COMPOSITION FOR TREATING AND PREVENTING ISCHEMIC DAMAGE

[0001] The present disclosure relates to a composition for treating and preventing an ischemic injury. More particularly, it relates to a composition containing a peptide derived from a telomerase, which is effective in treating and preventing an ischemic injury.

[0002] An ischemic injury refers to a tissue injury caused by restriction in blood supply to organs requiring blood supply such as the heart, brain, kidneys, etc. (myocardial infarction, cerebral infarction, renal infarction, etc.), leading to dysfunction of the organs and increased mortality rate. The ischemic injury causes fatal complications of the heart, brain, kidneys, etc., increases the risk of acute rejection in organ transplantation and, in the long term, decreases the survival rate of the transplanted organ.

[0003] Substantial shortage of oxygen supply due to ischemia induces a pathological condition known as hypoxia. Prolonged ischemia and hypoxia can lead to functional loss of tissue and even cell death. Various spontaneous and iatrogenic pathological conditions induce ischemia and hypoxia. Non-limiting examples include vascular obstructive disease, coronary thrombosis, cerebrovascular thrombosis, aneurysm rupture, systemic hemorrhage, crush injury, sepsis, severe skin burn, vascular ligation surgery (e.g., spinal ischemia following thoracoabdominal aneurysm surgery), cardiopulmonary bypass, organ transplantation, cardiopulmonary collapse (sudden cardiac death), suffocation, etc.

[0004] In general, ischemia and hypoxia caused thereby are treated by restoring blood and oxygen supply to a normal level by increasing systemic oxygen supply or removing the cause of vascular occlusion. When compared with the situation where ischemia or hypoxia is prolonged, it is expected an improved result may be obtained by restoring blood supply. However, during the restoration of blood and oxygen supply, cell death or functional loss may be additionally induced apart from the damage caused by ischemia or hypoxia.

[0005] The additional damage induced during the restoration of blood and oxygen supply is known as reperfusion injury. The paradoxical tissue injury caused by reperfusion injury appears to be similar to an acute inflammatory condition resulting from the adherence of inflammatory cells to the reperfused tissues, activation of the inflammatory cells and subsequent generation of free radicals [Granger et al. Ann. Rev. Physiol., 57, 311-332, (1995)]. The generation of free radicals and other cytotoxic biomolecules within the reperfused tissue can induce cell death by activation of necrotic or apoptotic pathway.

[0006] Ischemic-reperfusion (IR) tissue injury occurring during organ transplantation results in deferred restoration of organ function after the organ transplantation and this often is an undesired prognostic sign in the maintenance of the function of the transplanted organ in the long term due to inflammatory tissue response. The initial ischemic-reperfusion injury occurring incidentally with the transplantation of organs, particularly kidneys, can lead to subsequent organ failure and transplant rejection.

[0007] Recently, renal ischemic-reperfusion injury (IRI) has been newly identified as one of acute inflammatory responses in which the inflammatory cells of both the innate immune system and the acquired immune system are involved.

[0008] A flap refers to a skin or tissue which is lifted from a site of the body and moved to another site, which includes a blood vessel that allows survival of the tissue. Flap surgery is used for lost soft tissue, chronic wound, etc. that cannot be treated with, for example, skin grafting. It is a surgical method the most frequently used in plastic and reconstructive surgery. In particular, it is advantageous in that primary reconstruction is possible through transplantation of various complex tissues including bone, tendon, muscle, nerve, etc., thereby allowing fast restoration. In the flap surgery, the survival rate of the flap is very important in the treatment of ischemic-reperfusion injury. Accordingly, a method of stably improving the flap survival rate will be very useful.

[0009] As described, an effective method for treating the frequently occurring ischemic-reperfusion injury is not readily available. Therefore, an effective method for preventing and treating ischemic-reperfusion injury will be valuable.

[0010] The inventors of the present disclosure have made efforts to develop a composition effective in treating and preventing ischemic-reperfusion injury and have completed the present disclosure.

[0011] The inventors of the present disclosure have found out that a peptide derived from a telomerase may have excellent effect of treating and preventing ischemic-reperfusion injury.

[0012] The present disclosure is directed to providing a composition effective in treating and preventing ischemic-reperfusion injury.

[0013] In an aspect, the present disclosure provides a composition for treating and preventing an ischemic injury, containing a peptide comprising an amino acid sequence of SEQ ID NO 1, a peptide having 80% or more sequence identity with the amino acid sequence or a peptide which is a fragment thereof.

[0014] In an exemplary embodiment of the present disclosure, the fragment may comprise three or more amino acids.

[0015] In an exemplary embodiment of the present disclosure, the ischemic injury may be caused by one or more selected from a group consisting of ischemic-reperfusion injury, vascular disease, coronary thrombosis, cerebrovascular thrombosis, aneurysm rupture, systemic hemorrhage, crush injury, sepsis, skin burn, vascular ligation surgery, cardiopulmonary bypass, organ transplantation, cardiopulmonary collapse (sudden cardiac death) and suffocation.

[0016] In an exemplary embodiment of the present disclosure, the ischemic injury may be caused by ischemic-reperfusion injury.

[0017] In an exemplary embodiment of the present disclosure, the ischemic-reperfusion injury may be selected from a group consisting of cerebrovascular ischemic-reperfusion injury, renal ischemic-reperfusion injury, hepatic ischemic-reperfusion injury, ischemic-reperfusion cardiomyopathy, ischemic-reperfusion skin injury, gastrointestinal ischemic-reperfusion injury, intestinal ischemic-reperfusion injury, gastric ischemic-reperfusion injury, ischemic-reperfusion lung injury, pancreatic ischemic-reperfusion injury, ischemic-reperfusion skeletal muscle injury, ischemic-reperfusion abdominal muscle injury, ischemic-reperfusion limb injury, ischemic-reperfusion colitis, mesenteric ischemic-reperfusion injury and asymptomatic ischemic-reperfusion injury.

[0018] In an exemplary embodiment of the present disclosure, the ischemic-reperfusion injury may be caused by organ transplantation.

[0019] In an exemplary embodiment of the present disclosure, the ischemic-reperfusion injury may occur in the kidneys.

[0020] In an exemplary embodiment of the present disclosure, the ischemic-reperfusion injury may occur in a flap.

[0021] In an exemplary embodiment of the present disclosure, the peptide may be derived from human telomerase.

[0022] In an exemplary embodiment of the present disclosure, the composition may be a pharmaceutical composition.

[0023] In an exemplary embodiment of the present disclosure, the composition may be a food composition.

[0024] In another aspect, the present disclosure provides a method for treating and preventing an ischemic injury, including administering the above-described composition to a subject in need thereof.

[0025] A peptide comprising an amino acid sequence of SEQ ID NO 1, a peptide having 80% or more sequence identity with the amino acid sequence or a peptide which is a fragment thereof has a superior effect of treating and preventing an ischemic injury. Accordingly, a composition containing the peptide may be effectively used for an ischemic injury, particularly for ischemic-reperfusion injury caused by organ transplantation, etc.

[0037] The present disclosure can be modified and embodied in various ways. Hereinafter, the present disclosure will be described in more detail through exemplary embodiments. However, the following examples are not intended to be limitative of the present disclosure. Rather, the present disclosure can be variously changed based on the appended claims. It is to be understood that the present disclosure includes any change, equivalent or substitute that falls within the technical idea and scope of the present disclosure. In the description, details of well-known features and techniques may be omitted to avoid unnecessarily obscuring the presented embodiments.

[0038] Telomere is known as a repetitive sequence of genetic material found at the ends of chromosomes that prevent chromosomes from damage or merging onto other chromosomes. The length of the telomere is shortened at each cell division, and after a certain number of cell division, the telomere length is extremely shortened to the extent in which the cell stops dividing and dies. On the other hand, the elongation of telomeres is known to extend the life span of a cell. For an example, cancer cells excrete an enzyme called telomerase, which prevents shortening of telomeres, thus resulting in proliferation of cancer cells. The inventors of the present disclosure have identified that a peptide derived from telomerase is effective in treating and preventing ischemic-reperfusion injury and have completed the present disclosure.

[0039] In an exemplary embodiment of the present disclosure, a peptide of SEQ ID NO: 1, a peptide which is a fragment of the peptide of SEQ ID NO: 1 or a peptide having 80% or more sequence identity with the peptides includes a peptide derived from telomerase, specifically human (Homo sapiens) telomerase.

[0040] The peptides disclosed herein may include peptides comprising an amino acid sequence at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99% of sequence homology with the peptide of SEQ ID NO: 1 or a fragment thereof. Moreover, the peptides disclosed in the present invention may include peptides having differences from SEQ ID NO: 1 or a fragment thereof in at least one amino acids, at least 2 amino acids, at least 3 amino acids, at least 4 amino acids, at least 5 transformed amino acids, at least 6 transformed amino acids, or at least 7 amino acids.

[0041] In one embodiment of the present invention, changes in amino acids include modifications of peptide's physical and chemical characteristics. For example, amino acid modification can be performed for improving thermal stability of the peptide, altering substrate specificity, and changing the optimal pH.

[0042] The term “amino acid” herein includes not only the 22 standard amino acids that are naturally integrated into a peptide but also the D-isomers and modified amino acids. Therefore, in a specific embodiment of the present invention, a peptide herein includes a peptide having D-amino acids. On the other hand, a peptide may include non-standard amino acids such as those that have been post-translationally modified. Examples of post-translational modification include phosphorylation, glycosylation, acylation (including acetylation, myristorylation, plamitoylation), alkylation, carboxylation, hydroxylation, glycation, biotinylation, ubiquitinylation, modification in chemical properties (e.g. β-removing deimidation, deamidation) and structural modification (e.g. formation of disulfide bridge). Also, changes of amino acids include the changes of amino acids that occur due to chemical reaction during the combination process with cross-linkers for formation of a peptide conjugate, such as changes in an amino group, carboxyl group or side chain.

[0043] A peptide disclosed herein may be a wild-type peptide that has been identified and isolated from natural sources. On the other hand, when compared to SEQ ID NO: 1 or its fragments, the peptides disclosed herein may be artificial variants that comprise one or more amino acids substituted, deleted and/or inserted. Amino acid alteration in wild-type polypeptides—not only in artificial variants—comprises protein folding and/or conservative substitutions of amino acids that do not influence activities significantly. Examples of conservative substitutions may be within the groups of basic amino acids (arginine, lysine and histidine), acidic amino acids (glutamic acid and aspartic acid), polar amino acids (glutamine and asparagines), hydrophobic amino acids (leucine, isoleucine, valine and methionine), aromatic amino acids (phenylalanine, tryptophan and tyrosine), and small amino acids (glycine, alanine, serine, and threonine). The amino acid substitutions that do not generally alter the specific activities are known in the art. Most common occurring alterations are Ala/Ser, Val/Ile, Asp/Glu, Thr/Ser, Ala/Gly, Ala/Thr, Ser/Asn, Ala/Val, Ser/Gly, Tyr/Phe, Ala/Pro, Lys/Arg, Asp/Asn, Leu/Ile, Leu/Val, Ala/Glu, Asp/Gly, and the opposite alterations thereof Other examples of conservative substitutions are shown in the following table 2.

TABLE 2
Original	Examples of	Preferable
amino	residue	residue
acid	substitution	substitution
Ala (A)	val; leu; ile	Val
Arg (R)	lys; gln; asn	Lys
Asn (N)	gln; his; asp, lys; arg	Gln
Asp (D)	glu; asn	Glu
Cys (C)	ser; ala	Ser
Gln (Q)	asn; glu	Asn
Glu (E)	asp; gln	Asp
Gly (G)	ala	Ala
His (H)	asn; gln; lys; arg	Arg
Ile (I)	leu; val; met; ala; phe; norleucine	Leu
Leu (L)	norleucine; ile ; val; met; ala; phe	Ile
Lys (K)	arg; gln; asn	Arg
Met (M)	leu; phe; ile	Leu
Phe (F)	leu; val; ile; ala; tyr	Tyr
Pro (P)	ala	Ala
Ser (S)	thr	Thr
Thr (T)	ser	Ser
Trp (W)	tyr; phe	Tyr
Tyr (Y)	trp; phe ; thr; ser	Phe
Val (V)	ile; leu; met; phe; ala; norleucine	Leu

[0044] The substantial modification of the biological properties of peptides are performed by selecting significantly different substitution in the following efficacies: (a) the efficacy in maintaining the structure of the polypeptide backbone in the area of substitution, such as sheet or helical three-dimensional structures, (b) the efficacy in maintaining electrical charge or hydrophobicity of the molecule in a target area, or (c) the efficacy of maintaining the bulk of the side chain. Natural residues are divided into groups by general side chain properties as the following:

[0045] (1) hydrophobicity: Norleucine, met, ala, val, leu, ile;

[0046] (2) neutral hydrophilicity: cys, ser, thr;

[0047] (3) acidity: asp, glu;

[0048] (4) basicity: asn, gln, his, lys arg;

[0049] (5) residue that affects chain orientation: gly, pro; and

[0050] (6) aromaticity: trn, tyr, phe.

[0051] Non-conservative substitutions may be performed by exchanging a member of the above classes with that of different classes. Any cysteine residues that are not related to maintaining the proper three-dimensional structure of the peptide can typically be substituted with serine, thus increasing the oxidative stability of the molecule and preventing improper cross-linkage. Conversely, improvement of stability can be achieved by adding cysteine bond(s) to the peptide.

[0052] Another type of amino acid variants of peptides are those having a changed pattern of peptide glycosylation. The term “change” herein means deletion of at least one carbohydrate residues that are found in a peptide and/or addition of at least one glycosylated residues that do not exist within a peptide

[0053] Glycosylation in peptides are typically N-linked or 0-linked. The term “N-linked” herein refers to that carbohydrate residues are attached to the side chain of asparagine residues. As tripeptide sequences, asparagine-X-serine and asparagine-X-threonine (wherein the X is any amino acid except proline) are a recognition sequence for attaching a carbohydrate residue enzymatically to the side chain of asparagine. Therefore, with the presence of one of these tripeptide sequences in a polypeptide, the potential glycosylation sites are created. “O-linked glycosylation” means attaching one of sugar N-acetylgalactosamine, galactose, or xylose to hydroxyl amino acids. The hydroxyl amino acids are most typically serine or threonine, but 5-hydroxyproline or 5-hydroxylysine can be used.

[0054] Addition of glycosylation site to a peptide is conveniently performed by changing an amino acid sequence to contain the tripeptide sequence mentioned above (for N-linked glycosylation sites). These changes may be made by addition of at least one serine or threonine residues to the first peptide sequence, or by substitution with those residues (for O-linked glycosylation sites).

[0055] In the present disclosure, “ischemic injury” refers to a damage occurring as a result of restriction in blood supply and hence shortage of oxygen supply to organs requiring blood supply such as the heart, brain, kidneys, etc., which can lead to dysfunction of tissues and cell death. The cause of an ischemic injury includes vascular disease, coronary thrombosis, cerebrovascular thrombosis, aneurysm rupture, systemic hemorrhage, crush injury, sepsis, severe skin burn, vascular ligation surgery (e.g., spinal ischemia during thoracoabdominal aneurysm surgery), cardiopulmonary bypass, organ transplantation, cardiopulmonary collapse (sudden cardiac death), suffocation, etc., but is not limited thereto.

[0056] In the present disclosure, the “ischemic injury” also includes ischemic-reperfusion injury that may occur, for example, during organ transplantation. The ischemic-reperfusion injury includes cerebrovascular ischemic-reperfusion injury, renal ischemic-reperfusion injury, hepatic ischemic-reperfusion injury, ischemic-reperfusion cardiomyopathy, ischemic-reperfusion skin injury, gastrointestinal ischemic-reperfusion injury, intestinal ischemic-reperfusion injury, gastric ischemic-reperfusion injury, ischemic-reperfusion lung injury, pancreatic ischemic-reperfusion injury, ischemic-reperfusion skeletal muscle injury, ischemic-reperfusion abdominal muscle injury, ischemic-reperfusion limb injury, ischemic-reperfusion colitis, mesenteric ischemic-reperfusion injury, asymptomatic ischemic-reperfusion injury, etc., but is not limited thereto.

[0057] The ischemic-reperfusion injury can occur frequently during organ transplantation. For example, it is known that gradual functional loss and dysfunction of a transplanted kidney is associated with ischemic-reperfusion injury and the activation of the innate immune system by the ischemic reperfusion tissue injury is one of the important causes.

[0058] The peptide having a sequence of SEQ ID NO: 1, the peptide which is a fragment of the peptide having the sequence of SEQ ID NO: 1 or the peptide having 80% or more sequence identity with the peptide according to the present disclosure are advantageous in that they exhibit a high in-vivo stability because of low toxicity. The peptide of SEQ ID NO: 1 is derived from telomerase and consists of 16 amino acids.

[0059] The peptide described in SEQ ID NO: 1 is same as the following table 1. The “name” in Table 1 below was used for distinction of peptides. In one aspect, the peptide of SEQ ID NO:1 is the entire peptide of a human telomerase. In a different specific embodiment of the present invention, the peptide having a sequence of SEQ ID NO: 1, the peptide which is a fragment of the peptide having the sequence of SEQ ID NO 1 or the peptide having 80% or more sequence identity with the peptide according to the present disclosure includes “synthetic peptides” synthesized by selecting and synthesizing a peptide corresponding to the pertinent position within the telomerase. SEQ ID NO: 2 is the amino acid sequence of the entire telomerase.

TABLE 1
SEQ
ID		POSITION IN
No.	Name	TELOMERASE	SEQUENCE	LENGTH
1.	pep1	[611-626]	EARPALLTSRLRFIPK	16 aa
2.	Telomerase	[1-1132]	MPRAPRCRAVRSLLRSHYRE	1132 aa
			VLPLATFVRRLGPQGWRLVQ
			RGDPAAFRALVAQCLVCVP
			WDARPPPAAPSFRQVSCLKE
			LVARVLQRLCERGAKNVLAF
			GFALLDGARGGPPEAFTTSV
			RSYLPNTVTDALRGSGAWGL
			LLRRVGDDVLVHLLARCALF
			VLVAPSCAYQVCGPPLYQLG
			AATQARPPPHASGPRRRLGC
			ERAWNHSVREAGVPLGLPAP
			GARRRGGSASRSLPLPKRPRR
			GAAPEPERTPVGQGSWAHPG
			RTRGPSDRGFCVVSPARPAEE
			ATSLEGALSGTRHSHPSVGR
			QHHAGPPSTSRPPRPWDTPCP
			PVYAETKHFLYSSGDKEQLR
			PSFLLSSLRPSLTGARRLVETI
			FLGSRPWMPGTPRRLPRLPQ
			RYWQMRPLFLELLGNHAQC
			PYGVLLKTHCPLRAAVTPAA
			GVCAREKPQGSVAAPEEEDT
			DPRRLVQLLRQHSSPWQVYG
			FVRACLRRLVPPGLWGSRHN
			ERRFLRNTKKFISLGKHAKLS
			LQELTW
			KMSVRDCAWLRRSPGVGCV
			PAAEHRLREEILAKFLHWLM
			SVYVVELLRSFFYVTETTFQK
			NRLFFYRKSVWSKLQSIGIRQ
			HLKRVQLRELSEAEVRQHRE
			ARPALLTSRLRFIPKPDGLRPI
			VNMDYVVGARTFRREKRAE
			RLTSRVKALFSVLNYERARR
			PGLLGASVLGLDDIHRAWRT
			FVLRVRAQDPPPELYFVKVD
			VTGAYDTIPQDRLTEVIASIIK
			PQNTYCVRRYAVVQKAAHG
			HVRKAFKSHVSTLTDLQPYM
			RQFVAHLQETSPLRDAVVIE
			QSSSLNEASSGLFDVFLRFMC
			HHAVRIRGKSYVQCQGIPQG
			SILSTLLCSLCYGDMENKLFA
			GIRRDGLLLRLVDDFLLVTPH
			LTHAKTFLRTLVRGVPEYGC
			VVNLRKTVVNFPVEDEALGG
			TAFVQMPAHGLFPWCGLLLD
			TRTLEVQSDYSSYARTSIRAS
			LTFNRGFKAGRNMRRKLFGV
			LRLKCHSLFLDLQ
			VNSLQTVCTNIYKILLLQAYR
			FHACVLQLPFHQQVWKNPTF
			FLRVISDTASLCYSILKAKNA
			GMSLGAKGAAGPLPSEAVQ
			WLCHQAFLLKLTRHRVTYVP
			LLGSLRTAQTQLSRKLPGTTL
			TALEAAANPALPSDFKTILD

[0060] In an aspect, the present disclosure provides a composition for treating and preventing an ischemic injury, containing a peptide comprising an amino acid sequence of SEQ ID NO: 1, a peptide having 80% or more sequence identity with the amino acid sequence or a peptide which is a fragment thereof as an active ingredient.

[0061] In one embodiment of the present invention, the composition may contain 0.1 μg/mg to 1 mg/mg, specifically 1 μg/mg to 0.5 mg/mg, more specifically 10 μg/mg to 0.1 mg/mg of a peptide comprising amino acid sequence of at least one of SEQ ID NO: 1, a peptide comprising a amino acid sequence at least 80% sequence homology with the above-mentioned sequences, or a fragment of the above-mentioned peptides. When the peptide is contained in the above-mentioned ranges, both of safety and stability of the composition can be satisfied and the ranges are appropriate in terms of cost-effectiveness.

[0062] In one embodiment of the present invention, the composition may have applications with all animals including human, dog, chicken, pig, cow, sheep, guinea pig, and monkey.

[0063] In an exemplary embodiment, the present disclosure provides a pharmaceutical composition for treating and preventing ischemic-reperfusion injury, containing a peptide comprising an amino acid sequence of SEQ ID NO: 1, a peptide having 80% or more sequence identity with the amino acid sequence or a peptide which is a fragment thereof as an active ingredient.

[0064] In one embodiment of the present invention, the pharmaceutical composition may be administered through oral, rectal, transdermal, intravenous, intramuscular, intraperitoneal, in the bone marrow, epidural or subcutaneous routes.

[0065] Forms of oral administration may be, but not limited to, tablets, pills, soft or hard capsules, granules, powders, solution, or emulsion. Forms of non-oral administration can be, but not limited to, injections, drips, lotions, ointments, gels, creams, suspensions, emulsions, suppository, patch, or spray.

[0066] In one embodiment of the present invention, the pharmaceutical composition, if necessary, may contain additives, such as diluents, excipients, lubricants, binders, disintegrants, buffers, dispersants, surfactants, coloring agents, aromatics or sweeteners. In one embodiment of the present invention, the pharmaceutical composition may be manufactured by conventional methods of the industry in the art.

[0067] In one embodiment of the present invention, the dose of the active ingredient of the medical composition may vary according to the patient's age, sex, weight, pathology and state, administration route, or prescriber's judgment. Dosage based on these factors may be determined within levels of those skilled in the art, and the daily dose, for example, may be, but not limited to, 0.1 μg/kg/day to 1 g/kg/day, specifically 1 μg/kg/day to 10 mg/kg/day, more specifically the 10 μg/kg/day to 1 mg/kg/day, more specifically the 50 μg/kg/day to 100 μg/kg/day. In one embodiment of the present invention, the pharmaceutical composition may be administered, but not limited to, 1 to 3 times a day.

[0068] In an exemplary embodiment, the present disclosure provides a food composition for treating and preventing ischemic-reperfusion injury, containing a peptide comprising an amino acid sequence of SEQ ID NO: 1, a peptide having 80% or more sequence identity with the amino acid sequence or a peptide which is a fragment thereof as an active ingredient.

[0069] In one embodiment of the present invention, food composition is not limited to specific forms, but, for example, may be tablets, granules, powder, liquid, and solid forms. Each form may be formed with ingredients commonly used in the industry appropriately chosen by those skilled in the art, in addition to the active ingredient, and may produce a synergic effect in combination of other ingredients.

[0070] Decision for dosage on the above-mentioned active ingredient is within the level of those skilled in the art, and daily dosage, for example, may be 1 μg/kg/day to 10 mg/kg/day, more specifically the 10 μg/kg/day to 1 mg/kg/day, more specifically the 50 μg/kg/day to 100 μg/kg/day, but not limited to these numbers and can vary according to age, health status, complications and other various factors.

[0071] The terms used herein is intended to be used to describe the embodiments, not to limit the present invention. Terms without numbers in front are not to limit the quantity but to show that there may be more than one thing of the term used. The terms “comprising”, “having”, “including” and “containing” shall be interpreted openly (i.e. “including but not limited to”).

[0072] Mention of a numerical range is used instead of stating separate numbers within the range, so unless it is explicitly stated, the range should be construed as if all the numbers within the range are separately described herein. The end values of all the ranges are included in the range and can be combined independently.

[0073] Unless otherwise noted or clearly contradicting in context, all methods mentioned herein can be performed in a proper order. The use of any one embodiment and all embodiment, or exemplary language (e.g., “such as”, “like”), unless included in the claims, is used to more clearly describe the present invention, not to limit the scope of the present invention. Any language herein outside of the claims should not be interpreted as a necessity of the present invention. Unless defined otherwise, technical and scientific terms used herein have meanings ordinarily understood by a person skilled in the art that the present invention belongs to.

[0074] The preferred embodiments of the present invention include the best mode known to the inventors to perform the present invention. Variations in the preferred embodiments can become clear to those skilled in the art after reading the statements above. The present inventors hope that those skilled in the art can use the variations adequately and present invention be conducted in other ways than listed herein. Thus, the present invention, as allowed by the patent law, includes equivalents, modifications and variations thereof, of the key points of the invention stated in the appended claims. In addition, all possible variations within any combination of the above-mentioned components are included in the present invention, unless explicitly stated otherwise or contradicting in context. Although the present invention is described and shown by exemplary embodiments, those skilled in the art will understand well that there can be various changes in the form and details without departing from the spirit of the invention and range, defined by the claims below.

[0075] In the following examples, the effect of a peptide having a sequence of SEQ ID NO: 1 (PEP 1) of preventing and treating an ischemic injury was investigated by administering the peptide to ischemic-reperfusion injury portions induced by renal and rectus abdominis myocutaneous flaps and confirming the effect of inhibiting renal injury and improving flap survivability.

[0076] Hereinafter, the present disclosure will be described in detail through examples and test examples. However, the following examples and test examples are for illustrative purposes only and it will be apparent to those of ordinary skill in the art that the scope of the present disclosure is not limited by the examples and test examples.

[0077] The peptide of SEQ ID NO: 1 was synthesized according to the conventionally known method of solid phase peptide synthesis. More specifically, the peptide was synthesized by coupling each amino acid from C-terminus through Fmoc solid phase peptide synthesis, SPPS, using ASP48S (Peptron, Inc., Daejeon ROK). Those peptides with their first amino acid at the C-terminus being attached to a resin were used as follows:

• • [0078] NH₂-Lys(Boc)-2-chloro-Trityl Resin
  • [0079] NH₂-Ala-2-chloro-Trityl Resin
  • [0080] NH₂-Arg(Pbf)-2-chloro-Trityl Resin

[0081] All the amino acids to synthesize the peptide were protected by Fmoc at the N-terminus, and the amino acid residues were protected by Trt, Boc, t-Bu (t-butylester), Pbf (2,2,4,6,7-pentamethyl dihydro-benzofuran-5-sulfonyl) that can be dissolved in an acid. Examples include the followings:

• • [0082] Fmoc-Ala-OH, Fmoc-Arg(Pbf)-OH, Fmoc-Glu(OtBu)-OH, Fmoc-Pro-OH, Fmoc-Leu-OH, Fmoc-Ile-OH, Fmoc-Phe-OH, Fmoc-Ser(tBu)-OH, Fmoc-Thr(tBu)-OH, Fmoc-Lys(Boc)-OH, Fmoc-Gln(Trt)-OH, Fmoc-Trp(Boc)-OH, Fmoc-Met-OH, Fmoc-Asn(Trt)-OH, Fmoc-Tyr(tBu)-OH, Fmoc-Ahx-OH, Trt-Mercaptoacetic acid.

[0083] HBTU[2-(1H-Benzotriazole-1-yl)-1,1,3,3-tetamethylaminium hexafluorophosphate]/HOBt[N-Hydroxybenzotriazole]/NMM[4-Methylmorpholine] were used as the coupling reagents. Piperidine in 20% DMF was used to remove Fmoc. In order to remove the protection from residues or to separate the synthesized peptides from Resin, cleavage cocktail [TFA (trifluoroacetic acid)/TIS (triisopropylsilane)/EDT (ethanedithiol)/H₂O=92.5/2.5/2.5/2.5] was used.

[0084] The peptide synthesis was performed by using solid phase scaffold with the repetition of the following processes : starting with the amino acid protection, separate reaction of each amino acid, washing with solvents, and deprotection. Each peptide was synthesized by using the solid phase scaffold combined to starting amino acid with the amino acid protection, reacting the corresponding amino acids separately, washing with a solvent and deprotected, and repeating the processes. Upon the release from the resin, the synthesized peptides were purified by HPLC, validated by Mass Spectrometry, and freeze-dried, and verify for synthesis by MS, and then freeze-dried.

[0085] The purity of the prepared peptide was found to be 95% or higher by high-performance liquid chromatography.

[0086] A specific peptide synthesis process is described as the following based on the synthesis process of PEP 1 which has SEQ ID NO: 1.

[0087] 1) Coupling

[0088] The amino acid (8 equivalent) protected with NH₂-Lys(Boc)-2-chloro-Trityl Resin, and coupling agent HBTU(8 equivalent)/HOBt(8 equivalent)/NMM(16 equivalent) melted in DMF were mixed together, and incubated at room temperature (RT) for 2 hr. Following the incubation, the reaction mixture was subjected to the sequential washes of DMF, MeOH, and DMF.

[0089] 2) Fmoc deprotection

[0090] Piperidine in 20% DMF was added and incubated at RT for 5 minutes 2 times, then sequentially washed with DMF, MeOH, and DMF.

[0091] 3) Making the basic framework of peptide, NH₂-E(OtBu)-A-R(Pbf)-P-A-L-L-T(tBu)-S(tBu)-R(Pbf)L-R(Pbf)-F-I-P-K(Boc)-2-chloro-Trityl Resin) by repeating the above mentioned reactions 1) and 2).

[0092] 4) Cleavage: Cleavage Cocktail was added to the completely synthesized peptide, thus separating the synthesized peptide from the resin.

[0093] 5) Pre-chilled diethyl ether was added into the obtained mixture, and then centrifugation was used to precipitate gathered peptide.

[0094] 6) After purification by Prep-HPLC, the molecular weight was confirmed by LC/MS and lyophilized to produce in a powder form.

[0095] A renal ischemic-reperfusion injury mouse model was established by inducing ischemic reperfusion by bilaterally clamping renal pedicles for 30 minutes and restoring blood flow 30 minutes later by removing the clamps. Test groups were divided into an administered group (PEP 1), a control group (PBS without PEP 1), and a sham group (no bilateral clamping). PEP 1 was subcutaneously injected at a concentration of 1000 nmol/kg 30 minutes before and 12 hours after the induction of ischemic reperfusion.

[0096] C57BL/6 mouse (8 weeks old; Charles River Laboratories, Wilmington, Mass.) was used to induce renal ischemic-reperfusion injury. After blocking blood flow by clamping the renal pedicles with vascular forceps and inducing ischemia for 28 minutes, reperfusion was performed.

[0097] The peptide PEP 1 was diluted in PBS to a concentration of 1000 nmol/kg and intraperitoneally (i.p.) injected twice 30 minutes before and 12 hours after the ischemic reperfusion. The test was conducted for the administered group (PEP 1), the control group (PBS), and the sham group (no ischemic reperfusion).

[0098] Blood was taken 24 hours after the ischemic reperfusion and the levels of blood urea nitrogen (BUN) and creatine as renal toxicity markers were measured. Renal tissue was taken and prepared into paraffin blocks for immunohistochemical and histological studies. Then, proteins were extracted and the levels of cytokines were measured. The concentrations of creatine and BUN were measured using an autoanalyzer (Technicon RA-1000; Bayer, Tarrytown, N.Y.).

[0099] As a result, the PEP 1-administered group showed significantly decreased BUN and creatine levels as compared to the PBS control group (FIG. 1).

[0100] Renal tissue was stained with periodic acid-Schiff (PAS) stain according to the protocol of the manufacturer (Polysciences, Inc., Warrington, Pa., USA) 24 hours after the ischemic reperfusion. After the staining, renal tissue injury was evaluated through renal tissue injury scoring. The PEP 1-administered group showed remarkably decreased renal tissue injury as compared to the PBS control group (FIG. 2 and FIG. 3).

[0101] Renal apoptosis was evaluated by staining renal tissue with TUNEL stain 24 hours after the ischemic reperfusion. Renal paraffin sections were stained with TUNEL using a TUNEL staining kit (Roche Applied Science, Indianapolis, Ind., USA).

[0102] As a result, the PEP 1-administered group showed remarkably decreased TUNEL-positive cells as compared to the PBS control group, indicating that PEP 1 inhibits the cell death of the renal tissue (FIG. 4 and FIG. 5).

[0103] Infiltration of innate immune cells was evaluated by immnohistologically staining renal tissue with F4/80 (macrophage maker) and Gr-1 (neutrophil maker) 24 hours after the ischemic reperfusion. Specifically, macrophage-specific antibody (F4/80; Abcam, Cambridge, Mass.) was used to immunochemically stain infiltrating macrophages and neutrophils in paraffin sections.

[0104] The PEP 1-administered group showed remarkably decreased infiltration of macrophages and neutrophils into renal tissue as compared to the PBS control group (FIG. 6 and FIG. 7).

[0105] Protein was extracted from renal tissue 24 hours after the ischemic reperfusion and the levels of IL-6, MCP-1 and TNF-α were measured according to the cytometric bead array method. Mouse IL-6, MCP-1, TNF-α ELISA kits were purchased from R&D Systems and the test was conducted according to the manufacturer's protocol.

[0106] As a result, the PEP 1-administered group showed significantly decreased IL-6 and MCP-1 levels as compared to PBS control group, whereas no significant difference was observed for TNF-α (FIGS. 8-10).

[0107] As described above, the PEP 1's effect of preventing renal ischemic-reperfusion injury was evaluated by testing renal failure (BUN and creatine), renal tissue injury (tubular injury), renal apoptosis, immune cell infiltration and secretion of cytokines in renal tissue.

[0108] The PBS control group showed increased serum BUN and creatine levels and increased renal tissue injury as compared to the sham group. In contrast, the PEP 1-administered group showed significantly decreased BUN and creatine levels and decreased renal tissue injury and renal apoptosis as compared to the control group. Also, the PEP 1-administered group showed inhibited infiltration of inflammatory cells (neutrophils and macrophages) and significantly inhibited secretion of inflammatory cytokines (interleukin-6 and monocyte chemotactic protein-1) in the kidneys as compared to the PBS control group.

[0109] A rat model of ischemic-reperfusion injury was established by acquiring 5 cm×5 cm skin flaps from the abdomen of Sprague-Dawley rats (weighing 180-230 g), administering PEP1 or saline, inducing local ischemia through clamping and then restoring blood flow 7 hours later by removing the clamps (see FIG. 11).

[0110] Test groups were divided into an administered group (PEP 1), a control group (PBS without PEP 1), and a sham group (no ischemic-reperfusion injury induced). PEP 1 (10 mg/500 μL) or PBS (500 μL) was intramuscularly injected 30 minutes before and 1, 2, 3, 4, 5 and 7 days after the induction of ischemic reperfusion.

[0111] Flap survivability was measured 7 days after the induction of ischemic reperfusion. The flap survival rate was measured through analysis of digital images using the imageJ program.

[0112] As a result, the flap survival rate of the PBS-treated group was 34.69%±16.44% and the PEP1-treated group showed improved flap survival rate of 58.88%±11.44% (see FIG. 12). A statistical significance (p<0.05) was found between the groups.