Anti-hemojuvelin (hjv) antibodies for treating myelofibrosis

Abstract

Aspects of the application provide anti-hemojuvelin antibodies and methods of using the same in treating myelofibrosis and/or conditions associated with myelofibrosis.

What is claimed is: 
     
         1 . A method of treating a subject having myelofibrosis, the method comprising:
 administering to the subject an effective amount of the isolated antibody that binds to human hemojuvelin (HJV), wherein the antibody comprises:   a heavy chain complementary determining region 1 (HC CDR1) set forth as X 1 YGMN (SEQ ID NO: 105), in which X 1  can be N or Y;   a heavy chain complementary determining region 2 (HC CDR2) set forth as MIYYDSSX 2 KHYADSVKG (SEQ ID NO: 106), in which X 2  can be E or D;   a heavy chain complementary determining region 3 (HC CDR3) set forth as GX 3 TPDX 4  (SEQ ID NO: 107), in which X 3  can be T or S, and X 4  can be Y, V, or K; and/or   a light chain complementary determining region 1 (LC CDR1) set forth as RSSQSLX 5 X 6 SDGX 7 TFLX 8  (SEQ ID NO: 108), in which X 8  can be A or E, X 6  can be T, S, E, or D, X 7  can be D, Y, or G, and X 8  can be E or H,   a light chain complementary determining region 2 (LC CDR2) set forth as X 9 VSX 10 RFS (SEQ ID NO: 109), in which X 9  can be E, D or A, and X 10  can be N, S, T, E or H,   a light chain complementary determining region 3 (LC CDR3) set forth as X 11 QX 12 TX 13 DPX 14 X 15  (SEQ ID NO: 110), in which X 11  can be F or M, X 12  can be V or A, X 13  can be H or Y, X 14  can be M, L or V, and X 15  can be T or S.   
     
     
         2 . The method of  claim 1 , wherein the subject is administered via subcutaneous injection. 
     
     
         3 . The method of  claim 1  or  claim 2 , wherein the subject having myelofibrosis has anemia resulting from hepcidin expression that is induced by pro-inflammatory cytokines, and wherein the administration of the antibody reduces the anemia. 
     
     
         4 . The method of  claim 3 , wherein the pro-inflammatory cytokines comprises Interleukin-6 (IL-6). 
     
     
         5 . The method of any one of  claims 1 - 4 , wherein the antibody comprises a HC CDR1 of SEQ ID NO: 1, a HC CDR2 of SEQ ID NO: 2, a HC CDR3 of SEQ ID NO: 3, and a LC CDR1 of SEQ ID NO: 17, a LC CDR2 of SEQ ID NO: 5, a LC CDR3 of SEQ ID NO: 27. 
     
     
         6 . The method of any one of  claims 1 - 5 , wherein the antibody comprises a heavy chain variable region (VH) comprising an amino acid sequence of SEQ ID NO: 38, and a light chain variable region (VL) comprising an amino acid sequence of SEQ ID NO: 39. 
     
     
         7 . The method of any one of  claims 1 - 6 , wherein the antibody is a humanized antibody comprising a humanized VH and/or a humanized VL. 
     
     
         8 . The method of any one of  claims 1 - 7 , wherein the antibody is selected from the group consisting of a full-length IgG, a Fab fragment, a F(ab′) fragment, a F(ab′)2 fragment, a scFv, and a Fv. 
     
     
         9 . The method of any one of  claims 1 - 8 , wherein the antibody is a full-length IgG comprising a heavy chain constant region of the isotype IgG1, IgG2, IgG3, or IgG4. 
     
     
         10 . The method of  claim 9 , wherein the antibody comprises a heavy chain comprising an amino acid sequence of SEQ ID NO: 61 or 117, and a light chain comprising an amino acid sequence of SEQ ID NO: 62. 
     
     
         11 . The method of  claim 9 , wherein the antibody comprises a heavy chain comprising an amino acid sequence of SEQ ID NO: 63 or 118, and a light chain comprising an amino acid sequence of SEQ ID NO: 62. 
     
     
         12 . The method of any one of  claims 1 - 11 , wherein the subject has myelofibrosis initiating mutations in JAK2, MPL, ASXL1, TET2, NFE2, SH2B3, SF3B1, or CALR. 
     
     
         13 . The method of any one of  claims 1 - 12 , wherein the subject has primary myelofibrosis. 
     
     
         14 . The method of any one of  claims 1 - 13 , wherein the subject has a DIPSS score of more than 1. 
     
     
         15 . The method of any one of  claims 1 - 14 , wherein the subject presents with a serum hemoglobin level of less than 10 g/dL 
     
     
         16 . The method of any one of  claims 1 - 15 , wherein the subject presents with a serum hemoglobin level of less than 8 g/dL. 
     
     
         17 . The method of any one of  claims 1 - 16 , wherein the subject is erythrocyte-transfusion dependent. 
     
     
         18 . The method of any one of  claims 1 - 17 , wherein the subject has previously received a selective JAK-STAT inhibitor selected from the group consisting of ruxolitinib, fedratinib, pacritinib, INCB039110, AG490, and PpYLKTK. 
     
     
         19 . An isolated antibody that binds to human hemojuvelin (HJV), wherein the antibody comprises a VH comprising an amino acid sequence of SEQ ID NO: 38, and/or a VL comprising an amino acid sequence of SEQ ID NO: 39. 
     
     
         20 . The isolated antibody of  claim 19 , wherein the antibody is a humanized antibody. 
     
     
         21 . The isolated antibody of  claims 19  or  20 , wherein the antibody is selected from the group consisting of a full-length IgG, a Fab fragment, a F(ab′) fragment, a F(ab′)2 fragment, a scFv, and a Fv. 
     
     
         22 . The isolated antibody of  claim 21 , wherein the antibody is a full-length IgG comprising a heavy chain constant region of the isotype IgG1, IgG2, IgG3, or IgG4. 
     
     
         23 . The isolated antibody of  claim 22 , wherein the antibody comprises a heavy chain comprising an amino acid sequence of SEQ ID NO: 61 or 117, and a light chain comprising an amino acid sequence of SEQ ID NO: 62. 
     
     
         24 . The isolated antibody of  claim 22 , wherein the antibody comprises a heavy chain comprising an amino acid sequence of SEQ ID NO: 63 or 118, and a light chain comprising an amino acid sequence of SEQ ID NO: 62. 
     
     
         25 . A method of treating a subject having myelofibrosis, the method comprising:
 administering to the subject by subcutaneous administration an effective amount of the isolated antibody that binds to human hemojuvelin (HJV), wherein the antibody comprises:   a heavy chain variable region (VH) comprising an amino acid sequence of SEQ ID NO: 38, and a light chain variable region (VL) comprising an amino acid sequence of SEQ ID NO: 39.   
     
     
         26 . A method of inhibiting HJV activity in a subject having myelofibrosis, the method comprising:
 administering to the subject by subcutaneous administration an effective amount of the isolated antibody that binds to human hemojuvelin (HJV), wherein the antibody comprises:   a heavy chain variable region (VH) comprising an amino acid sequence of SEQ ID NO: 38, and a light chain variable region (VL) comprising an amino acid sequence of SEQ ID NO: 39.   
     
     
         27 . A method of reducing hepcidin-25 in a subject having myelofibrosis, the method comprising: administering to the subject an effective amount of the isolated antibody that binds to human hemojuvelin (HJV), wherein the antibody comprises:
 a heavy chain variable region (VH) comprising an amino acid sequence of SEQ ID NO: 38, and a light chain variable region (VL) comprising an amino acid sequence of SEQ ID NO: 39.   
     
     
         28 . The method of  claim 27 , wherein the subject is administered via subcutaneous injection. 
     
     
         29 . The method of  claim 27  or  claim 28 , wherein the administration reduces hepcidin-25 with 4 hours, 6 hours, 8 hours, 12 hours, 28 hours, 24 hours, 2 days, 3 days, 4 days, 5 days, 6 days, 1 week, or two weeks of administration. 
     
     
         30 . The method of any one of  claims 27 - 29 , wherein the administration reduces hepcidin-25 by at least 30%, least 40%, least 50%, least 60%, least 70%, least 80%, least 90%, or least 95% of hepcidin compared to the hepcidin level in the subject prior to administration. 
     
     
         31 . An isolated antibody that binds to human hemojuvelin (HJV) for use in a method of treating a subject having myelofibrosis, wherein the antibody comprises a heavy chain variable region (VH) comprising an amino acid sequence of SEQ ID NO: 38, and a light chain variable region (VL) comprising an amino acid sequence of SEQ ID NO: 39. 
     
     
         32 . The isolated antibody for use according to  claim 31 , wherein the subject is administered by subcutaneous administration. 
     
     
         33 . The isolated antibody for use according to  claims 31  or  32 , wherein the subject having myelofibrosis has anemia resulting from hepcidin expression that is induced by pro-inflammatory cytokines, and wherein the administration of the antibody reduces the anemia. 
     
     
         34 . The isolated antibody for use according to  claim 33 , wherein the pro-inflammatory cytokines comprise interleukin-6 (IL-6). 
     
     
         35 . The isolated antibody for use according to any one of  claims 31 - 34 , wherein the antibody is a humanized antibody comprising a humanized VH and/or a humanized VL. 
     
     
         36 . The isolated antibody for use according to any one of  claims 31 - 35 , wherein the antibody is selected from the group consisting of a full-length IgG, a Fab fragment, a F(ab′) fragment, a F(ab′)2 fragment, a scFv, and a Fv. 
     
     
         37 . The isolated antibody for use according to any one of  claims 31 - 36 , wherein the antibody is a full-length IgG comprising a heavy chain constant region of the isotype IgG1, IgG2, IgG3, or IgG4. 
     
     
         38 . The isolated antibody for use according to  claim 37 , wherein the antibody comprises a heavy chain comprising an amino acid sequence of SEQ ID NO: 61 or 117, and a light chain comprising an amino acid sequence of SEQ ID NO: 62. 
     
     
         39 . The isolated antibody for use according to  claim 37 , wherein the antibody comprises a heavy chain comprising an amino acid sequence of SEQ ID NO: 63 or 118, and a light chain comprising an amino acid sequence of SEQ ID NO: 62. 
     
     
         40 . The isolated antibody for use according to any one of  claims 31 - 39 , wherein the subject has myelofibrosis initiating mutations in JAK2, MPL, ASXL1, TET2, NFE2, SH2B3, SF3B1, CALR, or a combination thereof. 
     
     
         41 . The isolated antibody for use according to any one of  claims 31 - 40 , wherein the subject has primary myelofibrosis. 
     
     
         42 . The isolated antibody for use according to any one of  claims 31 - 41 , wherein the subject has a DIPSS score of more than 1, optionally between 1-4, or optionally between 5-6. 
     
     
         43 . The isolated antibody for use according to any one of  claims 31 - 42 , wherein the subject presents with a serum hemoglobin level of less than 10 g/dL, optionally wherein the subject presents with a serum hemoglobin level of less than 8 g/dL. 
     
     
         44 . The isolated antibody for use according to any one of  claims 31 - 43 , wherein the subject is erythrocyte-transfusion dependent. 
     
     
         45 . The isolated antibody for use according to any one of  claims 31 - 44 , wherein the subject has previously received a selective JAK-STAT inhibitor selected from the group consisting of ruxolitinib, fedratinib, pacritinib, INCB039110, AG490, and PpYLKTK. 
     
     
         46 . The isolated antibody for use according to any one of  claims 31 - 45 , wherein the method further comprises administering to the subject one or more of an erythropoietin stimulating agent, a JAK-STAT inhibitor, a growth factor ligand trap, and an anti-fibrotic agent. 
     
     
         47 . An isolated antibody that binds to human hemojuvelin (HJV) for use in a method of treating a subject having myelofibrosis, wherein the subject is administered with the isolated antibody by subcutaneous administration, and wherein the antibody comprises a heavy chain variable region (VH) comprising an amino acid sequence of SEQ ID NO: 38, and a light chain variable region (VL) comprising an amino acid sequence of SEQ ID NO: 39. 
     
     
         48 . An isolated antibody that binds to human hemojuvelin (HJV) for use in a method of inhibiting HJV activity in a subject having myelofibrosis, wherein the subject is administered with the isolated antibody by subcutaneous administration, and wherein the antibody comprises a heavy chain variable region (VH) comprising an amino acid sequence of SEQ ID NO: 38, and a light chain variable region (VL) comprising an amino acid sequence of SEQ ID NO: 39. 
     
     
         49 . An isolated antibody that binds to human hemojuvelin (HJV) for use in a method of reducing hepcidin-25 in a subject having myelofibrosis, wherein the antibody comprises:
 a heavy chain variable region (VH) comprising an amino acid sequence of SEQ ID NO: 38, and a light chain variable region (VL) comprising an amino acid sequence of SEQ ID NO: 39.   
     
     
         50 . The isolated antibody for use according to  claim 49 , wherein the subject is administered via subcutaneous injection. 
     
     
         51 . The isolated antibody for use according to  claim 49  or  claim 50 , wherein the administration reduces hepcidin-25 with 4 hours, 6 hours, 8 hours, 12 hours, 28 hours, 24 hours, 2 days, 3 days, 4 days, 5 days, 6 days, 1 week, or two weeks of administration. 
     
     
         52 . The method of any one of  claims 49 - 51 , wherein the administration reduces hepcidin-25 by at least 30%, least 40%, least 50%, least 60%, least 70%, least 80%, least 90%, or least 95% of hepcidin compared to the hepcidin level in the subject prior to administration.