APOLIPOPROTEIN A IV

TECHNICAL FIELD

[0001] The present disclosure relates to a method of treating diabetes using non- glycosylated apolipoprotein A-IV (apoA-IV). More particularly, the present disclosure relates to a method of treating type two diabetes mellitus by administering an effective amount of non-glycosylated apoA-IV which is produced by a protein expression system.

RELATED APPLICATIONS

[0002] This application claims priority to PCT Appln. No. PCT/US2012/021802, filed on January 19, 2012. This application also claims priority to U.S. Provisional Patent Appln. No. 61/675692, filed on July 25, 2012. The entire contents of the priority applications are incorporated herein by reference in their entirety.

BACKGROUND

[0003] The occurrence of diabetes is widespread, with approximately 8% of the population in the United States suffering from diabetes. Diabetes is a chronic disease characterized by high blood sugar due to the body's inability to effectively produce and/or use insulin. Diabetes can lead to a variety of physical complications, including but not limited to renal failure, blindness, nerve damage, heart disease, sleep apnea, and celiac disease. For example, in the United States, diabetes is the leading cause of renal failure, blindness, amputation, stroke, and heart attack. Also in the United States, diabetes is the sixth leading cause of death and has been shown to reduce the life expectancy of middle-aged adults by about five to ten years.

[0004] The most common form of diabetes is type 2 diabetes mellitus (also referred to as "T2DM" or "type 2 diabetes"). Type 2 diabetes is characterized by hyperglycemia, insulin resistance, β-cell dysfunction, and dysregulated hepatic gluconeogenesis.

Persons suffering from type 2 diabetes experience a loss of glucose-stimulated insulin secretion related to the impaired release of stored insulin granules from β-cells in the first phase of insulin secretion. In the second phase of insulin secretion, persons suffering from type 2 diabetes experience a gradual loss of the ability to actively synthesize insulin in response to glucose stimuli.

[0005] The prevalence of type 2 diabetes is increasing and in 2002, type 2 diabetes resulted in greater than $130 billion in health care expenses. As such, new therapies for effectively treating type 2 diabetes are needed.

SUMMARY

[0006] The invention is based on the surprising discovery that the apolipoprotein A-IV (apoA-IV) protein is non-glycosylated in humans. Prior to the present disclosure, it was known in the art that the apoA-IV protein was glycosylated. Weinberg and Scanu ((1983) J of Lipid Res vol. 24:52) reported that apoA-IV was a glycoprotein containing 6% carbohydrate by weight (mannose 1.8%, galactose 1.55%, N-acetyl glucosamine 1.55%, sialic acid 1.1%). As such, apoA-IV is commonly described as a glycoprotein (see, for example, Gomaraschi et al. (2010) Biochem Biophys Res Commun. 393(1): 126- 30). In contrast, as described in Example 13 below, apoA-IV is a non-glycosylated protein.

[0007] Thus, in one embodiment, the invention provide methods of treating type 2 diabetes using non-glycosylated (also referred to as unglycosylated) apoA-IV protein. The method comprises administering to the subject an effective amount of a non- glycosylated apoA-IV protein, or a biologically active analogue or fragment thereof having at least 90, 95, 96, 97, 98 or 99% identity to the apoA-IV protein.

[0008] In one embodiment, non-glycosylated apoA-IV is produced using an expression system which lacks the ability to glycosylate. For example, a bacterial expression system, such as Escherichia coli, may be used to make non-glycosylated apoA-IV.

[0009] In another embodiment, cell expression systems that may be used to make non- glycosylated apoA-IV include, but are not limited to, mammalian cell expression systems, yeast expression systems and baculovirus expression systems. In another embodiment, a cell free expression system may be used to make non-glycosylated apoA- IV protein. [0010] In another embodiment, a pharmaceutical composition comprising non- glycosylated apoA-IV protein is disclosed. The pharmaceutical composition comprises non-glycosylated apoA-IV protein having at least 90, 95, 96, 97, 98 or 99% identity to the apoA-IV protein, or a biologically active fragment thereof. The pharmaceutical composition may be formulated for administration to a subject for the treatment of type 2 diabetes.

[0011] In one embodiment, the invention provides a pharmaceutical composition comprising a non-glycosylated apoA-IV protein comprising an amino acid sequence as set forth in any one of SEQ ID NOs: 1, 3, 4, or 20 to 64 (or a sequence that is at least 90, 95, 96, 97, 98 or 99% identical to SEQ ID NO: 1, 3, 4, or 20-64), or a biologically active fragment thereof. In one embodiment, the invention provides a pharmaceutical composition comprising non-glycosylated apolipoprotein A-IV protein comprising an amino acid sequence as set forth in any one of SEQ ID NOs: 1, 3, 4, or 20-64, or an amino acid sequence which is at least 95% identical to any one of SEQ ID NOs: 1, 3, 4, or 20-64, or a biologically active fragment thereof. In another embodiment, the invention provides a pharmaceutical composition having an apolipoprotein A-IV protein comprising an amino acid sequence which is at least 96% identical to any one of SEQ ID NOs: 1, 3, 4, or 20-64, or a biologically active fragment thereof. In another embodiment, the invention provides a pharmaceutical composition having an apolipoprotein A-IV protein comprising an amino acid sequence which is at least 97% identical to any one of SEQ ID NOs: 1, 3, 4, or 20-64, or a biologically active fragment thereof. In another embodiment, the invention provides a pharmaceutical composition having an apolipoprotein A-IV protein comprising an amino acid sequence which is at least 98% identical to any one of SEQ ID NOs: 1, 3, 4, or 20-64, or a biologically active fragment thereof. In another embodiment, the invention provides a pharmaceutical composition having an apolipoprotein A-IV protein comprising an amino acid sequence which is at least 99% identical to any one of SEQ ID NOs: 1, 3, 4, or 20-64, or a biologically active fragment thereof.

[0012] In one embodiment, the pharmaceutical composition comprises a

pharmaceutically acceptable carrier or diluent. [0013] In another embodiment, the pharmaceutical composition is selected from the group consisting of a liquid formulation, an aqueous formulation, and a lyophilized formulation.

[0014] In one embodiment, the invention provides a method of treating type 2 diabetes comprising administering to a subject having type 2 diabetes a non-glycosylated apoA- IV protein, or a biologically active analogue or fragment thereof, having an amino acid sequence comprising an amino acid sequence as set forth in any one of SEQ ID NOs: 1, 3, 4, or 20 to 64 (or a sequence that is at least 90, 95, 96, 97, 98 or 99% identical to SEQ ID NO: 1, 3, 4, or 20-64). In a further embodiment, the apoA-IV protein is produced using a prokaryotic expression system, e.g., bacterial expression system such as E. coli.

[0015] In yet another embodiment, a method for substantially restoring glucose tolerance in a subject in need thereof to a normal level is disclosed. The method comprises administering to the subject an effective amount of non-glycosylated apoA-IV or a biologically active analogue or fragment thereof, having at least 90, 95, 96, 97, 98 or 99% identity to an apoA-IV protein, for example, by systemic administration of the non-glycosylated apoA-IV or the biologically active analogue or fragment thereof. In one embodiment, the invention provides a method for substantially restoring glucose tolerance in a subject in need thereof to a normal level, said method comprising administering an effective amount of a non-glycosylated apoA-IV protein (or a biologically active analogue or fragment thereof) having an amino acid sequence as set forth in any one of SEQ ID NOs: 1, 3, 4, or 20 to 64 (or an amino acid sequence that is at least 90, 95, 96, 97, 98 or 99% identical to SEQ ID NO: 1, 3, 4, or 20-64)..

[00161 In yet still another embodiment, a method for lowering blood glucose level in a subject in need thereof is disclosed. The method comprises administering to the subject an effective amount of non-glycosylated apoA-IV or a biologically active analogue or fragment thereof having at least 90, 95, 96, 97, 98 or 99% identity to the non- glycosylated apoA-IV to the subject in need, for example, by systemic administration. In one embodiment, the invention provides a method for lowering blood glucose level in subject a subject in need thereof, the method comprising administering to the subject an effective amount of non-glycosylated apoA-IV (or a biologically active analogue or fragment thereof) comprising an amino acid sequence set forth in SEQ ID NOs: 1, 3, 4, or 20 to 64 (or a sequence that is at least 90, 95, 96, 97, 98 or 99% identical to SEQ ID NO: 1, 3, 4, or 20-64).

[0017] An "effective amount" is as described below and may include about 0.25 to 2 μg/g of the apoA-IV or the biologically active analogue thereof. In one embodiment the effective amount is about 0.1 mg/kg to 25 mg/kg. In another embodiment, the effective amount is a fixed dose of about 1 to 1000 mg. In a further embodiment, the effective amount is a fixed dose of about 1 to 10 mg.

[0018] These and other features and advantages of these and other various embodiments according to the present disclosure will become more apparent in view of the drawings, detailed description, and claims provided herein.

BRIEF DESCRIPTION OF THE DRAWINGS

[0019] The following detailed description of the embodiments of the present disclosure can be better understood when read in conjunction with the following drawings, where like structure is indicated with like reference numerals, and in which:

[0020] FIG. 1 is a side perspective view of a device having a reservoir of a pharmaceutical composition and a syringe according to an embodiment of the present disclosure.

[0021] FIG. 2 is a graph of plasma glucose (mg/dL) in male apoA-IV knockout and wild-type mice with respect to time (min) for an intraperitoneal glucose tolerance test.

[0022] FIG. 3 is a graph of plasma glucose (mg/dL) with respect to time (min) for an intraperitoneal glucose tolerance test in apoA-IV wild- type and knockout animals at 16 months of age.

[0023] FIG. 4 is a graph of plasma glucose (mg/dL) with respect to time (min) in male apoA-IV knockout mice following the intraperitoneal administration of recombinant apoA-IV ^g/g) or saline solution for an intraperitoneal glucose tolerance test.

[0024] FIG. 5 is a graph of plasma glucose (mg/dL) with respect to time (min) in apoA-IV knockout mice following the intraperitoneal administration of recombinant apoA-I or saline solution for an intraperitoneal glucose tolerance test. [0025] FIG. 6 is a graph of insulin secretion (ng/mL) with respect to time (min) in apoA-IV knockout mice following the intraperitoneal administration of recombinant apoA-I or saline solution.

[0026] FIG. 7 is graph of plasma glucose (mg/mL) with respect to time (min) in apoA- IV knockout and wild-type mice on a chronically high-fat diet for an intraperitoneal glucose tolerance test.

[0027] FIG. 8 is a graph of plasma glucose (mg/mL) with respect to time (min) in apoA-IV knockout mice on a chronically high-fat diet following the intraperitoneal administration of recombinant mouse apoA-IV (1 μg/g) or saline solution for an intraperitoneal glucose tolerance test.

[0028] FIG. 9 is a graph of plasma glucose (mg/dL) with respect to time (h) in diabetic mice following the intraperitoneal administration of recombinant mouse apoA-IV ( 1 μg/g) or saline solution for an intraperitoneal glucose tolerance test.

[0029] FIG. 10 depicts the results of a Western blot analysis of the level of serum amyloid A protein component in apoA-IV knockout mice, wild-type mice, and apoA-I knockout mice.

[0030] FIG. 11 is a graph of plasma glucose (mg/dL) in female apoA-IV knockout and wild-type mice with respect to time (min) during an intraperitoneal glucose tolerance test (IPGTT).

[0031] FIG 12. is a graph of plasma glucose (mg/dL) with respect to time (min) in wild type mice following the intraperitoneal administration of 1.0 μg/g human apoA-IV or saline solution during an intraperitoneal glucose tolerance test.

[0032] FIG. 13 is a graph of plasma glucose (mg/dL) with respect to time (min) in female wild type mice following the intraperitoneal administration of 1.0 μg/g recombinant mouse apoA-IV or saline solution during an intraperitoneal glucose tolerance test.

[0033] FIG. 14 is a bar graph showing the effect of 10 μg/g human apoA-IV on human islets depolarized by 30mM KC1 and 250μΜ diazoxide in the presence of 3mM or 20mM glucose. [0034] FIG. 15 is a protein with the amino acid sequence of full length wild type human apoA-IV (SEQ ID NO. 1).

[0035] FIG. 16 is a protein with the amino acid sequence of full length wild type mouse apoA-IV (SEQ ID NO. 2).

[0036] FIG. 17 is a protein having the amino acid sequence of full length wild type human apoA-IV with the addition of glycine at the N-terminus (SEQ ID NO. 3).

[0037] FIG. 18 is a protein with the amino acid sequence of human apoA-IV showing polymorphic substitutions T347S, Q360H, and/or E165K and the optional addition of glycine, alanine or valine to the N-terminus (SEQ ID NO. 4).

[0038] FIG. 19 is a polynucleotide (SEQ ID NO. 5) encoding full length wild type human apolipoprotein A-IV.

[0039] FIG. 20 includes the amino acid sequence and optimized nucleotide coding sequence of the Omp-Apo A-IV construct for periplasmic expression in E. coli.

[0040] FIG. 21 includes the amino acid sequence and optimized nucleotide coding sequence of PelB-Apo A-IV construct for periplasmic expression in E. coli.

[0041] FIG. 22 includes the amino acid sequence and optimized nucleotide coding sequence of ENX-Apo A-IV construct for periplasmic expression in E. coli.

[0042] FIG. 23 includes the amino acid sequence and optimized nucleotide coding sequence of Apo A-IV construct for cytoplasmic expression in E. coli.

[0043] FIGS. 24 A and B show N-glycosylation prediction results for the human wild type apoA-IV (FIG 24A) and variant P393H (FIG 24B).

[0044] FIGS.25A and B shows O-glycosylation prediction results for the human wild type apoA-IV (FIG. 25A) and variant P393H (FIG. 25B).

[0045] Skilled artisans appreciate that elements in the figures are illustrated for simplicity and clarity and are not necessarily drawn to scale. For example, the dimensions of some of the elements in the figures may be exaggerated relative to other elements, as well as conventional parts removed, to help to improve understanding of the various embodiments of the present disclosure. DETAILED DESCRIPTION

[0046] The following terms are used in the present application:

[0047] As used herein, the term "non-glycosylated" or "unglycosylated" means a protein without observable N-linked glycosylation and/or O-linked glycosylation, within the limits of detection, for example, by isoelectric focusing, PNGase F digestion and/or MALDI analysis. In one embodiment, the term "non-glycosylated" or "unglycosylated" means without observable N-linked glycosylation and without observable O-linked glycosylation. In another embodiment, the term "non-glycosylated" or "unglycosylated" means without observable N-linked glycosylation. In another embodiment, the term "non-glycosylated" or "unglycosylated" means without observable O-linked

glycosylation.

[0048] As used herein, the term "protein expression system" refers to a cell-based or non-cell-based expression system that is used to produce a protein of interest, e.g., apoA-IV. Given that apoA-IV has been surprisingly found to lack glycosylation, expression systems that lack glycosylation machinery may be used to produce the protein for use in the treatment of type II diabetes. In one embodiment, cell-based expression systems which do glycosylate, such as mammalian cells, may be used to produce non-glycosylated apoA-IV. In one embodiment, the protein expression system used to make apoA-IV includes either a bacterial expression system, a mammalian cell expression system, a baculovirus (insect) cell expression system, or a yeast expression system.

[0049] The term "recombinant host cell" (or simply "host cell"), as used herein, refers to a cell that has been transformed, or is capable of being transformed, with a nucleic acid sequence and thereby expresses a gene of interest, e.g., apoA-IV. It should be understood that such terms are intended to refer not only to the particular subject cell but to the progeny of such a cell. Because certain modifications may occur in succeeding generations due to either mutation or environmental influences, such progeny may not, in fact, be identical to the parent cell, but are still included within the scope of the term

"host cell" as used herein. Host cells may be prokaryotic or eukaryotic cells that are capable of expressing exogenous nucleic acid sequences. Examples of host cells include bacteria such as E. coli, yeast, plant cells, Chinese hamster ovary (CHO) cells, human embryonic kidney (HEK)-293 cells and insect cells. [0050] The term "isolated" as it is used in reference to a protein, is a protein, polypeptide or antibody that by virtue of its origin or source of derivation: (1) is not associated with naturally associated components that accompany it in its native state; (2) is free of other proteins from the same species; (3) is expressed by a cell from a different species; or (4) does not occur in nature. Thus, a polypeptide that is, e.g., chemically synthesized or synthesized in a cellular system different from the cell from which it naturally originates will be "isolated" from its naturally associated components. A protein may also be rendered substantially free of naturally associated components by isolation, using any suitable protein purification technique. In one embodiment, the apoA IV protein used in the compositions and methods of the invention is an isolated protein obtained from a recombinant host cell, e.g., a bacterial cell.

[0051] The phrase "percent identical" or "percent identity" refers to the similarity (e.g., 95%, 96%, 97%, 98%, or 99%) between at least two different sequences. This percent identity can be determined by standard alignment algorithms, for example, the Basic Local Alignment Search Tool (BLAST) described by Altshul et al. ((1990) J. Mol. Biol. 215:403-10); the algorithm of Needleman et al. ((1970) J. Mol. Biol. 48:444-53); or the algorithm of Meyers et al. ((1988) Comput. Appl. Biosci. 4: 11-17). A set of parameters may be, for example, the Blosum 62 scoring matrix with a gap penalty of 12, a gap extend penalty of 4, and a frameshift gap penalty of 5. The percent identity between two amino acid or nucleotide sequences can also be determined using the algorithm of Meyers and Miller ((1989) CABIOS 4: 11-17), which has been incorporated into the ALIGN program (version 2.0), using a PAM120 weight residue table, a gap length penalty of 12, and a gap penalty of 4.

[0052] The term "recombinant protein" refers to a protein molecule that is expressed from recombinant DNA. For example, a recombinant ApoA-IV protein is one that is expressed in a recombinant host cell. Preferably, the ApoA-IV protein used in the methods and compositions of the invention is a recombinant ApoA-IV protein.

[0053] As used herein, the term "effective amount" describes the amount necessary or sufficient to realize a desired biologic effect. The effective amount for any particular application may vary depending on a variety of factors, including but not limited to the particular composition being administered, the size of the subject, and/or the severity of the disease and/or condition being treated. In one embodiment, an "effective amount" is a dose of about 0.25 to 10 μg/g of a non-glycosylated apoA-IV or biologically active analogue thereof. Alternatively, an "effective amount of a non-glycosylated apoA-IV or a biologically active analogue thereof is about 1 to 10 μg/g, about 0.25 to 2 μg/g, about 1 μg/g, or 0.1 mg/kg to 25 mg/kg. In another embodiment, the effective amount is a fixed dose of about 1 to 1000 mg. In a further embodiment, the effective amount is a fixed dose of about 1 to 10 mg.

[0054] Non-glycosylated apoA-IV or a biologically active analogue is administered one time daily. Alternatively, non-glycosylated apoA-IV or a biologically active analogue thereof is administered about 2 times per day. In yet another alternative, non- glycosylated apoA-IV or a biologically active analogue thereof is administered more than twice a day, for example, three times per day. In yet another alternative, non- glycosylated apoA-IV is administered once every second, third, fourth, fifth or sixth day, or once weekly.

[0055] As used herein, the term "desired biologic effect" describes reducing the effects of, counteracting, and/or eliminating a disease or condition. For example, in the context of type 2 diabetes, desired biologic effects include, but are not limited to lowering blood glucose, improving glucose tolerance, substantially restoring glucose tolerance to a normal level, improving insulin secretion, and/or substantially restoring insulin secretion to a normal level.

[0056] As used herein, the term "normal level" describes a level that is substantially the same as the level in a subject who is not in need of treatment. For example, in the context of treating type 2 diabetes, a normal level of blood glucose is from about 70 mg/dL to about 130 mg/dL before meals and less than about 180 mg/dL about one to two hours after meals, or from about 70 mg/dL to about 100 mg/dL before meals and less than about 140 mg/dL about one to two hours after meals. In another example in the context of treating type 2 diabetes, a normal level of glucose tolerance describes the ability of the subject to metabolize carbohydrates such that the level of blood glucose is from about 70 mg/dL to about 130 mg/dL before meals and less than about 180 mg/dL about one to two hours after meals, or from about 70 mg/dL to about 100 mg/dL before meals and less than about 140 mg/dL about one to two hours after meals. In still another example in the context of treating type 2 diabetes, the normal level of insulin secretion is the amount required to maintain a normal level of glucose tolerance, wherein the level of insulin secretion is greater than about 1 ng/mL about fifteen hours after meals. In a further embodiment, a normal level of blood glucose is from about 70 mg/dl to 100 mg/dl for a morning fasting blood sugar test.

[0057] In the context of blood glucose level, the term "restore" describes changing the blood glucose level of a subject to a normal level. Similarly, in the context of glucose tolerance, the term "restore" describes changing the glucose tolerance of a subject to a normal level. Also, in the context of insulin secretion, "restore" describes changing the insulin secretion of a subject to a normal level.

[0058] In the context of non-glycosylated apoA-IV, the term "biologically active fragment" describes a fragment of non-glycosylated apoA-IV which is capable of realizing a desired biologic effect in a subject with type 2 diabetes. The term

"biologically active analogue" describes an analogue of non-glycosylated apoA-IV which is capable of realizing a desired biologic effect in a subject with type 2 diabetes. In one example, a desired biological effect is to restore glucose tolerance in apoA-IV knockout mice as described in Example 2. Another example of a desired biological effect is to cause a statistically significant lowering of abnormal glucose levels in an animal model of type 2 diabetes, such as the mouse model described in Example 7.

[0059] As used herein, the term "obese" describes a condition in which a subject is well above a normal weight. In one specific example, the term obese describes a condition in which a subject is more than about 20% over their ideal weight and/or has a body mass index of about thirty or greater than about thirty. In one embodiment, the subject being treated is obese; in another embodiment, the subject being treated is not obese; and in yet another embodiment, the subject being treated has a normal body weight.

[0060] Embodiments of the present disclosure relate to methods for treating type 2 diabetes in a subject in need thereof and pharmaceutical compositions for the treatment of type 2 diabetes. In one embodiment, a method of treating diabetes is disclosed. In one particular embodiment, a method of treating type 2 diabetes in a subject in need thereof is disclosed, wherein the method comprises administering an effective amount of non-glycosylated apolipoprotein A-IV (hereinafter "apoA-IV") or a biologically active analogue or fragment thereof to the subject. [0061] In one embodiment, the method of treating type 2 diabetes is effective to lower blood glucose level of a subject. In one particular embodiment, the method is effective to lower blood glucose level of a subject by about 20 to 50%. In a further embodiment, the method is effective to lower the blood glucose level of a subject by about 40%. In a further embodiment, the method is effective to lower the blood glucose level of a subject by about 70 %. In still a further embodiment, the method is effective to substantially restore blood glucose level to a normal level.

[0062] In one embodiment, the method of treating type 2 diabetes results in a lower blood glucose level of a subject. In one particular embodiment, the method is effective to lower blood glucose level of a subject by about 1 mg/dl, 2 mg/dl, 3 mg/dl, 4 mg/dl, 5 mg/dl, 6 mg/dl, 7 mg/dl, 8 mg/dl, 9 mg/dl, 10 mg/dl, 11 mg/dl, 12 mg/dl, 13 mg/dl, 14 mg/dl, 15 mg/dl, 16 mg/dl, 17 mg/dl, 18 mg/dl, 19 mg/dl, 20 mg/dl, 40 mg/dl, 60 mg/dl, 80 mg/dl, 100 mg/dl, 120 mg/dl, 140 mg/dl, 160 mg/dl, 180 mg/dl, 200 mg/dl, 220 mg/dl, or 240 mg/dl, from a baseline level over the course of the dosing interval.

[0063] In another embodiment, the method of treating type 2 diabetes is effective to substantially restore glucose tolerance of a subject to a normal level. In one particular embodiment, the method is effective to substantially restore glucose tolerance of a subject to a normal level within about two hours after administration of a dose of non- glycosylated apoA-IV or a biologically active analogue thereof . In another

embodiment, the method is effective to substantially restore glucose tolerance of a subject to a normal level within about three hours or within about four hours after administration of a dose of an apoA-IV or a biologically active analogue thereof . In another embodiment, the glucose tolerance of a subject is substantially restored to a normal level for about eight to twelve hours.

[0064] In yet another embodiment, the treatment is effective to substantially restore insulin secretion to a normal level. In one particular embodiment, the treatment is effective to substantially restore insulin secretion to a normal level within about two hours after the administration of a dose of non-glycosylated apoA-IV or a biologically active analogue or fragment thereof . In another embodiment, insulin secretion is substantially restored to a normal level for about eight to twelve hours. In still another embodiment, the treatment is effective to lower the level of C-reactive protein. [0065] In one embodiment, non-glycosylated apoA-IV or a biologically active analogue thereof is administered systemically. Systemic administration of the non- glycosylated apoA-IV or the analogue thereof is selected from the group consisting of oral, subcutaneous, intravenous, intramuscular, and intraperitoneal administration.

[0066] In another embodiment, a pharmaceutical composition is disclosed. In one particular embodiment, the pharmaceutical composition comprises non-glycosylated apoA-IV or a biologically active analogue or fragment thereof. In another embodiment, the non-glycosylated apoA-IV or analogue thereof is formulated for administration to a subject for the treatment of type 2 diabetes. In this particular embodiment, a method for treating type 2 diabetes in a subject in need thereof is also provided, wherein the method comprises administering an effective amount of the pharmaceutical composition to the subject.

[0067] An "apolipoprotein A-IV" refers to mammalian apoA-IV and includes full- length apoA-IV and biologically active fragments of apoA-IV. The full-length human apoA-IV protein is a 376 amino acid protein (SEQ ID NO: 1), the amino acid sequence of which is shown in FIG. 15 and the molecular weight of which is 43.4 kDa . The amino acid sequence of full length mouse apoA-IV protein (SEQ ID NO. 2) is shown in FIG. 16. Also encompassed by the term "apolipoprotein A-IV" is the known analogue in which a glycine is added to N-terminus of the apoA-IV of the full length human sequence (SEQ ID NO. 3, as shown in FIG. 17), and analogues thereof having conservative substitutions for the N-terminal glycine (such as alanine and valine). An "apolipoprotein A-IV" also includes polymorphic forms thereof, including T347S, Q360H, or E165K substitutions to the human sequence represented by SEQ ID NO. 1 or the corresponding positions of SEQ ID NO. 3. As such, "apolipoprotein A-IV" includes the protein of SEQ ID NO. 4, shown in FIG. 18. In addition, human "apolipoprotein A- IV" includes variants (SEQ ID NOs: 20-64) each with a missense mutation: P393H, Q385K, Q381K, Q380H, Q377P, T367S, S353A, N352Y, V336M, D335H, G311R, V307L, R305C, R304Q, E291G, V274M, V274A, R264Q, A260T, E250K, N235S, Q231K, R220C, Q214H, E207K, T202M, R200C, D191N, D184N, P181L, A172T, R169W, A161S, R154W, T148M, S147N, A139E, N127K, S95L, R90C, T85A, Q77H, G74S, V13M, or V6M, as shown below in Table 1. SEQ ID NOs: 20-65 include the signal sequence. In one embodiment, the methods and compositions described herein include the mature forms of the proteins described in SEQ ID NOS: 20-65.

[0068] In one embodiment, the methods and compositions described herein use a non- glycosylated ApoA-IV protein comprising an amino acid sequence selected from the group consisting of 1, 3, 4, or 20-64, or a biologically active fragment thereof.

Alternatively, the methods and compositions described herein use a non-glycosylated ApoA-IV protein comprising an amino acid sequence having at least 95%, 96%, 97%, 98%, or 99% identity to a sequence selected from the group consisting of 1, 3, 4, or 20- 64, or a biologically active fragment thereof.

[0069] A biologically active analogue of apoA-IV has at least 90, 95, 96, 97, 98 or 99% identity to an apoA-IV. As described in the previous paragraph, an apoA-IV includes full length mammalian apoA-IV (e.g., human or mammalian) (human is described in SEQ ID NO: 1), polymorphic forms thereof, the protein of SEQ ID NOS. 3 and 4, and biologically active fragments of any of the foregoing. Amino acid variations in the biologically active analogues preferably have conservative substitutions relative to the wild type sequences. A "conservative substitution" is the replacement of an amino acid with another amino acid that has the same net electronic charge and approximately the same size and shape. Amino acid residues with aliphatic or substituted aliphatic amino acid side chains have approximately the same size when the total number of carbon and heteroatoms in their side chains differs by no more than about four. They have approximately the same shape when the number of branches in their side chains differs by no more than one. Amino acid residues with phenyl or substituted phenyl groups in their side chains are considered to have about the same size and shape. Listed below are five groups of amino acids. Replacing an amino acid residue with another amino acid residue from the same group results in a conservative substitution:

Group I: glycine, alanine, valine, leucine, isoleucine, serine, threonine, cysteine, and non-naturally occurring amino acids with C1-C4 aliphatic or C1-C4 hydroxyl substituted aliphatic side chains (straight chained or monobranched).

Group II: glutamic acid, aspartic acid and non-naturally occurring amino acids with carboxylic acid substituted C1-C4 aliphatic side chains (unbranched or one branch point). Group III: lysine, ornithine, arginine and non-naturally occurring amino acids with amine or guanidine substituted C1-C4 aliphatic side chains (unbranched or one branch point).

Group IV: glutamine, asparagine and non-naturally occurring amino acids with amide substituted C1-C4 aliphatic side chains (unbranched or one branch point).

Group V: phenylalanine, phenylglycine, tyrosine and tryptophan.

[0070] An apoA-IV or a biologically active analogue thereof is preferably

unglycosylated. The preparation of recombinant unglycosylated human and mouse apoA-IV is described in Example 12. The polynucleotide sequence of full length wild type human apolipoprotein (SEQ ID NO. 1) is shown as SEQ ID NO. 5 in Figure 19.

[0071] ApoA-IV used in Examples 1-10 is unglycosylated. Non-glycosylated apoA-IV may be prepared according to standard methods known in the molecular biology field. For example, non-glycosylated apoA-IV may be prepared via traditional molecular cloning techniques.

[0072] In one embodiment, apoA-IV is prepared according to the methods described in Tubb et al. (2009) J of Lipid Res 50: 1497, where the authors expressed recombinant apoA-IV with an affinity tag (Histidine (His) tag) in a bacterial expression system, i.e., E. coli. Tubb et al. describe the use of the tobacco etch virus (TEV) protease as a means for cleaving the His tag from the apoA-IV protein. Thus, the apoA-IV protein may be expressed in a recombinant host cell, e.g., E. coli, using a His tag which is cleaved by the TEV protease. Alternatively, the apoA-IV protein may be expressed in a recombinant host cell, e.g., E. coli, using a glutatione S-transferase (GST) tag which is cleaved by the TEV protease. In one embodiment, the TEV protease is used to cleave an affinity tag from the apoA-IV protein.

[0073] In one embodiment, a bacterial host may be used to produce unglycosylated apoA-IV. Examples of bacterial hosts include, but are not limited to, E. coli BL-21, BL- 21 (DE3), BL21-AI™, BL21(DE3)pLysS, BL21(DE3)pLysE, BL21 Star™(DE3), and BL21 Star™ (DE3)pLysS, (Invitrogen). Corynebacterium may also be used as a host cell for expressing apoA-IV. Prior to transformation into the bacterial host, the DNA segment encoding ApoA-IV or its analogue may be incorporated in any of suitable expression vectors for transformation into the bacterial host. Suitable expression vectors include plasmid vectors, cosmid vectors, and phage vectors variously known to those of skill in the art, for example, as described in Sambrook, et al., Molecular Cloning Manual, 2d Edition, 1989. Examples of the expression vector include pET Vectors (Invitrogen), pDEST vectors (Invitrogen), pRSET vectors (Invitrogen), and pJexpress Vector (DNA2.0 Inc.). In one embodiment, E. Coli BL-21 (DE3) is transformed with pET30 expression vector which contains the gene encoding the ApoA-IV.

[0074] In addition to prokaryotes, eukaryotic microbes such as filamentous fungi or yeast are suitable cloning or expression hosts for apoA-IV-encoding vectors.

Saccharomyces cerevisiae, or common baker's yeast, is the most commonly used among lower eukaryotic host microorganisms. However, a number of other genera, species, and strains are commonly available and useful herein, such as Schizosaccharomyces pombe; Kluyveromyces hosts such as, e.g., K. lactis, K fragilis (ATCC 12,424), K. bulgaricus (ATCC 16,045), K. wickeramii (ATCC 24,178), K. waltii (ATCC 56,500), K.

drosophilarum (ATCC 36,906), K. thermotolerans, and K. marxianus; yarrowia (EP 402,226); Pichia pastoris (EP 183,070); Candida; Trichoderma reesia (EP 244,234); Neurospora crassa; Schwanniomyces such as Schwanniomyces occidentalis; and filamentous fungi such as, e.g., Neurospora, Penicillium, Tolypocladium, and

Aspergillus hosts such as A. nidulans and A. niger.

[0075] Suitable host cells for the expression of apoA-IV may also be derived from multicellular organisms. Examples of invertebrate cells include plant and insect cells. Numerous baculoviral strains and variants and corresponding permissive insect host cells from hosts such as Spodoptera frugiperda (caterpillar), Aedes aegypti (mosquito), Aedes albopictus (mosquito), Drosophila melanogaster (fruitfly), and Bombyx mori have been identified. A variety of viral strains for transfection are publicly available, e.g., the L-l variant of Autographa californica NPV and the Bm-5 strain of Bombyx mori NPV, and such viruses may be used as the virus herein according to the present invention, particularly for transfection of Spodoptera frugiperda cells.

[0076] Plant cell cultures of cotton, corn, potato, soybean, petunia, tomato, and tobacco can also be utilized as hosts.

[0077] Another suitable host cell for production of apoA-IV protein is a vertebrate cell. Examples of useful mammalian host cell lines include, but are not limited to, monkey kidney CVl line transformed by SV40 (COS-7, ATCC CRL 1651); human embryonic kidney line (e.g., 293 or 293 cells subcloned for growth in suspension culture, Graham et al., J. Gen Virol. 36:59 (1977)); baby hamster kidney cells (BHK, e.g., ATCC CCL 10); Chinese hamster ovary cells/-DHFR(CHO, Urlaub et al., Proc. Natl. Acad. Sci. USA 77:4216 (1980)), including, but not limited to CHO Kl, CHO pro3.sup.-, CHO DG44, CHO DUXB11, Lecl3, B-Lyl, and CHO DP12 cells, preferably a CHO DUX (DHFR-) or subclone thereof (herein called "CHO DUX"); C127 cells, mouse L cells; Ltk.sup.- cells; mouse Sertoli cells (TM4, Mather, Biol. Reprod. 23:243-251 (1980)); monkey kidney cells (CVl ATCC CCL 70); African green monkey kidney cells (VERO-76, ATCC CRL-1587); human cervical carcinoma cells (HeLa, ATCC CCL 2); canine kidney cells (MDCK, ATCC CCL 34); buffalo rat liver cells (BRL 3A, ATCC CRL 1442); human lung cells (W138, ATCC CCL 75); human liver cells (Hep G2, HB 8065); mouse myeloma cells; NS0; hybridoma cells such as mouse hybridoma cells; COS cells; mouse mammary tumor (MMT 060562, ATCC CCL51); TR1 cells (Mather et al., Annals N.Y. Acad. Sci. 383:44-68 (1982)); MRC 5 cells; FS4 cells; and a human hepatoma line (Hep G2).

[0078] Host cells are transformed with expression or cloning vectors for production of the apoA-IV protein, and cultured in conventional nutrient media modified as appropriate for inducing promoters, selecting transformants, or amplifying the genes encoding the desired sequences.

[0079] ApoA-IV knockout mice used in the examples were generated according to procedures disclosed in J Lipid Res. 1997 Sep;38(9): 1782-94, the entire teachings of which are incorporated herein by reference.

[0080] Also included in the methods of the invention are combination therapies for treating type 2 diabetes. Examples of additional therapeutic agents that may be used in combination with apolipoprotein A-IV include, but are not limited to, sulfonylureas, meglitinides, biguanides, thiazolidinediones, alpha-glucosidase inhibitors, DPP-4 inhibitors, incretin mimetics, and insulin. An additional therapeutic agent may be administered prior to, concurrently with, or subsequent to administration of apoA-IV to the subject in need thereof.

[0081] The effective amount or apoA-IV administered to a subject for the treatment of type 2 diabetes may, for example, be a weight-based dose (e.g., mg/kg) or, in another example, be a fixed dose (non- weight dependent). In one embodiment, about 1 to 10 mg/kg, about 0.25 to 2 mg/kg, about 1 mg/kg, or 0.1 mg/kg to 25 mg/kg of apoA-IV is administered to a subject in need thereof. In another embodiment, the effective amount of apoA-IV administered to a subject in need thereof is a fixed dose of about 1 to 1000 mg. In a further embodiment, the effective amount is a fixed dose of apoA-IV administered to a subject in need thereof, is about 1 mg, 2 mg, 3 mg, 4 mg, 5 mg, 6 mg, 7 mg, 8 mg, 9 mg, 10 mg, 11, mg, 12 mg, 13 mg, 14 mg, 15 mg, 16 mg, 17 mg, 18 mg, 19 mg, 20 mg, 21 mg, 22 mg, 23 mg, 24 mg, 25 mg, 26 mg, 27 mg, 28 mg, 29 mg, 30 mg, 40 mg, 50 mg, 60 mg, 70 mg, 80 mg, 90 mg, 100 mg, 120 mg, 140 mg, 160 mg, 180 mg, 200 mg, 250 mg, 300 mg, 350 mg, 400 mg, 450 mg, 500 mg, 550 mg 600 mg, 650 mg, 700 mg, 750 mg, 800 mg, 850 mg, 900 mg, 950 mg, or 1000 mg.

[0082] In one particular embodiment, the pharmaceutical composition may further comprise a pharmaceutically acceptable carrier. Pharmaceutically acceptable carriers include a wide range of known diluents (i.e., solvents), fillers, extending agents, binders, suspending agents, disintegrates, surfactants, lubricants, excipients, wetting agents and the like commonly used in this field. The pharmaceutical composition is preferably aqueous, i.e., is a liquid formulation, and preferably comprises pyrogen free water. These carriers may be used singly or in combination according to the form of the pharmaceutical preparation. The resulting preparation may incorporate, if necessary, one or more solubilizing agent, buffers, preservatives, colorants, perfumes, flavorings and the like that are widely used in the field of pharmaceutical preparation.

[0083] The non-glycosylated apoA-IV or biologically active analogue thereof may be formulated into a dosage form selected from the group consisting of tablets, capsules, granules, pills, injections, solutions, emulsions, suspensions, and syrups. The form and administration route for the pharmaceutical composition are not limited and can be suitably selected. For example, tablets, capsules, granules, pills, syrups, solutions, emulsions, and suspensions may be administered orally. Additionally, injections (e.g. subcutaneous, intravenous, intramuscular, and intraperitoneal) may be administered intravenously either singly or in combination with a conventional replenisher containing glucose, amino acid and/or the like, or may be singly administered intramuscularly, intracutaneously, subcutaneously and/or intraperitoneally. [0084] The pharmaceutical composition of the invention for treating type 2 diabetes may be prepared according to a method known in the pharmaceutical field of this kind using a pharmaceutically acceptable carrier. For example, oral forms such as tablets, capsules, granules, pills and the like are prepared according to known methods using excipients such as saccharose, lactose, glucose, starch, mannitol and the like; binders such as syrup, gum arabic, sorbitol, tragacanth, methylcellulose, polyvinylpyrrolidone and the like; disintegrates such as starch, carboxymethylcellulose or the calcium salt thereof, microcrystalline cellulose, polyethylene glycol and the like; lubricants such as talc, magnesium stearate, calcium stearate, silica and the like; and wetting agents such as sodium laurate, glycerol and the like.

[0085] Injections, solutions, emulsions, suspensions, syrups and the like may be prepared according to a known method suitably using solvents for dissolving the active ingredient, such as ethyl alcohol, isopropyl alcohol, propylene glycol, 1,3-butylene glycol, polyethylene glycol, sesame oil and the like; surfactants such as sorbitan fatty acid ester, polyoxyethylenesorbitan fatty acid ester, polyoxyethylene fatty acid ester, polyoxyethylene of hydrogenated castor oil, lecithin and the like; suspending agents such as cellulose derivatives including carboxymethylcellulose sodium, methylcellulose and the like, natural gums including tragacanth, gum arabic and the like; and preservatives such as parahydroxybenzoic acid esters, benzalkonium chloride, sorbic acid salts and the like.

[0086] The proportion of the active ingredient to be contained in the pharmaceutical composition of the invention for treating type 2 diabetes can be suitably selected from a wide range.

[0087] In one particular embodiment, the subject in need of treatment of type 2 diabetes is a mammal. The mammal may be selected from the group consisting of humans, non-human primates, canines, felines, murines, bovines, equines, porcines, and lagomorphs. In one specific embodiment, the mammal is human. In another embodiment, non-glycosylated apoA-IV or a biologically active analogue thereof may be administered to a subject for the treatment of type 2 diabetes wherein the subject is obese. Alternatively, non-glycosylated apoA-IV may be administered to a subject for the treatment of type 2 diabetes wherein the subject is not obese. [0088] Referring to FIG. 1, in yet another embodiment, a device 1 is disclosed. In one embodiment, the device 1 comprises a reservoir 10 of the pharmaceutical composition previously discussed above. In a further embodiment, the reservoir 10 comprises a vial 12. The vial 12 may be formed of any material that does not inhibit the function of the pharmaceutical composition. For example, the vial 12 may comprise glass and/or plastic. Additionally, the vial 12 may comprise a pierceable septum 14 through which the pharmaceutical composition may be removed. In use, the septum 14 of the vial is pierced by the needle 22 of a syringe 20, the pharmaceutical composition is removed by the syringe 20 from the vial 12, and the pharmaceutical composition is administered via injection to a subject in need.

EXAMPLES

[0089] The following non-limiting examples illustrate the methods of the present disclosure.

Example 1: Glucose Intolerance of ApoA-IV Knockout Mice

[0090] Experimental Protocol. Male apoA-IV knockout ("hereinafter "KO") mice were obtained. Wild-type (hereinafter "WT") mice served as controls. ApoA-IV KO and WT mice were obtained from a colony kept at the University of Cincinnati (Cincinnati, OH). ApoA-IV KO and WT mice were fed a chow diet. Prior to performing the glucose tolerance tests, ApoA-IV KO mice and WT mice were fasted for five hours. In the glucose tolerance tests, the apoA-IV KO mice and WT mice were injected intraperitoneally with a dose of about 2 mg/g body weight of glucose and plasma glucose was measured at about 0, 15, 30, 60, and 120 minutes following the injection of glucose. The glucose tolerance tests were performed twice, once at three months of age and again at sixteen months of age.

[0091] Experimental Results. As shown in FIG. 2, apoA-IV KO mice were glucose intolerant relative to the WT mice. Specifically, FIG. 2 shows that plasma glucose levels in WT mice were lower than plasma glucose levels in apoA-IV KO mice for two hours following intraperitoneal injection with glucose. While not being bound by the theory, the implication of these studies was that apoA-IV is necessary for normal glucose homeostasis (at least in males). Moreover, as shown in FIG. 3, apoA-IV KO mice demonstrated an increased glucose intolerance when tested at sixteen months of age. Specifically, FIG. 3 shows that plasma glucose levels in apoA-IV KO mice tested at sixteen months of age were higher than the plasma glucose levels in apoA-IV KO tested at three months of age. While not being bound by the theory, the implication of these studies was that glucose tolerance of apoA-IV KO mice worsens with age.

Experiment with Female Wild Type and ApoA-IV Knockout Mice

[0092] Female ApoA-IV wildtype and knockout mice were subjected to the same intraperitoneal glucose tolerance test as was used for the male apoA-IV KO and WT mice, as described earlier in this Example 1. The results are shown in Figure 11. Female apoA-IV ^" ^ ^" mice, when challenged intraperitoneally with glucose, have increased plasma glucose levels compared with female WT animals, but there is no statistical significant difference. On the other hand, the males have a significant difference between WT and KO animals.

Example 2: Restoration of Glucose Tolerance in ApoA-IV Knockout Mice

[0093] Experimental Protocol. Upon demonstrating that apoA-IV KO mice are glucose intolerant, a series of extensive studies were performed to determine whether administration of apoA-IV to apoA-IV KO mice would restore glucose tolerance to a normal level. Specifically, a series of studies were performed to determine not only the amount of apoA-IV to be administered but also the optimal time in which to administer apoA-IV prior to conducting glucose tolerance tests.

[0094] ApoA-IV male KO mice were injected intraperitoneally with doses of about 0.25, 0.5, 1, and 2 μg/g by weight of apoA-IV. ApoA-IV KO mice were also injected intraperitoneally with saline solution to serve as a control. Following injection with mouse apoA-IV or saline solution, glucose tolerance tests were conducted at three months of age as previously discussed. Specifically, glucose tolerance tests were conducted about two hours following injection with apoA-IV or saline solution.

Experimental results indicated that the optimal time to restore glucose tolerance in apoA-IV KO mice was to administer apoA-IV about two hours prior to conducting glucose tolerance tests.

[0095] Experimental Results. As shown in FIG. 4, the administration of apoA-IV to apoA-IV KO mice restored glucose tolerance to a normal level. Specifically, FIG. 4 shows that plasma glucose levels in apoA-IV KO mice injected with apoA-IV were lower than plasma glucose levels in apoA-IV KO mice injected with saline solution. Moreover, as shown in FIG. 4, plasma glucose levels in apoA-IV KO mice injected with apoA-IV were the lowest in the apoA-IV KO mice injected with the highest dosage of apoA-IV; similarly, plasma glucose levels in apoA-IV KO mice injected with apoA-IV were the highest in the apoA-IV KO mice injected with the lowest dosage of apoA-IV. Accordingly, it was discovered that the degree of improvement of glucose tolerance was dependent on the dose of apoA-IV administered, with higher doses resulting in improved glucose tolerance.

Example 3: Specificity of ApoA-IV in Restoring Glucose Tolerance in ApoA-IV Knockout Mice

[0096] Experimental Protocol. In order to assess the specificity of apoA-IV, we administered apolipoprotein AI (hereinafter "apoA-I") to apoA-IV KO mice. ApoA-I is a protein made by the small intestinal epithelial cells which also produce apoA-IV. ApoA-I shares many of the functions of apoA-IV. ApoA-IV KO mice were injected intraperitoneally with a dose of 1 μg/g by weight of apoA-I. ApoA-IV KO mice were also injected intraperitoneally with saline solution to serve as a control. Following injection with apoA-I or saline solution, glucose tolerance tests were conducted at three months of age as previously discussed. Specifically, glucose tolerance tests were conducted about two hours following injection with apoA-I or saline solution.

[0097] Experimental Results. As shown in FIG. 5, the administration of apoA-I to apoA-IV KO mice failed to restore or improve glucose tolerance.

Example 4: Mechanism of Restoration of Glucose Tolerance in ApoA-IV

Knockout Mice

[0098] Experimental Protocol. In order to assess the mechanism by which ApoA-IV improves glucose tolerance in apoA-IV KO mice, we measured glucose-induced insulin secretion in apoA-IV KO mice. More specifically, we measured glucose-induced insulin secretion during glucose tolerance tests at three months of age as previously discussed. In this study, apoA-IV KO mice were injected intraperitoneally with a dose of about 1 ug/g by weight of mouse apoA-IV two hours prior to conducting the glucose tolerance tests. ApoA-IV KO mice were injected with saline solution about two hours prior to conducting glucose tolerance tests to serve as a control.

[0099] Experimental Results. As shown in FIG. 6, phase I insulin secretion was absent in apoA-IV KO mice injected with saline solution. However, as shown in FIG. 6, phase I insulin secretion was restored in apoA-IV KO mice when apoA-IV was injected intraperitoneally two hours prior to performing the glucose tolerance tests.

Example 5: Efficacy of ApoA-IV in ApoA-IV Knockout and Wild-Type Mice on High Fat Diets

[00100] Experimental Protocol. ApoA-IV KO and WT mice were chronically fed a high-fat semi-purified, nutritionally complete experimental diets (AIN-93M) purchased from Dyets (Bethlehem, PA) for 10 weeks. The high-fat diets contain about 20 g of fat (i.e. about 19 g of butter fat and 1 g of soybean oil to provide essential fatty acids) per 100 g of diet. The apoA-IV KO and WT mice were housed in individual tub cages with corncob bedding in a temperature- (about 22 + 1° C) and light- (about 12 h light/12 dark) controlled vivarium. Glucose tolerance tests were performed at three months of age as previously discussed. Prior to performing the glucose tolerance tests, apoA-IV KO mice and WT mice were fasted for five hours. In the glucose tolerance tests, the apoA-IV KO mice and WT mice were injected intraperitoneally with a dose of about 2 mg/g body weight of glucose.

[00101] Experimental Results. As shown in FIG. 7, apoA-IV KO mice displayed greater glucose intolerance relative to the WT mice. Specifically, FIG. 7 shows that plasma glucose levels in WT mice were lower than plasma glucose levels in apoA-IV KO mice for two hours following intraperitoneal injection with glucose.

Example 6: Restoration of Glucose Tolerance in ApoA-IV Knockout and Wild- Type Mice on High Fat Diets

[00102] Experimental Protocol. A series of studies were performed related to the administration of apoA-IV to apoA-IV KO and WT mice on high-fat diets for 14 weeks at three months of age (20% by weight of fat, 19% of butter fat and 1% of safflower oil). Specifically, apoA-IV KO and WT mice were injected intraperitoneally with a dose of about 1 μg/g body weight of mouse apoA-IV. ApoA-IV KO and WT mice were also injected intraperitoneally with saline solution to serve as a control. Following injection with apoA-IV or saline solution, glucose tolerance tests were conducted. Specifically, glucose tolerance tests were conducted two hours following injection with apoA-IV or saline solution.

[00103] Experimental Results. As shown in FIG. 8, the administration of apoA-IV in apoA-IV KO mice significantly improved glucose tolerance. Specifically, FIG. 8 shows that plasma glucose levels in apoA-IV KO mice injected with apoA-IV were lower than plasma glucose levels in apoA-IV KO mice injected with saline solution, [the previous sentence is redundant since the next sentence describes the same thing. Although the data is not included herein, it was also discovered that the administration of apoA-IV in WT mice fed chronically a high fat diet also significantly improved glucose tolerance.

Example 7: Restoration of Glucose Tolerance in Mice with Type 2 Diabetes

[00104] Experimental Protocol. In order to confirm that apoA-IV is effective in promoting glucose tolerance in animals with type 2 diabetes, heterozygous KK Cg-A/J (hereinafter "Cg-A/J") mice were obtained from Jackson Laboratories (Bar Harbor, Maine). Cg-A/J mice develop hyperglycemia, hyperinsulinemia, obesity, and glucose intolerance by eight weeks of age. The main cause of diabetes in these mice is insulin resistance produced by the polygenic interactions with the A ^y mutation, which encodes the agouti related protein and antagonist of the melanocortin-IV receptor. The Cg-A/J mice were fed chow diet. Additionally, there was a marked increase in blood glucose from ten to fourteen weeks of feeding the chow diet.

[00105] At fourteen weeks of age, the Cg-A/J mice were administered either mouse apoA-IV (about 1 μg/g body weight) or saline solution (to serve as a control) via intraperitoneal injection. Plasma glucose was then determined at about 0, 0.5, 1, 2, 3, 4, 5, 7, 11, and 24 hours.

[00106] Experimental Results. As shown in FIG. 9, apoA-IV has a marked effect in lowering the blood sugar level of the Cg-A/J mice relative to the saline control. While the Cg-A/J mice injected with saline solution maintained a steady plasma glucose level throughout the 24 hour period of study, the Cg-A/J mice injected with apoA-IV experienced a decrease in plasma glucose for over 10 hours, and, during most of this period, the plasma glucose level was comparable to the C57BL/6J animals we have been studying. From this study, we conclude that the administration of apoA-IV is effective in lowering the plasma glucose in Cg-A/J mice.

Example 8: Level of Serum Amyloid P Component in ApoA-IV KO, ApoA-I KO, and WT Mice

[00107] Experimental Protocol. A series of studies were performed in related to determining the level of serum amyloid A protein component (hereinafter "SAP") in apoA-IV KO, apoA-I KO, and WT mice on atherogenic diets. The apoA-IV KO, apoA- I KO, and WT mice were obtained from the University of Cincinnati. SAP is a serum form of amyloid P component (hereinafter "AP"), a 25 kDa pentameric protein first identified as the pentagonal constituent of in vivo pathological deposits called amyloid. SAP behaves like C-reactive protein in humans. Specifically, the level of plasma SAP in apoA-IV KO, apoA-I KO, and WT mice was determined in apoA-IV KO, apoA-I KO, and WT mice after 12 weeks on an atherogenic diet. The level of plasma SAP was determined via Western blot analysis.

[00108] Experimental Results. As shown in FIG. 10, the level of SAP in apoA-IV KO mice (corresponding to mouse numbers 1, 8, and 10) increased relative to the level of SAP in apoA-I KO mice (corresponding to mouse numbers 28, 29, and 30) and WT mice (corresponding to mouse numbers 19, 20, and 25).

[00109] For the purposes of describing and defining the present disclosure it is noted that the terms "about" and "substantially" are utilized herein to represent the inherent degree of uncertainty that may be attributed to any quantitative comparison, value, measurement, or other representation. The terms "about" and "substantially" are also utilized herein to represent the degree by which a quantitative representation may vary from a stated reference without resulting in a change in the basic function of the subject matter at issue.

[00110] The above description and drawings are only to be considered illustrative of exemplary embodiments, which achieve the features and advantages of the present disclosure. Modification and substitutions the features and steps described can be made without departing from the intent and scope of the present disclosure. Accordingly, the disclosure is not to be considered as being limited by the foregoing description and drawings, but is only limited by the scope of the appended claims.

Example 9: Human ApoA-IV Lowers Blood Glucose Levels in Wild-Type Mice Undergoing Intraperitoneal Glucose Tolerance Testing

[00111] Experimental Protocol. Studies were performed to determine whether administration of human apoA-IV to wild type mice would affect blood glucose levels in mice undergoing glucose tolerance testing.

[00112] Three month old wild type mice were injected intraperitoneally with doses of about 1 μg/g by weight of human apoA-IV. As a control, another group of wild type mice was injected intraperitoneally with saline solution. Following injection with human apoA-IV or saline solution, glucose tolerance tests were conducted. Specifically, glucose tolerance tests were conducted about two hours following injection with apoA- IV or saline solution and after five hours of fasting. Tail blood was collected and measure by glucometer.

[00113] Experimental Results. As shown in Figure 12, human apoA-IV was effective in lowering blood glucose in wild type mice undergoing glucose tolerance testing.

Example 10. Effect of Mouse ApoA-IV in Wild-Type Female Mice Undergoing Intraperitoneal Glucose Tolerance Testing

[00114] Experimental Protocol. Studies were performed to determine whether administration of mouse apoA-IV to female wild type mice would affect blood glucose levels in mice undergoing glucose tolerance testing.

[00115] Three month old female wild type mice were injected intraperitoneally with doses of about 1 μg/g by weight of mouse apoA-IV. As a control, another group of female wild type mice were injected intraperitoneally with saline solution. Following injection with human apoA-IV or saline solution, glucose tolerance tests were conducted. Specifically, glucose tolerance tests were conducted about two hours following injection with apoA-IV or saline solution and after five hours of fasting. Tail blood was collected and measure by glucometer.

Experimental Results. As shown in Figure 13, mouse apoA-IV was effective in lowering blood glucose in wild type female mice undergoing glucose tolerance testing. Example 11 Human ApoA-IV Stimulates Insulin Release in Human Islets

[00116] High purity human islets were provided by University of Virginia, Axon Cells. Islets were cultured in RPMI 1640, containing 10 % FBS and l lmM glucose at 37° C in a humidified atmosphere of 95 % air and 5% CO2 for 48 hours. Four Groups of 50 IEQ islets were then pre-incubated at 37° C for 1 h in regular KRB (129mM NaCl, 4.8mM KCl, 2.5mM CaCl2, 1.2 mM MgSOzi, 1.2mM KH2PO4, 5mM NaHCC>3, lOmM HEPES and 0.2% BSA)containing 3.0 mM glucose. Islets in the first two groups were then incubated in regular KRB containing 3.0mM glucose for an hour in the presence or absence of 10μg/ml human A-IV and were further incubated with 20 mM glucose for an additional hour in the presence or absence of 10 μg/ml human A-IV. Islets in the last two groups were incubated in 30mM KCl KRB (103.8 mM NaCl, 30mM KCl, 2.5mM CaCl2, 1.2 mM MgSC-4, 1.2mM KH2PO4, 5mM NaHCC>3, lOmM HEPES and 0.2% BSA) plus 250μιηο1/1 diazoxide containing 3.0mM glucose for an hour in the presence or absence of 10μ /ηι1 human A-IV and were further incubated with 20mM glucose for an additional hour in the presence or absence of 10μ /ηι1 human A-IV. Media were collected at the end of each one -hour incubation. Insulin levels were measured by ELISA kit (Millipore).

[00117] As can be seen from FIG. 14, when the human islets were maximally depolarized by 30mM KCl plus 250μΜ diazoxide, 10 μg/ml hA-IV showed a significant stimulatory effect on insulin secretion.

Example 12 Preparation of Non- Glycosylated ApoA-IV

[00118] Human and mouse apoA-IV cDNA was contained in a pSP65 maintenance vector, and an Afl III restriction site was engineered immediately 5' of the coding sequence for the mature apoA-IV protein. The gene was excised from the maintenance vector and ligated into the pET30 expression vector. The construct was transfected into E. Coli BL-21 (DE3) cells and grown in Luria- Bertani cultures supplemented with kanamycin (30 Mg/ml) at 37 °C. After induction of apoA-IV protein synthesis in the cells, the cells were harvested and sonicated. ApoA-IV protein from the lysate was purified by His-bind affinity column chromatography and dialysis. The resultant apoA-IV protein was diluted to a final concentration of 1.0 mg/ml in saline.

Example 13 Absence of N- and O- Glycosylation in Human ApoA-IV

[00119] Using NetNGlyc 1.0 server at www.cbs.dtu.dk/cgi- bin/webface?jobid=netNglyc, 4F9C6AD203AFBD5C, human apoA-IV and 45 missense variants were analyzed in silico. Details regarding the missense variants are provided in Table 1. The O- and N-linked glycosylation analyses are exemplified in Figures 24 and 25 by the native apoA-IV and an exemplary variant, i.e., P393H. The results show that human apoA-IV and the missense variants do not possess any N-linked or N-linked glycosylation sites. Notably, the variants described in Table 1 (represented by the amino acid sequences described in SEQ ID NOs: 20-64; SEQ ID NO 65 represents ApoAIV with the signal sequence) had glycosylation profiles identical to those presented in Figures 24 and 25. These results are unexpected in view of common knowledge in the art, e.g., Weinberg, et al., J Lipid Res. 1983, 24(l):52-9, that apoA-IV is glycosylated by mannose, galactose, N-acetyl glucosamine, and sialic acid.

Table 1. ApoAIV variants (APOA4 gene (mRNA accession no, NM 000482.3))

Example 14 Optimization of ApoA-IV for Bacterial Expression

[00120] To facilitate periplasmic expression of apoA-IV in E. coli, constructs were prespared using various signal peptides. These signal peptides (i.e. OmpA, PelB, and ENX) were each fused to the N-terminal of apoA-IV. The amino acid and nucleic acid sequences of each these signal sequences are provided as follows:

[00121] OmpA signal peptide

M K K T A I A I A V A L A G F T A V A Q A (SEQIDNO:6)

ATG AAA AAG ACA GCT ATC GCG ATT GCA GTG GCA CTG GCT GGT TTC GCT ACC GTA GCG C AG GCC (SEQ ID NO : 7)

PelB signal peptide

M K Y L L P T A A A G L L L L A A Q P A M A (SEQ ID NO: 8) ATG AAA TAC CTG CTG CCG ACC GCT GCT GCT GGT CTG CTG CTC CTC GCT GCC C AG CCG GCG ATG GCC (SEQ ID NO : 9)

ENX signal peptide

M F K F K K N F L V G L S A A L M S I S L F S A T A S A (SEQ ID NO: 10)

ATG TTT AAG TTT AAA AAG AAT TTC TTA GTT GGA TTA TCG GCA GCT TTA ATG AGT ATT AGC TTG TTT TCG GCA ACC GCC TCT GCA (SEQ ID NO: 11)

[00122] To improve protein yield in E. coli, the codon usage for apoA-IV was optimized. Optimization was performed using DNA2.0's algorithm (DNA2.0 Inc.) or other algorithms based on experimental data and the tRNA chargeability (amino acetylation). The apoA-IV coding sequence with optimized codons was then fused at the 5 ' end to the 3 ' end of the nucleotide sequence of a signal peptide. In addition, the codon-optimized sequence can be linked at its 3 ' end to a double stop codon. Constructs with the optimized codons and cloning sites are exemplified in Figures 20-23. The optimized DNA sequences are described in SEQ ID NOs: 13, 15, 17, and 19, with the resulting amino acid sequences set forth in SEQ ID NOs: 12, 14, 16, and 18, respectively. Notably, the optimized sequences (SEQ ID NOs: 12-19) may also be used in the methods and compositions of the invention.

[00123] The apoA-IV- constructs can then be synthesized by DNA2.0, Inc. and sub- cloned into a pJexpress vector (e.g., pJexpress401) using Ndel-Xhol restriction sites. These constructs can be transformed into BL21 E. coli strain (Novagen) (F ^~ OmpT hsdSei i"B tnB ) gal dcm) and clones containing these constructs can be selected with Kanamycin. A pre-culture in 125 ml of YES medium containing Kanamycin (e.g., 50 μg/ml) can be inoculated starting from one isolated colony and incubated at 37 °C with agitation at 270 rpm for about 16 hours. A fresh culture in 500 ml of Kanamycin- containing YES medium can be inoculated with 10 mL of the pre-culture and incubated at 37 °C with agitation at 270 rpm until the OD ₆ oo reaches 0.5 to 1.0 (optimum = 0.6). The resultant culture will then be induced with IPTG (e.g., with a final concentration of 1 mM) and incubated at 37 °C for 1 hour, 2 hours, 4 hours, or 22 hours.

[00124] ApoA-IV protein can be isolated from periplasmic and cytoplasmic fractions of the culture prepared above. More specifically, the culture can be pelleted. The resultant culture pellet can be suspended in hypertonic TES buffer (sucrose 20%) / OD ₆ oo / rnL and incubated for 5 min at room temperature before dilution in 4 volumes of purified water at 4°C. The diluted suspension can be further incubated for 10 min on ice and centrifuged for 5 min at 13,000 rpm. The resultant supernatant is periplasmic fraction (P) and the pellet is the cytoplasmic fraction. Expression of apoA-IV can be analyzed by SDS-PAGE or Western analysis. ApoA-IV in these fractions can then be purified by conventional and/or affinity chromatography, and formulated for delivery to humans for treatment of type II diabetes.

Incorporation by Reference

The contents of all references and patents cited herein are hereby incorporated by reference in their entirety.

Equivalents

Those skilled in the art will recognize, or be able to ascertain using no more than routine experimentation, many equivalents to the specific embodiments of the invention described herein. Such equivalents are intended to be encompassed by the following claims.