMODULATORY METHODS AND SYSTEMS FOR TREATMENT AND/OR PREVENTION OF ANEURYSMS

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[ EN ]
Immunomodulatory Methods and Systems for Treatment and/or

Prevention of Aneurysms

CROSS REFERENCE TO RELATED APPLICATIONS

[0001] The present application claims priority to US Provisional Application S/N 61/413,372 entitled Immunomodulatory Methods and Systems for Treatment and/or Prevention of Aneurysms" filed on November 12, 2010, with docket number P686-USP, which is herein incorporated by reference in its entirety The present application is also related to PCT application WO 02/080954 filed on April 5, 2002, PCT application S/N entitled

"Immunomodulatory Methods and Systems for Treatment and/or Prevention of Hypertension" filed on November 11, 2011 with docket number P694-PCT, and to PCT application

S/N entitled "Immunomodulatory Compositions, Methods And Systems Comprising

Immunogenic Fragments Of ApoblOO" filed on November 11, 2011 with attorney docket P700-PCT, each of which is herein incorporated by reference in its entirety.

FIELD

[0002] The present disclosure relates to immunomodulatory methods, systems, compositions, and vaccines that are particularly suitable for the treatment or prevention of an aneurysm and/or of a condition associated thereto.

BACKGROUND

[0003] Aneurysm formation affects an increasing percentage of the population. Treatment of aneurysms is currently performed mainly through various types of surgical procedures.

[0004] For example, arterial aneurysms are typically treated through surgical intervention, or watchful waiting in combination with control of blood pressure and other risk factors. In recent years, endovascular or minimally invasive techniques have been developed for many types of aneurysms.

[0005] Providing an effective treatment and/or prevention for aneurysms is currently still challenging.

SUMMARY

[0006] Provided herein are methods and systems that allow in several embodiments treatment and/or prevention of aneurysms in an individual, which in an embodiment can be used in combination or in place of a surgical intervention.

[0007] According to a first aspect, a method to treat and/or prevent an aneurysm and/or a condition associated thereto is described. The method comprises administering to an individual an immunogenic fragment of ApoBlOO or an immunogenically active portion thereof.

[0008] According to a second aspect, a method to treat and/or prevent an aneurysm and/or a condition associated thereto is described. The method comprises administering to an individual CD8(+) T cells specific for an immunogenic fragment of ApoB-100 or an immunogenically active portion thereof.

[0009] According to a third aspect, a system to treat and/or prevent an aneurysm and/or a condition associated thereto in an individual is described. The system comprises at least two of one or more of a CD8(+) T cell specific for an immunogenic fragment of ApoB-100 or an immunogenically active portion thereof and one or more enhancers of the CD8(+) T cell. In particular, in several embodiments, the one or more of a CD8(+) T cell specific for an immunogenic fragment of ApoB-100 or an immunogenically active portion thereof and one or more enhancers of the CD8(+) T cell are included in the system for simultaneous, combined or sequential use in methods herein described.

[0010] According to a fourth aspect, a system to treat and/or prevent an aneurysm and/or a condition in an individual is described. The system comprises one or more immunogenic fragments of ApoB-100 or an immunogenically active portion thereof and CD8(+) T cells, and one or more of a CD8(+) T cell specific for an immunogenic fragment of ApoB-100 or an immunogenically active portion thereof. In particular, in several embodiments, the one or more immunogenic fragments of ApoB-100 or an immunogenically active portion thereof and CD8(+) T cells, and one or more of a CD8(+) T cell are included in the system for simultaneous, combined or sequential use in methods herein described.

[0011] The fragments, cells, compositions, methods and systems herein described can be used in connection with applications wherein reduction of an aneurysm, aneurismal segment formation, aneurismal rupture, and/or a therapeutic or preventive effect for aneurysm in an individual is desired.

[0012] The details of one or more embodiments of the disclosure are set forth in the accompanying drawings and the description below. Other features, objects, and advantages will be apparent from the description and drawings, and from the claims.

BRIEF DESCRIPTION OF THE DRAWINGS

[0013] The accompanying drawings, which are incorporated into and constitute a part of this specification, illustrate one or more embodiments of the present disclosure and, together with the detailed description and the examples, serve to explain the principles and implementations of the disclosure.

[0014] Figure 1 shows a representation of the locations of the segments examined for average diameter of segmental aneurysm according to an embodiment herein described.

[0015] Figure 2 shows a Kaplan Meier survival curve for mice immunized with or without p210 according to an embodiment herein described.

[0016] Figure 3 shows p210 immunization confers athero-protective effect. (A) Immunization with native p210 resulted in a significant reduction in aortic atherosclerosis when compared to PBS and cBSA/Alum group (n=9-10 each group, representative picture from each group shown). (B) P210 immunization significantly reduced macrophage infiltration and DC presence assessed by MOMA-2 (n=9-10 each group) and CDl lc (n=7-12 each group) immuno-reactivity, respectively in aortic sinus plaques.

[0017] Figure 4 Effect of p210 immunization on DCs. One week after primary immunization, (A) CDl lc(+) or (B) CDl lc(+)CD86(+) cells at the immunization sites was significantly reduced in p210/cBS A/alum group when compared to cBSA/alum group. N=10 each group. (C) One week after third immunization, p210 immunized mice had reduced CDl lc(+)CD86(+) cells in lymph nodes compared to cBSA/alum group (n=5 in each group; ANOVA followed by

multiple group comparison).

[0018] Figure 5 shows IgM or IgG titer against p210 before and after p210 immunization. (A) The p210 IgG titers were low before immunization and remained low in the PBS group at euthanasia but significantly increased in cBS A/alum and p210/cBS A/alum groups, with the highest titer in the cBSA/alum group. (B) The p210 IgM titers were low before immunization and significantly increased at euthanasia with no difference among 3 groups of mice. N=5 for 6-7 week time-point and n=9 for 25 week time-point.

[0019] Figure 6 shows activated lymphocyte population after immunization in vivo. (A) CD8(+)CD25(+) T-cell population in the lymph nodes was significantly higher in p210/cBS A/alum group when compared to that of PBS or cBSA/alum groups; (B) CD4(+)CD25(+) T-cells in the lymph nodes did not differ among the three groups. There was a significantly larger population of splenic CD8(+)CD25(+)IL-10(+) T-cells in p210/cBS A/alum group among 3 groups (C) without difference in splenic CD8(+)CD25(+)IL12(+) T-cells among 3 groups (D). Splenic CD4(+)CD25(+)IL-10(+) T-cell population significantly increased in the cBS A/alum group, but was significantly attenuated by the p210/cBS A/alum immunization (E) and (F) splenic CD4(+)CD25(+)IL12(+) T-cells did not differ among 3 groups. N=9-10 in each group for (A) and (B); n=5 in each group for (C), (D), (E) and (F).

[0020] Figure 7 shows adoptive transfer of CD8(+) T-cells from p210 immunized donors recapitulated the athero -protective effect of p210 immunization but not by transfer of B-cells or CD4(+)CD25(+) T-cells. (A) The recipient mice of CD8(+) T-cells from p210/cBS A/alum immunized donors developed significantly smaller atherosclerotic lesions compared to the recipient mice of CD8(+) T-cells from other 2 groups (n=9-10 each group). (B) Adoptive transfer of B-cells from p210/cBS A/alum donors did not reduce atherosclerosis when compared to the recipient mice of B-cells from PBS or cBSA/alum groups (n=9 each group). Recipient mice of CD4(+)CD25(+) T-cells (n=9-13 each group) with 2 different doses (C. lxlO5 cells/mouse or D. 3xl05 cells/mouse) did not reproduce the athero-reducing effect of p210 immunization.

[0021] Figure 8 shows increased cytolytic activity of CD8(+) T cells from p210 immunized

mice against dendritic cells in vitro. CD8(+) T-cells from p210 immunized mice significantly had a higher cytolytic activity against dendritic cells when compared to those from PBS or BSA/alum groups. Experiments were repeated 4 times with CD8(+) T-cells pooled from 5 mice in each group each time. Duplicate or triplicate was done each time with total of 11 data-points in each group altogether.

[0022] Figure 9 shows CD8(+) T-cells from p210 immunized mice containing higher level of Granzyme B when compared to those from PBS or cBSA/alum group; whereas there is no difference in perforin level.

[0023] Figure 10 shows IgG titers against KLH or TNP after p210 immunization. (A) Prior immunization with p210 did not affect the efficacy of subsequent T-cell dependent (KLH, n=3-6 each group) or (B) T-cell independent (TNP, n=4-5 each group) immunization as assessed by the IgG antibody titers when compared to mice received PBS or cBSA/alum.

[0024] Figure 11 shows a Kaplan Meier survival curve for mice immunized with or without p210 according to an embodiment herein described.

[0025] Figure 12 shows Antibody response to p210 in apoE-/- mice according an embodiment herein described.

[0026] Figure 13 shows cytolytic activity of p210-immune CD8+ T cells is abrogated by depletion of CD25+ cells. Lytic activity specific to p210 is also abrogated by absence of serum lipids in the assay medium.

[0027] Figure 14 shows endocytosis of FITC-labeled p210 by DCs according one embodiment herein described.

[0028] Figure 15 shows presentation of the peptide p210 by DCs to CD8+CD25" T cells in vitro as shown by increased activated CD25+ cells according one embodiment herein described.

[0029] Figure 16 shows CD8+ lytic activity gated on FITC+ cells according an embodiment herein described. p210-specific lytic activity by CD8+ T cells from p210-vaccinated mice using DCs loaded with FITC-labeled p210.

DETAILED DESCRIPTION

[0030] Methods and systems are herein described that allow in several embodiments, treatment and/or prevention of an aneurysm and/or a condition associated thereto.

[0031] The term "aneurysm" as used herein indicates a localized blood filled dilation of a blood vessel or of a portion thereof. In particular, an aneurysm can be an abnormal widening or ballooning of a portion of an artery due to weakness in the wall of the blood vessel, and can occur within any vasculature in the body. Aneurysms can be "true" in which the inner layers of a blood vessel bulges outside the outer layer of the vessel, or "false," which is a collection of blood leaking out of an artery or vein. Aneurysms commonly occur, but are not limited to, in arteries at the base of the brain or aortic in the main artery carrying blood from the left ventricle of the heart. In particular, with reference to the aorta, aneurysms can occur at different segments of the aorta including, but not limited to, the beginning of the arch, the end of the arch, the apex, between segments 3 and 5, the supra renal segment, the infra renal segment, before bifurcation, and between the renal artery. Symptoms of aneurysms include pain, peripheral embolization, bleeding and additional symptoms identifiable by a skilled person.

[0032] The term "treat," or "treating" or "treatment" as used herein indicates any activity that is part of a medical care for, or that deals with, a condition medically or surgically. The term "preventing" or "prevention" as used herein indicates any activity, which reduces the burden of mortality or morbidity from a condition in an individual. This takes place at primary, secondary and tertiary prevention levels, wherein: a) primary prevention avoids the development of a disease; b) secondary prevention activities are aimed at early disease treatment, thereby increasing opportunities for interventions to prevent progression of the disease and emergence of symptoms; and c) tertiary prevention reduces the negative impact of an already established disease by restoring function and reducing disease-related complications.

[0033] The term "condition" as used herein indicates the physical status of the body of an individual (as a whole or of one or more of its parts) that does not conform to a physical status of the individual (as a whole or of one or more of its parts) that is associated with a state of complete physical, mental and possibly social well-being. Conditions herein described include but are not limited to disorders and diseases wherein the term "disorder" indicates a condition of the living individual that is associated to a functional abnormality of the body or of any of its parts, and the term "disease" indicates a condition of the living individual that impairs normal functioning of the body or of any of its parts and is typically manifested by distinguishing signs and symptoms. Exemplary conditions include but are not limited to injuries, disabilities, disorders (including mental and physical disorders), syndromes, infections, deviant behaviours of the individual and atypical variations of structure and functions of the body of an individual or parts thereof.

[0034] The wording "associated to" or "associated hereto" as used herein with reference to two items indicates a relation between the two items such that the occurrence of a first item is accompanied by the occurrence of the second item, which includes but is not limited to a cause-effect relation and sign/symptoms-disease relation. Exemplary conditions associated to an aneurysm comprise compression of nearby structures such as nerves, including but not limited to compressions leading to weakness and numbness of the area where the blood vessel is located, as well as infection, possibly leading to body-wide illness and rupture. An additional exemplary condition associated to an aneurysm is rupture of a blood vessel, which on its turn is possibly to massive bleeding, resulting in stroke, disability, and death. A further exemplary condition associated to aneurysm is atherosclerosis. Additional conditions include symptoms of aneurysms such pain, peripheral embolization, bleeding, and additional symptoms identifiable by a skilled person.

[0035] In some embodiments, treatment and/or prevention of aneurysm can be provided by administering to an individual an effective amount of one or more immunogenic fragments of ApoBlOO or an immunogenically active portion thereof.

[0036] The term "administer" or "administering" or "administration" as used herein means any method of providing an individual with a substance in any fashion including, but not limited to, those discussed herein.

[0037] The term "individual" or "individuals" as used herein indicates a single biological organism such as higher animals and in particular vertebrates such as mammals and more particularly human beings. In some embodiments, the individual has been previously identified as having an increased risk of aneurysm based on the detection of conditions typically associated with an increased risk of aneurysm (e.g. higher blood pressure, atherosclerosis). In some embodiments, the individual has not been identified as having an increased risk of aneurysm. In some embodiments, no investigation as to the risk for aneurysm in the individual has been performed.

[0038] The term "immunogenic fragment" or "antigenic fragment" as used herein indicates a portion of a polypeptide of any length capable of generating an immune response, such as an antigen. An antigen is a molecule recognized by the immune system. An antigenic fragment of ApoBlOO is accordingly a portion of apoB-100 that presents antigenic properties. The ability of a fragment or other molecule to generate an immune response and in particular a cellular and/or humoral response can be detected with techniques and procedures identifiable by a skilled person.

[0039] The term "fragment of ApoBlOO" in the sense of the present disclosure comprises not only fragments of any length from ApoBlOO, but also peptides produced by genetic recombination or chemically synthesized comprising sequences from ApoBlOO. The term "immunogenic fragments" in the sense of the present disclosure further comprise also derivative of any fragment, such as mutated fragments (including fragments with replaced, added or deleted residues) oxidative derivative and/or peptide treated with MDA or copper, which maintain a detectable antigenic property of the original fragment (e.g. a specific humoral and/or cellular response).

[0040] The term "derivative" as used herein with reference to a first peptide (e.g., an immunogenic fragment), indicates a second peptide that is structurally related to the first peptide and is derivable from the first peptide by a modification that introduces a feature that is not present in the first peptide while retaining functional properties of the first peptide. Accordingly, a derivative peptide of an immunogenic fragment, or of any portion thereof, (e.g. an epitope thereof), usually differs from the original immunogenic fragment or portion thereof by modification of the amino acidic sequence that might or might not be associated with an additional function not present in the original polypeptide or portion thereof. A derivative peptide of an immunogenic fragment or of any portion thereof retains however one or more of

the immunogenic activities that are herein described in connection with an immunogenic fragment or portion thereof. The antigenic properties can be verified with methods and systems such as the ones already described for the immunogenic fragments and additional methods and systems identifiable to a skilled person. Typically, a derivative of an immunogenic fragment comprises at least one epitope of the immunogenic fragment

[0041] The term "immunogenically active portion" in the sense of the present disclosure indicates any part of a reference antigen that can elicit specific immune response. Exemplary immunogenically active portions are epitopes typically formed by 5 or more residues within an immunogenic fragment. In some embodiments, epitopes within one or more fragments can overlap.

[0042] Immunogenic fragments can be expressed by recombinant technology, such as a fusion with an affinity or epitope tag, chemical synthesis of an oligopeptide, either free or conjugated to carrier proteins, or any other methods known in the art to express the ApoB-100 peptides.

[0043] Exemplary fragments of ApoBlOO are peptides each comprising or essentially consisting of one of the sequences listed in the Sequence Listing as SEQ ID NO: 1 to SEQ ID NO: 302 described in further detail in the Examples section. Methods and systems suitable to identify an immunogenic fragment in the sense of the present are described in WO 02/080954, herein incorporated by reference. Additional methods are exemplified in the Examples section (see e.g. Example 1).

[0044] The term "protein" or "polypeptide" or "peptide" as used herein indicates an organic polymer composed of two or more amino acid monomers and/or analogs thereof. The term "polypeptide" includes amino acid polymers of any length including full length proteins or peptides, as well as analogs and fragments thereof. A peptide of three or more amino acids is also called an oligopeptide. As used herein the term "amino acid", "amino acidic monomer", or "amino acid residue" refers to any of the twenty amino acids including synthetic amino acids with unnatural side chains and including both D and L optical isomers. The term "amino acid analog" refers to an amino acid in which one or more individual atoms have been replaced, either with a different atom, isotope, or with a different functional group but is otherwise identical to its natural amino acid analog.

[0045] In an embodiment, the one or more immunogenic fragments of ApoBlOO suitable to treat aneurysm are associated to atherosclerosis reduction.

[0046] Methods to identify a molecule associated with atherosclerosis reduction are identifiable by a skilled person and include the exemplary procedures described in WO 02/080954 herein incorporated by reference in its entirety. In particular, the ability of a molecule to reduce atherosclerosis can be tested in an animal model following administration of the molecule in a suitable amount using procedure identifiable by a skilled person. For example following subcutaneous administration of a molecule herein described the ability of the molecule to affect atherosclerosis can be tested in mice as illustrated in the Examples sections. A skilled person will be able to identify additional procedure, schedule of administration and dosages upon reading of the present disclosure.

[0047] Accordingly in an exemplary embodiment, immunogenic molecule associated with atherosclerosis reduction can be identified by identifying a candidate immunogenic molecule able to provide a cellular and/or humoral response in the individual of interest; and testing the candidate immunogenic molecule for an ability to reduce atherosclerosis, to select the candidate immunogenic molecule associated with atherosclerosis reduction.

[0048] In particular, in some embodiments, immunogenic fragments of ApoBlOO are immunogenic fragments producing an immune response associated to atherosclerosis reduction in the individual or in an animal model. In some of those embodiments, a percentage atherosclerosis reduction is at least about 20%, or at least about 30%, from about 40% to about 60% or about 50% to about 80%.

[0049] Reference is made to Examples section wherein embodiments of the present disclosure are exemplified with reference to immunogenic fragment p210 associated with a reduction of atherosclerosis of about 57.6% and also associated to number of aneurismal sections induced by angiotensin infusion; (see Example 2) and is expected to reduce mortality from aneurysm rupture (see Examples section). Additional fragments associated to atherosclerosis reduction are particularly expected to be effective in treatment and/or prevention of aneurysms (see Examples section).

[0050] In some embodiments, the immunogenic fragment associated to atherosclerosis reduction and suitable to be used to treat and/or prevent aneurysm comprises at least one of peptide, each comprising pi (SEQ ID NO: 1), p2 (SEQ ID NO: 2), pl l (SEQ ID NO: ll), p25 (SEQ ID NO:25), p45 (SEQ ID NO:45), p74 (SEQ ID NO:74), p99 (SEQ ID NO:99), plOO (SEQ ID NO: 100), pl02(SEQ ID NO: 102), pl03 (SEQ ID NO: 103), pl05 (SEQ ID NO: 105), pl29 (SEQ ID NO: 129), pl43 (SEQ ID NO: 143), pl48 (SEQ ID NO: 148), p210 (SEQ ID NO:210), or p301 (SEQ ID NO:301).

[0051] In an embodiment, the one or more immunogenic fragments associated to atherosclerosis reduction and suitable to be used to treat and/or prevent aneurysm comprises one or more peptides each comprising p2 (SEQ ID NO:2), pl l (SEQ ID NO: 11), p45 (SEQ ID NO: 45), p74 (SEQ ID NO: 74), pl02 (SEQ ID NO: 102), pl48 (SEQ ID NO: 148), or p210 (SEQ ID NO:210).

[0052] In an embodiment, the one or more immunogenic fragments associated to atherosclerosis reduction and suitable to be used to treat and/or prevent aneurysm comprise two peptides each comprising pl43 (SEQ ID NO: 143), or p210 (SEQ ID NO:210). In an embodiment, the one or more immunogenic fragments associated to atherosclerosis reduction comprises three peptides each comprising, one of pll (SEQ ID NO: l l), p25 (SEQ ID NO: 25), or p74 (SEQ ID NO:74). In an embodiment, the one or more immunogenic fragments associated to atherosclerosis reduction comprises five peptides each comprising one of p99 (SEQ ID NO: 99), plOO (SEQ ID NO: 100), pl02 (SEQ ID NO: 102), pl03 (SEQ ID NO: 103), and pl05 (SEQ ID NO: 105).

[0053] In an embodiment, the one or more immunogenic fragments associated to atherosclerosis reduction and suitable to be used to treat and/or prevent aneurysm comprises one or more peptides each comprising p2 (SEQ ID NO: 2), p45 (SEQ ID NO: 45), p74 (SEQ ID NO: 74), pl02 (SEQ ID NO: 102), or p210 (SEQ ID NO:210).

[0054] In an embodiment, the one or more immunogenic fragments associated to atherosclerosis reduction and suitable to be used to treat and/or prevent aneurysm comprise a peptide comprising amino acids 16-35 of human apoB-100 (p2; SEQ ID NO:2).

[0055] In an embodiment the one or more immunogenic fragments associated to atherosclerosis reduction and suitable to be used to treat and/or prevent aneurysm comprise a peptide comprising amino acids 661-680 of human apoB-100 (p45; SEQ ID NO:45).

[0056] In an embodiment, the one or more immunogenic fragments associated to atherosclerosis reduction and suitable to be used to treat and/or prevent aneurysm comprise a peptide comprising amino acids 3136-3155 of human apoB-100 (p210; SEQ ID NO: 210).

[0057] In an embodiment, the one or more immunogenic fragments associated to atherosclerosis reduction and suitable to be used to treat and/or prevent aneurysm comprise a peptide comprising amino acids 4502-4521 of human apoB-100 (p301 ; SEQ ID NO: 301).

[0058] In an embodiment, the one or more immunogenic fragments associated to atherosclerosis reduction and suitable to be used to treat and/or prevent aneurysm comprise a peptide comprising amino acids 1-20 of human apoB-100 (pi; SEQ ID NO: 1).

[0059] Exemplary data showing association of the above peptides to atherosclerosis reduction are shown in Example 5 of the present disclosure and in International application WO 02/080954, herein incorporated by reference in its entirety (see in particular Table 1, Table 2, Table A and Table B). In particular for some of those peptides or combination thereof a percentage reduction of 64.6% (pl43 and p210), 59.6% (pll, p25 and p74), 56.8% (pl29,pl48, and pl67), p67.7 (p2), 57.9% (p210), 55.2% (p301), 47.4% (p45), 31% (pi) has been detected (see WO/02080954 incorporated herein by reference in its entirety, and in particular Table B).

[0060] Immunogenic peptides comprising any of the sequences herein described or immunogenically active portions of those peptides are identifiable by a skilled person using in silico and/or in vitro approaches. For example, in silico methods can be used to identify epitopes or immunogenic peptides based on any of the sequences herein described. Reference is made for example, to the papers [44] to [51] each of which is incorporated herein by reference in its entirety.

[0061] Those papers describe various algorithms such as Tepitope (Radrizzani et al 2000), Adept (Maksuytov et al 1993), antigenic index (Jameson et al 1988) and others which can be used to identify the immunogenic molecules comprising the sequences at issue or any relevant epitopes.

[0062] Additional tests and laboratory procedures in vitro and/or in vivo suitable to be used alone or in connection with the identification in silico (e.g. ELISA, antigen- specific T cell proliferation assay, ELISPOT, antibody measurement) are identifiable by a skilled person that can be used by a skilled person to verify the in silico data and/or identify immunologically active molecules comprising any of the sequences herein described or immunologically active portions of those sequences.

[0063] Accordingly, in an exemplary embodiments, immunogenic peptides, herein described, immunogenically active portions thereof as well as derivative thereof can be identified by identifying candidate peptides, candidate active portion and/or candidate derivative by in silico analysis of any one of the sequences herein described, and by identifying the immunogenic peptides, immunogenically active portions and/or derivative by in vitro and/or in vivo testing of the candidate peptides, candidate active portion and/or candidate derivative. In particular, the in silico analysis can be performed by analyzing the sequence of the candidate with algorithm suitable to identify immunogenicity of a molecule or portion thereof. Similarly, the in vitro and/or in vivo testing comprises methods directed to identify immunogenicity of the candidate peptide, candidate active portion and/or derivative as well as effects of those molecules on aneurysm, with particular reference to formation or regression. Suitable methods and techniques are identifiable by a skilled person upon reading of the present disclosure.

[0064] In several embodiments, the immunogenic peptides, active portions thereof and derivative thereof are expected to include a sequence of at least about 5 amino acids, consistently with the typical length of epitopes as indicated in WO 02/080954 herein incorporated by reference in its entirety.

[0065] In an embodiment, immunization with one or more of the immunogenic molecules herein described reduces the incidence of experiencing aortic aneurysm rupture (e.g. Example 2).

[0066] In an embodiment, immunization with one or more of the immunogenic molecules herein described reduces the aortic aneurysmal segment formation. In particular, in some of those embodiments, reduction of aneurysms can occur at different segments of the aorta including, but

not limited to, the beginning of the arch, the end of the arch, the apex, between segments 3 and 5, the supra renal segment, the infra renal segment, before bifurcation, and between the renal arteries (se e.g. Example 3). The expected reduction of aneurysm after immunization is at least about 20%, and in particular about 20-80% when compared to a control measurement.

[0067] In an embodiment, immunization with one or more of the immunogenic molecules herein described reduces mortality associated with aortic aneurysmal rupture (see e.g. Example 4).

[0068] The term "effective amount" as used herein is meant to describe that amount of antigen, e.g. p210, which induces an antigen- specific immune response.

[0069] Effective amounts of an immunogenic fragment and of one or more of the immunogenic molecules herein described to treat and/or prevent aneurysm will depend on the individual wherein the activation is performed and will be identifiable by a skilled person upon reading of the present disclosure. For example in an embodiment the T cell activation can be performed with an effective amount of from about 100 μg to about less than about 1000 μg immunogenic fragment or immunogenically active portion thereof. In an embodiment, treatment and/or prevention aneurysm can be performed with an effective amount of from about 1 to about 100 mg immunogenic fragment or immunogenically active portion thereof. Additional effective amounts are identifiable by a skilled person in view of the individual where activation is performed and the desired activation.

[0070] In an embodiment, an effective amount for the treatment or prevention can be about 100 μg or more. In particular, treatment with 100 μg p210 can prevent aneurysm rupture is expected (see e.g. Example 2). In some embodiments, treatment and/or prevention can be performed with an amount that is 1 mg or more, e.g. up to 100 mg.

[0071] A greater concentration can be used in some embodiments depending on the desired effect as illustrated in the present disclosure. For example, in embodiments wherein treatment of an aneurysm is desired, treatment is expected to be performed with an effective amount of about 250 μg or more and in particular with about 500 μg. In another example, wherein the aneurysm is at an early stage detection of an aneurysm an effective amount to treat the aneurysm is expected to be at a lower amount compared to an amount used for treatment (e.g. from 100 to

250 μg) even if in some cases, an amount falling within the range of 250 μg or 500 μg or higher is also expected to be effective also depending on other factors affecting the pharmacological activity of the molecule in an individual.

[0072] In particular the effective amount is also expected to vary depending on the number and combination of peptides utilized for each particular vaccine, and specific characteristic and conditions of the individual treated (e.g. immune system diet and general health and additional factors identifiable by a skilled person). More particular, lower or higher amounts within the defined range are expected to be effective in an individual depending on factors such as weight, age, gender of the individual as well as additional factors identifiable by a skilled person.

[0073] In some embodiments, the immunogenic peptides herein described or related immunogenically active portions can be administered in combination with an adjuvant or other carrier suitable to affect and in particular increase immunogenicity of the peptide o active portion thereof. In particular, in some embodiments, the immunogenic peptide or active portion thereof can be conjugated to the adjuvant or carrier according to procedures identifiable to a skilled person. Suitable carriers comprise BSA, and in particular, cationized BSA, Human Serum Albumin (HSA) and in particular cationized HSA, aluminum salts such as aluminum phosphate and aluminum hydroxide and additional carriers identifiable by a skilled person.

[0074] In some embodiments, immunogenic molecules herein described can be administered in ratios of immunogenic molecule to carrier to aluminum of about: 1:2:35, 1:2:20.6, 1:2:7.7, 1:2:3.3, 1: 1: 13.8 weight to weight ratios. In particular, in some embodiments, ratios can be provided wherein the number of peptides conjugated to each carrier molecule while minimizing the amount of aluminum (adjuvant). In particular in one embodiment, ratio can be provided that result in a concentration up to 2.7 mg conjugate/mL.

[0075] In an embodiment, the administering is performed according to a schedule of administration to be determined in view of the desired effect. In particular, administration is expected to be performed in accordance with dosages and schedule which will be identified based on the condition of the individual to be treated and the desired effect. For example, administration can be performed by performing either a single administration, or a plurality of administrations (e.g. 2 administrations or more, in particular up to 6 administrations) of immunogenic fragments or immunogenically active portion thereof herein described in intervals to obtain a desired immunization based on the condition of the individual.

[0076] In some embodiments the immunogenic molecules herein described can be administered according to a schedule of administration devised in view of the amount of time required by the adaptive immune system of an individual to mount a response to the initial exposure to an immunogen. Typically, the response is expected to plateau at 2 - 3 weeks after exposure. Subsequent exposures often elicit a more rapid response. In various embodiments, the following schedules and manner of administration can be followed: (1) single administration, (2) two administrations 2 - 3 weeks apart, (3) three weekly administrations, (4) up to 6 administrations on a 1 every 3 week schedule. The vaccines have been administered by: (1) subcutaneous injection; (2) intraperitoneal injection; (3) nasal installation; (4) subcutaneous infusion.

[0077] The route of immunization can vary depending on the purposes of immunization described herein. Successful prevention and treatment of aneurysms in mice occurred by subcutaneous osmotic pump injections (Examples 2, 3, and 4). The type of immune response triggered is largely determined by the route of immunization. Various routes can be used comprising subcutaneous, parenteral, and systemic among the others. In particular, the mucosal linings of airways and intestines contain lymphatic tissue that, when exposed to antigen, elicits anti-inflammatory, immunosuppressive responses. Distinct immunological features of the respiratory and intestinal mucosa lead to partly different types of protective immunity upon antigen exposure by the nasal or oral route.

[0078] In an embodiment, administering one or more immunogenic fragment or an immunogenically active portion thereof can be performed subcutaneously or intramuscularly.

[0079] In some embodiments, methods are provided to prevent an aneurysm and/or a condition associated thereto in an individual, the method comprising increasing in the individual an activated CD8(+) T cell specific for an immunogenic fragment of ApoB-100 or an immunogenically active portion thereof herein described.

[0080] The term "T cells" as used herein indicates T lymphocytes belonging to a group of white blood cells known as lymphocytes, and participate in humoral or cell-mediated immunity. T cells can be distinguished from other lymphocyte types, such as B cells and natural killer cells (NK cells) by the presence of special markers on their cell surface such as T cell receptors (TCR). Additional markers identifying T cell include CDla, CD3, or additional markers possibly associated to a T cell state and/or functionality as will be understood by a skilled person.

[0081] The term "CD8(+) T cells" indicates T cells expressing the CD8 glycoprotein at their surface, wherein the CD8 (cluster of differentiation 8) glycoprotein is a transmembrane glycoprotein that serves as a co-receptor for the T cell receptor (TCR). Similarly to the TCR, CD8 binds to a major histocompatibility complex (MHC) molecule, but is specific for the class I MHC protein. Exemplary CD8 T cells comprise cytotoxic memory CD8 T cells, regulatory CD8 T cells, cytotoxic effector CD8 T-cells and additional cells identifiable by a skilled person. There are two isoforms of the protein, alpha and beta, each encoded by a different gene. In humans, both genes are located on chromosome 2 in position 2pl2.

[0082] The term "activated" and activation as used herein indicate the process by which a T cells interacts with an antigen presenting cell which presents a specific antigen for a time and under condition resulting in a T cell having a preassigned immunological role (e.g. cytotoxicity) within the immune system. The term "antigen-presenting cell" (APC) indicates a cell that displays antigen complex with major histocompatibility complex (MHC) on its surface. T-cells recognize this complex using their T-cell receptor (TCR). Exemplary APCs comprise dendritic cells (DCs) which are known to play an important role in linking innate and acquired immunity, see references (3) (4), and both immune responses participate in atherogenesis, see references (5) (6).

[0083] Detection of T cells and in particular, CD8(+) T cells, can be performed by detection of markers such as CD8, alone or in combination with TCR and additional markers identifiable by a skilled person. Detection of activated CD8(+) T cells can be performed by detection of T cells markers and in particular of markers such as CD25, CD44, CD62 and additional markers identifiable by a skilled person using process and techniques suitable for detecting surface markers.

[0084] The terms "detect" or "detection" as used herein indicates the determination of the existence, presence or fact of a molecule or cell in a limited portion of space, including but not limited to a sample, a reaction mixture, a molecular complex and a substrate. The "detect" or "detection" as used herein can comprise determination of chemical and/or biological properties of the target, including but not limited to ability to interact, and in particular bind, other compounds, ability to activate another compound and additional properties identifiable by a skilled person upon reading of the present disclosure. The detection can be quantitative or qualitative. A detection is "quantitative" when it refers, relates to, or involves the measurement of quantity or amount of the target or signal (also referred as quantitation), which includes but is not limited to any analysis designed to determine the amounts or proportions of the target or signal. A detection is "qualitative" when it refers, relates to, or involves identification of a quality or kind of the target or signal in terms of relative abundance to another target or signal, which is not quantified.

[0085] Exemplary techniques suitable for detecting T cell markers comprise use of suitable monoclonal or polyclonal antibodies or antigen-specific HLA or MHC pentamers or hexamers labeled with an appropriate molecule allowing detection as well as additional methods and techniques identifiable by a skilled person. In an exemplary approach T cell markers are identified by flow cytometric analysis as described in the Examples section. Exemplary techniques suitable for detecting T cell markers comprise use of suitable monoclonal or polyclonal antibodies or antigen-specific HLA or MHC pentamers or hexamers labeled with an appropriate molecule allowing detection as well as additional methods and techniques identifiable by a skilled person. In an exemplary approach T cell markers are identified by flow cytometric analysis as described in the Examples section.

[0086] In some embodiments of the T cell, compositions methods and systems herein described CD8(+) T cells can be activated using one or more immunogenic fragments of ApoBlOO or an immunogenically active portion thereof.

[0087] In particular, activated CD8(+) T cells specific for an immunogenic fragment of ApoBlOO are obtainable by contacting a CD8(+) T cells with one or more peptides selected from the group consisting of pi (SEQ ID NO: 1), p2 (SEQ ID NO: 2), pll (SEQ ID NO: ll), p25

(SEQ ID NO:25), p45 (SEQ ID NO:45), p74 (SEQ ID NO:74), p99 (SEQ ID NO:99), plOO (SEQ ID NO: 100), pl02(SEQ ID NO: 102), pl03 (SEQ ID NO: 103), pl05 (SEQ ID NO: 105), pl29 (SEQ ID NO: 129), pl43 (SEQ ID NO: 143), pl48 (SEQ ID NO: 148), p210 (SEQ ID NO:210), or p301 (SEQ ID NO:301).or an immunogenically active portion thereof for a time and under condition to activate the CD8(+) T cell, the activated CD8(+) T cell specific for the one or more peptides or the immunogenically active portion thereof.

[0088] Activated T cells herein described are specific for one or more immunogenic fragment or immunogenically active portion thereof. The wording "specific" "specifically" or "specificity" as used herein with reference to the immunogenic response refers to the ability of an immunological agent to direct the immunological activity towards an antigen, together with substantially less to no immunological activity towards other antigen that may be present. As consequence, CD8 (+) T cells herein are specifically activated towards the immunogenic fragment or active portion used to activate them and not for other antigens.

[0089] Exemplary antigenic properties that can be used to identify CD8 T cell specific for the immunogenic fragments comprise humoral and/or cellular responses detectable using methods and techniques such as the ones exemplified in the Examples section as well as other methods and techniques identifiable by a skilled person. Exemplary methods and systems for detecting antigenic properties in the sense of the present disclosure comprise ELISA and in particular serum ELISA and additional methods exemplified in the Examples section.

[0090] In an embodiment, activated the CD8(+) T cells are specific for one or more of any of the peptides between SEQ ID NO: l and SEQ ID NO:302 or an immunogenically active portion thereof that are associated with treatment or prevention of atherosclerosis. In some embodiments the immunogenic fragment comprises one or more of the peptides SEQ ID NO:2, SEQ ID NO: 11, SEQ ID NO: 45, SEQ ID NO: 74, SEQ ID NO: 102, SEQ ID NO: 148, , SEQ ID NO:210 or an immunogenically active portion thereof. In some embodiments the immunogenic fragment comprises one or more of the peptides SEQ ID NO: 2, SEQ ID NO: 45, SEQ ID NO: 74, SEQ ID NO: 102, SEQ ID NO:210 or an immunogenically active portion thereof. Even more particularly, in some embodiments the immunogenic fragment comprises amino acids 3136-3155 of human apoB-100 (P210; SEQ ID NO: 210) or an immunogenically active portion thereof. In

general, the same combination of immunogenic fragments proven or expected to be associated with treatment and/or prevention of aneurysm in an individual are also expected to be able to activate CD8(+)T cells to be used in treatment and/or prevention of an aneurism in the individual. In particular, T cell activation can be performed using any of the molecules herein described administered in vivo in an amount suitable to treat or prevent aneurysms, (see e.g. Example section). Activation of T cell can also be performed in vitro using methods and procedures such as the ones described in ref [52] as well as additional procedures identifiable by a skilled person.

[0091] In an embodiment, an increasing of CD8(+)T cell to treat and/or prevent an aneurysm in the individual can be performed by administering to the individual an effective amount of an activated CD8(+) T cell.

[0092] In an embodiment the effective amount is expected to be comprised between about 500,000 to 2,000,000 cells. In embodiment the effective amount is expected to be comprised between about 750,000 to about 1,500,000 cells. In an embodiment, the effective amount is expected to be about 1,000,000 cells.

[0093] In particular, in an embodiment administration of about 1,000,000 cells is expected to result in both treatment and prevention of atherosclerosis and is therefore expected to also be effective in treatment and prevention of aneurysms. Administration is expected to be performed in accordance with dosages and schedule which will be identified based on the condition of the individual to be treated and the desired effect. For example in administration directed to prevention, administering an effective amount of activated CD8(+) T cell can performed by performing either a single administration, or a plurality of administrations (e.g. 3 administrations or more, in particular up to 6 administrations) of activated CD8(+) T cell herein described in intervals to obtain a desired immunization based on the condition of the individual. In particular, a plurality of administrations can be performed whenever a prolonged immunizing effect is desired.

[0094] In some embodiments, activated CD8+ T cells herein described are expected to be effective according to a schedule of administration wherein those cells are administered daily (for up to 21 days) and on an every 10 day schedule (days 0, 10, 20). Additional schedules expected to be effective can be identified by a skilled person based on cell treatments of other condition such as HIV and/or cancer.

[0095] Administration of CD8(+) T cell herein described can be performed according to methods to immunize an individual identifiable to a skilled person. In an embodiment, the administering can be performed by parenteral administration. Parenteral administration is a systemic route of administration where the substance is given by route other than the digestive tract and includes but is not limited to intravenous administration, intra- arterial administration, intramuscular administration, subcutaneous administration, intradermal, administration, intraperitoneal administration, and intravesical infusion. In particular, in an embodiment the administering can be performed by intravenous administration.

[0096] In an embodiment, administration can be performed by administering activated CD8(+) T cell one time, typically via intravenous route, one time or multiple times, depending on the desired duration of the immunization effect.

[0097] In some embodiments wherein methods are provided to treat and/or prevent an aneurysm and/or a condition associated thereto in an individual an effective amount of CD8(+) T cells specific for an immunogenic fragment of ApoBlOO can be administered alone or in combination with an effective amount of one or more immunogenic fragments herein described or immunogenically active portion thereof. In particular, the one or more immunogenic fragments or immunogenically active portion thereof can be administered in a same or less amount required to treat and/or prevent aneurysms.

[0098] In some embodiments wherein methods are provided to treat and/or prevent an aneurysm and/or a condition associated thereto in an individual, the effective amount of activated CD8(+) T cells and/or immunogenic fragment of ApoBlOO or immunogenically active portion thereof vary, and so is the route of immunization which can vary depending on the purposes of immunization described herein. Various routes can be used comprising subcutaneous, parenteral, and systemic among the others. In particular, the mucosal linings of airways and intestines contain lymphatic tissue that, when exposed to cells, elicits anti-inflammatory, immunosuppressive responses.

[0099] In some embodiments, administering of an immunogenic fragment and/or a CD8(+) T cell can be performed in combination with an enhancer of CD8(+) T cell activation.

[00100] The terms "enhancer" and "enhance" as it pertains to a molecule in connection with CD8 T cell refers to the ability of a molecule to modify the immune response by promoting the activation of cells of the immune system. The choice of appropriate enhancer can allow control of activation of the immune response. Exemplary enhancers include cytokines such as IL10, IL-2, IL12, IL-4 IL-16. The term "cytokine" as used herein refers cell signaling molecules that act as has immunomodulating agents, and comprise proteins such as interleukins and interferons as would be identifiable to a skilled person. Selection of a suitable cytokine can result under appropriate conditions in the preferential induction of a humoral or cellular immune response.

[00101] In an embodiment, the enhancer can be Interleukin 2 (IL2), interleukin 10 (IL10), Interleukin 15 (IL-15), TGF-beta (TGF-β), IL2-antiIL-2 antibody complex and/or additional enhancer identifiable by a skilled person upon reading of the present disclosure. Reference is made to the references Mitchell et al 2010 [38], Perret et al 2008 [39] and Kamimura et al 2007 [40], each incorporated by reference in its entirety, which describe exemplary use of enhancer in connection with T cell activation.

[00102] In particular in some embodiments, the enhancing is performed by reducing CD86 expression and/or IL12 secretion by dendritic cells in the individual.

[00103] In some embodiments, an immunogenic fragment of ApoB-100 is further administered with the methods that are provided to treat and/or prevent an aneurysm and/or a condition associated thereto in an individual together with an effective amount of CD8(+) T cells specific for an immunogenic fragment of ApoBlOO and possibly one or more enhancers.

[00104] As disclosed herein, the immunogenic fragments or immunogenically active portion thereof, CD8(+) Tcell, and enhancers herein described can be provided as a part of systems to treat and/or prevent an aneurysm or of a condition associated thereto.

[00105] In an embodiment, the system comprises at least two of one or more of a CD8(+) T cell presenting an epitope of an immunogenic fragment of ApoB-100 and one or more cytokine able

to enhance the activated CD8(+) T cell.

[00106] In an embodiment, the system comprises at least two of one or more immunogenic fragments of apoB-100 and one or more of an activated CD8(+) T cell specific for an immunogenic fragment of ApoB-100.

[00107] In an embodiment, the system comprises at least two of one or more immunogenic fragments of apoB-100 and CD8(+) T cell and one or more of a CD8(+) T cell presented with an epitope of an immunogenic fragment of ApoB-100 and further comprising one or more cytokines able to enhance the CD8(+) T cell.

[00108] The systems can be provided in the form of kits of parts. In a kit of parts, the immunogenic fragments, CD8(+) T cell herein described and other reagents to perform the method herein described can be comprised in the kit independently. The CD8(+) T cell herein described can be included in one or more compositions, and each CD8(+) T cell herein described can be in a composition together with a suitable vehicle.

[00109] Additional components can include enhancers molecules able to detect CD8(+) Tcell herein described, such as labeled molecules and in particular, labeled antibodies, labels, microfluidic chip, reference standards, and additional components identifiable by a skilled person upon reading of the present disclosure. The terms "label" and "labeled molecule" as used herein as a component of a complex or molecule referring to a molecule capable of detection, including but not limited to radioactive isotopes, fluorophores, chemiluminescent dyes, chromophores, enzymes, enzymes substrates, enzyme cofactors, enzyme inhibitors, dyes, metal ions, nanoparticles, metal sols, ligands (such as biotin, avidin, streptavidin or haptens) and the like. The term "fluorophore" refers to a substance or a portion thereof which is capable of exhibiting fluorescence in a detectable image. As a consequence, the wording "labeling signal" as used herein indicates the signal emitted from the label that allows detection of the label, including but not limited to radioactivity, fluorescence, chemiluminescence, production of a compound in outcome of an enzymatic reaction and the like.

[00110] In some embodiments, detection of a CD8(+) T cell or immunogenic fragments herein described can be carried either via fluorescent based readouts, in which the labeled antibody is labeled with fluorophore, which includes, but not exhaustively, small molecular dyes, protein chromophores, quantum dots, and gold nanoparticles. Additional techniques are identifiable by a skilled person upon reading of the present disclosure and will not be further discussed in detail.

[00111] In particular, the components of the kit can be provided, with suitable instructions and other necessary reagents, in order to perform the methods here described. The kit will normally contain the compositions in separate containers. Instructions, for example written or audio instructions, on paper or electronic support such as tapes or CD-ROMs, for carrying out the assay, will usually be included in the kit. The kit can also contain, depending on the particular method used, other packaged reagents and materials (e.g. wash buffers and the like).

[00112] In some embodiments, the immunogenic fragments, active portions thereof, CD8(+) Tcell and/or enhancers herein described can be included in compositions together with a suitable vehicle.

[00113] The term "vehicle" as used herein indicates any of various media acting usually as solvents, carriers, binders or diluents for T cell comprised in the composition as an active ingredient.

[00114] In some embodiments, where the composition is to be administered to an individual the composition can be a pharmaceutical anti-inflammatory composition, and comprises T cell and a pharmaceutically acceptable vehicle.

[00115] In particular, in some embodiments, disclosed are pharmaceutical compositions which contain at least one the immunogenic fragments, active portions thereof, CD8(+) Tcell and/or enhancers herein described as herein described, in combination with one or more compatible and pharmaceutically acceptable vehicles, and in particular with pharmaceutically acceptable diluents or excipients. In those pharmaceutical compositions the immunogenic fragments, active portions thereof, CD8(+) Tcell and/or enhancers herein described can be administered as an active ingredient for treatment or prevention of a condition in an individual.

[00116] The term "excipient" as used herein indicates an inactive substance used as a carrier for the active ingredients of a medication. Suitable excipients for the pharmaceutical compositions herein disclosed include any substance that enhances the ability of the body of an individual to absorb a immunogenic fragments, active portions thereof, CD8(+) Tcell and/or enhancers herein described. Suitable excipients also include any substance that can be used to bulk up formulations with the immunogenic fragments, active portions thereof, CD8(+) Tcell and/or enhancers herein described to allow for convenient and accurate dosage. In addition to their use in the single-dosage quantity, excipients can be used in the manufacturing process to aid in the handling of the immunogenic fragments, active portions thereof, CD8(+) Tcell and/or enhancers herein described. Depending on the route of administration, and form of medication, different excipients can be used. Exemplary excipients include but are not limited to antiadherents, binders, coatings disintegrants, fillers, flavors (such as sweeteners) and colors, glidants, lubricants, preservatives, sorbents.

[00117] The term "diluent" as used herein indicates a diluting agent which is issued to dilute or carry an active ingredient of a composition. Suitable diluent include any substance that can decrease the viscosity of a medicinal preparation.

[00118] In an embodiment, compositions herein described can further include an adjuvant. The term "adjuvant" as used herein indicates an agent that can stimulate the immune system and increase the response to a vaccine, without having any specific antigenic effect in itself. The word "adjuvant" comes from the Latin word adjuvare, meaning to help or aid. Typically, an immunologic adjuvant is defined as any substance that acts to accelerate, prolong, or enhance antigen-specific immune responses when used in combination with specific vaccine antigens.

[00119] In some embodiments, pharmaceutical composition can include (1) a peptide or other immunogenic molecule herein described administered alone, (2) a peptide or other immunogenic molecule herein described + carrier(s); (3) a peptide or other immunogenic molecule herein described + adjuvant; (4) a peptide or other immunogenic molecule herein described + carrier + adjuvant. In particular, the carriers for each of the exemplary composition (1) to (4) can comprise: (1) cBSA, (2) rHSA, (3) KLH, (4) cholera toxin subunit B, respectively, each of which can be mineral salt-based. Other carriers, known to those skilled in the art, are expected to be suitable as well as will be identified by a skilled person. Examples of those adjuvants comprise adjuvants having Th2 effects, carriers having adjuvant properties, e.g., diphtheria toxoid, and adjuvants able to function as carriers, e.g., oil-water emulsions. In some embodiments, a necessary, and under certain conditions sufficient, component for the pharmaceutical composition is the immunogenic peptides. Additional components of the composition can be selected to modulate the immunological impact of the peptides or other immunogenic molecule herein described as will be understood by a skilled person.

[00120] Further advantages and characteristics of the present disclosure will become more apparent hereinafter from the following detailed disclosure by way of illustration only with reference to an experimental section.

EXAMPLES

[00121] The methods system herein described are further illustrated in the following examples, which are provided by way of illustration and are not intended to be limiting.

[00122] In particular, the following examples illustrate exemplary immunogenic fragments and methods for immunizing individuals to treat or prevent an aneurysm and in particular methods using fragment p210.

[00123] A person skilled in the art will appreciate the applicability and the necessary modifications to adapt the features described in detail in the present section, to additional immunogenic fragments, administered subcutaneously or using other routes of administration in vivo or in vitro according to embodiments of the present disclosure.

[00124] Unless otherwise indicated the following material and methods were followed in the Examples reported below.

[00125] Selection of peptides and their preparation for immunization The establishment and screening of human apoB-100 peptides has been reported (8). Based on Applicants pilot experiments and prior reports, see references (9), (10) Applicants selected peptide 210 (p210, KTTKQ SFDLS VKAQY KKNKH - SEQ ID NO: 210) as a candidate immunogen. Native p210 peptide (Euro-Diagnostica AB, Sweden) was conjugated to cationic bovine serum albumin (cBSA) as carrier using a method described previously see references (3), (4) Alum was used as adjuvant and mixed with peptide/cBSA conjugate with 1:1 ratio in volume. Peptide conjugation and mixing with alum were prepared fresh prior to each immunization.

[00126] Immunization protocols Male apoE (-/-) mice (Jackson Laboratories) were housed in an animal facility accredited by the American Association of Accreditation of Laboratory Animal Care and kept on a 12-hour day/night cycle with unrestricted access to water and food. The Institutional Animal Care and Use Committee of Cedars-Sinai Medical Center approved the experimental protocols. In a pilot experiment, p210 immunization using lOC^g dose conferred optimum athero-reduction compared to 25 or 5C^g dose. Hence lOC^g dose was used for all subsequent experiments. Mice, maintained on normal chow diet, received subcutaneous primary immunization in the dorsal area between scapulas at 6-7 weeks of age, followed by a booster at 9 and 12 weeks of age. One week after last booster, diet was switched to high cholesterol chow (TD 88137, Harlan-Teklad) and continued until euthanasia at the age of 25 weeks. Separate groups of mice receiving PBS or cBSA/alum at the same immunization time-points served as control. Some mice were sacrificed at 8 or 13 weeks of age to assess immune response against p210.

[00127] Tissue harvesting and preparation At euthanasia the hearts were harvested and embedded in OCT compound (Tissue-Tek) for cryo-section. Whole aortas were cleaned, processed and stained with Oil Red O to assess the extent of atherosclerosis en face with computer-assisted histomorphometry, see references (3), (4).

[00128] Immunohistochemistry and histomorphometry The sections from aortic sinus were stained with MOMA-2 (Serotec), or CD 11c (eBioscience) antibody to identify macrophages or dendritic cells immunohistochemically using standard protocol. Oil-Red-0 stain for plaque size was done using standard protocol. Computer-assisted morphometric analysis was performed to assess histomorphometry as described previously, see references (3), (4).

[00129] Serum ELISA Flat-bottomed 96-well polystyrene plates (MaxiSorp, Germany) were pre-coated with lOOul (2(^g/ml) p210, KLH, TNP-KLH (Biosearch Technologies T-5060) or BSA (2μg/ml for IgG or lC^g/ml for IgM) respectively by incubation overnight at 4°C to assess antibodies levels using standard protocol. The coating concentration was optimized in pilot experiments. Goat anti-mouse HRP -IgG (Pierce 31437) or IgM (Southern Biotech) were used as detecting antibodies and the bound antibodies were detected by developing in ABTS (Southern Biotech) as substrate and optical density values were recorded at 405 nm.

[00130] Flow cytometric analysis Flow cytometric analysis was performed using standard protocols with antibodies listed in Table 1 below and a FACScan (Becton Dickinson) or a CyAn ADP analyzer (Beckman Coulter). For intracellular cytokine staining, Brefeldin A (3 g/ml) was added to the cultured cells for 2 hours before cells subject to staining procedure. Cell membranes were permeabilized for staining intracellular molecules.

Table 1


[00131] Adoptive transfer experiment Male apoE (-/-) mice on regular chow received subcutaneous immunization as described in previous paragraph and were sacrificed at 13 weeks of age as donors. Splenocytes from the same treatment group were pooled before cell isolation. Donor CD8(+) T-cells, CD4(+)CD25(+) T-cells or B-cells were isolated using Dynabeads FlowComp (Invitrogen) according to the manufacturer's protocols. CD4(+) T-cells were negatively selected from the splenocytes followed by positive selection of CD4(+)CD25(+) cells. B cells were negatively isolated whereas CD8(+) T-cells were positively isolated first and released from beads. The purity of pooled CD8(+) T-cells, CD4(+)CD25(+) T-cells and B-cells was 90%, 80% and 70%, respectively. The isolated CD8(+) T-cells (lxlO6 cells/mouse), CD4(+)CD25(+) T-cells (lxlO5 or 3xl05 cells/mouse) or B-cells (2xl07 cells/mouse) were then adoptively transferred to naive male apoE (-/-) recipient mice at 6-7 weeks of age via tail vein injection. In the published literatures of vascular biology, the number of adoptively transferred lymphocytes varied greatly. For B-cells transfer, the number of 2x10 cells/mouse was chosen based on two prior reports, see references (11), (12). For CD4(+)CD25(+) T-cells transfer, the number of cells transferred ranged from 5xl04 cells/mouse to lxlO6 cells/mouse in the published literature see references (13), (14), (15). Hence we chose 2 intermediate doses for our experiment. As to CD8(+) T-cells, lxlO6 cells was chosen based on a report from the field of autoimmune disease see ref (16). Applicants did not adoptively transferred CD4(+) T-cells because naive or antigen-primed CD4(+) T-cells are known to be pro-atherogenic see references (17),(18) Recipient mice were fed normal chow until 13 weeks of age when chow was switched to high cholesterol diet until euthanasia at 25 weeks of age. Aortas were harvested to assess the extent of atherosclerosis.

[00132] KLH or Trinitrophenyl-lipopolysaccharide (TNP-LPS) Immunization Applicants also tested if p210 immunization affected the efficacy of subsequent immunization with other antigens. KLH was chosen as a prototypical T-cell dependent and TNP as a T-cell independent antigen. Male C57/BL6 mice on regular chow received subcutaneous immunization with p210 conjugate or adjuvant control as described in previous paragraphs for apoE (-/-) mice. At 13 and 15 weeks of age mice were subcutaneously immunized with 100 μg KLH (with alum as adjuvant) at injection sites away from p210 sites or injected intraperitoneally with 100 μg TNP-LPS (Sigma). KLH or TNP immunization was done in separate groups of mice. Blood was collected via retro-orbital puncture at euthanasia (16 weeks of age).

[00133] In vitro Generation of BM-derived dendritic cells (BMDCs) The method for generating BMDC with GM-CSF was adapted from previous publication with modification see reference (19). Briefly, bone marrow cells from femurs and tibiae of male apoE-/- mice were plated into 10cm culture plates (Falcon) with 20 ml complete RPMI-1640 containing lOng/ml GM-CSF (R&D Systems) and lOng/ml IL-4 (Invitrogen). Cells were washed and fed on day 3 and day 5 by removing the old medium followed by replenishing with fresh culture medium with GM-CSF and IL-4. On day 8, the immature DC appeared as non-adherent cells under the microscope and harvested by vigorous pipetting and subcultured into new culture plates with 2xl05 DCs in 1.5ml medium.

[00134] In vitro CD8(+) T-cells isolation and co-culture with dendritic cells Donor mice [male apoE (-/-) mice] for CD8(+) T-cells were immunized with PBS, cBSA/Alum, or cBSA/Alum/P210 according to the schedule described in earlier paragraphs and splenocytes were harvested at 13 weeks of age. CD8(+) T-cells were negatively isolated using a CD8 selection Dynabeads kit (Invitrogen) per manufacturer's protocol. The selected CD8(+) T-cells were then co-culture with DCs in a CD8:DC ratio of 3: 1. A series of pilot studies has been performed to determine the optimal CD8:DC ratio for this assay. After co-culture for 4 hours, cells were collected and processed for flow cytometric determination of CD 11c and 7-AAD by LSR II flow cytometer (BD Biosciences) and data was analyzed with Summit V4.3 software. Dendritic cell death without CD8(+) T-cells in the co-culture was used as baseline and percentage of specific lysis of cells was calculated using a method described previously, see reference (20).

[00135] Statistics Data are presented as mean + Std. Number of animals in each group is listed in text or description of the figures. Data were analyzed by ANOVA followed by Newman- Keuls multiple group comparison, or by t-test when appropriate. P < 0.05 was considered as statistically significant and horizontal bars in each figure indicated statistically significant difference between groups.

Example 1: Immunogenic fragments of ApoB-100

[00136] Specific immunogenic epitopes by focusing on the single protein found in LDL, apolipoprotein B-100 (apo B) were characterized. A peptide library comprised of 302 peptides, 20 amino acid residues in length, covering the complete 4563 amino acid sequence of human apo B was produced. The peptides were produced with a 5 amino acid overlap to cover all sequences at break points. Peptides were numbered 1-302 starting at the N-terminal of apo B as indicated in Table 2 below.

Table 2

Table 2

Table 2

Table 2

Table 2

Table 2

Table 2

Table 2

Table 2

Table 2

Table 2

[00137] The full length sequence of ApoBlOO can be found in various publications reference (43) (see in particular Figure 1) herein incorporated by reference in its entirety.

Example 2: Immunization with an apoB-100 immunogenic fragments reduced aortic aneurysm rupture

[00138] Male apoE KO mice were subcutaneously immunized at 7, 10, and 12 weeks of age with either Group 1: P210/cBSA conjugate using alum as adjuvant (10( g P210); Group 2: control- 100 μg of cBSA/alum (cBSA); Group 3: control PBS (PBS). Fourteen P210, 17 cBSA, 16 PBS, and 8 Saline injected mice were examined.

[00139] Angll (lOOOng/Kg/min) was delivered by a subcutaneous osmotic pump implanted at 10 weeks of age for 4 weeks to cause aneurysms in all three groups. Saline was delivered to the control group. Mice were sacrificed at 14 weeks of age of age. The mice were fed normal chow for the duration of experiment.

[00140] Aneurysm formation (including rupture) and incidence were investigated. The results are illustrated in Table 3 A and Table 3B below.

Table 3A.


Table 3B

Pump Group Number of mice in Aneurysm incidence Survival at 28 days

each group

P210 42 54.8% 90.5%

Ang II

cBSA 46 84.8% 69.6%

PBS 37 81.1% 64.9%

Saline Saline 8 0% 100%

[00141] As illustrated in the above Tables, P210 immunization reduced mortality from aneurismal rupture. Immunization with apoB-100 related peptide P210 has a 90.5% chance of survival at 28 days after starting of angiotensin II infusion, whereas only 69.9% or 64.9% for cBSA group and PBS group, respectively.

[00142] A possible mechanism of action provided herein for guidance purposes only and not intended to be limiting is that p210 immunization reduces BP; 2. Effect of p210 immunization is mediated by CD8 to a same or comparable extent detected for reduction of atherosclerosis illustrated in the following examples. Accordingly, ability to elicit a T cell response is specific for p210 (antigen specificity) and other apoB-100 peptides are expected to show similar antigen-specific CD8 effect.

Example 3: Immunization with an immunogenic fragment of ApoB-100 reduces aortic aneurysmal segment formation

[00143] Male apoE KO mice were subcutaneously immunized at 7, 10, and 12 weeks of age with either Group 1: P210/cBSA conjugate using alum as adjuvant (100μg P210); Group 2: control-100 μg of cBSA/alum (cBSA); Group 3: control PBS (PBS). 42 P210, 46 cBSA, 37 PBS, and 8 Saline injected mice were examined.

[00144] Angll (lOOOng/Kg/min) was delivered by a subcutaneous osmotic pump implanted at 10 weeks of age for 4 weeks to cause aneurysms in all three groups. Saline was delivered to the

control group. Mice were sacrificed at 14 weeks of age of age. The male apoE KO mice were fed normal chow for the duration of experiment.

[00145] The measurement of the aorta was taken at 8 segments: 1) beginning of arch, 2) end of arch, 3) apex level, 4) between 3 & 5, 5) supra renal, 6) infra renal, 7) before bifurcation, and 8) between renal arteries (see schematic illustration of Figure 1).

[00146] The average diameters of each segment illustrated in Figure 1 are reported in Table 4 below, wherein the segmental aneurysms are circled.

Table 4


[00147] A further elaboration of the data of Table 4, illustrated in Table 5 below suggests that P210 immunization significantly reduces aneurysmal section formation. Whereas the aneurysmal segment/total segment percentage is 29.6% for cBSA controls and 23.4% for PBS controls, P210 immunization reduced the aneurysmal segment/total segment percentage to 14.3%.

Table 5


Example 4: Immunization with an immunogenic fragment of ApoB 100 reduces mortality associated with aortic aneurysmal rupture

[00148] Male apoE KO mice were subcutaneously immunized at 7, 10, and 12 weeks of age with either Group 1: P210/cBSA conjugate using alum as adjuvant (100μg P210); Group 2: control-100 μg of cBSA/alum (cBSA); Group 3: control PBS (PBS). 42 P210, 46 cBSA, 37 PBS, and 8 Saline injected mice were examined.

[00149] Angll (lOOOng/Kg/min) was delivered by a subcutaneous osmotic pump implanted at 10 weeks of age for 4 weeks to cause aneurysms in all three groups. Saline was delivered to the control group. Mice were sacrificed at 14 weeks of age of age. 42 P210, 46 cBSA, 37 PBS, and 8 Saline injected mice were examined. Mice were sacrificed at 14 weeks of age. The male apoE KO mice were fed normal chow for the duration of experiment.

[00150] The results are illustrated in the chart of Figure 2, which shows survival of the mice treated with p210 over the control groups. The survival rate was 90.5% for P210, 69.6% for cBSA, 64.9% for PBS, and 0% for the saline control at 28 days after implantation of an osmotic pump for angiotensin II infusion to elicit aneurysm formation, as shown in the illustration of Figure 2.

Example 5: Athero-protective effects of p210 immunization

[00151] The vaccine preparation consisted of the p210 peptide (Euro-Diagnostica AB, Sweden) conjugated to cationic bovine serum albumin (cBSA) as carrier using a method described previously3'4. Alum was used as adjuvant and mixed with peptide/cBSA conjugated with 1: 1 ratio in volume. Peptide conjugation was performed on the day of immunization and freshly mixed with alum just prior to each immunization. Mice fed normal chow diet received subcutaneous primary immunization in the dorsal area between scapulas at 6-7 weeks of age, followed by a booster at 10 and 12 weeks of age. One week after the last booster, diet was switched to high cholesterol chow (TD 88137, Harlan-Teklad) and continued until euthanasia at the age of 25 weeks.

[00152] Immunization with p210 reduced aortic atherosclerosis by 57% and 50% compared to PBS and cBSA/Alum group, respectively (Figure 3A) without affecting circulating cholesterol levels or body weight (Table 6).

Table 6 Circulating level of cholesterol and body weight of mice from PBS, cBS A/alum and p210/cB S A/alum group

[00153] The aortic sinus plaques from p210/cBS A/alum group contained significantly reduced macrophage and DC immuno-reactivity assessed by MOMA-2 and CD 11c immuno-staining, respectively (Figure 3B). with no difference in the atherosclerotic lesions (PBS group 0.40+0.13 mm2, n=10; cBSA/alum group 0.42+0.09 mm2, n=10; p210/cBS A/alum group 0.40+0.08 mm2, n=9).

Example 6: Characterization of p210-immunization elicited immune responses

[00154] Since DCs are the major cell type upstream to both cellular and humoral immune responses, Applicants determined if these cells were affected by the immunization strategy. Cells from the subcutaneous immunization sites were isolated for flow cytometric analysis one week after primary immunization. The PBS group could not be included in this analysis because mice receiving PBS injection did not develop swelling or cell accumulation at the injection site.

[00155] There were significantly fewer CDl lc(+) and CDl lc(+)CD86(+) cells in p210/cBS A/alum group compared to cBS A/alum group at the immunization site (Figure 4A and 4B). When flow cytometry was performed on LN cells 1 week after the third immunization, CDl lc(+)CD86(+) cells were also significantly reduced compared with cBSA/alum group (Figure 4C).

[00156] Applicants next assessed antibody response to define the humoral immune response against p210. Before immunization all 3 groups of mice had low levels of IgG titers against p210. At euthanasia, the IgG titer against p210 remained low in the PBS group but was

significantly increased in cBSA/alum group. Immunization with p210/cBS A/alum resulted in increased p210 IgG titer compared with PBS group but was significantly reduced compared with cBS A/alum group (Figure 5A). In contrast to p210 IgG response, there was a significant increase in p210 IgM titer in all groups (Figure 5B), suggesting an endogenous immune response against p210.

[00157] The IL-2Rcc (CD25) is a well-defined lymphocyte activation marker. Applicants therefore analyzed the expression of CD25 on CD4(+) or CD8(+) T-cells from superficial cervical and axillary lymph nodes (LN) from mice one week after primary immunization to assess the T-cell immune response. CD8(+)CD25(+) T-cell population in the lymph nodes was significantly higher in p210/cBS A/alum group when compared to that of PBS or cBS A/alum groups (Figure 6A) whereas CD4(+)CD25(+) T-cells in the lymph nodes (Figure 6B) did not differ among 3 groups.

[00158] There was a significantly larger population of splenic CD8(+)CD25(+)IL-10(+) T-cells in p210/cBS A/alum group when compared to PBS or cBSA/alum groups (Figure 6C) without difference in splenic CD8(+)CD25(+)IL12(+) T-cells among 3 groups (Figure 6D). Splenic CD4(+)CD25(+)IL-10(+) T-cell population significantly increased in the cBSA/alum group. However, this increased response was significantly attenuated by the p210/cBS A/alum immunization (Figure 6E); whereas splenic CD4(+)CD25(+)IL12(+) T-cells did not differ among the three groups (Figure 6F).

Example 7: Adoptive transfer of CD8(+) T-cells from p210 immunized mice to naive recipients recapitulates the athero-protective effect of p210 immunization

[00159] Donor apoE(-/-) mice were subjected to the same immunization protocol with the same groupings, namely: PBS, cBSA/alum, or p210/cBSA/alum. Recipient naive male apoE(-/-) mice were injected with donor cells at 6-7 weeks of ageand were fed normal chow until 13 weeks of age when chow was switched to high cholesterol diet until euthanasia at 25 weeks of age.

[00160] At euthanasia, the recipient mice injected with CD8(+) T-cells from p210/cBS A/alum group developed significantly less atherosclerotic lesions in aorta compared to the recipient mice injected with CD8(+) T-cells from PBS or cBSA/alum groups strongly suggesting that the

effector T cell induced by the vaccine are CD8+ and is mechanistically involved (Figure 7A).

[00161] This reduction of aortic lesions was coupled with decreased splenic CDl lc(+) DCs (PBS group: 4.3+1.7%; cBSA/alum group: 3.4+0.3%; p210/cBS A/alum group: 1.5+0.3%; n=5 each group, p < 0.05 p210/cBS A/alum group vs. PBS or cBSA/alum group by ANOVA ) with no difference in circulating levels of total cholesterol among 3 groups (PBS group: 1083+296 mg/dl; cBSA/alum group: 975+401 mg/dl; p210/cBS A/alum group: 1098+379 mg/dl).

[00162] Adoptive transfer of B cells isolated from the spleens of p210 immunized donor mice did not affect atherosclerosis in recipient mice compared to mice receiving B cells from other donors (Figure 7B) These observations ruled out B cells as mediators of athero-protective effect of p210 immunization..

[00163] To rule out CD4(+)CD25(+) T-cells as possible athero-protective mediators induced by sub-cutaneous p210 immunization, Applicants adoptively transferred CD4(+)CD25(+)T-cells at a dose of lxlO5 cells/mouse into naive recipient apoE-/- mice. There was no difference in lesion size among the 3 groups of CD4(+)CD25(+)T-cell recipients. Depletion of CD25+ cells from the pool of CD8+ T cells abrogated the reduction in atherosclerosis observed in the p210/cBS A/alum recipient mice, further supporting the notion that CD8+CD25+ T cells are mechanistically involved in the protective effects of the vaccine against atherosclerosis (Figure 7C). Transfer of a higher number of CD4(+)CD25(+) T-cells at 3xl05 cells/mouse did not reduce lesion sizes in all 3 recipient groups (Figure 7D).

Example 8: Increased cytolytic activity of CD8(+) T cells from p210 immunized mice against dendritic cells in vitro

[00164] Given the observation that p210 immunization reduced DCs in the immunization sites and atherosclerotic plaques and adoptive transfer of CD8(+) T-cells from p210 immunized donors rendered a decrease of splenic DCs in the recipients, Applicants hypothesized that DCs could be a potential target of CD8(+) T-cells.

[00165] To test this, Applicants co-cultured bone marrow derived DCs with CD8(+) T-cells from various immunized groups. CD8(+) T-cells from p210 immunized mice significantly increased the percentage of DC death when compared to those from PBS or BSA/alum groups (Figure 8).

This increased cytolytic function of CD8(+) T-cells was associated with increased granzyme B expression but not perforin (Figure 9).

Example 9: Immunization with p210 does not affect the adaptive immune response to other T-cell dependent or independent antigens

[00166] Given the observations that p210 immunization decreased CDl lc(+) DCs and reduced adaptive IgG response to p210, Applicants next tested if such modulation of DCs by p210 immunization would alter the host immune response to other antigens.

[00167] Applicants first immunized mice with p210 as described in previous sections followed by two separate subcutaneous KLH immunizations or intra-peritoneal injection of TNP-LPS. Using the KLH- or TNP-IgG titer as a surrogate for the efficacy of individual immunization, Applicants found that there was no difference in KLH- or TNP-IgG titers between p210 immunized mice and the titers from mice of PBS or cBS A/alum groups (Figure 10).

Example 10: Immunization with an apoB-100 immunogenic fragments reduces hypertension and mortality in Angiotensin II-induced aortic aneurysm

[00168] ApoE (-/-) mice were immunized with p210/cBS A/Alum (p210; 100 μg) at 7, 10, and 12 weeks of age. Mice receiving PBS or cBSA/Alum (cBSA) served as controls. At 10 weeks of age, mice were subcutaneously implanted with an osmotic pump which released Angll (1 mg/Kg/min), and were euthanized 4 weeks later. The aorta, spleen, and lymph nodes (LN) were harvested. The p210 vaccine significantly reduced mortality due to AA rupture compared to controls (see Figure 11).

[00169] Flow cytometric analysis of dendritic cells (DCs) in LNs and spleen showed intracellular IFN-γ expression was upregulated in the p210 group. Aortic superoxide production measured by in situ dihydroethidine method and aortic ATI receptor (AT1R) expression measured by Western blot were significantly decreased in p210 group. The p210 vaccine significantly decreased mean arterial BP at 13 weeks of age (see Table 7).

[00170] Mortality from Angll induced AA rupture was significantly reduced by the p210 vaccine. This protective effect was associated with upregulation of IFN-γ expression in DCs and decreased arterial BP, AT1R expression, and superoxide production in aorta. The vaccine may be a promising new non-invasive treatment for AA.

Table 7 Flow cytometric analysis of intracellular IFN-γ expression of dendritic cells (DCs)


Example 11: Increased cytolytic activity of CD8 (+) T cells from apoB-100 immunogenic fragments immunized mice is specific to lipid-associated antigens

[00171] Applicants have shown that immunization with apoB-100 related-peptide p210 significantly reduces atherosclerosis and decreases intra-plaque CDl lc+ dendritic cells (DCs) in apoE-/- mice. Adoptive transfer experiments showed that athero-protection was mediated by CD8+ T cells. Because apoB-100 is found on the LDL fraction of serum lipids, Applicants assessed the CD8+ T cell cytolytic activity of p210 immunized mice specific to lipid-associated antigens presented by DCs.

[00172] ApoE-/- mice were immunized at 7, 9, and 12 weeks of age with p210/cBS A/alum, cBS A/alum, or PBS. One week after the third immunization, mice were euthanized to collect

spleen CD8+ T cells. Bone-marrow derived DCs were differentiated from naive apoE-/- mice and used as target cells. A four-hour lytic assay was performed using a CD8-to-DC ratio of 3: 1 in culture medium with 10% FBS. The cells were then collected and stained for CDl lc to identify DCs and 7-AAD to assess cell lysis using flow cytometry. There was significantly more lytic activity by CD8+ T cells from p210/cBS A/alum immunized mice compared to cBS A/alum and PBS (Table). When the assay was performed in media with delipidated FBS, the lytic activity specific to CD8+ T cells from from p210/cBS A/alum immunized mice was abrogated (Table 8), suggesting that the lipid fraction of FBS in the culture media provided a source of antigen. Loading of DCs with FITC-labeled p210 24 hours prior to the lytic assay demonstrated antigen uptake and specificity of the lytic activity of CD8+ T cells from p210/cBS A/alum immunized mice (see Table 8).

[00173] These results show that the cytolytic function of CD8+ T cells targeting DCs are specific to lipid- associated antigens, specifically the p210 fragment of apoB-100, and this may underly the protective effects of p210 immunization.

Table 8 Flow cytometric analysis of cytolytic activity of CD8 (+) T cells.


Example 12: Antibody response to the p210 vaccine

[00174] Antibody titers to p210 was low prior to immunization. At euthanasia at 25 weeks of age, there was a significant increase in p210 IgM titer in all groups (Figure 12), suggesting an endogenous immune response against self -peptide p210. There was a significant increase in p210 IgG titers in both cBS A/alum group and p210/cBS A/alum compared with the PBS group, but

titers in the cBSA/alum was surprisingly the higher between the 2 responding groups. The presence of alum as adjuvant in the cBS A/alum group and p210/cBS A/alum groups likely resulted in class switching of the IgM response to IgG, which did not occur in the PBS group.

Example 13: CD4 (+) T cell and CD8 (+) T cell response to the p210 vaccine

[00175] T cells from superficial cervical and axillary lymph nodes (LN) from mice one week after primary immunization were collected to assess the T cell immune response. CD4+CD25+ T cells in the lymph nodes (Table 1) did not differ among 3 groups. Splenic CD4+CD25+IL-10+ T cell population significantly increased in the cBSA/alum group. However, this increased response was significantly attenuated by the p210/cBS A/alum immunization (Table 9). Interestingly, splenic CD4+CD62L+ T cell (Table 1) population was lower in cBSA/alum group.

[00176] One week after primary immunization, the CD8+CD25+ T cell population in the lymph nodes was significantly higher in p210/cBS A/alum group when compared to that of PBS or cBS A/alum groups (Table 2). There was a significantly larger population of splenic CD8+CD25+IL-10+ T cells in p210/cBS A/alum group when compared to PBS or cBSA/alum groups (Table 2). The splenic CD8+CD62L+ T cell population was significantly higher in p210/cBS A/alum group when compared to that of PBS or cBS A/alum groups (Table 9). The T cell profile at other time points were not significantly different between groups.

Table 9 CD4 (+) and CD 8 (+) T cell response to the p210 vaccine

CD4+ T cell response to p210 vaccine.

PBS cBSA/a!um p21G/cBSA/aium

LN CD4+CD25+ 12.9±1.9 12.5±1.4 14.012.8

Spl CD4+CD25+IL-10+ 2.3+0.3 4.312.1* 1.710.6

Spi CD4+CD62L+ 26.711.7 21.412.7* 29.914.8

P<0.05 vs. other groups

CD8+ T ceil response to p210 vaccine.

PBS cBSA/a!um 210/εΒ8Α¾Ιϋηι

LN CD8+CD25+ 4.410.8 4.111.0 6.813.0*

Spi CD8+CD25+IL-10+ 4.913.9 6.013.2 12.613.9*

Spi CD8+CD62L+ 18.413.4 19.015.5 27.615.1*

P<0.05 vs. other groups

Example 14: Effector role of CD8+CD25+ T cells involves cytotoxic function

[00177] The vaccine reduced DC presence in the plaques (Figure 3), and in the spleens of p210/cBS A/alum recipient mice, suggesting that the effector role of CD8+ T cells after immunization was manifested in decreasing DCs in the plaque. Applicants therefore assessed the effect of the vaccine on cytotoxic activity of CD8+ T cells against syngeneic bone marrow-derived DCs. CD8+ T cells from the immunized groups were negatively isolated using a CD8 selection Dynabeads kit (Invitrogen) followed by co-culture with DCs in a CD8:DC ratio of 3: 1 in RPMI supplemented with 10% FBS. Cells were collected and processed for flow cytometric determination of CDl lc+ and 7-AAD 4 hours later.20 Dendritic cell death without CD8+ T cells in the co-culture was used as baseline and percentage of specific lysis of cells was calculated using a method described previously. 20

[00178] CD8+ T cells from p210 immunized mice significantly increased the percentage of DC lysis when compared to those from PBS or cBSA/alum groups (Figure 13, panel A). This increased cytolytic function of CD8+ T cells was associated with increased granzyme B expression but not perforin. Depletion of CD25+ cells abrogated the increased cytolytic activity specific to the CD8+ T cells from p210 immunized mice (Figure 13, panel B) indicating that CD8+CD25+ T cells were the effector population. The increased cytolytic function specific to CD8+ T cells from p210 immunized mice was also lost with the use of delipidated serum supplemented medium (Figure 13, panel C), indicating that the antigen on the target DCs recognized by the CTLs was derived from serum LDL containing apoB-100 in the medium.

Example 15: p210 peptide is endocytosed by DCs in vitro.

[00179] Peptide loading on BMDCs was defined using p210 labeled with FITC (FITC conjugating kit from Pierce). The presence of FITC fluorescence in the dendritic cells indicated uptake of p210 by dendritic cells. Reference is made in particular to Figurel4 which shows the FITC-labeled p210 is endocytosed by DCs, indicating antigen uptake.

Example 16: p210 peptide is presented by DCs to CD8+ T cells.

[00180] The p210 peptide contains the proteoglycan binding site of the apoB-100 molecule. This peptide is a cell-penetrating peptide capable of efficiently delivering antigens for cross-presentation to cytotoxic CD8+ T cells.53 Applicants therefore assessed activation of CD8+CD25~ T cells co-cultured with DCs loaded with p210 and matured with LPS. There was significantly increased CD8+CD25+ T cells 48 hours after co-culture with p210-loaded DCs treated with LPS compared to untreated, or LPS only treated co-cultures (Figure 15). The results suggest that the p210 antigen is presented by DCs to CD8+ T cells.

Example 17: p210-loaded DCs are specifically targeted by immune CD8+ T cells.

[00181] The results shown above in Example 16 support the notion that p210 is presented by DCs to CD8+ T cells. It remained unclear if the lytic activity against DCs was specific to the p210 antigen. Applicants therefore repeated the lytic assay using FITC-labeled p210 loaded BMDC as targets. Lytic activity against FITC+ DCs was significantly increased in CD8+ T cells from the p210/cBS A/alum mice (Figure 16), indicating antigen specific lytic activity.

[00182] In summary, in several embodiments, described herein are immunomodulatory agents, T cell, compositions, methods and systems for treating and/or preventing an aneurysm and/or a condition associated thereto in an individual.

[00183] The examples set forth above are provided to give those of ordinary skill in the art a complete disclosure and description of how to make and use the embodiments of the molecules, compositions, systems and methods of the disclosure, and are not intended to limit the scope of what the inventors regard as their disclosure. All patents and publications mentioned in the specification are indicative of the levels of skill of those skilled in the art to which the disclosure pertains.

[00184] The entire disclosure of each document cited (including patents, patent applications, journal articles, abstracts, laboratory manuals, books, or other disclosures) in the Background, Summary, Detailed Description, and Examples is hereby incorporated herein by reference. All references cited in this disclosure are incorporated by reference to the same extent as if each reference had been incorporated by reference in its entirety individually. However, if any inconsistency arises between a cited reference and the present disclosure, the present disclosure takes precedence. Further, the sequence listing submitted herewith in the txt file "P686-PCT-2011-11-11-Sequence Listing_ST25" created on November 11, 2011, forms integral part of the present application and is incorporated herein by reference in its entirety.

[00185] The terms and expressions which have been employed herein are used as terms of description and not of limitation, and there is no intention in the use of such terms and expressions of excluding any equivalents of the features shown and described or portions thereof, but it is recognized that various modifications are possible within the scope of the disclosure claimed Thus, it should be understood that although the disclosure has been specifically disclosed by preferred embodiments, exemplary embodiments and optional features, modification and variation of the concepts herein disclosed can be resorted to by those skilled in the art, and that such modifications and variations are considered to be within the scope of this disclosure as defined by the appended claims.

[00186] It is also to be understood that the terminology used herein is for the purpose of describing particular embodiments only, and is not intended to be limiting. As used in this specification and the appended claims, the singular forms "a," "an," and "the" include plural referents unless the content clearly dictates otherwise. The term "plurality" includes two or more referents unless the content clearly dictates otherwise. Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which the disclosure pertains.

[00187] When a Markush group or other grouping is used herein, all individual members of the group and all combinations and possible subcombinations of the group are intended to be individually included in the disclosure. Every combination of components or materials described or exemplified herein can be used to practice the disclosure, unless otherwise stated. One of ordinary skill in the art will appreciate that methods, device elements, and materials other than those specifically exemplified can be employed in the practice of the disclosure without resort to undue experimentation. All art-known functional equivalents, of any such methods, device elements, and materials are intended to be included in this disclosure. Whenever a range is given in the specification, for example, a temperature range, a frequency range, a time range, or a composition range, all intermediate ranges and all subranges, as well as, all individual values included in the ranges given are intended to be included in the disclosure. Any one or more individual members of a range or group disclosed herein can be excluded from a claim of this disclosure. The disclosure illustratively described herein suitably can be practiced in the absence of any element or elements, limitation or limitations which is not specifically disclosed herein.

[00188] A number of embodiments of the disclosure have been described. The specific embodiments provided herein are examples of useful embodiments of the disclosure and it will be apparent to one skilled in the art that the disclosure can be carried out using a large number of variations of the devices, device components, methods steps set forth in the present description. As will be obvious to one of skill in the art, methods and devices useful for the present methods can include a large number of optional composition and processing elements and steps.

[00189] In particular, it will be understood that various modifications may be made without departing from the spirit and scope of the present disclosure. Accordingly, other embodiments are within the scope of the following claims.

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