(12) Patent Application Publication (10) Pub. No.: US 2016/0051674 A1 LATOUR Et Al
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US 2016.0051674A1 (19) United States (12) Patent Application Publication (10) Pub. No.: US 2016/0051674 A1 LATOUR et al. (43) Pub. Date: Feb. 25, 2016 (54) METHODS AND PHARMACEUTICAL A6II 45/06 (2006.01) COMPOSITIONS (CTPS1 INHIBITORS, E.G. A613 L/655 (2006.01) NORLEUCINE) FOR INHIBITING T CELL A613 L/436 (2006.01) PROLIFERATION IN A SUBJECT IN NEED A63L/85 (2006.01) THEREOF A613 L/353 (2006.01) A613 L/404 (2006.01) (71) Applicants: INSERM (INSTITUT NATIONAL DE A63L/215 (2006.01) LASANTE ET DE LA RECHERCHE A613 L/405 (2006.01) MEDICALE), Faris (FR): A 6LX3/5377 (2006.01) FONDATION IMAGINE, Paris (FR): A613 L/52 (2006.01) UNIVERSITE PARIS DESCARTES, A638/3 (2006.01) Paris (FR), ASSISTANCE GOIN33/50 (2006.01) PUBLIQUE-HOPITAUX DE PARIS A613 L/42 (2006.01) (APHP), Paris (FR): THE (52) U.S. Cl. UNIVERSTY OF MANCHESTER, CPC ............. A61K 39/3955 (2013.01); A61K3I/42 Manchester (GB) (2013.01); A61 K3I/7068 (2013.01); A61 K 3 1/713 (2013.01); A61K 45/06 (2013.01); (72) Inventors: Sylvain LATOUR, Paris (FR); Alain A6 IK3I/655 (2013.01); A61 K3I/436 FISCHER, Paris (FR); Emmanuel (2013.01); A61 K3I/I85 (2013.01); A61 K MARTIN, Paris (FR); Peter 31/353 (2013.01); A61K 31/404 (2013.01); ARKWRIGHT, Manchester (GB) A6 IK3I/215 (2013.01); A61 K3I/4015 (2013.01); A61 K3I/5377 (2013.01); A61 K (21) Appl. No.: 14/781,353 3 1/52 (2013.01); A61K 38/13 (2013.01); G0IN (22) PCT Filed: Apr. 17, 2014 33/505 (2013.01); G0IN33/5023 (2013.01) (57) ABSTRACT (86). PCT No.: PCT/EP2014/057895 The present invention relates to methods and pharmaceutical S371 (c)(1), compositions for inhibiting lymphocyte proliferationina Sub (2) Date: Sep. 30, 2015 ject in need thereof. In particular, the invention relates to a CTP synthase 1 (CTPS1) inhibitor for use in a method for (30) Foreign Application Priority Data inhibiting lymphocyte proliferationin a subject in need thereof. The invention also relates to a method for screening Apr. 18, 2013 (EP) .................................. 13305504.6 a plurality of test substances useful for inhibiting lymphocyte proliferationin a Subject in need thereof comprising the steps Publication Classification consisting of i) testing each of the test Substances for its ability to inhibit CTPS1 activity or expression and ii) identi (51) Int. Cl. fying the test substance which inhibits CTPS1 activity or A 6LX39/395 (2006.01) expression thereby to identify a test substance useful for A6 IK3I/7068 (2006.01) inhibiting lymphocyte proliferationin a subject in need A6 IK3I/713 (2006.01) thereof. Patent Application Publication Feb. 25, 2016 Sheet 1 of 5 US 2016/0051674 A1 sh scramblethis shCTPS1 Sh CelTrace violet : O arti-CTPS1 anti-CTPS at-ACTiN Figure 1A Patent Application Publication Feb. 25, 2016 Sheet 2 of 5 US 2016/0051674 A1 5 1. P1.2 O, 5 fw CeTrace wiolet -- anti-CD3 gmi) Figure 1B Ct. P1.2 C a -EptyEct. wisco :9 9 g HHCTFS wer E H. g 50 - |P12 A. al-re 30 art-CTPS1 g 20 Unplus anti-CTPS2 2 3 4. s 7 8 Mun at ACTN Time (days) Figure 1C Patent Application Publication Feb. 25, 2016 Sheet 3 of 5 US 2016/0051674 A1 d UTP +cytidine GTP 9 ATP Ctrl. no stim. Oanti-CD3/CD28 anti-CD3/CD28 +rucleotide orrucleoside P2 CelTracgwilet - Figure 1D 6 Cir. P1.2 CCtrl+CTP Cir. -Cytidine P.12+CTP P1.2+Cytidine 4. O 2O stir. anti-CD3 Figure 1E Patent Application Publication Feb. 25, 2016 Sheet 4 of 5 US 2016/0051674 A1 - Deazauridre - guanosine - adenosine + 4 nucleosides no stim. anti-CD3/CD28 anti-CD3/CD28 +nucleoside CalTraia villet he Figure 1F H 9 r 12 120 Ctr. Ctrl+ Deaza. X 5 80 80 P12 5 b 4. 4. OAZ 's no stir. anti-CD3f28 Figure 1G Patent Application Publication Feb. 25, 2016 Sheet 5 of 5 US 2016/0051674 A1 h Hf - Y 300 - E 'y g 200 v. - O - Y W - Cir. C) Pat. Pat.-CTPS1 Figure 1H U.75 3 9. 3. 5 -- P1.2P2.1 |Empty Wector ? L HH s 25 O 5 O 5 20 25 30 Time (days) Figure 1 US 2016/005 1674 A1 Feb. 25, 2016 METHODS AND PHARMACEUTICAL osphate (CTP) is a precursor required for the metabolism of COMPOSITIONS (CTPS1 INHIBITORS, E.G. DNA, RNA and phospholipids". CTP originates from two NORLEUCINE) FOR INHIBITING T CELL Sources: a Salvage pathway and a de novo synthesis pathway PROLIFERATION IN A SUBJECT IN NEED that depends on two enzymes, the CTP synthase (or syn THEREOF thetase) 1 and 2 (CTPS1 and CTPS2), although their respec tive roles are not known 7. CTP synthase activity is a poten FIELD OF THE INVENTION tially important step for DNA synthesis in lymphocytes. 0001. The present invention relates to methods and phar Here, the inventors report the identification of a loss of func maceutical compositions for inhibiting lymphocyte prolifera tion mutation (rs145092287) in CTPS1 in humans causing a novel and life threatening immunodeficiency characterized tion in a subject in need thereof. by an impaired capacity of activated T and B cells to prolif BACKGROUND OF THE INVENTION erate. Proliferation in response to antigen receptor-mediated activation is defective in CTPS1-deficient subject T and B 0002 Lymphocyte proliferation is the normal component cells or in normal T cells knocked-down with shRNA for of the immune reaction toward an antigen (e.g. a pathogen CTPS1. In contrast, proximal and distal TCR signaling events antigen). However in certain circumstances lymphocyte pro and responses were only weakly affected by the absence of liferation appears deleterious. For example, organ transplan CTPS1. Normal T-cell proliferation was restored in CTPS1 tation elicits a complex series of immunologic processes that deficient cells by expressing wild-type CTPS1 or by addition are generally categorized as inflammation, immunity, tissue of exogenous CTP or its nucleoside precursor, cytidine. repair and structural reinforcement of damaged tissues. Typi CTPS1 expression was found to be low in resting T cells, but cally T cell proliferation leads to inflammation by the secre rapidly upregulated following TCR activation. These results tion of proinflammatory cytokines, e.g., interleukin-2 (IL-2) highlight a key and specific role of CTPS1 in the immune and IFN-g. Accordingly, the skilled man in the art has tried to system by its capacity to Sustain the proliferation of activated develop immunosuppressive agents. Immunosuppressive lymphocytes during the immune response. CTPS1 may there drugs fall into five groups: (i) regulators of gene expression; fore represent a therapeutic target of immunosuppressive (ii) alkylating agents; (iii) inhibitors of de novo purine Syn drugs that could specifically dampen lymphocyte activation. thesis; (iv) inhibitors of denovo pyrimidine synthesis; and (v) 0005 Accordingly a first aspect of the invention relates to inhibitors of kinases and phosphatases. For example, gluco a method for reducing or inhibiting lymphocyte proliferation corticoids exert immunosuppressive and anti-inflammatory in a subject in need thereof comprising administering the activity mainly by inhibiting the expression of the genes for subject with a therapeutically effective amount of at least one IL-2 and other mediators. Methotrexate and its polyglutamate derivatives Suppress inflammatory responses through release CTP synthase 1 (CTPS1) inhibitor. of adenosine. Mycophenolic acid and mizoribine inhibit 0006. In some embodiments, the method of the present inosine monophosphate dehydrogenase. Mycophenolic acid invention is suitable for inhibiting or reducing T cell prolif induces apoptosis of activated T-lymphocytes. Cyclosporine eration. and FK-506/Tacrolimus inhibit the phosphatase activity of 0007. In some embodiments, the method of the present calcineurin. Rapamycin inhibits signal transduction from the invention is suitable for inhibiting or reducing B cell prolif IL-2, epidermal growth factor and other cytokine receptors. eration. Immunosuppressive and anti-inflammatory compounds in 0008. In some embodiments, the subject is a transplanted development include inhibitors of p38 kinase and of the type Subject. Typically the Subject may have been transplanted IV isoform of cyclic AMP phosphodiesterase, which is with a graft selected from the group consisting of heart, expressed in T cells. However, immunosuppressive agents are kidney, lung, liver, pancreas, pancreatic islets, brain tissue, associated with toxicity due to their nonspecific immunosup stomach, large intestine, Small intestine, cornea, skin, tra pressive effects. Reducing immunosuppression can prevent chea, bone, bone marrow, muscle, or bladder. The method of side effects related to over-immunosuppression. However, the invention is indeed particularly suitable for preventing or since the intrinsic immunosuppressive requirements for each Suppressing an immune response associated with rejection of donor recipient pair are unknown, immunosuppressive mini a donor tissue, cell, graft, or organ transplant by a recipient mization carries a potential risk of under-immunosuppression subject. Graft-related diseases or disorders include graft ver and consequent acute rejection, premature graft loss and sus host disease (GVDH), such as associated with bone mar death. A promising future application of immunosuppressive row transplantation, and immune disorders resulting from or drugs is to search for agents that inhibit lymphocyte prolif associated with rejection of organ, tissue, or cell graft trans eration by novel mechanisms, as the currently used agents, plantation (e.g., tissue or cell allografts or Xenografts), which all possess non-specific broad immunosuppressive including, e.g., grafts of skin, muscle, neurons, islets, organs, effects. parenchymal cells of the liver, etc. With regard to a donor tissue, cell, graft or Solid organ transplant in a recipient Sub SUMMARY OF THE INVENTION ject, it is believed that CTPS1 inhibitor according to the invention may be effective in preventing acute rejection of 0003. The present invention relates to methods and phar Such transplant in the recipient and/or for long-term mainte maceutical compositions for inhibiting lymphocyte prolifera nance therapy to prevent rejection of Such transplant in the tion in a subject in need thereof.