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WO 2010/037397 Al (12) INTERNATIONALAPPLICATION PUBLISHED UNDER THE PATENT COOPERATION TREATY (PCT) (19) World Intellectual Property Organization International Bureau (10) International Publication Number (43) International Publication Date 8 April 2010 (08.04.2010) WO 2010/037397 Al (51) International Patent Classification: (81) Designated States (unless otherwise indicated, for every A61K 38/17 (2006.01) C07K 14/705 (2006.01) kind of national protection available): AE, AG, AL, AM, A61K 47/48 (2006.01) GOlN 33/50 (2006.01) AO, AT, AU, AZ, BA, BB, BG, BH, BR, BW, BY, BZ, CA, CH, CL, CN, CO, CR, CU, CZ, DE, DK, DM, DO, (21) International Application Number: DZ, EC, EE, EG, ES, FI, GB, GD, GE, GH, GM, GT, PCT/DK2009/050257 HN, HR, HU, ID, IL, IN, IS, JP, KE, KG, KM, KN, KP, (22) International Filing Date: KR, KZ, LA, LC, LK, LR, LS, LT, LU, LY, MA, MD, 1 October 2009 (01 .10.2009) ME, MG, MK, MN, MW, MX, MY, MZ, NA, NG, NI, NO, NZ, OM, PE, PG, PH, PL, PT, RO, RS, RU, SC, SD, (25) Filing Language: English SE, SG, SK, SL, SM, ST, SV, SY, TJ, TM, TN, TR, TT, (26) Publication Language: English TZ, UA, UG, US, UZ, VC, VN, ZA, ZM, ZW. (30) Priority Data: (84) Designated States (unless otherwise indicated, for every PA 2008 0 1381 1 October 2008 (01 .10.2008) DK kind of regional protection available): ARIPO (BW, GH, 61/101,898 1 October 2008 (01 .10.2008) US GM, KE, LS, MW, MZ, NA, SD, SL, SZ, TZ, UG, ZM, ZW), Eurasian (AM, AZ, BY, KG, KZ, MD, RU, TJ, (71) Applicant (for all designated States except US): DAKO TM), European (AT, BE, BG, CH, CY, CZ, DE, DK, EE, DENMARK A/S [DK/DK]; Produktionsvej 42, DK-2600 ES, FI, FR, GB, GR, HR, HU, IE, IS, IT, LT, LU, LV, Glostrup (DK). MC, MK, MT, NL, NO, PL, PT, RO, SE, SI, SK, SM, TR), OAPI (BF, BJ, CF, CG, CI, CM, GA, GN, GQ, GW, (72) Inventors; and ML, MR, NE, SN, TD, TG). (75) Inventors/Applicants (for US only): BRIX, Liselotte [DK/DK]; Haspegardsvej 38, DK-2800 Bagsvsrd (DK). Published: SCHOLLER, Jβrgen [DK/DK]; Sverigesvej 13A, — with international search report (Art. 21(3)) DK-2800 Lyngby (DK). PEDERSEN, Henrik [DK/DK]; Lynge Bygade 12D, DK-3450 Lynge (DK). — before the expiration of the time limit for amending the claims and to be republished in the event of receipt of (74) Agent: HOIBERG A/S; St. Kongensgade 59A, DK- 1264 amendments (Rule 48.2(h)) Copenhagen K (DK). [Continued on next page] (54) Title: MHC MULTIMERS IN CMV IMMUNE MONITORING molecule Figure 1: Schematic representation of MHC multimer (57) Abstract: The present invention relates to MHC-peptide complexes and uses thereof in the diagnosis of, treatment of or vac cination against a disease in an individual. More specifically the invention discloses MHC complexes comprising CMV antigenic peptides and uses there of. — with sequence listing part of description (Rule 5.2(a)) MHC MULTIMERS IN CMV IMMUNE MONITORING All patent and non-patent references cited in US 61/101 ,898 as well as in this application are hereby incorporated by reference in their entirety. US 61/101 ,898 is hereby also incorporated herein by reference in its entirety. PCT/DK2009/050185, PCT/DK2008/0001 18, and PCT/DK2008/050167 are hereby also incorporated herein by reference in their entirety. All patent and non-patent references cited in PCT/DK2009/050185, PCT/DK2008/0001 18, and PCT/DK2008/0501 67 are hereby also incorporated by reference in their entirety. Field of invention The present invention relates to MHC-peptide complexes and uses thereof in the treatment of a disease in an individual. Background of invention Biochemical interactions between peptide epitope specific membrane molecules encoded by the Major Histocompatibility Complex (MHC, in humans HLA) and T-cell receptors (TCR) are required to elicit specific immune responses. This requires activation of T-cells by presentation to the T-cells of peptides against which a T-cell response should be raised. The peptides are presented to the T-cells by the MHC complexes. The immune response The immune response is divided into two parts termed the innate immune response and the adaptive immune response. Both responses work together to eliminate pathogens (antigens). Innate immunity is present at all times and is the first line of defense against invading pathogens. The immediate response by means of pre- existing elements, i.e. various proteins and phagocytic cells that recognize conserved features on the pathogens, is important in clearing and control of spreading of pathogens. If a pathogen is persistent in the body and thus only partially cleared by the actions of the innate immune system, the adaptive immune system initiate a response against the pathogen. The adaptive immune system is capable of eliciting a response against virtually any type of pathogen and is unlike the innate immune system capable of establishing immunological memory. The adaptive response is highly specific to the particular pathogen that activated it but it is not so quickly launched as the innate when first encountering a pathogen. However, due to the generation of memory cells, a fast and more efficient response is generated upon repeated exposure to the same pathogen. The adaptive response is carried out by two distinct sets of lymphocytes, the B cells producing antibodies leading to the humoral or antibody mediated immune response, and the T cells leading to the cell mediated immune response. T cells express a clonotypic T cell receptor (TCR) on the surface. This receptor enable the T cell to recognize peptide antigens bound to major histocompatibility complex (MHC) molecules, called human leukocyte antigens (HLA) in man. Depending on the type of pathogen, being intracellular or extracellular, the antigenic peptides are bound to MHC class I or MHC class II, respectively. The two classes of MHC complexes are recognized by different subsets of T cells; Cytotoxic CD8+ T cells recognizing MHC class I and CD4+ helper cells recognizing MHC class II. In general, TCR recognition of MHC-peptide complexes result in T cell activation, clonal expansion and differentiation of the T cells into effector, memory and regulatory T cells. B cells express a membrane bound form of immunoglobulin (Ig) called the B cell receptor (BCR). The BCR recognizes an epitope that is part of an intact three dimensional antigenic molecule. Upon BCR recognition of an antigen the BCR:antigen complex is internalized and fragments from the internalized antigen is presented in the context of MHC class Il on the surface of the B cell to CD4+ helper T-cells (Th). The specific Th cell will then activate the B cell leading to differentiation into an antibody producing plasma cell. A very important feature of the adaptive immune system is its ability to distinguish between self and non-self antigens, and preferably respond against non-self. If the immune system fails to discriminate between the two, specific immune responses against self-antigens are generated. These autoimmune reactions can lead to damage of self-tissue. The adaptive immune response is initiated when antigens are taken up by professional antigen presenting cells such as dendritic cells, Macrophages, Langerhans cells and B- cells. These cells present peptide fragments, resulting from the degradation of proteins, in the context of MHC class Il proteins (Major Histocompatibility Complex) to helper T cells. The T helper cells then mediate help to B-cells and antigen-specific cytotoxic T cells, both of which have received primary activation signals via their BCR respective TCR. The help from the Th-cell is mediated by means of soluble mediators e.g. cytokines. In general the interactions between the various cells of the cellular immune response is governed by receptor-ligand interactions directly between the cells and by production of various soluble reporter substances e.g. cytokines by activated cells. MHC-peptide complexes. MHC complexes function as antigenic peptide receptors, collecting peptides inside the cell and transporting them to the cell surface, where the MHC-peptide complex can be recognized by T-lymphocytes. Two classes of classical MHC complexes exist, MHC class I and II. The most important difference between these two molecules lies in the protein source from which they obtain their associated peptides. MHC class I molecules present peptides derived from endogenous antigens degraded in the cytosol and are thus able to display fragments of viral proteins and unique proteins derived from cancerous cells. Almost all nucleated cells express MHC class I on their surface even though the expression level varies among different cell types. MHC class Il molecules bind peptides derived from exogenous antigens. Exogenous proteins enter the cells by endocytosis or phagocytosis, and these proteins are degraded by proteases in acidified intracellular vesicles before presentation by MHC class Il molecules. MHC class Il molecules are only expressed on professional antigen presenting cells like B cells and macrophages. The three-dimensional structure of MHC class I and Il molecules are very similar but important differences exist. MHC class I molecules consist of two polypeptide chains, a heavy chain, α, spanning the membrane and a light chain, β2-microglobulin (β2m). The heavy chain is encoded in the gene complex termed the major histocompatibility complex (MHC), and its extracellular portion comprises three domains, α1, α2 and α3. The β2m chain is not encoded in the MHC gene and consists of a single domain, which together with the α3 domain of the heavy chain make up a folded structure that closely resembles that of the immunoglobulin. The α1 and α2 domains pair to form the peptide binding cleft, consisting of two segmented α helices lying on a sheet of eight β-strands.
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