AU2005205807A1 - FVIIa antagonists - Google Patents

Description

AUSTRALIA

Patents Act 1990 COMPLETE SPECIFICATION STANDARD PATENT Applicant(s): GENENTECH, INC.

Invention Title: FVIIA ANTAGONISTS The following statement is a full description of this invention, including the best method of performing it known to me/us: FVIIa Antagonists Background of the Invention SField of the Invention SThis invention relates to novel compounds which prevent or block a FVIIa mediated or associated process or event such as the catalytic conversion of FX to FXa, FVII to FVIIa or FIX to FIXa. In particular aspects, the compounds of the invention bind Factor VIIa (FVIIa), its zymogen Factor VII (FVII) and/or block the association of FVII or FVIIa with Sa peptide compound of the present invention. The invention also relates to 00 00 pharmaceutical compositions comprising the novel compounds as well as their S use in research, diagnostic, therapeutic, and prophylactic methods.

y Description of Related Disclosures 0 Factor VIIa (FVIIa) is a trypsin-like plasma serine protease that participates in hemostasis through the extrinsic pathway of the coagulation cascade (Davie et al., (1991) Biochem. 30(43):10363-10370). FVIIa is converted from its zymogen factor VII (FVII) by proteolysis of a single internal peptide bond. Circulating FVII is a globular protein with an Nterminal y-carboxyglutamic acid (Gla)-domain, two epidermal growth factor (EGF) domains, and a C-terminal protease domain. Prior to conversion to FVIIa, FVII associates with tissue factor (TF) constitutively expressed on cells separated from plasma by the vascular endothelium (Carson, S. D. and J. P. Brozna, (1993) Blood Coag. Fibrinol. 4:281-292). TF and FVII form a one-to-one protein complex (TF-FVIIa) in the presence of calcium ions (Wildgoose et al., (1993) Biochem. 32:114-119). This association facilitates the proteolysis of FVII to FVIIa at a site (Argl52-Ilel53 for human FVII (hFVII)) located between the C-terminal EGF domain (EGF2) and the protease domain (Hagen et al., (1986) Proc. Natl. Acad. Sci USA, 83:2412- 2416). While a number of serine proteases activate FVII in vitro, the protease responsible for in vivo activation of FVII is not known (Wildgoose et al., supra).

TF functions as a cofactor for FVIIa with the FVIIa Gla domain interacting at the C-terminal end of TF near the membrane and the FVIIa protease domain situated over the N-terminal domain (Higashi et al., (1994) J. Biol. Chem. 269:18891-18898). The structures of the human TF (hTF) extracellular domain and its complex with active site inhibited FVIIa have recently been determined by x-ray crystallography (Harlos et al., (1994) Nature 370:662-666; Muller et al., (1994) Biochemistry 33:10864; Banner et al., (1996) Nature 380:41-46).

The TF-FVIIa complex constitutes the primary initiator of the extrinsic pathway of blood coagulation (Carson, S. D. and Brozna, J. P., (1993) Blood Coag. Fibrinol. 4:281-292; Davie, E. W. et al., (1991) Biochemistry 30:10363-10370; Rapaport, S. I. and L. V. M. Rao, (1992) Arterioscler. Thromb. 12:1111-1121). The complex initiates the extrinsic -1opathway by activation of FX to Factor Xa (FXa), FIX to Factor IXa (FIXa), cand additional FVII to FVIIa. The action of TF-FVIIa leads ultimately to Sthe conversion of prothrombin to thrombin, which carries out many biological Sfunctions (Badimon, L. et al., (1991) Trends Cardiovasc. Med. 1:261-267).

Among the most important functions of thrombin is the conversion of fibrinogen to fibrin, which polymerizes to form a clot. The TF-FVIIa complex also participates as a secondary factor in extending the physiological effects of the contact activation system.

The involvement of these plasma protease systems have been suggested 00 in 3 to play a significant role in a variety of clinical manifestations including arterial and venous thrombosis, septic shock, adult respiratory distress i syndrome (ARDS), disseminated intravascular coagulation (DIC) and various Sother disease states (Haskel, E. J. et al., (1991) Circulation 84:821-827); Holst, J. et al., (1993) Haemostasis 23 (suppl. 1):112-117; Creasey, A. A.

et al., (1993) J. Clin. Invest. 91:2850-2860; see also, Colman R. W. (1989) N. Engl. J. Med 320:1207-1209; Bone, R. C. (1992) Arch. Intern. Med.

152:1381-1389).

Antibodies reactive with the protease domain of FVII have been shown to inhibit TF-FVIIa proteolytic function (Dickinson et al., (1998) J. Mol.

Biol. 277:959-971). Peptides corresponding to the EGF2 domain of factor VII are potent inhibitors of TF-FVIIa mediated activation of FX (Husbyn et al., J. Peptide Res. (1997) 50:475-482). Several peptides corresponding to various regions of FVII (for example, amino acid sequence residues 372-337 and 103-112 of hFVII) have been proposed as therapeutic anticoagulants based upon their ability to inhibit TF-FVIIa mediated coagulation (International Publication No. WO 90/03390; International Publication No. W095/00541).

Active site modified FVII variants capable of binding TF have been proposed as pharmaceutical compositions for the prevention of TF/FVIIa mediated coagulation (International Publication No. WO 91/11514). International Publication No: WO 96/40779 describes peptide fragments of TF that inhibit FX activation. U.S. Patent Nos. 5,759,954, 5,863,893, 5,880,256 and 5,834,244 describes variant Kunitz-type serine protease inhibitors that inhibit TF-FVIIa activity and have been shown to prolong tissue factor initiated prothrombin time This is consistant with the ability of these TF-FVIIa active site inhibitors to prevent FX activation through inhibition of the TF-FVIIa complex.

Summary of the Invention The present invention provides compounds and compositions which inhibit a FVII/FVIIa mediated or associated process such as the catalytic conversion of FVII to FVIIa, FIX to FIXa, or FX to FXa and thereby block initial events of the extrinsic pathway of blood coagulation. In addition, the compositions of the present invention are capable of neutralizing the thrombotic effects of endogenous TF by binding to FVII or FVIIa and Spreventing the TF-FVIIa mediated activation of FX. The compositions of the present invention are therefore useful in therapeutic and prophylactic Smethods for inhibiting TF-FVIIa mediated or associated processes.

SAdvantageously, the compositions allow for a potent inhibition of FVIIa and the TF-FVIIa complex providing, in preferred embodiments, for low dose O pharmaceutical formulations.

Accordingly, the invention provides compounds which, by virtue of binding FVII or FVIIa, inhibit a FVII or FVIIa mediated coagulation event.

SSuch compounds preferably bind FVII or FVIIa with a Kd less than about 100 00 Lt 10 pM, preferably less than about 100 nM, and preferably do not substantially Sinhibit the activity of other proteases of the coagulation cascade. The kn compounds of the present invention can be, for example, peptides or peptide Sderivatives such as peptide mimetics. Specific examples of such compounds (K include linear or cyclic peptides and combinations thereof, preferably between about 10 and 100 amino acid residues in length, optionally modified at the N-terminus or C-terminus or both, as well as their salts and derivatives, functional analogues thereof and extended peptide chains carrying amino acids or polypeptides at the termini of the sequences for use in the inhibition of FVIIa mediated activation of FX.

The invention further provides a method for identifying a compound which blocks FVII/FVIIa mediated activation of FX comprising the steps of: contacting FVII/FVIIa with a peptide compound of the invention in the presence and absence of a candidate compound under conditions which allow specific binding of the peptide compound of the invention to FVII/FVIIa to occur; detecting the amount of specific binding of the peptide compound of the invention to FVII/FVIIa that occurs in the presence and absence of the candidate compound wherein a decrease in the amount of binding of the peptide compound in the presence of the candidate compound relative to the amount of binding in the absence of the candidate compound is indicative of the ability of the candidate compound to block FVII/FVIIa mediated activation of FX.

The invention further provides a peptide crystal including but not limited to the peptide crystal of TF76 (SEQ ID NO: 8) and their use in various methods described herein. According to one aspect, the invention provides a method of identifying peptidomimetics or peptide analogs of the peptides of the present invention comprising the step of screening a small molecule database with structural parameters derived from peptide crystals of the invention such as those described for TF76. Therefore, according to a particular aspect, the invention relates to the identification of compounds such as peptide analogs and peptidomimetics identified using the structural parameters of the peptide compounds provided herein.

The invention further provides a method of inhibiting the activation of FX 'to FXa comprising contacting FVII with TF under conditions which allow Sformation of a TF-FVIIa complex in the presence of a peptide compound of the invention (or, according to certain aspects, a compound that prevents the interaction of FVII/FVIIa with a peptide compound of the invention) and further contacting the TF-FVIIa complex with FX. According to this aspect of the invention, the contacting steps may occur in vivo or in vitro.

In particular aspects, the invention is directed to combinations of Speptide compounds with other peptide compounds or with other proteins, 00 tn 0 especially serum proteins or peptides. The combinations are prepared with Svarious objectives in mind, including; increasing the affinity or avidity of Sthe peptide compound for FVII/FVIIa, as for example, by the use of various multimerization domains as described herein; increasing the stability of the i peptide compound or facilitating its recovery and purification, as for example, by expressing the peptide compound as a Z protein fusion; and improving the therapeutic efficacy of the peptide compound in aspects of the invention involving in vivo use of the peptide compound, by for example, increasing or decreasing the serum half life, by for example, fusing the peptide compound to a plasma protein such as serum albumin, an immunoglobulin, apolipoproteins or transferrin (such fusion being made conveniently in recombinant host cells or by the use of bifunctional crosslinking agents).

The invention includes compositions, including pharmaceutical compositions, comprising compounds such as peptides for the treatment of a FVII/FVIIa mediated disorder as well as kits and articles of manufacture.

Kits and articles of manufacture preferably include: a container; a label on or associated with said container; and a composition comprising a compound of the present invention contained within said container; wherein the composition is effective for treating a FVII/FVIIa mediated disorder. Preferably, the label on said container indicates that the composition can be used for treating a FVII/FVIIa mediated disorder and the compound in said composition comprises a compound which binds FVII/FVIIa and prevents FVII/FVIIa mediated activation of FX. The kits optionally include accessory components such as a second container comprising a pharmaceutically-acceptable buffer and instructions for using the composition to treat a disorder.

Also disclosed are methods useful in the treatment of coagulopathic disorders, especially those characterized by the involvement of FVII/FVIIa or the TF-FVIIa complex. Therefore, the invention provides a method of treating a FVII/FVIIa or TF-FVIIa mediated disease or disorder in a host in need thereof comprising administering to the host a therapeutically effective amount of a compound of the invention. The methods are useful in preventing, blocking or inhibiting a FVII/FVIIa or TF-FVIIa associated Cevent. In preferred embodiments, the methods of the present invention are 4 employed to reduce or prevent the severity of or the degree of tissue injury Sassociated with blood coagulation.

S The present invention further provides various dosage forms of the compounds of the present invention, including but not limited to, those suitable for parenteral, oral, rectal and pulmonary administration of a compound. In preferred aspects of the present invention a therapeutic S dosage form is provided suitable for inhalation and the invention provides 00 S) for the therapeutic treatment of diseases or disorders involving a S FVII/FVIIa mediated or associated process or event, such as the activation Af of FX, via pulmonary administration of a compound of the invention. More S particularly, the invention is directed to pulmonary administration of the compounds of the invention, especially the peptide compounds, by inhalation.

Thus, the present invention provides an aerosol formulation comprising an amount of a compound of the invention, more particularly a peptide compound of the invention, effective to block or prevent a FVII/FVIIa mediated or associated process or event and a dispersant. In one embodiment, the compound of the invention, particularly the peptide compound of the invention, can be provided in a liquid aerosol formulation. Alternatively, the compound can be provided as a dry powder aerosol formulation. Therefore, according to the present invention, formulations are provided which provide an effective noninvasive alternative to other parenteral routes of administration of the compounds of the present invention for the treatment of FVII/FVIIa or TF-FVIIa mediated or associated events.

Brief Description of the Drawings Figure 1 shows the inhibition of FX activation by selected peptides.

Figures 2A and 2B. Figure 2A shows the inhibition by various peptides of the TF dependent extrinsic clotting pathway as measured by the dose dependent prolongation of the prothrombin time (PT) in human plasma. Figure 2B shows the results (no evidence for prolonging the clotting time) in the surface dependent intrinsic pathway as determined by the activated partial thromboplastin time (APTT) in human plasma.

Figure 3 shows the inhibition of TF147b (SEQ ID NO:40) binding to FVIIa or TF-FVIIa by selected peptides.

Figure 4 shows SDS-PAGE analysis of the reduced and unreduced TF151-Fc fusion revealing bands at about 30 and about 60 kDa respectively, suggesting association of two peptide-Fc monomers to form a dimer.

Figure 5 shows the inhibition of TF147b binding to FVIIa by the TF151- Fc fusion is comparable to TF151.

Figure 6 shows that the TF151-Fc fusion is capable of inhibiting FX activation by TF-FVIIa in a FX activation assay.

Figure 7 shows the prolongation of the prothrombin time in human CK1 plasma with the TFl5l-Fc fusion and Figures BA through 8D show the amino *acid sequences of selected peptides and their IC50 values for inhibiting FX activation as well as the IC50 values for the inhibition of the binding of TF147b to either FVIIa or TF-FVIla. denotes CH 3 C0-modified N-terminus; "-NH 2 or "-amide" denotes NH 2 modified C-terminus; "Or" denotes ornithine; "Na" denotes napthylalanine; denotes norleucine; "aca" denotes aminocaproic; f denotes the c amino group of lysine as derivatized; "biotin", "bi" or 000 denotes biotin; "mY" denotes metatyrosine; "gla" denotes y-carboxyglutamic acid; i+8 lock)" denotes an i 8 helical lock; denotes i) 4methyl phenylalanine, ii) 4-amino phenylalanine, iii) 3-(3,4dihydroxphenyl)alanine (DOPA); "X=ElO-,Kl4lock" denotes a helical lock between side chain residues of glutamic acid and lysine in positions 10 and 14 respectively. Peptide name TF56 (SEQ ID NO:1); TF58 (SEQ ID NO:2); TF61 (SEQ ID NO:3); TF62 (SEQ ID NO:4); TF63 (SEQ ID NO:5); TF74 (SEQ ID NO:6); (SEQ ID NO:7); TF76 (SEQ ID NO:8); TF77 (SEQ ID NO:9); TF86 (SEQ ID NO:l0); TF89 (SEQ ID NO:ll); TF90 (SEQ ID NO:12); TF92 (SEQ ID NO:13); (SEQ ID NO:14); TF96 (SEQ ID NO:15); TF97 (SEQ ID NO:16); TF98 (SEQ ID D NO:17); TF106 (SEQ ID NO:18); TF107 (SEQ ID NO:19); TFlO8 (SEQ ID TF109 (SEQ ID NO:21); TF110 (SEQ ID NO:22); TF111 (SEQ ID NO:23); TF112 (SEQ ID NO:24); TF113 (SEQ ID NO:25); TF114 CSEQ ID NO:26); TF115 (SEQ ID NO:27); TF119 (SEQ ID NO:28); TF120 (SEQ ID NO:29); TF121 (SEQ ID NO:30); TF127 (SEQ ID NO:31); TF128 (SEQ ID NO:32); TF129 (SEQ ID NO:33); TF130 (SEQ ID NO:34); TF131 (SEQ ID NO:35); TP1l32 (SEQ ID NO:36); TF144 (SEQ ID NO:37); TF145 (SEQ ID NO:38); TF146 (SEQ ID NO:39); TFl47b (SEQ ID NO:40); TF148 (SEQ ID NO:41); TF149 (SEQ ID NO:-42); TF151 (SEQ ID NO:43); TF152 (SEQ ID NO:44); TF155 (SEQ ID NO:45); TF156 (SEQ ID NO:46); TF160 (SEQ ID NO:47); TF161 (SEQ ID NO:48); TF162 (SEQ ID NO:49); TF163 (SEQ ID NO:50); TF178 (SEQ ID NO:51); it. TF179 (SEQ ID NO:52); TF180 (SEQ ID NO:53); TF189 (SEQ ID NO:54); TF190 (SEQ ID NO:55); TF191 (SEQ ID NO:56); TF305 (SEQ ID NO:57); TF306 (SEQ ID NO:58); TF307 (SEQ ID NO:59); TF316 (SEQ ID NO:60); TF317 (SEQ ID NO:61); TF318 (SEQ ID NO:62); TF319 (SEQ ID NO:63); TF320 (SEQ ID NO:64).

Figure 9: Structure of TF76 (SEQ ID NO: 8).

Detailed Description of the Preferred Embodiments Definitions Terms used in the claims and specification are defined as set forth below unless otherwise specified.

Abbreviations used throughout the description include: FIXa for Factor IXa and FIX for zymogen Factor IX; FXa for Factor Xa and FX for zymogen Factor X; FVII for zymogen factor VII; FVIIa for Factor VIla; TF for tissue factor; TF-FVIIa for the tissue factor-Factor VIla complex; FVII/FVIIa for Fy11 and/or FVIIa; sTF or TFl- 2 19 for soluble tissue factor composed of the extracellular domain amino acid residues 1-219; TF 1 243 for membrane tissue Cfactor composed of the extracellular domain and transmembrane amino acid Sresidues 1-243 (Paborsky et al., (1991) J. Biol. Chem. 266:21911-21916); PT for prothrombin time; APTT for activated partial thromboplastin time.

The expressions "agent"'and "compound" are used within the scope of the present invention interchangeably and are meant to include any molecule or substance which blocks or prevents the interaction between FVII/FVIIa and a peptide compound of the present invention. Such molecules include small organic and bioorganic molecules, e.g. peptide mimetics and peptide analogs, 00 f 3 antibodies, immunoadhesins, proteins, peptides, glycoproteins, glycopeptides, glycolipids, polysaccharides, oligosaccharides, nucleic L acids, pharmacological agents and their metabolites, and the like.

Preferred compounds of the present invention include peptide analogs or mimetics of the peptide compounds of the present invention. These include, for example, peptides containing non-naturally occurring amino acids provided the compound retains FVII/FVIIa inhibitory activity as described herein. Similarly, peptide mimetics and analogs may include non-amino acid chemical structures that mimic the structure of the peptide compounds of the present invention and retain the FVII/VIIa inhibitory activity described.

S Such compounds are characterized generally as exhibiting similar physical characteristics such as size, charge or hydrophobicity that is present in the appropriate spacial orientation as found in the peptide compound counterparts. A specific example of peptide mimetic compound is a compound in which the amide bond between one or more of the amino acids is replaced, for example, by a carbon-carbon bond or other bond as is well known in the art (see, for example Sawyer, in Peptide Based Drug Design pp. 378-422 (ACS, Washington DC 1995).

The term "peptide" is used herein to refer to constrained (that is, having some element of structure as, for example, the presence of amino acids which initiate a p turn or P pleated sheet, or for example, cyclized by the presence of disulfide bonded Cys residues) or unconstrained linear) amino acid sequences of less than about 50 amino acid residues, and preferably less than about 40 amino acids residues, including multimers, such as dimers thereof or there between. Of the peptides of less than about 40 amino acid residues, preferred are the peptides of between about 10 and about 30 amino acid residues and especially the peptides of about 20 amino acid residues. However, upon reading the instant disclosure, the skilled artisan will recognize that it is not the length of a particular peptide but its ability to bind FVII/FVIIa and compete with the binding of a peptide compound described herein that distinguishes the peptide. Therefore, amino acid sequences of 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 21, 22, 23, 24 and 25 amino acid residues, for example, are equally likely to be compounds within the context of the present invention.

The term "amino acid" within the scope of the present invention is used in its broadest sense and is meant to include the naturally occurring L a-amino acids or residues. The commonly used one and three letter abbreviations for naturally occurring amino acids are used herein C1 (Lehninger, Biochemistry, 2d ed., pp. 71-92, (1975), Worth Publishers, SNew York). The term includes D-amino acids as well as chemically modified amino acids such as amino acid analogs, naturally occurring amino acids that are not usually incorporated into proteins such as norleucine, and Schemically synthesized compounds having properties known in the art to be VL characteristic of an amino acid. For example, analogs or mimetics of phenylalanine or proline, which allow the same conformational restriction of A the peptide compounds as natural Phe or Pro are included within the definition of amino acid. Such analogs and mimetics are referred to herein K as "functional equivalents" of an amino acid. Other examples of amino acids S are listed by Roberts and Vellaccio (The Peptides: Analysis, Synthesis, Biology,) Eds. Gross and Meiehofer, Vol. 5 p 341, Academic Press, Inc, N.Y.

1983, which is incorporated herein by reference.

The term "conservative" amino acid substitution as used within this invention is meant to refer to amino acid substitutions which substitute functionally equivalent amino acids. Conservative amino acid changes result in silent changes in the amino acid sequence of the resulting peptide. For example, one or more amino acids of a similar polarity act as functional equivalents and result in a silent alteration within the amino acid sequence of the peptide. The largest sets of conservative amino acid substitutions include: hydrophobic: His, Trp, Tyr, Phe, Met, Leu, Ile, Val, Ala; neutral hydrophilic: Cys, Ser, Thr; polar: Ser, Thr, Asn, Gln; acidic/negatively charged: Asp, Glu; charged: Asp, Glu, Arg, Lys, His; positively charged: Arg, Lys, His; basic: His, Lys, Arg; residues that influence chain orientation: Gly, Pro; and aromatic: Trp, Tyr, Phe, His.

In addition, structurally similar amino acids can substitute conservatively for some of the specific amino acids. Groups of structurally similar amino acids include: (Ile, Leu, and Val); (Phe and Tyr); (Lys and Arg); (Gln and Asn); (Asp and Glu); and (Gly and Ala). In this regard, it is understood that amino acids are substituted on the basis of side chain bulk, charge and/or hydrophobicity.

Amino acid residues can be further classified as cyclic or noncyclic, aromatic or non aromatic with respect to their side chain groups these designations being commonplace to the skilled artisan.

(C1 Original Exemplary Conservative Preferred Conservative S Residue Substitution Substitution Ala Val, Leu, Ile Val Arg Lys, Gin, Asn Lys 0 Asn Gin, His, Lys, Arg Gin Asp Glu Glu Cys Ser Ser Gin Asn Asn 00 Glu Asp Asp Gly Pro Pro SHis Asn, Gin, Lys, Arg Arg Ile Leu, Val, Met, Ala Leu Phe Leu Ile, Val Ile Met, Ala, Phe Lys Arg, Gin, Asn Arg Met Leu, Phe, Ile Leu Phe Leu, Val, Ile, Ala Leu Pro Gly Gly Ser Thr Thr Thr Ser Ser Trp Tyr Tyr Tyr Trp, Phe, Thr, Ser Phe i Val Ile, Leu, Met, Phe Leu Ala Peptides synthesized by the standard solid phase synthesis techniques described here, for example, are not limited to amino acids encoded by genes for substitutions involving the amino acids. Commonly encountered amino acids which are not encoded by the genetic code, include, for example, those described in International Publication No. WO 90/01940 and described in Table I below, as well as, for example, 2-amino adipic acid (Aad) for Glu and Asp; 2-aminopimelic acid (Apm) for Glu and Asp; 2-aminobutyric (Abu) acid for Met, Leu, and other aliphatic amino acids; 2-aminoheptanoic acid (Ahe) for Met, Leu and other aliphatic amino acids; 2-aminoisobutyric acid (Aib) for Gly; cyclohexylalanine (Cha) for Val, and Leu and Ile; homoarginine (Har) for Arg and Lys; 2,3-diaminopropionic acid (Dpr) for Lys, Arg and His; N-ethylglycine (EtGly) for Gly, Pro, and Ala; N-ethylglycine (EtGly) for Gly, Pro, and Ala; N-ethylasparigine (EtAsn) for Asn, and Gin; Hydroxyllysine (Hyl) for Lys; allohydroxyllysine (AHyl) for Lys; 3-(and 4)hydoxyproline (3Hyp, 4Hyp) for Pro, Ser, and Thr; allo-isoleucine (AIle) for Ile, Leu, and Val; p-amidinophenylalanine for Ala; N-methylglycine (MeGly, sarcosine) for Gly, Pro, and Ala; N-methylisoleucine (MeIle) for 00 Ile; Norvaline (Nva) for Met and other aliphatic amino acids; Norleucine (Nie) for Met and other aliphatic amino acids; Ornithine (Orn or Or) for Lys, Arg and His; Citruiline (Cit) and methionine suifoxide (MSO) for Thr, Asn and Gin; -methyiphenylalanine (MePhe), trimethyiphenylalanine, halo (F, Ci, Br, and I)phenylaianine, trifiouryiphenylalanine, for The.

Table 1 Abbreviations used in the specification Compound IAbbreviation Acetyi Ac Alanine Ala A 3- (2-Thiazolyl) -L-alanine Tza Arginine Arg, R Asparagine Asn N Aspartic acid Asp D t-Butyloxycarbonyl Boc Benzotriazol-i-yioxy-tris- (dimethylamino) Bop phosphonium-hexa fluorophosphate (-Alanine I3Ala 1-Valine I3Va 1 3- (2-Pyridyl) -alanine Pal (2) 3- (3-Pyridyl) -alanine Pal (3) (3-(4-Pyridyl) -alanine Pal (4) 3- (3-N-Methylpyridinium) -alanine Pai~e (3) t-Butyl tBu, But t-Butyioxycarbonyl Boc Caffeic acid Ca ff Cysteine Cys C Cyclohexylalanine Cha Cyclohexyiglycine Chg 3, 5-Dinitrotyrosine Tyr(3, 5-No 2 3, 5-Diiodotyrosine Tyr 3, 5-Dibromotyrosine Tyr(3, 9-Fluorenylmethyloxy-carbonyl Fmoc Glutamine Gin IQ I 00 Glutamic acid Glu E y-Carboxygiutanic acid Gia Glycine Gly G Histidine His H Homoarginine hArg 3-Hydroxyproline Hyp Isoleucine Ile I Leucine Leu L tert-Leucine Tie Lys ine Lys K Mercapto-3, f-cyciopentamethylene-propionic acid Mpp Mercaptoacetic acid Mpa Mercaptopropionic acid Mpr Methionine Met M 1-Naphthylaianine Na Nicotinic acid Ni c Nipecotic acid Npa N-methyi nicotinic acid NicMe Norarginine nArg Norieucine Nie nL Norvaiine Nva Ornithine Orn or Or Orni thine-derived dimethyiamidinium Orn (N6-C 3 HN) Phenyiaianine PheF p-Guanidinophenyiaianine Phe (Gua) p-Ainophenyiaianine Phe (NH 2 p-Chlorophenylaianine Phe (Ci) p-Fiurophenylaianine Phe(F) p-Nitrophenylaianine Phe (NO 2 p-Hydroxyphenyigiycine Pgi (OH) p-Toluenesulfonyl To s m-Amidinophenyiaianine mAph p-Amidinophenyiaianine pAph___ Phenyigiycine Pgi Phenyimaionic acid jPma___ -11- 00 o Proline Pro P 4-Quinolinecarboxy 4-Qca Sarcosine Sar Serine Ser S Succinyl Suc Threonine Thr T Tryptophan Trp W Tyrosine Tyr Y 3-iodotyrosine Tyr(3-I) O-Methyl tyrosine Tyr (Me) Valine Val V Amino acids of D configuration are denoted by D-prefix using three-letter code D-Ala, D-Cys, D-Asp, D-Trp).

A useful method for identification of certain residues or regions of the compound for amino acid substitution other than those described herein is called alanine scanning mutagenesis as described by Cunningham and Wells (1989) Science, 244:1081-1085. Here a residue or group of target residues are identified charged residues such as Arg, Asp, His, Lys, and Glu) and replaced by a neutral or negatively charged amino acid to affect the interaction of the amino acids with the surrounding aqueous environment in or outside the cell. Those regions demonstrating functional sensitivity to the substitution are then refined by introducing further or other variations at or for the sites of substitution. Thus while the site for introducing an amino acid sequence variation is predetermined the nature of the mutation per se need not be predetermined. For example, to optimize the performance of a mutation at a given site, Ala scanning or random mutagenesis may be conducted at the target codon or region and the expressed compound screened for the optimal combination of desired activity.

Phage display of protein or peptide libraries offers another methodology for the selection of compounds with improved affinity, altered specificity, or improved stability (Smith, (1991) Curr. Opin.

Biotechnol. 2:668-673; Lowman, (1997) Ann. Rev. Biophys. Biomol. Struct.

26:401-404). High affinity proteins, displayed in a monovalent fashion as fusions with the M13 gene III coat protein (Clackson, (1994) et al.,Trends Biotechnol. 12:173-183), can be identified by cloning and sequencing the corresponding DNA packaged in the phagemid particles after a number of rounds of binding selection.

Other compounds include the fusion to the or C- terminus of the compounds described herein of immunogenic polypeptides, bacterial polypeptides such as beta lactamase or an enzyme encoded by E coli Trp locus S or yeast protein, other polypeptides such as the Z-domain of protein-A, and SC-terminal fusion with proteins having a long half-life such as y) immunoglobulin constant region or other immunoglobulin regions, albumin, or ferritin as described in WO 89/02922 published 6 April 1989. Further, free O functional groups on the side chains of the amino acid residues can also be modified by amidation, acylation or other substitution, which can, for example, change the solubility of the compounds without affecting their activity. for example denotes a CH 3 CO- modified N terminus and "-NH2" 00 S3 a -NH 2 modified C-terminus.

Preferred amino acid sequences within the context of the present tf invention are non-naturally occurring amino acid sequences. By non- Snaturally occurring is meant that the amino acid sequence is not found in S nature. Preferred are non-naturally occuring amino acid sequences of between about 10 and 30 amino acid residues and preferably about 20 amino acid residues. These include peptides, peptide analogs and mimetics containing naturally as well as non-naturally occurring amino acids.

Especially preferred are sequences as described above consisting of naturally occurring amino acids.

The term "multimerization domain" as used in particular aspects of the present invention, is meant to refer to the portion of the molecule to which the compound, especially the peptide compound, is joined, either directly or through a "linker domain." The multimerization domain is an amino acid domain which, according to preferred embodiments, facilitates the interaction of two or more multimerization domains. While the multimerization domain promotes the interaction between two or more multimerization domains, there is no requirement within the context of the present invention that the peptide joined to a multimerization domain be present as a portion of a multimer.

According to preferred aspects of the present invention the multimerization domain is a polypeptide which promotes the stable interaction of two or more multimerization domains. By way of example and not limitation, a multimerization domain may be an immunoglobulin sequence, such as an immunoglobulin constant region, a leucine zipper, a hydrophobic region, a hydrophilic region, a polypeptide comprising a free thiol which forms an intermolecular disulfide bond between two or more multimerization domains or, for example a "protuberance-into-cavity" domain described in U.S. Patent 5,731,168. In that patent, protuberances are constructed by replacing small amino acid side chains from the interface of a first polypeptide with a larger side chain (for example a tyrosine or tryptophan).

Compensatory cavities of identical or similar size to the protuberances are optionally created on the interface of a second polypeptide by replacing Slarge amino acid side chains with smaller ones (for example alanine or threonine).

Therefore, in a preferred aspect, the multimerization domain provides Cthat portion of the molecule which promotes or allows stable interaction of C 5 two or more multimerization domains and promotes or allows the formation of dimers and other multimers from monomeric multimerization domains.

Preferably, according to this aspect of the invention, multimerization domains are immunoglobulin constant region domains. Immunoglobulin constant 0 domains provide the advantage of improving in vivo circulating half-life of VL the compounds of the invention and optionally allow the skilled artisan to incorporate an "effector function" as described herein below into certain In aspects of the invention.

Throughout the present specification and claims, the numbering of the CK residues in an immunoglobulin heavy chain is that of the EU index as in S Kabat et al., Sequences of Proteins of Immunological Interest, 5th Ed.

Public Health Service, National Institutes of Health, Bethesda, MD (1991), expressly incorporated herein by reference. The "EU index as in Kabat" refers to the residue numbering of the human IgGl EU antibody.

"Antibodies" (Abs) and "immunoglobulins" (Igs) are typically glycoproteins having the same structural characteristics. While antibodies exhibit binding specificity to a specific antigen, immunoglobulins include both antibodies and other antibody-like molecules which lack antigen specificity. Polypeptides of the latter kind are, for example, produced at low levels by the lymph system and at increased levels by myelomas.

"Antibodies" and "immunoglobulins" are usually heterotetrameric glycoproteins of about 150,000 Daltons, composed of two identical light (L) chains and two identical heavy chains. Each light chain is linked to a heavy chain by one covalent disulfide bond, while the number of disulfide linkages varies between the heavy chains of different immunoglobulin isotypes. Each heavy and light chain also has regularly spaced intrachain disulfide bridges. Each heavy chain has an amino terminal variable domain (VH) followed by carboxy terminal constant domains. Each light chain has a variable N-terminal domain (VL) and a C-terminal constant domain; the constant domain of the light chain (CL) is aligned with the first constant domain (CH1) of the heavy chain, and the light chain variable domain is aligned with the variable domain of the heavy chain. According to the domain definition of immunoglobulin polypeptide chains, light chains have two conformationally similar domains VL and CL; and heavy chains have four domains (VH, CH1, CH2, and CH3) each of which has one intrachain disulfide bridge.

Depending on the amino acid sequence of the constant domain of the heavy chains, immunoglobulins can be assigned to different classes. There are five major classes of immunoglobulins: IgA, IgD, IgE, IgG, and IgM. The S immunoglobulin class can be further divided into subclasses (isotypes), IgGi, IgG 2 IgG 3 IgG 4 IgAj, and IgA 2 The heavy-chain constant domains that correspond to the different classes of immunoglobulins are a, 56, e, y, and p domains respectively. The light chains of antibodies from C 5 any vertebrate species can be assigned to one of two distinct types called kappa or lambda based upon the amino acid sequence of their constant domains. Sequence studies have shown'that the p chain of IgM contains five domains VH, CHpl, CHp2, CHp3, and CHp4. The heavy chain of S IgE also contains five domains.

In The subunit structures and three-dimensional configurations of different classes of immunoglobulins are well known. Of these IgA and IgM L are polymeric and each subunit contains two light and two heavy chains. The heavy chain of IgG contains a length of polypeptide chain lying between the CHyl and CHy2 domains known as the hinge region. The a chain of IgA has a hinge region containing an O-linked glycosylation site and the p and e chains do not have a sequence analogous to the hinge region of the y and a chains, however, they contain a fourth constant domain lacking in the others. The domain composition of immunoglobulin chains can be summarized as follows: Light Chain X VX CX K VK CK Heavy Chain IgG VH CHyl, hinge CHy2 CHy3 IgM VH CHpl CHp2 CHp3 CHp4 IgA VH CHal hinge CHa2 CHa3 IgE VH CHcl CHe2 CHe3 CHE4 IgD VH CH61 hinge CH62 CH53 The "CH2 domain" of a human IgG Fc region (also referred to as "Cy2" domain) usually extends from about amino acid 231 to about amino acid 340.

The CH2 domain is unique in that it is not closely paired with another domain. Rather, two N-linked branched carbohydrate chains are interposed between the two CH2 domains of an intact native IgG molecule.

The "CH3 domain" comprises the stretch of residues C-terminal to a CH2 domain in an Fc region from about amino acid residue 341 to about amino acid residue 447 of an IgG).

"Hinge region" is generally defined as stretching from Glu216 to Pro230 of human IgG1 (Burton, Molec. Immunol.22:161-206 (1985)). Hinge regions of other IgG isotypes may be aligned with the IgGl sequence by placing the first and last cysteine residues forming inter-heavy chain S-S bonds in the same positions.

The "lower hinge region" of an Fc region is normally defined as the stretch of residues immediately C-terminal to the hinge region, i.e.

residues 233 to 239 of the Fc region.

kn A TF-FVIIa mediated or associated process or event, or equivalently, San activity associated with plasma FVII/FVIIa, according to the present Sinvention is any event which requires the presence of FVIIa. The general Smechanism of blood clot formation is reviewed by Ganong, in Review of Medical Physiology, 13th ed., Lange, Los Altos CA, pp411-414 (1987).

SCoagulation requires the confluence of two processes, the production of thrombin which induces platelet aggregation and the formation of fibrin which renders the platelet plug stable. The process comprises several Sstages each requiring the presence of discrete proenzymes and procofactors.

00 L The process ends in fibrin crosslinking and thrombus formation. Fibrinogen is converted to fibrin by the action of thrombin. Thrombin, in turn, is l formed by the proteolytic cleavage of prothrombin. This proteolysis is Seffected by FXa which binds to the surface of activated platelets and in the presence of FVa and calcium, cleaves prothrombin. TF-FVIIa is required for 3 the proteolytic activation of FX by the extrinsic pathway of coagulation.

Therefore, a process mediated by or associated with TF-FVIIa, or an activity associated with FVII/FVIIa includes any step in the coagulation cascade from the formation of the TF-FVIIa complex to the formation of a fibrin platelet clot and which initially requires the presence FVII/FVIIa. For example, the TF-FVIIa complex initiates the extrinsic pathway by activation of FX to FXa, FIX to FIXa, and additional FVII to FVIIa.

TF-FVIIa mediated or associated process, or FVII/FVIIa mediated or associated activity, can be conveniently measured employing standard assays such as those described in Roy, (1991) J. Biol. Chem. 266:4665-4668, O'Brien, et al., (1988) J. Clin. Invest. 82:206-212; Lee et al. (1997) Biochemistry 36:5607-5611; Kelly et al., (1997) J. Biol. Chem. 272:17467- 17472 for the conversion of chromogenic substrates or Factor X to Factor Xa in the presence of Factor VII and other necessary reagents.

A TF-FVIIa related disease or disorder is meant to include chronic thromboembolic diseases or disorders associated with fibrin formation including vascular disorders such as deep venous thrombosis, arterial thrombosis, stroke, tumor metastasis, thrombolysis, arteriosclerosis and restenosis following angioplasty, acute and chronic indications such as inflammation, septic shock, septicemia, hypotension, adult respiratory distress syndrome (ARDS), disseminated intravascular coagulapathy (DIC) and other diseases. The TF-FVIIa related disorder is not limited to in vivo coagulopathic disorders such as those named above but includes inappropriate or undesirable coagulation related to circulation of blood through stents or artificial valves or related to extracorporeal circulation including blood removed in-line from a patient in such processes as dialysis procedures, blood filtration, or blood bypass during surgery.

As used herein, the term "pulmonary administration" refers to administration of a formulation of the invention through the lungs by -16inhalation. As used herein, the term "inhalation" refers to intake of air to the alveoli. In specific examples, intake can occur by self- Sadministration of a formulation of the invention while inhaling, or by administration via a respirator, to a patient on a respirator. The C 5 term "inhalation" used with respect to a formulation of the invention is synonymous with "pulmonary administration." As used herein, the term "parenteral" refers to introduction of a compound of the invention into the body by other than the intestines, and in particular, intravenous intraarterial intraperitoneal V"n 3 intramuscular intraventricular, and subcutaneous routes.

As used herein, the term "aerosol" refers to suspension in the air.

SIn particular, aerosol refers to the particlization of a formulation of the S invention and its suspension in the air. According to the present invention, an aerosol formulation is a formulation comprising a compound of the present invention that is suitable for aerosolization, i.e., particlization and suspension in the air, for inhalation or pulmonary administration.

The term "treatment" as used within the context of the present invention is meant to include therapeutic treatment as well as prophylactic, or suppressive measures for the disease or disorder. Thus, for example, the term treatment includes the administration of an agent prior to or following the onset of a disease or disorder thereby preventing or removing all signs of the disease or disorder. As another example, administration of the agent i after clinical manifestation of the disease to combat the symptoms of the disease comprises "treatment" of the disease. Further, administration of the agent after onset and after clinical symptoms have developed where administration affects clinical parameters of the disease or disorder, such as the degree of tissue injury or the amount or extent of leukocyte trafficking and perhaps amelioration of the disease, comprises "treatment" of the disease.

Those "in need of treatment" include mammals, such as humans, already having the disease or disorder, including those in which the disease or disorder is to be prevented.

The term "acyl" is used in its broadest sense to mean saturated or unsaturated, linear, branched or cyclic chains of about 1 to about 16 carbon atoms, which contain a carboxy group. Thus the term acyl includes, for example, groups such as formyl, acetyl, benzoyl and the like. The term "hydrophobic acyl" group refers to a group wherein Rl is an alkyl, aryl or other non-polar group.

-17- S Modes for Carrying out the Invention S Selection of Compounds SThe present invention provides compounds and compositions which inhibit a FVII/FVIIa mediated or associated process such as the catalytic 1 5 conversion of FVII to FVIIa, FIX to FIXa, or FX to FXa and thereby block initial events of the extrinsic pathway of blood coagulation. Preferred compounds of the present invention are distinguished by their ability compete with a peptide compound of Figure 8 for binding FVII/FVIIa and may S be selected as follows.

lk D For in vitro assay systems to determine whether a compound has the "ability" to compete with a peptide compound as noted above, the skilled Ln artisan can employ any of a number of standard competition assays. Such procedures include but are not limited to competitive assay systems using (K techniques such as radioimmunoassays, enzyme immunoassays (EIA), preferably the enzyme linked immunosorbent assay (ELISA), "sandwich" immunoassays, immunoradiometric assays, fluorescent immunoassays, and immunoelectrophoresis assays, to name but a few.

For these purposes the selected peptide compound of Figure 8 will be labeled with a detectable moiety (the detectably labeled peptide compound herein called the "tracer") and used in a competition assay with a candidate compound for binding FVII/FVIIa. Numerous detectable labels are available which can be preferably grouped into the following categories: Radioisotopes, such as 35 S, 14C, 125I, 3 H, and 131I. The peptide compound can be labeled with the radioisotope using the techniques described in Current Protocols in Immunology, Volumes 1 and 2, Coligen et al., Ed., Wiley-Interscience, New York, New York, Pubs., (1991) for example and radioactivity can be measured using scintillation counting.

Fluorescent labels such as rare earth chelates (europium chelates) or fluorescein and its derivatives, rhodamine and its derivatives, dansyl, Lissamine, phycoerythrin and Texas Red are available. The fluorescent labels can be conjugated to the peptide compounds using the techniques disclosed in Current Protocols in Immunology, supra, for example.

Fluorescence can be quantified using a fluorimeter.

Various enzyme-substrate labels are available and U.S. Patent No.

4,275,149 provides a review of some of these. The enzyme preferably catalyses a chemical alteration of the chromogenic substrate which can be measured using various techniques. For example, the enzyme may catalyze a color change in a substrate, which can be measured spectrophotometrically.

Alternatively, the enzyme may alter the fluorescence or chemiluminescence of the substrate. Techniques for quantifying a change in fluorescence are described above. The chemiluminescent substrate becomes electronically excited by a chemical reaction and may then emit light which can be measured (using a chemiluminometer, for example) or donates energy to a fluorescent -18acceptor. Examples of enzymatic labels include luciferases firefly luciferase and bacterial luciferase; U.S. Patent No. 4,737,456), luciferin, S2,3-dihydrophthalazinediones, malate dehydrogenase, urease, peroxidase such as horseradish peroxidase (HRP), alkaline phosphatase, p-galactosidase, glucoamylase, lysozyme, saccharide oxidases glucose oxidase, O galactose oxidase, and glucose-6-phosphate dehydrogenase), heterocyclic oxidases (such as uricase and xanthine oxidase), lactoperoxidase, microperoxidase, and the like.

0 Examples of enzyme-substrate combinations include, for example: 00 (f 10 Horseradish peroxidase (HRP) with hydrogen peroxidase as a substrate, wherein the hydrogen peroxidase oxidizes a dye precursor (e.g.

I ABTS, orthophenylene diamine (OPD) or 3,3',5,5'-tetramethyl benzidine hydrochloride (TMB)); S(ii) alkaline phosphatase (AP) with para-Nitrophenyl phosphate as chromogenic substrate; and (iii) -D-galactosidase (3-D-Gal) with a chromogenic substrate (e.g.

p-nitrophenyl-p-D-galactosidase) or fluorogenic substrate 4methylumbelliferyl-P-D-galactosidase.

According to a particular assay, the tracer is incubated with immobilized FVII/FVIIa in varying concentration of unlabeled candidate compound. Increasing concentrations of successful candidate compound effectively compete with binding of the tracer to immobilized FVII/FVIIa.

The concentration of unlabeled candidate compound at which 50% maximal tracer is displaced is referred to as the IC 50 and reflects the FVII/FVIIa binding affinity of the candidate compound. Therefore a candidate compound with an ICs 5 of 1 mM displays a substantially weaker interaction with FVII/FVIIa than a candidate peptide with an IC 50 of 1 pM.

Accordingly, the invention provides compound "having the ability to compete" for binding FVII/FVIIa in an in vitro assay as described.

Preferably the compound has an "IC 5 s" for FVIIa of less than 1 pM.

Preferred among these compound are compounds having an IC 50 of less than about 100 nM and preferably less than about 10 nM or less than about 1 nM.

In further preferred embodiments according to this aspect of the invention the compounds display an IC 50 for FVIIa of less than about 100 pM and more preferably less than about 10 pM.

A preferred in vitro assay for the determination of a candidate compound's ability to compete with a peptide compound of Figure 8 is as follows and is described more fully in Examples 1 and 2. The ability of peptides to compete with tracer for binding to FVIIa is monitored using an ELISA. Dilutions of candidate peptide in buffer are added to microtiter plates coated with TF-FVIIa (as described in the Example Sections) along with tracer for 1 hr. The microtiter plate is washed with wash buffer and the amount of tracer bound to FVIIa measured.

In particular embodiments the tracer is SEQ ID NO: 1 and is added to the FVII/FVIIa coated plated at a concentration of 10 pM. In another preferred embodiment the tracer is SEQ ID NO: 8 and is added to the FVII/FVIIa coated plate at a concentration of Compounds selected in this way are then tested for their ability to inhibit or block FVII/FVIIa activation of FX. The term "inhibits" or "blocks" when used to describe a characteristic of the candidate compound of r- the present invention means a compound that when added at a concentration of 0about 10pM in a standard chromogenic assay for FX activation (see, Roy, S., 00 kn D (1991) J. Biol. Chem. 266:4665-4668, O'Brien, et al., (1988) J. Clin.

Invest. 82:206-212; Lee et al. (1997) Biochemistry 36:5607-5611; Kelly et al.,(1997) J. Biol. Chem. 272:17467-17472) produces at least a inhibition of the conversion of Factor X to Factor Xa in the presence of Factor VII and other necessary reagents. Preferably the compound will produce at least a 50% inhibition at a concentration of about 1pM and more preferably at least a 50% inhibition at a concentration of about 100nM. In a more preferred embodiment the compound of the present invention will produce at least a 50% inhibition of the conversion of Factor X to Factor Xa when present in a concentration of about lOnM or less.

Pentides and Analogs Thereof According to preferred aspects of the present invention the compound is a cyclic peptide or analog thereof. Preferably, the compound has the following formula: Xj-Cys,-X)-Cys 2 -Xk wherein X i is absent or is a peptide of between 1 and 100 amino acids, preferably between about 1 and 50 amino acids, and more preferably between about 1 and 10 or about 1 and 4 amino acids; Xj is 9 amino acid peptide and Xk is absent or a peptide of between 1 and 100 amino acids, preferably between about 1 and 50 amino acids and more preferably between about 1 and 10 or about 1 and 4 amino acids, so long as the cyclic peptide or analog thereof retains the qualitative biological activity described above.

Preferred among this group of compounds are compounds comprising the sequence: -a-b-Cysl-d-e-f-g-h-i-j-k-l-Cys 2 -n-owherein a is an amino acid; b is an amino acid selected from the group consisting of Leu, Ile, Val, Ala, Arg, Gln, Asn and functional equivalents thereof; d is an amino acid; e is an amino acid; f is an amino acid selected from the group consisting of Ala, Asp, Glu, Phe, Gly, His, Ile, Lys, Leu, Met, Asn, Pro, Gln, Arg, Ser, Thr, Val, Trp, Tyr and functional equivalents thereof; g is an amino acid; h is an amino acid selected from the group consisting of Ala, Cys, Asp, Phe, Gly, His, Ile, Lys, Leu, Met, Ash, Pro, Gln, Arg, Thr, Val, Trp, Tyr and functional equivalents thereof; i is an amino acid selected from the group consisting of Ala, Asp, Glu, Phe, Gly, His, Lys, Met, Asn, Pro, Gin, Ser, Thr, Val, Trp, Tyr and functional equivalents thereof; j is an amino acid selected from the group consisting of Ala, Asp, Glu, Phe, Gly, His, Ile, Lys, Leu, Met, Asn, Pro, Gin, Arg, Ser, Thr, Val, Trp, Tyr and functional equivalents thereof; k is an amino ~-Kl acid selected from the group consisting of Trp, Tyr, Na, Phe and functional equivalents thereof; 1 is an amino acid selected from the group consisting of Tyr, Phe, Na, Trp and functional equivalents thereof; n is an amino acid r- and o is an amino acid selected from the group consisting of Phe Tyr, Trp, 0 Na and functional equivalents thereof.

00 in Preferred among this class of compounds are those described above wherein Xiis a peptide of between 2 and 10 or 2 and 4 amino acids and Xk is a peptide of between 2 and 10 or 2 and 4 amino acids. For example, preferred compounds are those described above wherein b is an amino acid (Nil selected from the group consisting of Leu, Ile, Val, Ala and functional equivalents thereof and preferably Leu, Ile, Val and functional equivalents thereof; f is any amino acid except Cys and preferable selected from the group consisting of Pro, Gly, Ala and functional equivalents thereof; h is an amino acid selected from the group consisting of Ile, Val, Leu and Ala and functional equivalents thereof; i is an amino acid selected from the group consisting of Asp, Glu, Ser, Thr and Ala and functional equivalents thereof; j is any amino acid except Cys and preferably any amino acid except Cys and Trp; k is an amino acid selected from the group consisting of Tyr, Phe, Trp, Na and functional equivalents thereof and preferably Trp and Na and functional equivalents thereof; I is an amino acid selected from the group consisting of Trp, Phe, Tyr, Phe and functional equivalents thereof and preferably Tyr, Na and functional equivalents thereof; o is an amino acid selected from the group consisting of Trp, Phe, Tyr and functional equivalents thereof.

Preferred among this class of cyclic peptide compounds or analogs thereof are those wherein h is an amino acid selected from the group consisting of Ile, Val and Leu and functional equivalents thereof; i is an amino acid selected from the group consisting of Asp, Giu, and Ser and functional equivalents thereof; j is an amino acid selected from the group consisting of Arg, Lys, Gin and Ala and functional equivalents thereof; and n is an amino acid selected from the group consisting of Gin, Met, Gly, Arg, Ser, Lys, Leu, Ala, Asn, Thr and functional equivalents thereof.

Preferred among this group of compounds are compounds wherein h is an amino acid selected from the group consisting of Ile and Val and functional equivalents thereof; i is Asp and functional equivalents thereof; j is Arg and functional equivalents thereof; 1 is Tyr and functional equivalents thereof; n is an amino acid selected from the group consisting of Gin and Met and functional equivalents thereof and o is Phe and functional equivalents thereof.

-21- 0 Preferred among this group are cyclic peptide compounds or analogs S thereof wherein a is an amino acid selected from the group consisting of "Asn, Arg, Phe, Gln, Gly, Pro, Thr, Ser and Ala and functional equivalents C) thereof; f is an amino acid selected from the group consisting of Pro, Gly, C 5 Ala and functional equivalents thereof.

Preferred among this class of compounds are compounds wherein X i is a peptide of between 2 to 6 amino acids; a is an amino acid selected from the group consisting of Ala, Thr and Ser and functional equivalents thereof; b Sis Leu and functional equivalents thereof; d is an amino acid selected from Vf 3 the group consisting of Asp, Glu, Ser, Ala, Arg, Thr, His, Met, Val and Asn and functional equivalents thereof; e is an amino acid selected from the group consisting of Asn, Asp, Arg, Ala and Glu and functional equivalents Sthereof; f is Pro and functional equivalents thereof; g is an amino acid N selected from the group consisting of Arg, Ala and Glu and functional S equivalents thereof; h is an amino acid selected from the group consisting of Ile, Val and Leu and functional equivalents thereof; i is an amino acid selected from the group consisting of Asp, Glu and Ser; j is an amino acid selected from the group consisting of Arg, Lys, Gln and Ala and functional equivalents thereof; n is an amino acid selected from the S group consisting of Gin, Met, Gly, Arg, Ser, Lys, Leu, Ala, Asn and Thr and functional equivalents thereof and Xk is a peptide of between 2 and 6 amino acids Preferred among this group of compounds are cyclic peptides or analogs thereof having the following formula Xi-Ala-Leu-Cysl-d-e-Pro-Arg-h-Asp-Arg-k-Tyr-CyS 2 -n-Phe-Xk (SEQ ID NO:105)wherein X i is absent or is a peptide of between 1 to 4 amino acids; d is an amino acid selected from the group consisting of Asp, Glu, Ser, Ala and Arg and functional equivalents therefore is an amino acid selected from the group consisting of Asn, Asp, Arg and Ala and functional equivalents thereof; h is an amino acid selected from the group consisting of Ile and Val and functional equivalents thereof; k is an amino acid selected from the group consisting of Trp and Na and functional equivalents thereof; n is an amino acid selected from the group consisting of Gln and Met and functional equivalents thereof and X, is a 3 amino acid peptide.

Examples of preferred linear or cyclic compounds are peptide compounds or analogs thereof having the following formula Xi-a-b-c-d-Asp-Pro-Arg-h-Asp-Arg-Trp-Tyr-m-n-o-Xk (SEQ ID NO:106) wherein X i is absent or a peptide of between 1 and 4 amino acids; a is an amino acid selected from the group consisting of Ala; Asn, Arg, Phe, Gin, Gly and Pro and functional equivalents thereof; b is an amino acid selected from the group consisting of Leu, Ala, Val, Ile, Arg, Gin and Asn and functional equivalents thereof; c is an amino acid selected from the group consisting of Ala and Cys and functional equivalents thereof; d is an amino in O acid; h is an amino acid selected from the group consisting of Ile, Val, Leu and Ala and functional equivalents thereof; m is an amino acid selected from 1 Ala and Cys and functional equivalents thereof; n is an amino acid and o is Can amino acid selected from the group consisting of Phe, Tyr, Trp and Na and K 5 functional equivalents thereof and Xk is a peptide of between 1 and 4 amino Sacids.

Preferred among this class of cyclic peptide compounds or analogs thereof are compounds having the following formula: Xi-a-Leu-Cys-d-Asp-Pro-Arg-h-Asp-Arg-Trp-Tyr-Cys-n-o-(Xaa)n Df 0 (SEQ ID NO:107)wherein a is an amino acid selected from the group consisting i of Ala, Thr and Ser and functional equivalents thereof; d is an amino acid V selected from the group consisting of Asp, Glu, Ser, Ala, Arg, Thr, His, SMet, Val and Asn and functional equivalents thereof; h is an amino acid CN selected from the group consisting of Ile, Val and Leu and functional equivalents thereof; n is an amino acid selected from the group consisting of Gln, Met, Gly, Arg, Ser, Lys, Ala, Asn and Thr and functional equivalents thereof and o is an amino acid selected from the group consisting of Phe and Tyr and functional equivalents thereof.

More preferred are cyclic peptide compounds or analogs thereof having D the following formula Xi- Ala-Leu-Cysl-d-Asp-Pro-Arg-h-Asp-Arg-Trp-Tyr-Cys 2 -n-Phe-Xk (SEQ ID NO:108)wherein d is an amino acid selected from the group consisting of Asp, Glu, Ser, Ala, Arg and functional equivalents thereof; n is an amino acid selected from the group consisting of Gin and Met and Xk is a 3 amino acid peptide.

Exemplary peptides of the present invention include but are not limited to those described in Figure 8.

In one embodiment, the invention contemplates the use of a compound such as a peptide or peptide analog and the compound comprises the following formula: -g-h-i-j-k-l-m-n-owherein g is an amino acid; h is an amino acid selected from the group consisting of lie, Val, Leu, Ala and functional equivalents thereof; i is an amino acid selected from the group consisting of Asp, Glu, Ser, Ala, Thr and functional equivalents thereof; j is an amino acid selected from the group consisting of Ala, Asp, Glu, Phe, Gly, His, Lys, Leu, Met, Asn, Pro, Gin, Arg, Ser, Thr, Val, Tyr and functional equivalents thereof; k is an amino acid selected from the group consisting of Trp, Na, Tyr, Phe and functional equivalents thereof; 1 is an amino acid selected from the group consisting of Tyr, Phe, Na, Trp and functional equivalents thereof; m is an amino acid selected from the group consisting of Cys, Ala and functional equivalents thereof; n is an amino acid and o is an amino acid selected from the group consisting of Phe Tyr, Trp, Na. These compounds specifically include

O

C peptide compounds as well as functional equivalents thereof, fragments S thereof, esters, amides, salts and derivatives thereof, and extended peptide Schains carrying additional amino acids or peptides at the termini of the C/ sequences.

C 5 Preferred among this class of compounds are compounds which comprises the following formula: a-b-c-d-e-f-g-h-i-j-k-l-m-n-o wherein a is an amino acid; b is an amino acid selected from the group O consisting of Leu, Ile, Val, Ala and functional equivalents thereof; c is an kl 3 amino acid selected from the group consisting of Cys, Ala and functional equivalents thereof; d is an amino acid; e is an amino acid selected from the group consisting of Ala, Cys, Asp, Glu, Phe, His, Ile, Lys, Leu, Met, Asn, Pro, Gln, Arg, Ser, Thr, Val, Trp, Tyr and functional equivalents N thereof; f is an amino acid selected from the group consisting of Pro, Gly, Ala and functional equivalents thereof g is an amino acid; -h is an amino acid selected from the group consisting of Ile, Val, Leu, Ala and functional equivalents thereof; i is an amino acid selected from the group consisting of Asp, Glu, Ser, Thr, Ala and functional equivalents thereof; j is an amino acid selected from the group consisting of Ala, Asp, Glu, Phe, Gly, His, Lys, Leu, Met, Asn, Pro, Gln, Arg, Ser, Thr, Val, Trp, Tyr and functional equivalents thereof; k is am amino acid selected from the group consisting of Trp, Tyr, Phe, Na and functional equivalents thereof; 1 is an amino acid selected from the group consisting of Tyr, Phe, Na and functional equivalents thereof; m is an amino acid selected from the group consisting of Cys, Ala and functional equivalents thereof; n is an amino acid; o is an amino acid selected from the group consisting of Tyr, Phe, Na and functional equivalents thereof.

The foregoing compounds can be used and are especially preferred in a method of inhibiting FVIIa activity comprising the steps of: a) contacting FVIIa with a compound of interest, especially the peptides and peptide analogs described in the foregoing section, in the presence or absence of tissue factor and under conditions which allow binding of the compound to FVIIa to occur and optionally, b) measuring or assessing the amount of FX activation that occurs in the presence of the compound of interest. According to certain aspects of the invention a standard FX activation assay as described herein is employed along with the foregoing method to measure the amount of FX activation that is blocked or inhibited by the compound of interest. This aspect of the present invention may be practiced in vitro or in vivo.

Peptide Crystals and Analogs Three dimensional structures of peptide compounds can be determined using X-ray crystallography. Structural information derived from a peptide crystal structure can be used for the identification of small bioorganic 0 molecules such as peptidomimetics and synthetic organic molecules which bind S FVII/FVIIa and preferably block or prevent a FVIIa mediated or associated process or event. An exemplary approach to such a structure based compound Cdesign is described in ("Structure Based Drug Design" Pandi Veerapandian, K 5 ed. Marcell Dekker, New York 1997).

The peptide analogs identified using the peptide compounds of the present invention are useful in the therapeutic methods described herein and as pharmaceutical compositions.

0 00 Chemical Synthesis t. D One method of producing the compounds of the invention involves chemical synthesis. This can be accomplished by using methodologies well V known in the art (see Kelley, R.F. Winkler, M.E. in Genetic Engineering Principles and Methods, Setlow, J.K, ed., Plenum Press, vol. 12, pp 1- (K 19 (1990), Stewart, J.M. Young, Solid Phase Peptide Synthesis, Pierce Chemical Co., Rockford, IL (1984); see also U.S. Pat. Nos. 4,105,603; 3,972,859;3,842,067; and 3,862,925).

Peptides of the invention can be conveniently prepared using solid phase peptide synthesis (Merrifield, (1964) J. Am. Chem. Soc., 85:2149; Houghten, (1985) Proc. Natl. Acad. Sci. USA, 82:5132. Solid phase synthesis begins at the carboxy terminus of the putative peptide by coupling a protected amino acid to an inert solid support. The inert solid support can be any macromolecule capable of serving as an anchor for the C-terminus of the initial amino acid. Typically, the macromolecular support is a crosslinked polymeric resin a polyamide or polystyrene resin) as shown in Figures 1-1 and 1-2, on pages 2 and 4 of Stewart and Young, supra. In one embodiment, the C-terminal amino acid is coupled to a polystyrene resin to form a benzyl ester. A macromolecular support is selected such that the peptide anchor link is stable under the conditions used to deprotect the aamino group of the blocked amino acids in peptide synthesis. If a baselabile a-protecting group is used, then it is desirable to use an acidlabile link between the peptide and the solid support. For example, an acid-labile ether resin is effective for base-labile Fmoc-amino acid peptide synthesis as described on page 16 of Stewart and Young, supra.

Alternatively, a peptide anchor link and a-protecting group that are differentially labile to acidolysis can be used. For example, an aminomethyl resin such as the phenylacetamidomethyl (Pam) resin works well in conjunction with Boc-amino acid peptide synthesis as described on pages 11-12 of Stewart and Young, supra.

After the initial amino acid is coupled to an inert solid support, the a-amino protecting group of the initial amino acid is removed with, for example, trifluoroacetic acid (TFA) in methylene chloride and neutralizing in, for example, triethylamine (TEA). Following deprotection of the initial amino acid's a-amino group, the next a-amino and sidechain protected amino S acid in the synthesis is added. The remaining a-amino and, if necessary, 1 side chain protected amino acids are then coupled sequentially in the Sdesired order by condensation to obtain an intermediate compound connected to the solid support. Alternatively, some amino acids may be coupled to one (2 5 another to form a fragment of the desired peptide followed by addition of the peptide fragment to the growing solid phase peptide chain.

The condensation reaction between two amino acids, or an amino acid and a peptide, or a peptide and a peptide can be carried out according to the usual condensation methods such as the axide method, mixed acid 00 VL anhydride method, DCC (N,N'-dicyclohexylcarbodiimide) or DIC diisopropylcarbodiimide) methods, active ester method, p-nitrophenyl ester I{ method, BOP (benzotriazole-l-yl-oxy-tris [dimethylamino] phosphonium Shexafluorophosphate) method, N-hydroxysuccinic acid imido ester method, etc, and Woodward reagent K method.

It is common in the chemical syntheses of peptides to protect any reactive side-chain groups of the amino acids with suitable protecting groups. Ultimately, these protecting groups are removed after the desired polypeptide chain has been sequentially assembled. Also common is the protection of the a-amino group on an amino acid or peptide fragment while the C-terminal carboxy group of the amino acid or peptide fragment reacts with the free N-terminal amino group of the growing solid phase polypeptide chain, followed by the selective removal of the a-amino group to permit the addition of the next amino acid or peptide fragment to the solid phase polypeptide chain. Accordingly, it is common in polypeptide synthesis that San intermediate compound is produced which contains each of the amino acid residues located in the desired sequence in the peptide chain wherein individual residues still carry side-chain protecting groups. These protecting groups can be removed substantially at the same time to produce the desired polypeptide product following removal from the solid phase.

a- and e-amino side chains can be protected with benzyloxycarbonyl (abbreviated isonicotinyloxycarbonyl (iNOC), o-chlorobenzyloxycarbonyl p-nitrobenzyloxycarbonyl [Z(NO 2 p-methoxybenzyloxycarbonyl t-butoxycarbonyl (Boc), t-amyloxycarbonyl (Aoc), isobornyloxycarbonyl, adamantyloxycarbonyl, 2-(4-biphenyl)-2propyloxycarbonyl (Bpoc), 9-fluorenylmethoxycarbonyl (Fmoc), methylsulfonyethoxycarbonyl (Msc), trifluoroacetyl, phthalyl, formyl, 2nitrophenylsulphenyl (NPS), diphenylphosphinothioyl (Ppt), and dimethylphosphinothioyl (Mpt) groups, and the like.

Protective groups for the carboxy functional group are exemplified by benzyl ester (OBzl), cyclohexyl ester (Chx), 4-nitrobenzyl ester (ONb), tbutyl ester (Obut), 4-pyridylmethyl ester (OPic), and the like. It is often desirable that specific amino acids such as arginine, cysteine, and serine possessing a functional group other than amino and carboxyl groups are O protected by a suitable protective group. For example, the guanidino group of arginine may be protected with nitro, p-toluenesulfonyl, benzyloxycarbonyl, adamantyloxycarbonyl, p-methoxybenzesulfonyl, 4-methoxy- 2,6-dimethylbenzenesulfonyl (Nds), 1,3,5-trimethylphenysulfonyl (Mts), and S the like. The thiol group of cysteine can be protected with pmethoxybenzyl, trityl, and the like.

Many of the blocked amino acids described above can be obtained from commercial sources such as Novabiochem (San Diego, CA), Bachem CA (Torrence, 00 CA) or Peninsula Labs (Belmont, CA).

Stewart and Young, supra, provides detailed information regarding S procedures for preparing peptides. Protection of a-amino groups is fn described on pages 14-18, and side chain blockage is described on pages 18- S28. A table of protecting groups for amine, hydroxyl and sulfhydryl r functions is provided on pages 149-151.

After the desired amino acid sequence has been completed, the peptide can be cleaved away from the solid support, recovered and purified. The peptide is removed from the solid support by a reagent capable of disrupting the peptide-solid phase link, and optionally deprotects blocked side chain functional groups on the peptide. In one embodiment, the peptide is cleaved away from the solid phase by acidolysis with liquid hydrofluoric acid (HF), which also removes any remaining side chain protective groups. Preferably, in order to avoid alkylation of residues in the peptide (for example, alkylation of methionine, cysteine, and tyrosine residues), the acidolysis reaction mixture contains thio-cresol and cresol scavengers. Following HF S cleavage, the resin is washed with ether, and the free peptide is extracted from the solid phase with sequential washes of acetic acid solutions. The combined washes are lyophilized, and the peptide is purified.

Disulfide Linked Peotides As described above, some embodiments of the invention are cyclized by formation of a disulfide bond between cysteine residues. Such peptides can be made by chemical synthesis as described above and then cyclized by any convenient method used in the formation of disulfide linkages. For example, peptides can be recovered from solid phase synthesis with sulfhydryls in reduced form, dissolved in a dilute solution wherein the intramolecular cysteine concentration exceeds the intermolecular cysteine concentration in order to optimize intramolecular disulfide bond formation, such as a peptide concentration of 25 mM to 1 pM, and preferably 500 pM to 1 pM, and more preferably 25 pM to 1 pM, and then oxidized by exposing the free sulfhydryl groups to a mild oxidizing agent that is sufficient to generate intramolecular disulfide bonds, e.g. molecular oxygen with or without catalysts such as metal cations, potassium ferricyanide, sodium tetrathionate, etc. In one embodiment, the peptides are cyclized as described in Example 2 below. Alternatively, the peptides can be cyclized as described in Pelton et al., (1986) J. Med. Chem., 29:2370-2375.

SCyclization can be achieved by the formation for example of a y) Sdisulfide bond or a lactam bond between Cys residues. Residues capable of forming a disulfide bond include for example Cys, Pen, Mpr, and Mpp and its 2-amino group-containing equivalents. Residues capable of forming a lactam bridge include for example, Asp, Glu, Lys, Orn, ap-diaminobutyric acid, diaminoacetic acid, aminobenzoic acid and mercaptobenzoic acid. The compounds herein can be cyclized for example via a lactam bond which can 00 utilize the side chain group of a non-adjacent residue to form a covalent attachment to the N-terminus amino group of Cys or other amino acid.

CN

(l Alternative bridge structures also can be used to cyclize the compounds of Sthe invention, including for example, peptides and peptidomimetics, which S can cyclize via S-S, CH2-S, CH2-O-CH2, lactam ester or other linkages.

Recombinant Synthesis In a further embodiment, the present invention encompasses a composition of matter comprising isolated nucleic acid, preferably DNA, encoding a peptide described herein. DNAs encoding the peptides of the invention can be prepared by a variety of methods known in the art. These methods include, but are not limited to, chemical synthesis by any of the methods described in Engels et al., (1989) Agnew. Chem. Int. Ed. Engl., 28:716-734, the entire disclosure of which is incorporated herein by reference, such as the triester, phosphite, phosphoramidite and Hphosphonate methods. In one embodiment, codons preferred by the expression host cell are used in the design of the encoding DNA. Alternatively, DNA encoding the peptide can be altered to encode one or more variants by using recombinant DNA techniques, such as site specific mutagenesis (Kunkel et al., (1991) Methods Enzymol. 204:125-139; Carter, et al., (186) Nucl.

Acids. Res. 13:4331; Zoller, M. J. et al., (1982) Nucl. Acids Res. 10:6487), cassette mutagenesis (Wells, J. et al., (1985) Gene 34:315), restriction selection mutagenesis (Wells, J. et al., (1986) Philos. Trans, R. Soc.

London SerA 317, 415), and the like.

The invention further comprises an expression control sequence operably linked to the DNA molecule encoding a peptide of the invention, and an expression vector, such as a plasmid, comprising the DNA molecule, wherein the control sequence is recognized by a host cell transformed with the vector. In general, plasmid vectors contain replication and control sequences which are derived from species compatible with the host cell. The vector ordinarily carries a replication site, as well as sequences which encode proteins that are capable of providing phenotypic selection in transformed cells.

Suitable host cells for expressing the DNA include prokaryote, yeast, or higher eukaryote cells. Suitable prokaryotes include but are not limited to eubacteria, such as Gram-negative or Gram-positive organisms, for N example, Enterobacteriaceae such as E. coli. Various E. coli strains are Spublicly available, such as E. coli K12 strain MM294 (ATCC 31,446); E. coli X1776 (ATCC 31,537); E. coli strain W3110 (ATCC 27,325) and K5 772 (ATCC C(1 5 53,635).

In addition to prokaryotes, eukaryotic organisms, such as yeasts, or cells derived from multicellular organisms can be used as host cells. For expression in yeast host cells, such as common baker's yeast or 0 Saccharomyces cerevisiae, suitable vectors include episomally replicating Vf 3 vectors based on the 2-micron plasmid, integration vectors, and yeast i artificial chromosome (YAC) vectors. Suitable host cells for expression V also are derived from multicellular organisms. Examples of invertebrate Scells include insect cells such as Drosophila S2 and Spodoptera Sf9, as well CN as plant cells. For expression in insect host cells, such as Sf9 cells, suitable vectors include baculoviral vectors. For expression in plant host cells, particularly dicotyledonous plant hosts, such as tobacco, suitable expression vectors include vectors derived from the Ti plasmid of Agrobacterium tumefaciens.

Examples of useful mammalian host cells include monkey kidney CV1 line S transformed by SV40 (COS-7, ATCC CRL 1651); human embryonic kidney line (293 or 293 cells subcloned for growth in suspension culture, Graham et al., (1977) J. Gen Virol., 36:59); baby hamster kidney cells (BHK, ATCC CCL Chinese hamster ovary cells/-DHFR (CHO, Urlaub and Chasin, (1980) Proc.

Natl. Acad. Sci. USA, 77:4216); mouse sertoli cells (TM4, Mather, (1980) S Biol. Reprod., 23:243-251); monkey kidney cells (CV1 ATCC CCL 70); African green monkey kidney cells (VERO-76, ATCC CRL-1587); human cervical carcinoma cells (HELA, ATCC CCL canine kidney cells (MDCK, ATCC CCL 34); buffalo rat liver cells (BRL 3A, ATCC CRL 1442); human lung cells (W138, ATCC CCL human liver cells (Hep G2, HB 8065); mouse mammary tumor (MMT 060562, ATCC CCL51); TRI cells (Mather et al., (1982) Annals N.Y. Acad. Sci., 383:44-68); MRC 5 cells; FS4 cells; and a human hepatoma cell line (Hep G2).

For expression in prokaryotic hosts, suitable vectors include pBR322 (ATCC No. 37,017), phGH107 (ATCC No. 40,011), pB0475, pS01 32 pRIT5, any vector in the pRIT20 or pRIT30 series (Nilsson and Abrahmsen, (1990) Meth.

Enzymol., 185:144-161), pRIT2T, pKK233-2, pDR540 and pPL-lambda.

Prokaryotic host cells containing the expression vectors of the present invention include E. coli K12 strain 294 (ATCC NO. 31446), E coli strain JM101 (Messing et al.,(1981) Nucl. Acid Res., 9:309), E. coli strain B, E.

coli strain X 1 7 7 6 (ATCC No. 31537), E. coli c600 (Appleyard, Genetics, 39: 440 (1954)), E. coli W3110 gamma-, prototrophic, ATCC No. 27325), E.

coli strain 27C7 (W3110, tonA, phoA E15, (argF-lac)169, ptr3, degP41, ompT, kanr) Patent No. 5,288,931, ATCC No. 55,244), Bacillus subtilis, Salmonella typhimurium, Serratia marcesans, and Pseudomonas species.

-29- For expression in mammalian host cells, useful vectors include vectors S derived from SV40, vectors derived from cytomegalovirus such as the pRK Svectors, including pRK5 and pRK7 (Suva et al., (1987) Science, 237:893-896; EP 307,247 (3/15/89), EP 278,776 (8/17/88)) vectors derived from vaccinia viruses or other pox viruses, and retroviral vectors such as vectors derived from Moloney's murine leukemia virus (MoMLV).

Optionally, the DNA encoding the peptide of interest is operably linked to a secretory leader sequence resulting in secretion of the Sexpression product by the host cell into the culture medium. Examples of 00 tL secretory leader sequences include stII, ecotin, lamB, herpes GD, Ipp, alkaline phosphatase, invertase, MIP.5 and alpha factor. Also suitable for l use herein is the 36 amino acid leader sequence of protein A (Abrahmsen et al., (1985) EMBO 4:3901).

Host cells are transfected and preferably transformed with the abovedescribed expression or cloning vectors of this invention and cultured in conventional nutrient media modified as appropriate for inducing promoters, selecting transformants, or amplifying the genes encoding the desired sequences.

Transfection refers to the taking up of an expression vector by a host cell whether or not any coding sequences are in fact expressed.

Numerous methods of transfection are known to the ordinarily skilled artisan, for example, CaPO 4 precipitation and electroporation. Successful transfection is generally recognized when any indication of the operation of this vector occurs within the host cell.

Transformation means introducing DNA into an organism so that the DNA is replicable, either as an extrachromosomal element or by chromosomal integrant. Depending on the host cell used, transformation is done using standard techniques appropriate to such cells. The calcium treatment employing calcium chloride, as described in section 1.82 of Sambrook et al., Molecular Cloning (2nd Cold Spring Harbor Laboratory, NY (1989), is generally used for prokaryotes or other cells that contain substantial cellwall barriers. Infection with Agrobacterium tumefaciens is used for transformation of certain plant cells, as described by Shaw et al., (1983) Gene, 23:315 and WO 89/05859 published 29 June 1989. For mammalian cells without such cell walls, the calcium phosphate precipitation method described in sections 16.30-16.37 of Sambrook et al., supra, is preferred.

General aspects of mammalian cell host system transformations have been described by Axel in U.S. 4,399,216 issued 16 August 1983. Transformations into yeast are typically carried out according to the method of Van Solingen et al., (1977) J. Bact., 130:946 and Hsiao et al., (1979) Proc. Natl. Acad.

Sci. (USA), 76:3829. However, other methods for introducing DNA into cells such as by nuclear injection, electroporation, or by protoplast fusion may also be used.

Other preferred vectors can be constructed using standard techniques S by combining the relevant traits of the vectors described above. Relevant Straits include the promoter, the ribosome binding site, the gene of interest 0) Sor gene fusion (the Z domain of protein A and gene of interest and a linker), the antibiotic resistance markers, and the appropriate origins of ^O replication.

A variation on the above procedures contemplates the use of gene fusions, wherein the gene encoding the desired peptide is associated, in the Svector, with a gene encoding another protein or a fragment of another 00 protein. This results in the desired peptide being produced by the host Scell as a fusion with another protein or peptide. The "other" protein or Speptide is often a protein or peptide which can be secreted by the cell, Smaking it possible to isolate and purify the desired peptide from the culture medium and eliminating the necessity of destroying the host cells which arises when the desired peptide remains inside the cell.

Alternatively, the fusion protein can be expressed intracellularly. It is useful to use fusion proteins that are highly expressed.

The use of gene fusions, though not essential, can facilitate the expression of heterologous peptides in insect cells as well as the subsequent purification.of those gene products. Protein A fusions are often used because the binding of protein A, or more specifically the Z domain of protein A, to IgG provides an "affinity handle" for the purification of the fused protein. For example, a DNA sequence encoding the desired peptide ligand can be fused by site directed mutagenesis to the genen for a consensus domain of protein A known as the Z domain (Nilsson et al., (1987) Protein Engineering 1:107-113). After expression and secretion the fusion protein can be enzymatically cleaved to yield free peptide which can be purified from the enzymatic mix (see, Varadarajan et al., (1985) Proc.

Natl. Acad. Sci USA 82:5681-5684; Castellanos-Serra et al., (1996) FEBS Letters 378:171-176; Nilsson et al., (1996) J. Biotechnol. 48:241-250).

Fusion proteins can be cleaved using chemicals, such as cyanogen bromide, which cleaves at a methionine, or hydroxylamine, which cleaves between an Asn and Gly residue. Using standard recombinant DNA methodology, the nucleotide base pairs encoding these amino acids may be inserted just prior to the 5' end of the gene encoding the desired peptide.

Alternatively, one can employ proteolytic cleavage of fusion protein.

Carter, in Protein Purification: From Molecular Mechanisms to Large-Scale Processes, Ladisch et al., eds. (American Chemical Society Symposium Series No. 427, 1990), Ch 13, pages 181-193.

Proteases such as Factor Xa, thrombin, and subtilisin or its mutants, and a number of others have been successfully used to cleave fusion proteins. Preferred according to the present invention for the production of peptide ligands of less than about 30 amino acids is the protease trypsin 2 which is highly specific for Arg and Lys residues. Trypsin cleavage is S discussed generally in Nilsson et al. (1996) J. Biotech. 48:241 and Smith et al., Methods Mol. Biol. 32:289. Typically, a peptide linker that is C/ amenable to cleavage by the protease used is inserted between the "other" protein the Z domain of protein A) and the desired peptide. Using recombinant DNA methodology, the nucleotide base pairs encoding the linker are inserted between the genes or gene fragments coding for the other proteins. Proteolytic cleavage of the partially purified fusion protein Scontaining the correct linker can then be carried out on either the native V) 3 fusion protein, or the reduced or denatured fusion protein.

The peptide may or may not be properly folded when expressed as a V fusion protein. Also, the specific peptide linker containing the cleavage site may or may not be accessible to the protease. These factors determine CN whether the fusion protein must be denatured and refolded, and if so, whether these procedures are employed before or after cleavage.

When denaturing and refolding are needed, typically the peptide is treated with a chaotrope, such a guanidine HC1, and is then treated with a redox buffer, containing, for example, reduced and oxidized dithiothreitol or glutathione at the appropriate ratios, pH, and temperature, such that the peptide is refolded to its native structure.

The host cells referred to in this disclosure encompass cells in in vitro culture as well as cells that are within a host animal.

In cyclized embodiments of the invention, the recombinantly produced peptide can be cyclized by formation of an intramolecular disulfide bond as described above.

The peptide compounds of the invention can be modified at the Nterminus or the C-terminus using an amino-protecting group or carboxy protecting group, respectively. Numerous such modifications will be apparent to those skilled in the art. For example, the N-terminus of a peptide or peptide analog can be chemically modified such that the Nterminal amino group is substituted for example by an acetyl, cyclopentylcarboxy, isoquinolylcarboxy, furoyl, tosyl, pyrazinecarboxy, or other such group, which can be sustituted by a substituent as described herein. The N-terminal amino group also can be substituted, for example, with a reverse amide bond. It should be recognized that the term amino group is used broadly herein to refer to any free amino group, including a primary, secondary, or teriary amino group, present in a peptide. By contrast the term N-terminus refers to the a-amino group of the first amino acid present in a peptide written in the conventional manner.

The N-terminus of a peptide of the invention can be protected by linking thereto an amino protecting group. The term "amino protecting group" is used broadly herein to refer to a chemical group that can react with a free amino group, including for example the a-amino group present at the N-terminus of a peptide of the invention. By virtue of reacting therewith, an amino protecting group protects the otherwise reactive amino Sgroup against undesirable reactions as can occur for example during a Ssynthetic procedure or due to exopeptidase activity on a final compound.

Modification of an amino group also can provide additional advantages, including, for example, increasing the solubility or the activity of the compound. Compounds having these modifications are meant to be included within the compounds of the present invention since their construction is Swithin the ability of the skilled artisan given the present disclosure.

00 f 3 Various amino protecting groups are known in the art and include, for Sexample, acyl groups such as an acetyl, picolyl, tert-butylacetyl, tert- (f butyloxycarbonyl, benzyloxycarbonyl, benzoyl groups, including for example a Sbenzyloxime such as a 2-aryl-2-o-benzyloxime as well as an amino acyl residue which itself can be modified by an amino-protecting group. Other amino-protecting groups are described for examiple in The Peptides, eds.

Gross and Meienhofer, Vol. 3 (acedemic Press, Inc. N.Y. 1981) and Greene and Wuts, in Protective groups in Organic Synthesis 2d ed., pages 309-405 (John Wiley sons, New York (1991), each of which is incorported herein by reference. The product of any such modification of the N-terminus amino group of a peptide or peptide analog of the invention is referred to herein as an "N-terminal derivative".

Similarly a carboxy group such as the carboxy group present at the Cterminus of a peptide can be chemically modified using a carboxy-protecting group. The terms "carboxy group" and "C-terminus" are used in a manner consistent with the terms amino groups and N-terminus as defined-above. A carboxy group such as that present at the C-terminus of a peptide can be modified by reduction of the C-terminal carboxy-group to an alcohol or aldehyde or by formation of an oral ester or by substituion of the carboxygroup with a substituent such as a thiazolyl, cyclohexyl, or other group.

J0 Oral esters are well known in the art and include, for example, alkoxymethyl groups such as methoxymethyl, ethoxymethyl, propoxymethyl, isopropoxy methyl, and the like.

Peptide Combinations A. Multimerization domains According to a preferred embodiment of the invention, the peptide compounds are combined with a multimerization domain. According to this aspect of the invention, hybrid molecules are provided which comprise at least two distinct domains. Each molecule comprises a peptide domain and a multimerization domain. According to the present invention, the peptide domain is joined to a multimerization domain such as an immunoglobulin Fc region, optionally via a flexible linker domain.

The hybrid molecules of the present invention are constructed by combining the peptide with a suitable multimerization domain. Ordinarily, -33when.preparing the hybrid molecules of the present invention, nucleic acid Cencoding the peptide will be operably linked to nucleic acid encoding the l multimerization domain sequence. Typically the construct encodes a fusion Sprotein wherein the C-terminus of the peptide is joined to the N-terminus of the multimerization domain. However, fusions where, for example, the Nterminus of the peptide is joined to the C-terminus of the multimerization domain are also possible.

Preferred multimerization domains are immunoglobulin constant region sequences. Typically, in such fusions the encoded hybrid molecule will 00 I retain at least functionally active hinge, CH2 and CH3 domains of the Sconstant region of an immunoglobulin heavy chain. Fusions are also made, for example, to the C-terminus of the Fc portion of a constant domain, or S immediately N-terminal to the CH1 of the heavy chain or the corresponding region of the light chain.

The precise amino acid site at which the fusion of the peptide to the immunoglobulin constant domain is made is not critical; particular sites are well known and may be selected in order to optimize the biological activity, secretion, or binding characteristics. In this regard, the skilled artisan may reference the construction of various immunoadhesins described in the literature Patent No.s 5,116,964, 5,714,147 and 5,336,603; Capon et al., (1989) Nature 337:525-531; Traunecker et al., (1989) Nature 339:68-70; and Byrn et al., (1990) Nature 344:667-670; Watson et al., (1990) J. Cell.

Biol. 110:2221-2229; Watson et al., (1991) Nature 349:164-167; Aruffo et al., (1990) Cell 61:1303-1313; Linsley et al., (1991) J. Exp. Med. 173:721- 730; Lisley et al., J. Exp. Med. 174:561-569; Stamenkovic et al., Cell 66:1133-1144; Ashkenazi et al., (1991) Proc. Natl. Acad. Sci. USA 88:10535- 10539; Lesslauer et al., (1991) Eur. J. Immunol. 27:2883-2886; and Peppel et al., (1991) J. Exp. Med. 174:1483-1489; Mohler et al., (1993) J. Immunol.

151:1548-1561); Bennett et al., (1991) J. Biol. Chem. 266:23060-23067; Ju Kurschner et al., (1992) J. Biol. Chem. 267:9354-9360; Chalupny et al., (1992) PNAS USA 89:10360-10364; Ridgway and Gorman, (1991) J. Cell. Biol.

115, Abstract No. 1448).

According to a particular aspect, an immunoglobulin type multimerization domain is selected to provide a multimer such as a dimer having an immunoglobulin Fc region. Therefore, the peptide is joined, in particular aspects, to an immunoglobulin heavy chain constant domain to provide a multimer comprising a functional Fc domain. In this case, DNA encoding an immunoglobulin chain-peptide sequence is typically coexpressed with the DNA encoding a second peptide-immunoglobulin heavy chain fusion protein. Upon secretion, the hybrid heavy chain will be covalently associated to provide an immunoglobulin-like structure comprising two disulfide-linked immunoglobulin heavy chains.

-34r V Preferably, the Fc region is a human Fc region, e.g. a native sequence Chuman Fc region human IgGl (A and non-A allotypes), IgG2, IgG3 or IgG4 Fc Sregion.

0) SIn a preferred embodiment, the peptide sequence is fused to the Nterminus of the Fc region of immunoglobulin G, (IgGi). It is possible to S fuse the entire heavy chain constant region to the peptide sequence.

However, more preferably, a sequence beginning in the hinge region just upstream of the papain cleavage site which defines IgG Fc chemically (i.e.

Sresidue 216, taking the first residue of heavy chain constant region to be 00 S) 114), or analogous sites of other immunoglobulins is used in the fusion. In S a particularly preferred embodiment, the peptide amino acid sequence is S fused to the hinge region and CH2 and CH3 or the CH1, hinge, CH2 and S CH3 domains, of an IgG heavy chain. In a preferred embodiment the peptide ligand amino acid sequence is fused to the hinge region and the CH3 domain of IgG1.

According to a particular aspect of this embodiment, hybrid molecules comprising a peptide and a multimerization domain are assembled as multimers, for example homodimers, or heterodimers or even heterotetramers.

Homodimers result from the pairing or crosslinking of two monomers comprising a peptide and a multimerization domain. However, it is not essential that two identical monomers pair. According to a particular aspect of the invention a hybrid molecule as defined herein comprising a peptide and a multimerization domain such as an immunoglobulin constant domain may pair with a companion immunoglobulin chain comprising one arm of an immunoglobulin. Various exemplary assembled hybrid molecules within the scope of the present invention are schematically diagramed below:

ACH

ACH-ACH

ACH-VHCH-VLCL

3V ACH-VHCH wherein each A represents identical or different peptide; VL is an immunoglobulin light chain variable domain; VH is an immunoglobulin heavy chain variable domain; CL is an immunoglobulin light chain constant domain and CH is an immunoglobulin heavy chain constant domain.

The hybrid molecules described herein are most conveniently constructed by fusing the cDNA sequence encoding the peptide portion inframe to an immunoglobulin cDNA sequence. However, fusion to genomic immunoglobulin fragments can also be used (see, e.g. Aruffo et al., (1990), Cell 61:1303-1313; and Stamenkovic et al. (1991), Cell 66:1133-1144). The latter type of fusion requires the presence of Ig regulatory sequences for expression. cDNAs encoding IgG heavy-chain constant regions can be isolated based on published sequences from cDNA libraries derived from spleen or peripheral blood lymphocytes, by hybridization or by polymerase chain Creaction (PCR) techniques. The cDNAs encoding the peptides and the 4 immunoglobulin parts of the hybrid molecule are inserted in tandem into a Splasmid vector that directs efficient expression in the chosen host cells.

Alternatively, and especially in embodiments where the peptide is synthesized by, for example standard solid phase synthesis techniques, the peptide may be linked to the multimerization domain by any of a variety of means familiar to those of skill in the art. Covalent attachment is typically the most convenient, but other forms of attachment may be employed 00 f) depending upon the application. Examples of suitable forms of covalent Sattachment include the bonds resulting from the reaction of molecules f bearing activated chemical groups with amino acid side chains in the S multimerization domain and can be made using a variety of bifunctional protein coupling agents such as N-succinimidyl-3-(2-pyridyldithiol) propionate (SPDP), iminothiolane bifunctional derivatives of imidoesters (such as dimethyl adipimidate HCL), active esters (such as disuccinimidyl suberate), aldehydes (such as glutareldehyde), bis-azido compounds (such as bis (p-azidobenzoyl) hexanediamine), bis-diazonium derivatives (such as bis-(p-diazoniumbenzoyl)-ethylenediamine), diisocyanates (such as tolyene 2,6-diisocyanate), and bis-active fluorine compounds (such as 1,5-difluoro-2,4-dinitrobenzene).

Peptide Fusions According to the present invention, the peptide is optionally linked to, for example, another peptide either directly or via a flexible peptide linker. According to the present invention, the linker domain, is any group of molecules that provides a spatial bridge between two or more peptide domains as described in more detail herein below. According to this aspect of the invention, peptides are linked together, as for example in a fusion protein.

J0 Linker Domains According to the present invention, the peptide domain is optionally linked to, for example, another peptide domain or a multimerization domain via a flexible peptide linker. The linker component of the hybrid molecule of the invention does not necessarily participate in but may contribute to the function of the hybrid molecule. Therefore, according to the present invention, the linker domain, is any group of molecules that provides a spatial bridge between two or more peptide domains or a peptide domain and a multimerization domain.

The linker domain can be of variable length and makeup. It is generally, the length of the linker domain and not its structure that is important. The linker domain preferably allows for the peptide domain of the hybrid molecule to bind, substantially free of spacial/conformational restrictions to the coordinant FVII/FVIIa molecule. Therefore, the length V of the linker domain is dependent upon the character of the two functional, Ce.g., the peptide and the multimerization domains of the hybrid molecule.

SOne skilled in the art will recognize that various combinations of 0) ry atoms provide for variable length molecules based upon known distances between various bonds (Morrison, and Boyd, Organic Chemistry, 3rd Ed, Allyn and Bacon, Inc., Boston, MA (1977)). For example, the linker domain may be a polypeptide of variable length. The amino acid composition of the polypeptide determines the character and length of the linker. Exemplary linker domains comprise one or more Gly and or Ser/Arg residues.

00 S0 Research and Diaonostic Compositions SIn a preferred embodiment, the peptides of the invention are noncovalently adsorbed or covalently bound to a macromolecule, such as a solid Ssupport. It will be appreciated that the invention encompasses both smacromolecules complexed with the peptides. In general, the solid support is an inert matrix, such as a polymeric gel, comprising a three dimensional structure, lattice or network of a material. Almost any macromolecule, synthetic or natural, can form a gel in a suitable liquid when suitably cross-linked with a bifunctional reagent. Preferably, the macromolecule selected is convenient for use in affinity chromatography. Most 0 chromatographic matrices used for affinity chromatography are xerogels.

Such gels shrink on drying to a compact solid comprising only the gel matrix. When the dried xerogel is resuspended in the liquid, the gel matrix imbibes liquid, swells and returns to the gel state. Xerogels suitable for use herein include polymeric gels, such as cellulose, cross-linked dextrans Sepharose), agarose, cross-linked agarose, polyacrylamide gels, and polyacrylamide-agarose gels.

Alternatively, aerogels can be used for affinity chromatography.

These gels do not shrink on drying but merely allow penetration of the surrounding air. When the dry gel is exposed to liquid, the latter JO displaces the air in the gel. Aerogels suitable for use herein include porous glass and ceramic gels.

Also encompassed herein are the peptides of the invention coupled to derivatized gels wherein the derivative moieties facilitate the coupling of the peptide ligands to the gel matrix and avoid steric hindrance of the peptide-FVII/FVIIa interaction in affinity chromatography. Alternatively, spacer arms can be interposed between the gel matrix and the peptide ligand for similar benefits.

In another embodiment, the invention provides fusion proteins in which a selected or desired polypeptide is fused at its N-terminus or its Cterminus, or at both termini, to one or more of the present peptides.

Pharmaceutical Compositions Pharmaceutical compositions which comprise the compounds, including Sthe hybrid molecules of the invention may be formulated and delivered or 0) Sadministered in a manner best suited to the particular FVII/FVIIa mediated disease or disorder being treated including formulations suitable for O parental, topical, oral, local, aerosol or transdermal administration or delivery of the compounds. In indications where the reduction of TF-FVIIa dependent coagulation is related to circulation of blood through stents or artificial valves or related to extracorporeal circulation including blood 00 D removed in-line from a patient in such processes as dialysis procedures, Sblood filtration, or blood bypass during surgery suitable formulations Sinclude those appropriate for coating devices such as stents, valves and filtration devices.

Somewhat more particularly, suitable compositions of the present invention comprise any of the compounds described herein along with a pharmaceutically acceptable carrier, the nature of the carrier differing with the mode of administration delivery or use, for example, in oral administration, usually using a solid carrier and in i.v. administration, a liquid salt solution carrier. For local administration such as may be appropriate where TF-FVIIa dependent coagulation is related to circulation of blood through artificial devices such as stents or valves the peptides may be linked, for example, covalently, to the artificial device preventing local thrombus formation. Alternatively, the peptide may be provided in a formulation that would allow for the peptide to slowly elute from the device providing both local and systemic protection against events associated with TF-FVIIa dependent coagulation. As but one example, stents adsorbed with peptides can be employed following angioplasty or other surgical procedure.

The compositions of the present invention include pharmaceutically acceptable components that are compatible with the subject and the compound of the invention. These generally include suspensions, solutions and elixirs, and most especially biological buffers, such as phosphate buffered saline, saline, Dulbecco's Media, and the like. Aerosols may also be used, or carriers such as starches, sugars, microcrystalline cellulose, diluents, granulating agents, lubricants, binders, disintegrating agents, and the like (in the case of oral solid preparations, such as powders, capsules, and tablets).

As used herein, the term "pharmaceutically acceptable" generally means approved by a regulatory agency of the Federal or a state government or listed in the U.S. Pharmacopeia or other generally recognized pharmacopeia for use in animals, and more particularly in humans.

The of choice can be accomplished using a variety of the aforementioned buffers, or even excipients including, for example, pharmaceutical grades of mannitol, lactose, starch, magnesium stearate, sodium saccharin cellulose, magnesium carbonate, and the like. "PEGylation" rof the compositions may be achieved using techniques known to the art (see for example International Patent Publication No. W092/16555, U.S. Patent No.

5,122,614 to Enzon, and International Patent Publication No. W092/00748).

A preferred route of administration of the present invention is in the aerosol or inhaled form. The compounds of the present invention, combined with a dispersing agent, or dispersant, can be administered in an aerosol formulation as a dry powder or in a solution or suspension with a diluent.

0As used herein, the term "dispersant" refers to a agent that assists 00 t aerosolization of the compound or absorption of the protein in lung tissue, or both. Preferably the dispersant is pharmaceutically acceptable. As used Sherein, the term "pharmaceutically acceptable" means approved by a Sregulatory agency of the Federal or a state government or listed in the U.S.

Pharmacopeia or other generally recognized pharmacopeia for use in animals, S and more particularly in humans. Suitable dispersing agents are well known in the art, and include but are not limited to surfactants and the like.

For example, surfactants that are generally used in the art to reduce surface induced aggregation of the compound, especially the peptide compound, caused by atomization of the solution forming the liquid aerosol may be used. Nonlimiting examples of such surfactants include polyoxyethylene fatty acid esters and alcohols, and polyoxyethylene sorbitan fatty acid esters. Amounts of surfactants used will vary, being generally within the range or 0.001 and 4% by weight of the formulation. In a specific aspect, the surfactant is polyoxyethylene sorbitan monooleate or sorbitan trioleate. Suitable surfactants are well known in the art, and can be selected on the basis of desired properties, depending on the specific formulation, concentration of the compound, diluent (in a liquid formulation) or form of powder (in a dry powder formulation), etc.

Moreover, depending on the choice of the compound, the desired therapeutic effect, the quality of the lung tissue diseased or healthy lungs), and numerous other factors, the liquid or dry formulations can comprise additional components, as discussed further below.

The liquid aerosol formulations generally contain the compound and a dispersing agent in a physiologically acceptable diluent. The dry powder aerosol formulations of the present invention consist of a finely divided solid form of the compound and a dispersing agent. With either the liquid or dry powder aerosol formulation, the formulation must be aerosolized.

That is, it must be broken down into liquid or solid particles in order to ensure that the aerosolized dose actually reaches the alveoli. In general the mass median dynamic diameter will be 5 micrometers or less in order to ensure that the drug particles reach the lung alveoli (Wearley, 1991, Crit. Rev. in Ther. Drug Carrier Systems 8:333). The term "aerosol particle" is used herein to describe the liquid or solid particle suitable -39for pulmonary administration, that will reach the alveoli. Other considerations such as construction of the delivery device, additional l components in the formulation and particle characteristics are important.

SThese aspects of pulmonary administration of a drug are well known in the art, and manipulation of formulations, aerosolization means and construction of a delivery device require at most routine experimentation by one of ordinary skill in the art.

With regard to construction of the delivery device, any form of aerosolization known in the art, including but not limited to nebulization, 00 f atomization or pump aerosolization of a liquid formulation, and S aerosolization of a dry powder formulation, can be used in the practice of f the invention. A delivery device that is uniquely designed for S administration of solid formulations is envisioned. Often, the aerosolization of a liquid or a dry powder formulation will require a propellent. The propellent may be any propellant generally used in the art.

Specific nonlimiting examples of such useful propellants are a chloroflourocarbon, a hydrofluorocarbon, a hydochlorofluorocarbon, or a hydrocarbon, including triflouromethane, dichlorodiflouromethane, dichlorotetrafuoroethanol, and 1,1,1,2-tetraflouroethane, or combinations thereof.

In a preferred aspect of the invention, the device for aerosolization is a metered dose inhaler. A metered dose inhaler provides a specific dosage when administered, rather than a variable dose depending on administration. Such a metered dose inhaler can be used with either a liquid or a dry powder aerosol formulation. Metered dose inhalers are well known in the art.

Once the compound reaches the lung, a number of formulation-dependent factors effect the drug absorption. It will be appreciated that in treating a disease or disorder that requires circulatory levels of the compound, such j0 factors as aerosol particle size, aerosol particle shape, the presence or absence of infection, lung disease or emboli may affect the absorption of the compounds. For each of the formulations described herein, certain lubricators, absorption enhancers, protein stabilizers or suspending agents may be appropriate. The choice of these additional agents will vary depending on the goal. It will be appreciated that in instances where local delivery of the compounds is desired or sought, such variables as absorption enhancement will be less critical.

Liquid Aerosol Formulations The liquid aerosol formulations of the present invention will typically be used with a nebulizer. The nebulizer can be either compressed air driven or ultrasonic. Any nebulizer known in the art can be used in conjunction with the present invention such as but not limited to: Ultravent, Mallinckrodt, Inc. (St. Louis, MO); the Acorn II nebulizer S (Marquest Medical Products, Englewood CO). Other nebulizers useful in Cconjunction with the present invention are described in U.S. Patent Nos.

4,624,251 issued November 25, 1986; 3,703,173 issued November 21, 1972; 0) S3,561,444 issued February 9, 1971 and 4,635,627 issued January 13, 1971.

SThe formulation may include a carrier. The carrier is a macromolecule which is soluble in the circulatory system and which is physiologically acceptable where physiological acceptance means that those of skill in the art would accept injection of said carrier into a patient as part of a therapeutic regime. The carrier preferably is relatively stable in the 00 00 circulatory system with an acceptable plasma half life for clearance. Such macromolecules include but are not limited to Soya lecithin, oleic acid and Ssorbitan trioleate, with sorbitan trioleate preferred.

The formulations of the present embodiment may also include other agents useful for protein stabilization or for the regulation of osmotic pressure. Examples of the agents include but are not limited to salts, such as sodium chloride, or potassium chloride, and carbohydrates, such as glucose, galactose or mannose, and the like.

Aerosol Dry Powder Formulations It is also contemplated that the present pharmaceutical formulation will be used as a dry powder inhaler formulation comprising a finely divided powder form of the compound and a dispersant. The form of the compound will generally be a lyophilized powder. Lyophilized forms of peptide compounds can be obtained through standard techniques.

In another embodiment, the dry powder formulation will comprise a finely divided dry powder containing one or more compounds of the present invention, a dispersing agent and also a bulking agent. Bulking agents useful in conjunction with the present formulation include such agents as lactose, sorbitol, sucrose, or mannitol, in amounts that facilitate the dispersal of the powder from the device.

JO Therapeutic Methods The compounds of the present invention can be used therapeutically to prevent the biological activity of the TF-FVIIa complex. The inhibition of TF-FVIIa is desirable in indications where the reduction of TF-FVIIa dependent coagulation is implicated. These situations include but are not limited to the prevention of arterial thrombosis in combination with thrombolytic therapy. It has been suggested that the TF-FVIIa plays a significant role in a variety of clinical states including deep venous thrombosis, arterial thrombosis, stroke, DIG, septic shock, cardiopulmonary bypass surgery, adult respiratory distress syndrome, hereditary angioedema.

Inhibitors of TF-FVIIa may therefore play important roles in the regulation of inflammatory and/or thrombotic disorders.

Thus the present invention encompasses a method for preventing TF- FVIIa mediated event in a human comprising administering to a patient in -41need thereof a therapeutically effective amount of the compound of the rpresent invention. A therapeutically effective amount of the compound of Sthe present invention is predetermined to achieve the desired effect. The 0) Samount to be employed therapeutically will vary depending upon therapeutic objectives, the routes of administration and the condition being treated.

O Accordingly, the dosages to be administered are sufficient to bind to available FVII/FVIIa and form an inactive complex leading to decreased coagulation in the subject being treated.

O The therapeutic effectiveness is measured by an improvement in one or 00 n more symptoms associated with the TF-FVIIa dependant coagulation. Such O therapeutically effective dosages can be determined by the skilled artisan Sand will vary depending upon the age condition, sex and condition of the O subject being treated. Suitable dosage ranges for systemic administration are typically between about 1 pg/kg to up to 100 mg/kg or more and depend upon the route of administration. According to the present invention a preferred therapeutic dosage is between about 1 pg/kg body weight and about mg/kg body weight. For example, suitable regimens include intravenous injection or infusion sufficient to maintain concentration in the blood in the ranges specified for the therapy contemplated.

The conditions characterized by abnormal thrombosis include those involving the arterial and venous vasculature. With respect to the coronary arterial vasculature, abnormal thrombus formation characterizes, for example, the rupture of an established atherosclerotic plaque which is the major cause of acute myocardial infarction and unstable angina, as well as also characterizing the occlusive coronary thrombus formation resulting from either thrombolytic therapy or percutaneous transluminal coronary angioplasty (PTCA). With respect to the venous vasculature, abnormal thrombus formation characterizes the condition observed in patients undergoing surgery in the lower extremities or the abdominal area who often suffer from thrombus formation in the venous vasculature resulting in reduced blood flow to the affected extremity and a predisposition to pulmonary embolism. Abnormal thrombus formation further characterizes disseminated intravascular coagulopathy commonly associated with both vascular systems during septic shock, certain viral infections and cancer, a condition wherein there is a rapid consumption of coagulation factors and systemic coagulation which results in the formation of life threatening thrombi occurring throughout the microvasculature leading to wide spread organ failure.

The following examples are offered by way of illustration and not by way of limitation. The disclosures of all citations in the specification are expressly incorporated herein by reference.

SEXAMPLES

C EXAMPLE I l Identification and Characterization of Peptides that Bind FVIIa and Inhibit FX Activation and Clotting Methods Phage Libraries Random sequence polyvalent peptide phage libraries have been described previously (Lowman H. B. et al. Biochemistry (1998) 37:8870). Peptide libraries were constructed of the form XiCXjCXk (where X Swas any of the 20 naturally occuring L-amino acids and j ranged from 4-10 00 IL 0 and i j k 18), an unconstrained library X20, and X4CX2GPX4CX4. Each of Sthe 10 libraries had in excess of 108 clones.

Vn Selection Conditions TFl-243 (Paborsky, L. R. et al. (1991) J. Biol.

Chem. 266: 21911) or recombinant human FVIIa (2 pg/ml each) were immobilized directly to Maxisorp plates (Nunc) in 50 mM ammonium bicarbonate, pH 9.3 by incubating overnight at 4 Wells were blocked using Sorting Buffer (50 mM HEPES, pH7.2, 5 mM CaCl2, 5 mM MgC12, 150 mM NaC1, 1% BSA) for 1 h at 25 'C.

Recombinant human FVIIa (2 pg/ml) in Sorting Buffer was added for 30 min to wells previously coated and blocked with TF to form the TF-FVIIa complex.

Phage from the libraries described above were pooled into 3 groups. Pool A 3 contained XiCXjCXk where j 5-7; Pool B contained X4CX2GPX4CX4, X20 and XiCXjCXk where j 4; Pool E contained XiCXjCXk where j 8-10. Phage from each pool were incubated with the immobilized targets in Sorting Buffer for 3 h at 25 generally about 5 x 10 10 phage were added at the beginning of each round. Unbound phage were removed by repetitive washing with Wash Buffer (50 mM HEPES, pH7.2, 150 mM NaC1, 0.005% Tween 20); remaining phage were eluted with 500 mM KC1, 10 mM HC1, pH2. The eluted phage were then propagated in XLl-Blue cells with VCSM13 helper phage (Stratagene) overnight at 37 Enrichment could be monitored by titering the number of phage which bound to a target coated well compared to a well coated with BSA.

FX Activation Assay Activation of FX by TF-FVIIa was monitored at room temperature as a function of peptide concentration. Each assay sample contained 100 pl of 460 pM relipidated TF1-243(TFpc) (Kelley, R. F. et al.

(1997) Blood 89:3219-3227) and 30 pM FVIIa in HBS/Ca buffer (20 mM HEPES, pH 7.4, 5 mM CaCl2, 150 mM NaCI, 0.1 PEG 8000); after 20 min, 25 pi of peptide diluted in HBS/Ca Buffer was added. Following a 30 min incubation the reaction was initiated by the addition of 25 ip of 1 pM FX in HBS/Ca (Note: this yields a final concentration of 306 pM TFpC, 20 pM FVIIa, and 166 nM FX). For kinetic analysis, the final concentration of FX was varied from between 20 and 500 nM. Aliquots of 25 pi were removed at 1, 3, 5, 7 and 9 min and quenched in 25 pi of 50 mM EDTA. The FXa generated in each aliquot could be measured by the addition of 100 p1 of 250 nM Spectrozyme fXa (American Diagnostica), 50 mM Tris, pH 8, 50 mM NaC1, 0.0025 Triton X-100.

The rate of FXa generated at each peptide concentration was proportional to -43-

I

the initial slope of the absorbance at 405 nm vs. time. Sigmoidal curves S were fit to a four parameter equation by nonlinear regression analysis S(Marquardt, J. Soc. Indust. Appl. Math. 11:431-441 (1963); the concentration of each peptide required to give a half-maximal signal in the assay was calculated from the curves and is referred to as the IC 50 value.

Clotting Assays Prothrombin time (PT) and activated partial thromboplastin time (APTT) clotting time assays were performed in citrated pooled normal plasmas (human or various animal species). Clotting.times S were determined using an ACL 300 Automated Coagulation Analyzer (Coulter 00 S3 Corp., Miami, FL) and commercially available reagents as follows.

SFor the PT assay, aqueous solutions of inhibitor at various S concentrations were added to citrated pooled normal plasma in a ratio of 1 S part inhibitor to 9 parts plasma. Following a 30 min incubation, these mixtures were added to sample cups of an ACL 300 Analyzer. Innovin® (Dade International Inc., Miami, FL), a mixture of human relipidated tissue factor and Ca 2 ions was added to the reagent cup. Precise volumes of sample and Innovin® (50 pl sample, 100 pl Innovin) were automatically transferred to cells of an acrylic rotor pre-equilibrated to 37 Following a 2 min incubation period, coagulation was initiated by mixing the two components by centrifugation. Coagulation was monitored optically and clotting time was reported in seconds. In this system, the clotting time of control plasmas (plasma plus inhibitor diluent) was typically 8 to 10 seconds. The fold prolongation is the clotting time of the inhibitor relative to the clotting time of the control.

i For the APTT assay, inhibitor and plasma were mixed together and transferred to the ACL 300 Analyzer sample cups as described above. Actin FS® and CaC1 2 (Dade International Inc., Miami, FL), were added to reagent cups 1 and 2 respectively. Precise volumes of sample (53 pl) and Actin FS® (53 pl) were automatically transferred to cells of a rotor pre-equilibrated O0 at 37 'C and mixed by centrifugation. Following a 2 min. activation period, coagulation was initiated by the addition of CaC1 2 (53 pl). Coagulation was monitored optically and clotting time was reported in seconds. APTT of plasma controls was typically 12 to 32 seconds, depending on the species of plasma used in the assay. The fold prolongation was the clotting time of the inhibitor relative to the clotting time of the control.

Phage ELISA The ability of peptides to compete with peptide-phage for binding to TF-FVIIa was monitored using a phage ELISA. Dilutions of peptide in Sorting Buffer were added to microtiter plates coated with the TF-FVIIa complex (as described above) for 30 min. Approximately 1011 monovalent phage displaying the TF74 peptide sequence were then added for an additional 15 min. The microtiter plate was washed with Wash Buffer and the phage bound to FVIIa were detected with an anti-gVIII/HRP monoclonal antibody conjugate (HRP/Anti-M13 Conjugate, Pharmacia Amersham Biotech). The -44o amount of HRP bound was measured using ABTS/H202 substrate and monitoring the absorbance at 405 nm. The absorbance at 405 nm was plotted versus the Sconcentration of peptide originally added to the well. Sigmoidal curves were fit to a four parameter equation by nonlinear regression analysis (Marquardt, J. (1963) Soc. Indust. Appl. Math. 11:431-441; the concentration of each peptide required to give a half-maximal signal in the assay was calculated from the curves and is referred to as the IC 50 value.

Partial and Complete Randomization on Monovalent Phage Monovalent libraries which display a single copy of a peptide on the surface of phage fused through a linker sequence to the tail protein coded for by gIII were constructed using single-stranded template-directed mutagenesis (Kunkel T.

A. et al. (1991) Methods Enzymol. 204:125-139) of the phagemid t4.g3.

Phagemid t4.g3 is a derivative of pA4G32 (Dennis M. S. and Lazarus, R. A.

S(1994) J. Biol. Chem. 269:22129-22136) where the coding sequence for APPI fused to gill has been replaced by a 60 bp spacer fused in frame to a linker sequence and gIII, in addition, the CMPr gene has been inserted into a unique hincII site in the AMP r gene. The change in drug resistance was designed to eliminate contamination by related although weaker affinity polyvalent clones which could take over the population through avidity effects (Cwirla, S. A. et al. (1990) Proc. Natl. Acad. Sci USA 87:6378- 6381). Partially randomized libraries were designed to maintain a bias towards the peptide sequences identified from the initial polyvalent libraries while allowing a 50% mutation rate at each amino acid position.

This mutation rate was attained by synthesizing the oligos with a 70-10-10mixture of bases (where each base in the doped region of the oligo is coupled using a mixture containing 70% of the base contributing to wildtype sequence and 10% each of the other 3 bases). In contrast, complete randomization in libraries was obtained by synthesizing oligos using NNS for particular codons in order to fully randomize portions of a displayed .3 peptide while keeping other portions of the sequence constant.

Peptide Synthesis Peptides were synthesized by either manual or automated (Perceptive Pioneer) Fmoc-based solid phase synthesis on a 0.25 mmol scale using a PEG-polystyrene resin (Bodansky, M. (1984) Principles of Peptide Synthesis, Springer, Berlin). Coupling of each amino acid was accomplished with 2-(H-Benzotriazole-l-yl)-1,1,3,3-tetramethyluronium hexafluorophosphate (HBTU) and N-Hydroxybenzotriazole (HOBt) with diisopropylethylamine (DIPEA) in dimethylacetamide (DMA). Peptides ending in a carboxy-terminal amide were prepared on Rink amide resin. Acetylation of the amino terminus was accomplished with acetic anhydride in triethylamine in dichloromethane. Side chain protecting groups were removed and the peptide was cleaved from the resin with 95 trifluoroacetic acid (TFA) and 5 triisopropylsilane. A saturated iodine solution in acetic acid was added to oxidize the disulfide bonds. Peptides were purified by reversed-phase HPLC using a water/acetonitrile gradient containing 0.1 TFA and lyophilized. Peptides were >95 pure by analytical HPLC and their identity was verified by mass spectrometry.

SBiotinylated Peptides- Peptides were synthesized using methods as described above. Peptides containing a carboxy-terminal biotin TF147b) were prepared on Fmoc-L-Lysine(c-Aloc)-PEG polystyrene Rink amide resin.

Coupling of each amino acid was accomplished as described above. At the completion of chain assembly the E- side chain protecting group of lysine was unmasked with Pdo. Fmoc-aminocaproic acid was coupled, deprotected, and then coupled to biotin as described above (Kates,. de la Torre, B.G., Eritja, and Albericio, F. (1994) Tetrahedron Lett. 35:1003).

SFVIIa Binding ELISA The ability of peptides to compete with biotinylated versions of TF76 TF147b, or other peptides described herein that could be biotinylated as described) for binding to FVIIa was monitored using a FVIIa Binding ELISA or a TF-FVIIa Binding ELISA.

Microtiter plates were coated overnight with 2 pg/ml recombinant human FVIIa or 2 pg/ml TFl-243 (Paborsky, L. R. et al. (1991) J. Biol. Chem. 266: 21911) in 50 mM ammonium bicarbonate pH 9 at 4 all other steps were performed at room temperature. Plates were then blocked with 1 BSA in Assay Buffer mM HEPES, pH 7.2, 5 mM CaCl2, 150 mM NaCI). For the TF-FVIIa ELISA, recombinant human FVIIa (2 pg/ml) in 1 BSA in Assay Buffer was added for min to the wells previously coated and blocked with TF to form the TF- FVIIa complex. Dilutions of peptide in Assay Buffer plus 0.05 Tween were added to the microtiter plate along with 20 nM TF147b for 1 h. The Smicrotiter plate was washed 3 times with Assay Buffer plus 0.05 Tween and the biotinylated-peptide bound was detected with a Streptavidin/HRP conjugate (Streptavidin-POD, Roche Molecular Biochemicals). The amount of HRP bound was measured using ABTS/H202 substrate (Kirkegaard and Perry Laboratories) and monitoring the absorbance at 405 nm. The absorbance at 405 nm was plotted versus the concentration of peptide originally added to the well. Sigmoidal curves were fit to a four parameter equation by nonlinear regression analysis (Marquardt, J. Soc. Indust. Appl. Math.

11:431-441 (1963); the concentration of each peptide required to give a half-maximal signal in the assay was calculated from the curves and is referred to as the IC 50 value.

Screening Assay Using the FVIIa Binding ELISA The FVIIa Binding ELISA described above can also be used to screen for any compound that would block peptides of the present invention from binding to FVIIa. This could be carried out as described above or modified as described below. Thus, a competitive binding assay was established for use in high-throughput screening of chemical libraries for the purpose of identifying inhibitors of peptide binding. The assay is performed in opaque white, high-binding, 384well plates coated with 1 pg/ml FVIIa and blocked with BSA. Sample, r S- control, or assay buffer (20 pl) and biotinylated peptide TF147b or S other peptides described herein that could be biotinylated as described) Spi) are added to each well, and the plates are incubated for 1 h at room temperature. Sample or control may compete with the biotinylated peptide for binding to the factor Vila on the plate. The unbound biotinylated 0 peptide is removed by washing the plate six times, and 40 pi of streptavidin-europium are added. During the subsequent 30 min incubation, the streptavidin-europium binds to the biotinylated peptide remaining on the S plate. After washing six times to remove the unbound streptavidin-europium, 00 S0 40 pl of enhancement solution are added to each well to dissociate the S europium from the existing nonfluorescent chelate and to replace this with a S highly fluorescent chelate. The fluorescence is read on a Wallac Victor S microplate reader with excitation at 340 nm and emission at 615 nm following a 100 p second delay. The percent inhibition of binding is calculated relative to controls with assay buffer as sample.

Results Polyvalent Peptide-Phage that bind to TF-FVIIa Polyvalent peptide libraries were sorted in 3 pools (designated A, B and E) against immobilized TF-FVIIa. Polyvalent phage display (Scott J. K. and Smith G. P. Science 3 (1990) 249:386-390; Lowman, H. B. (1997) Annu. Rev. Biophys. Biomol. Struct 26:401-424; Wells, J. A. and Lowman, H. B. (1992) Curr. Opin. Biotechnol.

3:355-362) was used to enhance binding through avidity effects. After 4 rounds of selection and amplification, the enrichment for Pool E, the number of phage eluted from a well coated with TF-FVIIa divided by the number of phage eluted from a well coated with BSA, was 1700-fold. The DNA from 12 random clones in each pool were sequenced. The clones in Pool E were all siblings from a single clone with the deduced peptide sequence: EAALCDDPRLDRWYCIFAGE (SEQ ID NO:1); a peptide containing this sequence was designated TF56. Phage bearing this sequence bound specifically to -0 immobilized FVIIa or TF-FVIIa but did not bind to wells coated with either TF or BSA. Additionally, this clone bound to both covalently and noncovalently active site blocked TF-FVIIa, where the active site of FVIIa was alkylated with biotinylated EGR chloromethylketone or blocked by TF7I-C, a Kunitz domain inhibitor (Dennis M. S. and Lazarus, R. A. (1994) J. Biol.

Chem. 269:22129-22136), indicating that the peptide bound to FVIIa, but at a site distinct from the active site an exosite.

Partial Randomization The initial peptide libraries that were designed, encoded a potential diversity of greater than 2020 (1026) different clones while the actual libraries that were made contained approximately only 109 clones, a very small fraction of the potential diversity. In order to narrow the search and yet further explore the peptide diversity within the area of the initially selected peptides, a partial randomization technique was employed. This technique maintains a -47bias towards the wildtype sequence while introducing a 50 mutation rate S (at the amino acid level) at each amino acid position; thus on average, a Sphage displayed 20 amino acid peptide would acquire 10 random mutations. In addition, anticipation of further affinity improvements led us to construct these libraries on monovalent phage via fusion to gIII in order to eliminate S avidity effects (Lowman, H. B. (1997) Annu. Rev. Biophys. Biomol. Struct 26:401-424; Lowman H. B. et al. (1991) Biochemistry 30: 10832-10838); Wells, J. A. and Lowman, H. B. (1992) Curr. Opin. Biotechnol. 3:355-362).

SA monovalent partial randomization library based upon the TF56 00 S) sequence (library e3) was constructed and sorted for 4 rounds on TF-FVIIa.

S Enrichment of 100,000 fold was observed. Again, random clones were selected S and sequenced; the deduced peptide sequences are shown in Table I. Several S amino acid positions in the TF56 sequence were retained 100 yet multiple Scodons were observed at many of these positions; wildtype amino acids were i still represented at each position reflecting the library design. One notable exception was the absence of L at position 10 suggesting V, I or F were superior replacements at this position. Residues strongly retained following partial randomization may be crucial for binding either through direct contacts or for structural reasons.

Table I SEQ ID clone frequency Deduced Amino Acid Sequence

NO:

1 Library E3 E A A L C D D P R L D R W Y C I F A G E EH 1/12 E A A L C E D P R V D R W Y C I F A G E 66 EL 1/12 E S A L C D D P R V D R W Y C I FA G D 2 EB 2/12 E G T L C D D P R I D R W Y C M F S G V -0 67 EA 2/12 E V A L C S D P R V D R W Y C M F A T D 68 EC 2/12 A A A L C D D P R I D R W Y C S F L G V 69 EG 1/12 E A A L C D D P R F D R W Y C T F V G E EE 3/12 E A A L C D D P R V D R W Y C T F V G E Peptide sequences were deduced from the DNA sequence of clones obtained after 4 rounds of selection.

The frequency represents the occurrence of each clone among the total number of clones sequenced from the pool.

Underlined residues indicate the wildtype sequence which was partial randomized as described in text.

Full maturation To complete the affinity maturation, a third set of libraries was constructed which fixed positions that were 100 conserved and fully randomized the remaining positions. In addition, the role of residues flanking the disulfide loop was addressed by constructing libraries o with either portions of the amino and carboxy terminal or both missing.

Thus, 4 monovalent libraries were constructed and are described in Table II.

SEnrichment of 100,000-fold was observed by each library by round 4; the sequences from random clones are presented in Table II. Even though these libraries (which fully randomized 9 amino acid positions) were far from complete, a comparison of the 4 libraries demonstrated a clear consensus for the optimum amino acid at each position.

00 oq o% SEQ ID clone

NO:

Library EAC Table II Deduced Amino Acid Sequence x x x x r Flx[D x FT77W-7- XFYI x EC31.

EC32 EC3 3 EC41 EC4 2 EC4 3 00 Library EAN EN 31 EN3 2 EN3 3 EN4 1 EN 42 EN43 x FEW-c7:-- x Mffr-TPTIRF-R9 X X FTA X X X G -D ~j4iV N S DR V S ~C D b _v A G D A CH V T CS EL V

Q

Q

G

L

M 31 R j Library EnNC X X FD M. X X X ENC31 ENC32 ENC34 ENC42 ENC4 4 ENC41 ENC4 3 IND 1 V4 T S f E vD T L

W~D~V

p S -W RW-V CQ D~ K Library EFL Y X x Xx X

W

X

EP42 EP4 3 EP44 EP4 5 EP4l1 EP3 1 EP32 EP33 EP3 4 T _4RV .S I i E v S E j L S V DRZv L CE D V E DT v D RV D I

Q

Q

A

S

S

Q

R

Q

Q

G ffl=-F Peptide sequences were deduced from the DNA sequence of clones obtained after 4 rounds of selection.

Shaded residues indicate the wildtype sequence which was fixed, underlined residues were fully randomized as described in text.

Characterization of Peptides that bind to TF-FVIIa In order to Cassess the activity of the sequences selected from the phage displayed Slibraries, peptides corresponding to sequences selected from these libraries 0) Swere chemically synthesized. Thus, peptide TF56 (EAALCDDPRLDRWYCIFAGE-NH2) S (SEQ ID NO:1), corresponding to a random-phage derived clone from library 0 E3, peptide TF58 (EGTLCDDPRIDRWYCMFSGV) (SEQ ID NO:2, corresponding to a clone derived from the partially randomized library, and TF76 (Ac- ALCDDPRVDRWYCQFVEG-NH2) (SEQ ID NO:8), corresponding to the consensus from S the fully matured sequence, were chemically synthesized. Data from these as 00 S) well as TF74 and TF151 are presented in the Figures.

SAlthough peptides were selected only for binding to the TF-FVIIa complex, we were interested in finding functionally relevant peptides, i.e.

S peptides that would inhibit the TF-FVIIa catalyzed activation of FX to FXa in a dose dependent manner, by interfering with the binding and/or turnover of FX. Thus they were tested for their ability to inhibit FX activation; the inhibition of FX activation by selected peptides is shown in Figure 1.

The sequences of selected peptides and IC50 values for inhibiting FX activation are shown in Figure 8. In addition, peptides derived later in the maturation process were more potent, demonstrating the effectiveness of this procedure.

In agreement with their ability to block FX activation using purified components, the peptides described herein were potent anticoagulants. The inhibition of the TF dependent extrinsic clotting pathway in human plasma, as measured by the dose dependent prolongation of the prothrombin time (PT), is shown in Figure 2A. It is significant that we see no evidence for prolonging the clotting time in human plasma in the surface dependent intrinsic pathway, as determined by the activated partial thromboplastin time (APTT) (Figure 2B). This implies that the E peptides do not inhibit any of the serine proteases involved in the intrinsic pathway, which include u thrombin, FXa, FIXa, FXIa, plasma kallikrein, and FXIIa.

FVIIa Binding ELISA The ability of peptides to compete with a biotinylated version of TF76 TF147b or other peptides described herein that could be biotinylated as described) for binding to FVIIa was monitored using a FVIIa Binding ELISA; the inhibition of TF147b binding to FVIIa or TF-FVIIa by selected peptides is shown in Figure 3. The sequences of selected peptides and the IC50 values for their inhibition of the binding of TF147b to either FVIIa or TF-FVIIa is shown in Figure 8. The FVIIa Binding ELISA can also be used to screen for any compound that would block peptides of the present invention from binding to FVIIa. This could be carried out using a variety of reagents to detect the biotinylated peptide.

Furthermore, a variety of peptides described herein could be used to develop the same type of assay. Thus, a competitive binding assay was established for use in high-throughput screening of chemical libraries for the purpose 0) N of identifying inhibitors of peptide binding.

SExample 2. Expression and Characterization of a Peptide Fusion that Binds FVIIa and Inhibits FX Activation and Clotting Methods Construction of TF151-Fc expression vector-Standard recombinant DNA techniques were used for the construction of recombinant transfer vectors based on the vector pVL1393 (Pharmigen) (Sambrook, Fritsch, E. and 00 S0 Maniatis, T. (1989) Molecular Cloning: A Laboratory Manual, second Ed., Cold Spring Harbor Laboratory Press, New York; O'Reilly, D. Miller, L. K., I and Luckow, V. A. (1994) Baculovirus Expression Vectors: A Laboratory Manual, Oxford University Press, New York). The pVL1393 derived plasmid K pbPH.His was linearized with Nco I and Sma I and treated with shrimp alkaline phosphatase (Dwyer, M. A. et al. (1999) J. Biol. Chem. 274:9738- 9743). The Fc portion of the human IgGl was obtained as a 700 base pair fragment by restriction digestion using Nde I and subsequent treatment with Klenow and Nco I of another pVL1393 derived plasmid pVL1393.IgG. The signal sequence for MIP.5 was introduced before the Fc sequence as a PCR fragment 0 digested with EcoR I, included within the fragment is an Asc I site. The Asc I site occurs following the putative signal sequence cleavage site.

Following ligation, competent E. coli XL-1 Blue were transformed and bacteria were selected for the correct recombinant plasmid (pVL1393.MIP.5sig.Fc) by DNA sequence analysis. Then, pVL1393.MIP.5sig.Fc was linearized with Asc I and Stu I and treated with shrimp alkaline phosphatase. The linearized vector was then ligated with a synthetic piece of DNA with compatible ends. The synthetic DNA inserts were formed by annealing 2 oligos with the sequences: 5'-GCC GGA GCT CCC GCC TCC GCC CTC CAC GAA CTG GCA GTA CCA CCT GTC GAT TCT GGG GTT GTC GCA CAG GGC GCC CAC GG- 3' (SEQ ID NO:102) and 5'-CGC GCC GTG GGC GCC CTG TGC GAC AAC CCC AGA ATC GAC AGG TGG TAC TGC CAG TTC GTG GAG GGC GGA GGC GGG AGC TCC GGC-3' (SEQ ID NO:103) coding for peptide sequence TF151 (Figure 8) including a GGGSSG linker (SEQ ID NO:104). Following ligation, competent E. coli XL-1 Blue were transformed and bacteria were selected for the correct recombinant plasmid (termed pVL.1393.MIP5.TF151-Fc) by DNA sequence analysis using the dRhodamine dye-terminator method and an Applied Biosystems ABI Model 373 automated DNA sequencer. Recombinant transfer vector was purified using a Qiagen Mini-Prep and used for construction of recombinant baculovirus.

Recombinant baculovirus, AcNpV.TF151-Fc, was generated following cotransfection of Sf9 cells with the transfer vector and the linearized wild type baculovirus DNA (Autographa californica nuclear polyhedrosis virus (AcNpV), Pharmingen). A primary amplification of the recombinant baculovirus, AcNpV.TF151-Fc, achieved detectable protein expression.

Subsequent plaque-purification and titering of the viral stock was performed S by plaque assays. Standard methods were utilized as previously described S(O'Reilly, D. Miller, L. and Luckow, V. A. (1994) Baculovirus d) SExpression Vectors: A Laboratory Manual, Oxford University Press, New York).

Cell Culture-Adherent cultures of Spodeptera frugiperda (Sf9) insect cells (ATCC CRL 1711) were maintained at 28 'C in Hink's TNM-FH insect medium supplemented GRACE's (JRH Biosciences, #51942-78P), with glutamine, streptomycin/penicillin, and 10% fetal bovine serum (heat inactivated for min at 56 Cultures were passaged every 3 days. Spinner cultures of 00 If High Five m cells (Trichoplusia ni, BT1.TN.SB1-4 (Invitrogen)) (500 ml at Sx 106 cells/ml) were infected at a multiplicity of infection of 0.5 and f harvested 60 h posttransfection. Suspension cultures were maintained in S spinner flasks at 28 'C using ESF-921 protein free insect cell culture medium (Expression Systems LLC, #96-001). Cultures were passaged every 3 days to a starting cell density of 106 cells/ml.

TF151-Fc Purification-Following the optimized infection protocol, the High Five- cells were removed by centrifugation at 800 x g at 4 'C for min. The clarified supernatant (0.5 L) was filtered using a 0.45 p Nalgene filter and applied to a 0.5 ml Hi-Trap Protein A Column (Amersham Pharmacia Biotech) equilibrated with PBS (phosphate buffered saline) at 25 After washing with 20 ml of PBS, the column was eluted with 3 ml of 0.2 N HOAc and fractions containing TF151-Fc were lyophilized and stored at 4 0

C.

SDS-PAGE -Samples were analyzed reduced and unreduced on a 4-20% Trisglycine SDS-PAGE (Novex) along with prestained protein molecular weight markers (SeaBlue, Novex) using the method of Laemmli (Laemmli, U. K. (1970) Nature 227:680-685).

Protein Sequencing-TF151-Fc purified from the infected Sf9 cell supernatants was subjected to SDS-PAGE, and then transferred to a PVDF membrane. Electroblotting onto Millipore Immobilon-PSQ membranes was carried out for 1 h at 250 mA constant current in a BioRad Trans-Blot transfer cell (Matsudaira, P. (1987) J. Biol. Chem. 262: 10035-10038). The PVDF membrane was stained with 0.1% Coomassie Blue R-250 in 50% methanol, min and destained for 2-3 min with 10% acetic acid in 50% methanol. The membrane was thoroughly washed with water and allowed to dry before storage at -20 The TF151-Fc band at about 50 kD was cut out and the first 11 residues were sequenced using a model 494A Applied Biosystems sequencer equipped with an on-line PTH analyzer. Peaks were integrated with Justice Innovation software using Nelson Analytical 760 interfaces. Sequence interpretation was performed on a DEC alpha (Henzel, W. Rodriguez, H., and Watanabe, C. (1987) J. Chromatog. 404: 41-52).

FVIIa Binding ELISA-The ability of TF151-Fc to compete with TF147b a biotinylated version of TF76, (Figure 8) for binding to FVIIa was monitored using a FVIIa Binding ELISA. Microtiter plates were coated overnight with 2 O pg/ml recombinant human FVIIa in 50 mM ammonium bicarbonate pH 9 at 4 OC; S all other steps were performed at room temperature. Plates were then 0 blocked with 1 BSA in Assay Buffer (50 mM HEPES, pH 7.2, 5 mM CaC12, 150 SmM NaCI). Dilutions of TF151-Fc in Assay Buffer plus 0.05 Tween 20 were added to the microtiter plate along with 20 nM TF147b for 1 h. The microtiter plate was washed 3 times with 300 pl Assay Buffer plus 0.05 Tween 20 and the TF147b bound was detected with a Streptavidin/HRP conjugate (Streptavidin-POD, Roche Molecular Biochemicals). The amount of HRP bound was measured using ABTS/H202 substrate (Kirkegaard and Perry Laboratories) and monitoring the absorbance at 405 nm. The absorbance at 405 nm was plotted versus the concentration of peptide originally added to the well.

S

Sigmoidal curves were fit to a four parameter equation by nonlinear regression analysis (Marquardt, J. Soc. Indust. Appl. Math. 11:431-441 S(1963); the concentration of TF151-Fc required to give a half-maximal signal in the assay was calculated from the curves and is referred to as the

IC

50 value.

FX Activation Assay- The FX activation assay was carried out as described in Example 1.

Clotting Assays- The PT clotting assay was carried out as described in Example 1.

RESULTS

Protein Characterization of TF151-Fc- Following purification, approximately 8 mg of control-Fc (an Fc lacking a fused peptide ligand) or TF151-Fc was obtained from a 500 ml culture. SDS-PAGE analysis of the reduced and unreduced fusions revealed bands at about 30 and about 60 kDa respectively, suggesting the association of two peptide-Fc monomers to form a dimer (Figure N-terminal sequence analysis of TF151-Fc revealed the sequence 'SQAQRRAVGAL...'(SEQ ID NO:43) indicating removal of the signal sequence and expression of the peptide as a fusion to the Fc.

0 TF151-Fc Activity- The ability of TF151-Fc to compete with TF147b a biotinylated version of TF76 for binding to FVIIa was monitored using a FVIIa Binding ELISA. The inhibition of TF147b binding to FVIIa was comparable to peptide TF151 and is shown in Figure 5; TF151 and the TF151-Fc fusion had IC50 values of 2 and 3 nM, respectively. The TF151-Fc fusion was also comparable to the peptide TF151 in its ability to inhibit FX activation by TF-FVIIa in a FX activation assay (Figure The ability to block FX activation with TF151-Fc was also reflected in the prolongation of the prothrombin time in human plasma (Figure The potency of TF151-Fc was comparable to peptide TF151 in this assay.

-54- Example 3. Purification, Crystalization and Structure Determination for TF76 S(SEQ ID NO: 8) SPeptide TF76 was synthesized as previously described (Lowman, et al. Molecular mimics of insulin-like growth factor 1 (IGF-1) for inhibiting IGF-1: IGF-binding protein interactions. Biochemistry 37, 8870-8878 (1998)).

CAcetylation of the amino terminus was accomplished with acetic anhydride in triethylamine in dichloromethane.

Harvested cell culture medium from 293 cells expressing human Factor S VII was treated with 5 mM EDTA and 2 mM benzamidine and loaded onto a DEAE 00 D Fast Flow column; bound FVII was eluted with 150 mM NaCl. The DEAE pool was S loaded onto a Q-Sepharose Fast Flow column and eluted with 5 mM CaCl2, 135 mM NaC1. The Q-Sepharose pool eluted as activated FVIIa and was S concentrated by ammonium sulfate precipitation. Solubilized FVIIa was passed over a Sephacryl-200 gel filtration column; N-terminal sequence analysis confirmed the loss of the Gla domain (proteolysis between Trp 41 and Ile 42). TF76 and Gla-domainless FVIIa, covalently active-site inhibited with D-Phe-L-Phe-Arg-chloromethyl ketone (D-FFRCMK) were combined in a 1:1 ratio and purified on a Superdex 75 column. Crystals grew from hanging drops equilibrated against 20% PEG 4000, 10% t-butyl alcohol, 0.1 M sodium cacodylate pH 5.5, were harvested into a cryoprotectant solution containing reservoir with 10% methylpentanediol, and flash frozen in liquid nitrogen. Data extending to 3 A were collected on a MAR345 scanner in space group P21 with a=70.49A, b=55.26A, c=111.73A, b=99.48° at SSRL beamline 9.1, with average redundancy 2.6, reduced with Mosflm and S processed with the CCP4 suite (Rmerge 10.4%, 26.2% in the outer shell; overall I/s 6.2, 2.7 in the outer shell; completeness 97.7%, 98.6% in the outer shell). Solution was by molecular replacement (Amore) using parts of the TFoFVIIa structure (Banner, et al. The crystal structure of the complex of blood coagulation factor VIIa with soluble tissue factor. Nature d0 380, 41-46 (1996)). Refinement and model adjustment were performed with X-PLOR v3.851and Xsight (Molecular Simulations Inc.). Non-crystallographic restraints were applied to the two complexes in the crystallographic asymmetric unit (rmsd 0.44A).

Statistics for data collection and refinement Refinement resolution 50.0 Number of relections 16915 Number of relections (R-free) 654 R-value 22.5% R-free 29.5% R-value (all) 22.8% rmsd bond distances 0.012 rmsd bond angles CN1~ rmsd dihedral angles 26.3 rmsd improper dihedral angles (0) Number of atoms 5919 Number of atoms occupancy zero Number of residues 756 Number of waters 4 Number of calcium ions 4 0.82 381 00 Number of rmsd main rmsd side cacodylate ions 2 chain B-factors (A2 chain B-factors (A2) Ramachandran plot residues in most favorable region(%) 75.8 nonglycine residues in disallowed regions(%) 0.0 Results The three-dimensional coordinants of the residues belonging to TF76 are listed in Table III.

structure.

Figure 9 shows the corresponding three dimensional

HETATM

HETATM

HETATM

ATOM

ATOM

ATOM

ATOM

ATOM

ATOM

ATOM

ATOM

ATOM

ATOM

ATOM

ATOM

ATOM

ATOM

ATOM

ATOM

ATOM

ATOM

2771 2772 2773 2774 2775 2776 2777 2778 2779 2780 2781 2782 2783 2784 2785 2786 2787 2788 2789 2790 2791

ACE

ACE

ACE

ALA

ALA

ALA

ALA

ALA

LEO

LEU

LEU

LEU

LEU

LEU

LEU

LEU

CYS

CYS

CYS

CYS

CYS

Table III x Y 47.255 4.812 47.964 5.744 47.834 3.531 45.937 4.822 45.118 5.891 44.432 4.967 45.082 4.091 45.941 6.936 43.134 5.121 42.426 4.229 42.764 4.536 42.872 3.628 40.917 4.331 40.385 3.758 39.296 2.764 41.481 3.055 42.972 5.811 43.296 6.214 44.497 5.411 44.523 4.997 43.559 7.746 43.887 8.582 45.480 5.179

Z

3.830 3.440 4.390 3.811 3.289 2.313 1.746 2.541 2.126 1.241 -0.215 -1.039 1.515 2.845 2.576 3.602 -0.525 -1.897 -2.414 -3.570 -1.949 -3.563 -1.557 Q B 1.00 53.97 1.00 59.91 1.00 58.28 1.00 46.68 1.00 42.60 1.00 43.82 1.00 46.46 1.00 41.30 1.00 39.56 1.00 35.42 1.00 35.86 1.00 33.01 1.00 34.51 1.00 26.75 1.00 25.71 1.00 26.42 1.00 38.67 1.00 41.34 1.00 41.10 1.00 41.41 1.00 41.81 1.00 38.88 1.00 36.60 ATOM 2792 SG CYS X ATOM 2793 N ASP X ATOM 2794 CA ASP X 4 46.654 4.434 -1.956 1.00 35.33 CNI ATOM 2795 C ASP X 4 46.313 3.116 -2.657 1.00 38.61 ATOM 2796 0 ASP X 4 47.090 2.631 -3.477 1.00 42.35 ATOM 2797 CB ASP X 4 47.506 4.134 -0.728 1.00 33.86 ATOM 2798 CG ASP X 4 48.134 5.375 -0.138 1.00 35.78 ATOM 2799 ODI ASP X 4 47.950 6.467 -0.721 1.00 34.64 ATOM 2800 0D2 ASP X 4 48.814 5.255 0.910 1.00 36.48 ATOM 2801 N ASP X 5 45.144 2.551 -2.358 1.00 37.77 ATOM 2802 CA ASP X 5 44.728 1.262 -2.923 1.00 35.76 00ATOM 2803 C ASP X 5 44.020 1.318 -4.278 1.00 38.42 ATOM 2804 0 ASP X 5 42.927 1.882 -4.411 1.00 41.77 ATOM 2805 CB ASP X 5 43.853 0.541 -1.898 1.00 38.54 ATOM 2806 CG ASP X 5 43.448 -0.836 -2.343 1.00 40.25 ATOM 2807 ODi ASP X 5 43.236 -1.015 -3.563 1.00 45.94 ATOM 2808 0D2 ASP X 5 43.334 -1.731 -1.471 1.00 38.72 ATOM 2809 N PRO X 6 44.613 0.677 -5.290 1.00 40.15 ATOM 2810 CA PRO X 6 44.071 0.644 -6.648 1.00 40.82 ATOM 2811 C PRO X 6 42.650 0.133 -6.843 1.00 41.06 ATOM 2812 0 PRO X 6 41.946 0.562 -7.766 1.00 44.99 ATOM 2813 CB PRO X 6 45.065 -0.210 -7.418 1.00 41.37 ATOM 2814 CG PRO X 6 46.330 -0.191 -6.622 1.00 42.24 ATOM 2815 CD PRO X 6 45.874 -0.080 -5.185 1.00 44.75 ATOM 2816 N ARG X 7 42.187 -0.761 -5.990 1.00 40.35 ATOM 2817 CA ARG X 7 40.841 -1.268 -6.236 1.00 43.82 i ATOM 2818 C ARC X 7 39.748 -0.453 -5.568 1.00 44.18 ATOM 2819 0 ARC X 7 38.647 -0.958 -5.328 1.00 47.84 ATOM 2820 CB ARG X 7 40.749 -2.774 -5.895 1.00 38.71 ATOM 2821 CG ARG X 7 40.594 -3.127 -4.437 1.00 38.07 ATOM 2822 CD ARC X 7 41.638 -4.143 -3.958 1.00 35.16 .0 ATOM 2823 NE ARG X 7 41.911 -3.887 -2.540 1.00 38.09 ATOM 2824 CZ ARG X 7 41.762 -4.770 -1.550 .1.00 37.97 ATOM 2825 NH1 ARC X 7 41.325 -5.999 -1.799 1.00 33.83 ATOM 2826 NH2 ARC X 7 41.999 -4.403 -0.290 1.00 35.94 ATOM 2827 N VAL X 8 40-.051 0.822 -5.305 1.00 44.03 ATOM 2828 CA VAL X 8 39.078 1.677 -4.638 1.00 42.46 ATOM 2829 C VAL. X 8 38.430 2.792 -5.431 1.00 42.88 ATOM 2830 0 VAL X 8 39.041 3.410 -6.308 1.00 46.76 ATOM 2831 CB VAL X 8 39.648 2.372 -3.420 1.00 40.58 ATOM 2832 CG1 VAL X 8 38.524 3.022 -2.629 1.00 38.58 ATOM 2833 CG2 VAL X 8 40.395 1.387 -2.558 1.00 42.72 ATOM 2834 N ASP X 9 37.185 3.073 -5.076 1.00 39.87 ATOM 2835 CA ASP X 9 36.461 4.142 -5.702 1.00 40.27 ATOM 2836 C ASP X 9 37.377 5.323 -5.573 1.00 42.07 00 D

A

A

A

A

A

A

A

A

A

A

A

A

A

A

ATOM 2837 0 ASP X 9 37.848 5.601 -4.478 1.00 ATOM 2838 CB ASP X 9 35.204 4.443 -4.936 1.00 ATOM 2839 CG ASP X 9 34.502 5.629 -5.487 1.00 ATOM 2840 ODi ASP X 9 35.014 6.222 -6.470 1.00 ATOM 2841 OD2 ASP X 9 33.441 5.964 -4.943 1.00 ATOM 2842 N ARC X 10 37.599 6.044 -6.661 1.00 ATOM 2843 CA ARG X 10 38.523 7.162 -6.599 1.00 ATOM 2844 C ARG X 10 38.029 8.362 -5.798 1.00 ATOM 2845 0 ARG X 10 38.755 9.338 -5.571 1.00 ATOM 2846 CE ARC X 10 38.911 7.542 -8.015 1.00 ATOM 2847 CG ARG X 10 39.575 6.367 -8.745 1.00 ATOM 2848 CD ARG X 10 41.077 6.227 -8.402 1.00 ATOM 2849 NE ARC X 10 41.331 6.132 -6.963 1.00 ATOM 2850 CZ ARG X 10 42.308 5.409 -6.414 1.00 ATOM 2851 NH1 ARG X 10 43.138 4.708 -7.177 1.00 ATOM 2852 NH2 ARC X 10 42.457 5.370 -5.101 1.00 ATOM 2853 N TRP X 11 36.796 8.246 -5.330 1.00 ITOM .2854 CA TRP X 11 36.128 9.267 -4.527 1.00 ATOM 2855 C TRP X 11 36.792 9.358 -3.177 1.00 ATOM 2856 0 TRP X 11 36.729 10.375 -2.486 1.00 ATOM 2857 CB TRP X 11 34.685 8.834 -4.337 1.00 ATOM 2858 CG TRP X 11 33.818 9.633 -3.432 1.00 ATOM 2859 CDI TRP X 11 32.991 10.652 -3.804 1.00 ATOM 2860 CD2 TRP X 11 33.467 9.310 -2.083 1.00 ATOM 2861 NEl TRP X 11 32.132 10.967 -2.787 1.00 ATOM 2862 CE2 TRP X 11 32.395 10.157 -1.715 1.00 TOM 2863 CE3 TRP X 11 33.937 8.376 -1.152 1.00 ~TOM 2864 CZ2 TRP X 11 31.789 10.108 -0.443 1.00 ~TOM 2865 CZ3 TRP X 1 33.333 8.325 0.121 1.00 TOM 2866 CH2 TRP X 11 32.267 9.187 0.455 1.004 TOM 2867 N TYR X 12 37.430 8.269 -2.806 1.002 TOM 2868 CA TYR X 12 38.051 8.214 -1.528 1.002 TOM 2869 C TYR X 12 39.346 8.991 -1.501 1.002 TOM 2870 0 TYR X 12 40.078 8.949 -0.503 1.00 2 TOM 2871 CB TYR X 12 38.248 6.745 -1.157 1.00 1 TOM 2872 CG TYR X 12 37.021 6.163 -0.516 1.00 1 TOM 2873 CD1'TYR X 12 35.961 5.734 -1.283 1.00 1 TOM 2874 CD2 TYR X 12 36.875 6.142 0.884 1.00 1 TOM 2875 CEl TYR X 12 34.798 5.309 -0.684 1.00 TOM 2876 CE2 TYR X 12 35.708 5.715 1.473 1.00 TOM 2877 CZ TYR X 12 34.697 5.310 0.677 1.00 TOM 2878 OH TYR X 12 33.558 4.858 1.222 1.00 1 TOM 2879 N CYS X 13. 39.634 9.709 -2.586 1.00 2 46.36 38.97 43.15 44 46.21 41.77 45.64 45.58 49.67 46.09 51. 91 51.06 53. 68 53.45 58.15 50.78 40.63 36.28 31.66 30.50 37.56 38.34 39.63 41. 41 40.82 43.60 45.51 43.79 48.58 16.05 1.31 ?0.80 ?5.81 7.65 .6.69 .3.49 .0.56 .3.83 5.00 5.00 5.00 2.55 7.88 .d ATOM 2880 CA CYS X 13 40.882 10.472 -2.664 1.00 30.17 ATOM 2881 C CYS X 13 40.713 11.899 -2.249 1.00 28.63 ATOM 2882 0 CYS X 13 41.668 12.552 -1.868 1.00 31.40 ATOM 2883 CB CYS X 13 41.462 10.432 -4.068 1.00 31.13 ATOM 2884 SG CYS X 13 42.084 8.789 -4.513 1.00 34.03 ATOM 2885 N GLN X 14 39.489 12.385 -2.324 1.00 30.33 ATOM 2886 CA GLN X 14 39.231 13.750 -1.925 1.00 31.72 ATOM 2887 C GLN X 14 39.561 13.913 -0.451 1.00 29.41 ATOM 2888 0 GLN X 14 39.728 15.023 0.027 1.00 36.99 D) ATOM 2889 CB GLN X 14 37.763 14.111 -2.136 1.00 33.64 ATOM 2890 CG GLN X 14 36.909 13.815 -0.916 1.00 42.04 ATOM 2891 CD GLN X 14 35.438 14.004 -1.167 1.00 45.95 ATOM 2892 OE1 GLN X 14 34.880 15.083 -0.944 1.00 50.57 ATOM 2893 NE2 GLN X 14 34.791 12.951 -1.629 1.00 50.89 ATOM 2894 N PHE X 15 39.668 12.824 0.287 1.00 26.86 ATOM 2895 CA PHE X 15 39.920 12.993 1.700 1.00 26.22 ATOM 2896 C PHE X 15 41.334 12.740 2.087 1.00 33.70 ATOM 2897 0 PHE X 15 41.609 12.586 3.264 1.00 36.36 ATOM 2898 CB PHE X 15 39.015 12.087 2.531 1.00 23.73 ATOM 2899 CG PHE X 15 37.626 11.895 1.954 1.00 25.30 ATOM 2900 CDl PHE X 15 37.375 10.922 0.992 1.00 21.70 ATOM 2901 CD2 PHE X 15 36.565 12.656 2.409 1.00 25.26 ATOM 2902 CEl PHlE X 15 36.111 10.714 0.512 1.00 22.78 ATOM 2903 CE2 PHE X 15 35.282 12.447 1.919 1.00 25.86 ATOM 2904 CZ PHE X 15 35.060 11.476 0.977 1.00 23.75 ATOM 2905 N VAL X 16 42.249 12.726 1.124 1.00 43.63 ATOM 2906 CA VAL X 16 43.646 12.459 1.463 1.00 53.34 ATOM 2907 C VAL X 16 44.560 13.658 1.557 1.00 59.99 ATOM 2908 0 VAL X 16 44.788 14.225 2.641 1.00 63.33 j ATOM 2909 CB VAL X 16 44.311 11.535 0.465 1.00 51.57 ATOM 2910 CG1 VAL X 16 45.263 10.606 1.214 1.00 53.93 ATOM 2911 CG2 VAL X 16 43.263 10.792 -0.338 1.00 55.02 ATOM 2912 N GLU X 17 45.120 13.999 0.400 1.00 65.70 ATOM 2913 CA GLU X 17 46.036 15.112 0.255 1.00 69.56 ATOM 2914 C GLU X 17 45.106 16.292 0.232 1.00 73.68 ATOM 2915 0 GLU X 17 43.942 16.059 -0.175 1.00 75.28 ATOM 2916 CB GLU X 17 46.778 14.996 -1.073 1.00 68.63 ATOM 2917 CG GLU X 17 48.190 15.528 -1.062 1.00 71.36 ATOM 2918 CD GU X 17 48.743 15.744 -2.472 1.00 73.73 ATOM 2919 OE1 GLU X 17 47.948 15.634 -3.436 1.00 73.37 ATOM 2920 0E2 GLU X 17 49.964 16.021 -2.618 1.00 71.80 ATOM 2921 OXT GLU X 17 45.522 17.402 0.634 1.00 80.00 The entire disclosure in the complete specification of our Australian Patent Application No. 59107/00 is by this cross- Sreference incorporated into the present specification.

00 oq o -59a-

Claims (34)

1. A compound which competes with SEQ ID NO:1 for binding FVIIa in an in vitro assay. 0)

2. The compound of claim 1 having an IC 50 for FVIIa of less than 1 pM.

3. The compound of claim 2 which competes with SEQ ID NO:8 for S binding FVIIa in an in vitro assay. 00

4. The compound of claim 3 having an ICo 0 for FVIIa of less than 1 pM. The compound of claim 4 having an IC 50 for FVIIa of less than 1 nM.

6. The compound of claim 1 which binds FIIa/inhibits FVIIa activity.

7. The compound of claim 6 which blocks an activity associated with FVIIa selected from the group consisting of activation of FVII, activation of FIX and activation of FX.

8. The compound of claim 7 having an ICs 5 for FX activation of less than 10 pM.

9. The compound of claim 8 having an IC 50 for FX activation of less than 100 nM. The compound of claim 9 having an IC 50 for FX activation of less than 5 nM.

11. The compound of claim 1 which is a peptide.

12. The peptide of claim 11 which is a cyclic peptide.

13. The peptide of claim 12 having the following formula: Xi-Cysl-Xj-Cys 2 -Xk wherein X i is absent or is a peptide of between 1 and 100 amino acids; Xj is 9 amino acid peptide and Xk is absent or a peptide of between 1 and 100 amino acids.

14. The peptide of claim 13 wherein Xi and Xk are peptides of between 1 and 50 amino acids. 0 15. The peptide of claim 13 wherein Xi and Xk are peptides of between 1 and 10 amino acids. O 16. The peptide of claim 15 wherein Xi and Xk are peptides of between 1 and 4 amino acids. (N

17. The peptide of claim 13 comprising the following amino acid sequence: -a-b-c-d-e-f-g-h-i-j-k-l-m-n-o- 00 wherein; Sa is an amino acid; C1 b is an amino acid selected from the group consisting of Leu Ile, Val, Ala, Arg, Gln, Asn and functional equivalents thereof; Sc is Cysl; d is an amino acid; e is an amino acid; f is an amino acid selected from the group consisting of Ala, Asp, Glu, Phe, Gly, His, Ile, Lys, Leu, Met, Asn, Pro, Gln, Arg, Ser, Thr, Val, Trp, Tyr and functional equivalents thereof; g is an amino acid; h is an amino acid selected from the group consisting of Ala Cys, Asp, Phe, Gly, His, Ile, Lys, Leu, Met, Asn, Pro, Gln, Arg, Thr, Val, Trp, Tyr and functional equivalents thereof; i is an amino acid selected from the group consisting of Ala, Asp, Glu, Phe, Gly, His, Lys, Met, Asn, Pro, Gin, Ser, Thr, Val, Trp, Tyr and functional equivalents thereof; j is an amino acid selected from the group consisting of Ala, Asp, Glu, Phe, Gly, His, Ile, Lys, Leu, Met, Asn, Pro, Gin, Arg, Ser, Thr, Val, Trp, Tyr and functional equivalents thereof; k is an amino acid selected from the group consisting of Trp, Tyr, Na, Phe and functional equivalents thereof; 1 is an amino acid selected from the group consisting of Tyr, Phe, Na, Trp and functional equivalents thereof; m is Cys 2 n is an amino acid and o is an amino acid selected from the group consisting of Phe Tyr, Trp, Na and functional equivalents thereof.

18. The peptide of claim 17 wherein; b is an amino acid selected from the group consisting of Leu, lie, Val, Ala and functional equivalents thereof; h is an amino acid selected from the group consisting of Ile, Val, Leu and Ala; i is an amino acid selected from the group consisting of Asp Glu, Ser, Thr and Ala; k is an amino acid selected from the functional equivalents thereof; 1 is an amino acid selected from the functional equivalents thereof; o is an amino acid selected from the functional equivalents thereof.

19. The peptide of claim 18 wherein h is an amino acid selected from the group consisting of Trp, Na and group consisting of Tyr, Phe and group consisting of Phe, Tyr and group consisting of Ile, Val and Leu; i is an amino acid selected from the group consisting of Asp, Glu, and Ser; j is an amino acid selected from the and Ala; and n is an amino acid selected from the Gly, Arg, Ser, Lys, Leu, Ala, Asn, Thr and group consisting of Arg, Lys, Gin group consisting of Gln, Met, functional equivalents thereof. The peptide of claim 19 wherein h is an amino acid selected from the group consisting of Ile and Val; i is Asp; j is Arg; 1 is Tyr; n is an amino acid selected from the group consisting of Gln and Met and o is Phe.

21. The peptide of claim 20 wherein: a is an amino acid selected from the group consisting of Asn, Arg, S Phe, Gin, Gly, Pro, Thr, Ser and Ala; f is an amino acid selected from the group consisting of Pro, Gly, Ala and functional equivalents thereof.

22. The peptide of claim 17 having wherein X i is a peptide of between 2 to 6 amino acids; a is an amino acid selected from the group consisting Ser; b is Leu d is an amino acid selected from the group consisting Ser, Ala, Arg, Thr, His, Met, Val and Asn; e is an amino acid selected from the group consisting Arg, Ala and Glu; of Ala, Thr and of Asp, Glu, of Asn, Asp, -62- 0 f is Pro; g is an amino acid selected from the group consisting of Arg, Ala and S Glu; h is an amino acid selected from the group consisting of Ile Val and Leu; i is an amino acid selected from the group consisting of Asp, Glu and Ser;. j is an amino acid selected from the group consisting of Arg, Lys, Gin and Ala; 00 n is an amino acid selected from the group consisting of Gln, Met, Gly, Arg, Ser, Lys, Leu, Ala, Asn and Thr; Xk is a peptide. of between 2 and 6 amino acids S23. The peptide of claim 22 having the following formula Xi-Ala-Leu-Cysl-d-e-Pro-Arg-h-Asp-Arg-k-Tyr-CyS2-n-Phe-Xk (SEQ ID NO:105) wherein Xi is absent or is a peptide of between 1 to 4 amino acids; d is an amino acid selected from the group consisting of Asp, Glu, Ser, Ala and Arg; e is an amino acid selected from the group consisting of Asn Asp, Arg and Ala; h is an amino acid selected from the group consisting of Ile and Val; k is an amino acid selected from the group consisting of Trp and Na; n is an amino acid selected from the group consisting of Gin and Met and Xk is a 3 amino acid peptide.

24. The peptide of claim 11 having the following formula Xi-a-b-c-d-Asp-Pro-Arg-h-Asp-Arg-Trp-Tyr-m-n-o-Xk (SEQ ID NO:106) wherein X i is absent or a peptide of between 1 and 4 amino acids; a is an amino acid selected from the group consisting of Ala; Asn, Arg, Phe, Gin, Gly and Pro; b is an amino acid selected from the group consisting of Leu, Ala, Val, Ile, Arg, Gin and Asn; c is an amino acid selected from the group consisting of Ala and Cys; d is an amino acid h is an amino acid selected from the group consisting of Ile Val, Leu and Ala; m is an amino acid selected from Ala and Cys; n is an amino acid and o is an amino acid selected from the group consisting of Phe, Tyr, Trp and Na and -63- Xk is a peptide of between 1 and 4 amino acids. The peptide of claim 24 having the following formula: X-a-Leu-Cys-d-Asp-Pro-Arg-h-Asp-Arg-Trp-Tyr-Cys-n-o-(Xaa)n (SEQ ID NO:107) D wherein a is an amino acid selected from the group consisting of Ala, Thr and Ser; D d is an amino acid selected from the group consisting of Asp, Glu, Ser, Ala, Arg, Thr, His, Met, Val and Asn; D h is an amino acid selected from the group consisting of Ile, Val and Leu; D n is an amino acid selected from the group consisting of Gln, Met, D Gly, Arg, Ser, Lys, Ala, Asn and Thr and o is an amino acid selected from the group consisting of Phe and Tyr.

26. The peptide of claim 25 having the following formula Xi- Ala-Leu-Cysl-d-Asp-Pro-Arg-h-Asp-Arg-Trp-Tyr-Cys 2 -n-Phe-X k (SEQ ID NO:108)wherein d is an amino acid selected from the group consisting of Asp, Glu, Ser, Ala, Arg; n is an amino acid selected from the group consisting of Gin and Met and Xk is a 3 amino acid peptide.

27. A method of inhibiting FVIIa activity comprising the steps of: a) contacting FVIIa with the compound of claim 1 in the presence of tissue factor and under conditions which allow binding of the compound to FVIIa to occur.

28. The method of claim 27 wherein the compound is a peptide.

29. The method of claim 28 wherein the peptide comprises the following amino acid sequence: -g-h-i-j-k-l-m-n-o- wherein g is an amino acid; h is an amino acid selected from the group consisting Leu, Ala and functional equivalents thereof; i is an amino acid selected from the group consisting Ser, Ala, Thr and functional equivalents thereof; j is an amino acid selected from the group consisting Glu, Phe, Gly, His, Lys, Leu, Met, Asn, Pro, Gln, Arg, Ser, and functional equivalents thereof; of Ile, Val, of Asp, Glu, of Ala, Asp, Thr, Val, Tyr -64- k is an amino acid selected from the group Phe and functional equivalents thereof; 1 is an amino acid selected from the group Trp and functional equivalents thereof; m is an amino acid selected from the group functional equivalents thereof; n is an amino acid and o is an amino acid selected from the group Na and functional equivalents thereof as well as consisting of Trp, Na, Tyr, consisting of Tyr, Phe, Na, consisting of Cys, Ala and consisting of Phe Tyr, Trp, fragments thereof, esters, amides, salts and derivatives thereof, functional analogues thereof and extended peptide chains carrying additional amino acids or peptides at the termini of the sequences. The method of claim 29 wherein the peptide comprises the following amino acid sequence: a-b-c-d-e-f-g-h-i-j-k-l-m-n-o wherein a is an amino acid b is an amino acid selected from the group consisting Val, Ala and functional equivalents thereof; c is an amino acid selected from the group consisting functional equivalents thereof; d is an amino acid; e is an amino acid selected from the group consisting Asp, Glu, Phe, His, lie, Lys, Leu, Met, Asn, Pro, Gin, Arg, Trp, Tyr and functional equivalents thereof; f is an amino acid selected from the group consisting and functional equivalents thereof g is an amino acid; h is an amino acid selected from the group consisting Ala and functional equivalents thereof; i is an amino acid selected from the group consisting Ser, Thr, Ala and functional equivalents thereof; j is an amino acid selected from the group consisting Glu, Phe, Gly, His, Lys, Leu, Met, Asn, Pro, Gin, Arg, Ser, Tyr and functional equivalents thereof; k is am amino acid selected from the group consisting Phe, Na and functional equivalents thereof; 1 is an amino acid selected from the group consisting and functional equivalents thereof; m is an amino acid selected from the group consisting functional equivalents thereof; n is an amino acid; of Leu, lie, of Cys, Ala and of Ala, Cys, Ser, Thr, Val, of Pro, Gly, Ala of Ile Val, Leu, of Asp, Glu, of Ala, Asp, Thr, Val, Trp, of Trp, Tyr, of Tyr, Phe, Na of Cys, Ala and o is an amino acid selected from the group consisting of Tyr, Phe, Na Sand functional equivalents thereof.

31. A method for selecting a compound which blocks FVII/FVIIa activation of FX comprising the steps of: contacting FVII/FVIIa with a compound of claim 1 in the presence and absence of a candidate molecule under conditions which allow specific binding of the compound of claim 1 to FVII/FVIIa to occur; detecting the amount of specific binding of the compound of claim 00 00 1 to FVII/FVIIa that occurs in the presence and absence of the candidate ncompound wherein the amount of binding in the presence of the candidate compound wherelative to the amount of binding in the absence of the candidate molecule is indicative of the ability of the candidate compound to block FVII/FVIIa activation of FX.

32. A method of inhibiting the activation of FX comprising comprising contacting FVII/FVIIa with a compound that prevents the interaction of FVII/FVIIa with a compound of claim 1.

33. The method of inhibiting the activation of FX of claim 32 comprising contacting FVII/FVIIa with a compound that prevents the interaction of FVII/FVIIa with SEQ ID NO:1.

34. The method of claim 33 wherein the contacting occurs in vivo. The method of claim 34 wherein the contacting occurs in vitro.

36. A method of treating a TF/FVIIa mediated disease or disorder in a host in need thereof comprising administering to the host a therapeutically effective amount of a compound of claim 1.

37. A method of treating a TF/FVIIa mediated disease or disorder in a host in need thereof comprising administering to the host a therapeutically effective amount of the peptide of claim 17.

38. A pharmaceutical composition comprising a compound of claim 1 and a pharmaceutically acceptable carrier.

39. A pharmaceutical composition comprising the peptide of claim 17 and a pharmaceutically acceptable carrier. The composition of claim 38 which is suitable for inhalation. I

41. The composition of claim 40 which is dry powder.

42. The composition of claim 40 which is a liquid.

43. The composition of claim 40 which is a crystal. (N

44. The compound of claim 1 which is a crystal. Dated this 1st day of September 2005 00 GENENTECH, INC. By their Patent Attorneys GRIFFITH HACK SFellows Institute of Patent and (C Trade Mark Attorneys of Australia -67-