Methods of Treating Autoimmune Diseases with DLL4 Antagonists

Abstract

The present invention provides methods of treating a disease or disorder, in which increasing the number of regulatory T cell (Treg) is beneficial, by administering to a subject suffering from such a disease or disorder a therapeutically effective amount of Dll4 antagonists that block Dll4-Notch signal pathways, thereby increasing the number of Treg. Diseases or disorders treatable by the methods of the invention include autoimmune diseases or disorders, such as multiple sclerosis (MS), diabetes, and the like. Suitable Dll4 antagonists for the invention include antibodies or antibody fragments that specifically bind Dll4 and block Dll4-Notch interactions, the extracellular domain of Dll4, and the like. The invention also provides methods of preventing an occurrence or recurrence of such diseases or disorders in a subject predisposed or susceptible to developing such diseases or disorders. Furthermore, the methods of the invention are useful in preventing or treating organ transplant rejections or graft-versus-host disease.

1 . A method of increasing the number of regulatory T (Treg) cells in a subject diagnosed with rheumatoid arthritis, comprising administering an effective amount of an anti-Dll4 antibody or fragment thereof to the subject, wherein the anti-Dll4 antibody or fragment thereof binds human Dll4 and blocks an interaction between Dll4 and a Notch receptor and the number of Treg cells is increased. 
     
     
         2 . (canceled) 
     
     
         3 . The method of  claim 1 , wherein the antibody or fragment thereof comprises a heavy chain variable region (HCVR) comprising heavy chain CDR1, CDR2 and CDR3 sequences of SEQ ID NO:22, 24 and 26, respectively, and a light chain variable region (LCVR) comprising light chain CDR1, CDR2 and CDR3 sequences of SEQ ID NO:30, 32 and 34, respectively. 
     
     
         4 . The method of  claim 3 , wherein the antibody or fragment thereof comprises (a) a HCVR sequence of SEQ ID NO:20 or 116, and a LCVR sequence of SEQ ID NO:28 or 118, or (b) a HCVR/LCVR combination of SEQ ID NO:20/28 or 116/118. 
     
     
         5 . A method of treating or ameliorating rheumatoid arthritis, the method comprising administering a therapeutically effective amount of an anti-Dll4 antibody or fragment thereof to a subject diagnosed with rheumatoid arthritis, wherein the anti-Dll4 antibody or fragment thereof binds to human Dll4 and blocks an interaction between Dll4 and Notch receptor, thereby increasing the number of Treg cells. 
     
     
         6 - 8 . (canceled) 
     
     
         9 . The method of  claim 5 , wherein the antibody or fragment thereof comprises a heavy chain variable region (HCVR) comprising heavy chain CDR1, CDR2 and CDR3 sequences of SEQ ID NO:22, 24 and 26, respectively, and a light chain variable region (LCVR) comprising light chain CDR1, CDR2 and CDR3 sequences of SEQ ID NO:30, 32 and 34, respectively. 
     
     
         10 . The method of  claim 9 , wherein the antibody or fragment thereof comprises (a) a HCVR sequence of SEQ ID NO:20 or 116, and a LCVR sequence of SEQ ID NO:28 or 118, or (b) a HCVR/LCVR combination of SEQ ID NO:20/28 or 116/118. 
     
     
         11 . The method of  claim 5 , further comprising coadministering concurrently or sequentially with the anti-Dll4 antibody or fragment thereof a therapeutically effective amount of at least one additional therapeutic agent selected from the group consisting of immunosuppressant, anti-inflammatory agent, and analgesic agent. 
     
     
         12 . The method of  claim 11 , wherein the additional therapeutic agent is at least one selected from the group consisting of glucocorticoides, cyclosporin, methotrexate, non-steroidal anti-inflammatory drugs (NSAIDs), TNF-α antagonists, IL-1 antagonists, IL-6 antagonists, and opioids. 
     
     
         13 . A method of reducing recurrence of rheumatoid arthritis in a subject previously diagnosed with rheumatoid arthritis, comprising administering to the subject a prophylactically effective amount of an anti-Dll4 antibody or fragment thereof that binds to human Dll4 and blocks an interaction between Dll4 and a Notch receptor, thereby increasing the number of Treg cells. 
     
     
         14 - 15 . (canceled) 
     
     
         16 . The method of  claim 13 , wherein the antibody or fragment thereof comprises a heavy chain variable region (HCVR) comprising heavy chain CDR1, CDR2 and CDR3 sequences of SEQ ID NO:22, 24 and 26, respectively, and a light chain variable region (LCVR) comprising light chain CDR1, CDR2 and CDR3 sequences of SEQ ID NO:30, 32 and 34, respectively. 
     
     
         17 . The method of  claim 16 , wherein the antibody or fragment thereof comprises (a) a HCVR sequence of SEQ ID NO:20 or 116, and a LCVR sequence of SEQ ID NO:28 or 118, or (b) a HCVR/LCVR combination of SEQ ID NO:20/28 or 116/118. 
     
     
         18 . The method of  claim 13 , further comprising coadministering concurrently or sequentially with the anti-Dll4 antibody or fragment thereof a prophylactically effective amount of at least one additional therapeutic agent selected from the group consisting of immunosuppressant, anti-inflammatory agent, and analgesic agent. 
     
     
         19 . The method of  claim 18 , wherein the additional therapeutic agent is at least one selected from the group consisting of glucocorticoides, cyclosporin, methotrexate, non-steroidal anti-inflammatory drugs (NSAIDs), TNF-α antagonists, IL-1 antagonists, IL-6 antagonists, and opioids. 
     
     
         20 - 26 . (canceled)