NZ329583A - Use of a BPI protein and an antibiotic to treat bacterial infections - Google Patents

Abstract

Methods and compositions for treating gram-negative bacterial infections, using BPI protein products in concurrence administration with an antibiotic in treatment of gram-negative bacterial infections improves the therapeutic effectiveness of the antibiotic. This includes increasing antibiotic susceptibility of gram-negative bacteria and reversing resistance of the bacteria to antibiotics.

Description

♦ 329583 Divided out of Application PATENTS FORM 5 Number 275205 PATENTS ACT 1953 Dated 22 September 1994 COMPLETE SPECIFICATION METHOD OF TREATING GRAM-NEGATIVE BACTERIAL INFECTION BY ADMINISTRATION OF BACTERICIDAL/PERMEABILITY-INCREASING (BPI) PROTEIN PRODUCT AND ANTIBIOTIC We, XOMA CORPORATION, a corporation organised under the laws of the State of Delaware, United States of America of 2910 Seventh Street, Berkeley, California 94710, United States of America, do hereby declare the invention for which we pray that a patent may be granted to us, and the method by which it is to be performed, to be particularly described in and by the following statement. (followed by page 1A) Intellectual Property Office of NZ 1 h JAM 1998 17534 WGN METHOD OF TREATING GRAM-NEGATIVE BACTERIAL INFECTION BY ADMINISTRATION OF BACTERICIDAL/PERMEABILITY-INCREASING (BPI) PROTEIN PRODUCT AND ANTIBIOTIC BACKGROUND OF THE INVENTION The present invention relates generally to methods 10 for treating giam-negative bacterial infections, and more specifically to the use of bactericidal/penneability-increasing protein (BPI) protein products for co-treatment of such infections with an antibiotic substance. Co-treatment with BPI protein products can improve the therapeutic effectiveness of antibiotics in gram-negative bacterial infections, increase the susceptibility of gram-negative organisms to 15 antibiotics, and reverse resistance of gram-negative organisms to antibiotics.

BPI is a protein isolated from the granules of mammalian polymorphonuclear leukocytes (PMNs or neutrophils), which are blood cells essential in the defense against invading microorganisms. Human BPI protein has been isolated from PMNs by acid extraction combined with either ion exchange 20 chromatography [Elsbach, J. Biol. Chem., 254:11000 (1979)] or E. coli affinity chromatography [Weiss, et al., Blood, 69:652 (1987)]. BPI obtained in such a manner is referred to herein as natural BPI and has been shown to have potent bactericidal activity against a broad spectrum of gram-negative bacteria. The molecular weight of human BPI is approximately 55,000 daltons (55 kD). The amino 25 acid sequence of the entire human BPI protein and the nucleic acid sequence of DNA encoding the protein have been reported in Figure 1 of Gray et al., J. Biol. Chem., 264:9505 (1989), incorporated herein by reference. The Gray et al. amino acid sequence is set out in SEQ ID NO: 69 hereto.

BPI is a strongly cationic protein. The N-tenninal half of BPI accounts 30 for the high net positive charge: the C-terminaJ half of the molecule has a net charge of -3. [Elsbach and Weiss (1981). supra.] A proteolytic N-terminal fragment of BPI PCT/US94/1122S having a molecular weight of about 25 kD has an amphipathic character, containing alternating hydrophobic and hydrophilic regions. This N-terminal fragment of human BPI possesses the anti-bacterial efficacy of the naturally-derived 55 kD human BPI holoprotein. [Ooi et al., J. Bio. Chan., 262: 14891-14894 (1987)]. In contrast to 5 the N-terminal portion, the C-terminal region of the isolated human BPI protein displays only slightly detectable anti-bacterial activity against gram-negative organisms. [Ooi et al., J. Exp. Med., 174:649 (1991).] An N-terminal BPI fragment of approximately 23 kD, referred to as "rBPI^," has been produced by recombinant means and also retains anti-bacterial activity against gram-negative organisms. 10 Gazzano-Santoro et al., Infect. Immun. 6&.4754-4761 (1992).

The bactericidal effect of BPI has been reported to be highly specific to gram-negative species, e.g., in Elsbach and Weiss, Inflammation: Basic Principles and Clinical Correlates, eds. Gallin et al., Chapter 30, Raven Press, Ltd. (1992). BPI is commonly thought to be non-toxic for other microorganisms, including yeast, 15 and for higher eukaryotic cells. Elsbach and Weiss (1992), supra, reported that BPI exhibits anti-bacterial activity towards a broad range of gram-negative bacteria at concentrations as low as 10"1 to 10"9 M, but that 100- to 1,000-fold higher concentrations of BPI were non-toxic to all of the gram-positive bacterial species, yeasts, and higher eukaryotic cells tested at that time. It was also reported that BPI 20 al a concentration of 1CT5 M or 160 fxg/ml had no toxic effect, when tested at a pH of either 7.0 or 5.5, on the gram-positive organisms Staphylococcus aureus (four strains), Staphylococcus epidermidis, Streptococcus faecalis, Bacillus subtilis, Micrococcus tysodeikricus, and Listeria monocytogenes. BPI at 10"6 M reportedly had no toxic effect on the fungi Candida albicans and Candida parapsilosis at pH 7.0 or 25 5.5, and was non-toxic to higher eukaryotic cells such as human, rabbit and sheep red blood cells and several human tumor cell lines. See also Elsbach and Weiss, Advances in Inflammation Research, ed. G. Weissmartn, Vol. 2, pages 95-113 Raven Press (1981). This reported target cell specificity was believed to be the result of the strong attraction of BPI for lipopoiysaccharide (I-PS), which is unique to the outer 30 membrane (or envelope) of gram-negative organisms.

The precise mechanism by which BPI kills gram-negative bacteria is not yet completeiy elucidated, but it is believed that BPI must first bind to the surface of the bacteria through electrostatic and hydrophobic interactions between the cationic BPI protein and negatively charged sites on LPS. LPS has been referred to as "endotoxin" because of the potent inflammatory response that it stimulates, i.e., the release of mediators by host inflammatory cells which may ultimately result in 5 irreversible endotoxic shock. BPI binds to lipid A, reported to be the most toxic and most biologically active component of LPS.

In susceptible gram-negative bacteria, BPI binding is thought to disrupt LPS structure, leading to activation of bacterial enzymes that degrade phospholipids and pcptidoglycans, altering the permeability of the cell's outer membrane, and 10 initiating events that ultimately lead to cell death. [Elsbach and Weiss (1992), supra]. BPI is thought to art in two stages. The first is a sublethal stage that is characterized by immediate growth arrest, permeabilizalion of the outer membrane and selective activation of bacterial enzymes that hydrolyze phospholipids and peptidoglycans. Bacteria at this stage can be rescued by growth in serum albumin supplemented media 15 [Mannion et al., J. Clin. Invest., 85:853-860 (1990)]. The second stage, defined by growth inhibition that cannot be reversed by serum albumin, occurs after prolonged exposure of the bacteria to BPI and is characterized by extensive physiologic and structural changes, including apparent damage to the inner cytoplasmic membrane.

Initial binding of BPI to LPS leads to organizational changes that 20 probably result from binding to the anionic groups in the KDO region of LPS, which normally stabilize the outer membrane through binding of Mg++ and Ca"*"\ Attachment of BPI to the outer membrane of gram-negative bacteria produces rapid permeabilization of the outer membrane to hydrophobic agents such as actinomycin D. Binding of BPI and subsequent gram-negative bacterial killing depends, at least 25 in part, upon the LPS polysaccharide chain length, with long O-chain bearing, "smooth" organisms being more resistant to BPI bactericidal effects than short O-chain bearing, "rough" organisms [Weiss et al., J. Clin. Invest. 65: 619-628 (1980)]. This first stage of BPI action, permeabilization of the gram-negative outer envelope, is reversible upon dissociation of the BPI, a process requiring the presence of divalent 30 cations and synthesis of new LPS [Weiss et al., J. Immunol. 132: 3109-3115 (1984)].

Loss of gram-negative bacterial viability, however, is not reversed by processes which restore the envelope integrity, suggesting that the bactericidal action is mediated by additional lesions induced in the target organism and which may be situated at the cytoplasmic membrane (Mannion et al., J. Clin. Invest. 86: 631-641 (1990)). Specific investigation of this possibility has shown that on a molar basis BPI is at least as inhibitory of cytoplasmic membrane vesicle function as polymyxin B 5 (In't Veld et al., Infection and Immunity 56: 1203-1208 (1988)) but the exact mechanism as well as the relevance of such vesicles to studies of intact organisms has not yet been elucidated.

BPI is also capable of neutralizing the endotoxic properties of LPS to which it binds. Because of its bactericidal properties for gram-negative organisms 10 and its ability to neutralize LPS, BPI can be utilized for the treatment of mammals suffering from diseases caused by gram-negative bacteria, such as bacteremia or sepsis.

U.S. Patent No. 5,198,541 discloses recombinant genes encoding and methods for expression of BPI proteins, including BPI holoprotein and fragments of 15 BPI. It also describes the use of N-terminal fragments of BPI protein for co-treatment with certain antibiotics, specifically penicillin, cephalosporins, rifampicin and actinomycin D.

Gram-negative bacteria include bacteria from the following species: Acidaminococcus, Acinetobacter, Aeromonas, Alcaligenes, Bacteroides, Bordetella, 20 Branhamella, Brucella, Caiymmaxobacterium, Campylobacter, Cardiobacterium, Chromobacterium, dtrobacter, Edwardsiella, Enterobacter, Escherichia, Flavobacterium, Francisella, Fusobacterium, Haemophilus, Klebsiella, Legionella, Moraxella, Morganella, Neisseria, Pasturella, Plesiomonas, Proteus, Providencia, Pseudomonas, Salmonella, Serraxia, Shigella, Streptobacillus, Veillonella, Vibrio, and 25 Yersinia species.

Antibiotics are natural chemical substances of relatively low molecular weight produced by various species of microorganisms, such as bacteria (including Bacillus species), actinomycetes (including Streptomyces) and fungi, that inhibit growth of or destroy other microorganisms. Substances of similar structure and mode 30 of action may be synthesized chemically, or natural compounds may be modified to produce semi-synthetic antibiotics. These biosynthetic and semi-synthetic derivatives are also effective as antibiotics. The major classes of antibiotics are (1) the 0- WO 95/08344 PCT/US94/11225 lactams, including the penicillins, cephalosporins and monobactams; (2) the aminoglycosides, e.g., gentaxnicin, tobramycin, netilmycin, and amikacin; (3) the tetracyclines; (4) the sulfonamides and trimethoprim; (5) the fluoroquinolones, e.g., ciprofloxacin, norfloxacin, and ofloxacin; (6) vancomycin; (7) the macrolides, which 5 include for example, erythromycin, azithromycin, and clarithromycin; and (8) other antibiotics, e.g., the polymyxins, chloramphenicol and the lincosamides.

Antibiotics accomplish their anti-bacterial effect through several mechanisms of action which can be generally grouped as follows: (1) agents acting on the bacterial cell wall such as bacitracin, the cephalosporins, cycloserine, 10 fosfomycin, the penicillins, ristocetin, and vancomycin; (2) agents affecting the cell membrane or exerting a detergent effect, such as colistin, novobiocin and polymyxins; (3) agents affecting cellular mechanisms of replication, information transfer, and protein synthesis by their effects on ribosomes, e.g., the aminoglycosides, the tetracyclines, chloramphenicol, clindamycin, cycloheximide, fucidin, lincomycin, 15 puromycin, rifampicin, other streptomycins, and the macrolide antibiotics such as erythromycin and oleandomycin; (4) agents affecting nucleic acid metabolism, e.g., the fluoroquinolones, actinomycin, ethambutol, 5-fluorocytosine, griseofulvin, rifamycins; and (5) drugs affecting intermediary metabolism, such as the sulfonamides, trimethoprim, and the tuberculostatic agents isoniazid and para-20 aminosalicylic acid. Some agents may have more than one primary mechanism of action, especially at high concentrations. In addition, secondary changes in the structure or metabolism of the bacterial cell often occur after the primary effect of the antimicrobial drug.

The penicillins have a characteristic double-ring system composed of 25 a ^-lactam ring, which provides the antibacterial activity, and a thiazolidene ring.

The penicillins are differentiated by a single side chain that is unique for each penicillin. Hie compounds are bactericidal and act by inhibiting bacterial transpeptidase, an enzyme involved in synthesis of the bacterial cell wall. Because of their mechanism of action, penicillins are generally active against growing, but not 30 resting, cells. Penicillins, especially penicillin G. have largely gram-positive activity ; the relative insensitivity of gram-negative rods to penicillin G and several other penicillins is probably due to the permeability barrier of the outer membrane of gram- negative bacteria. Ampicillin, carbenicillin, ticarciliin, and some other penicillins are active against gram-negative bacteria because they can pass through this outer membrane. Penicillins have relatively few adverse effects, the most important of which are the hypersensitivity (allergic) reactions. These compounds are widely 5 distributed in the body, but do not enter cells and do not usually accumulate in CSF.

Bacterial resistance to the penicillins is by production of the enzyme jS-lactamase, which catalyzes hydrolysis of the /S-lactam ring. The percentage of bacteria resistant to penicillin has risen to about 80%. Several penicillins, including methicillin, oxacillin, cloxacillin, dicloxacillin and nafcillin, are not affected by the 10 ^-lactamase of staphylococci. These antibiotics are useful against most /S-lactamase- producing species of Staphylococcus. However, a small number of species are resistant even to these penicillins. Some penicillins, amoxicillin and ticarciliin, are marketed in combination with clavuianic acid, which is a ^-lactamase inhibitor that covalently binds to the enzyme and prevents it from hydrolyzing the antibiotics. 15 Another inhibitor, sulbactam, is marketed in combination with ampicillin.

The cephalosporins are characterized by a /S-lactam ring, like the penicillins, but have an adjacent dihydrothiazine ring instead of a thiazolidene ring. For convenience, these compounds are generally classified by generations. The first generation includes cephalothin, cephapirin, cefazolin, cephalexin, cephradine and 20 cefadroxil. These drugs generally have excellent gram-positive activity except for enterococci and methicillin-resistant staphylococci, and have only modest gram-negative coverage. The second generation includes cefamandole, cefoxitin, ceforanide, cefuroxime, cefuroxime axetil, cefaclor, cefonicid and cefotetan. This generation generally loses some gram-positive activity by weight and gains limited 25 gram-negative coverage. The third generation includes cefotaxime, moxalactam, ceftizoxime, ceftriaxone, cefoperazone and ceftazidime. These compounds generally sacrifice further gram-positive activity by weight but gain substantial gram-negative coverage against Enterobacter and sometimes are active against Pseudomonas. The cephalosporins bind to penicillin-binding proteins with varying affinity. Once binding 30 occurs, protein synthesis is inhibited. Cephalosporins are usually well tolerated; adverse effects include hypersensitivity reactions and gastrointestinal effects. Cephalosporins may interact with nephrotoxic drugs, particularly aminoglycosides. to increase toxicity. Resistance to cephalosporins is mediated by several mechanisms, including production of ^-lactamase, although some strains that do not produce /S-lactamase are nevertheless resistant.

Imipenem is a N-fonnimidoyl derivative of the mold product 5 thienamycin. It contains a /S-lactam ring and somewhat resembles penicillin except for differences in the second ring. It has activity against both gram-positive and gram-negative organisms and is resistant to most ^-lactamases, although not those from Pseudomonas. It is marketed in combination with cilastin, a compound that inhibits inactivation of imipenem in the kidney by renal dihydropeptidase I enzyme. Cilastin 10 increases the concentration of imipenem in urine, although not in blood.

Aztreonam is the first of a new group of antibiotics referred to as the monobactams. These agents have a ^-lactam ring but lack the second ring characteristic of the penicillins and cephalosporins. It acts by binding to penicillin-binding proteins, and produces long, filamentous bacterial shapes that eventually lyse. 15 Aztreonam is active only against aerobic gram-negative bacteria, is susceptible to inactivation by some jS-lactamases, and has few adverse effects.

The aminoglycosides contain amino sugars linked to an aminocyclitol ring by glycosidic bonds. They have similar mechanisms of action and properties, but differ somewhat in spectrum of action, toxicity, and susceptibility to bacterial 20 resistance. The compounds are bactericidal, with activity against both gram-positive and gram-negative organisms, and act by binding to proteins on the 30S ribosome of bacteria and inhibiting protein synthesis. The aminoglycosides also bind to isolated LPS and have a very weak outer membrane permeabilizing effect. [Taber et al., Microbiological Reviews 53: 439-457 (1987)); Kadurugamuwa et al., Antimicrobial 25 Agents and Chemotherapy, 37: 715-721 (1993); Vaara, Microbiological Reviews 56: 395-411 (1992)]. This class of antibiotics includes amikacin, gentamicin, kanamycin, neomycin, netilmycin, paromomycin and tobramycin. The aminoglycosides are usually reserved for more serious infections because of severe adverse effects including ototoxicity and nephrotoxicity. There is a narrow therapeutic window 30 between the concentration required to produce a therapeutic effect, e.g., 8 ng/ml for gentamicin, and the concentration that produces a toxic effect, e.g., 12 ^g/'ml for gentamicin. Neomycin in particular is highly toxic and is never administered parenterally.

Tetracyclines have a common four-ring structure and are closely congeneric derivatives of the polycyclic naphthacenecarboxamide. The compounds 5 are bacteriostatic, and inhibit protein synthesis by binding to the 30S subunit of microbial ribosomes and interfering with attachment of aminoacyl tRNA. The compounds have some activity against both gram-positive and gram-negative bacteria; however, their use is limited because many species are now relatively resistant. Adverse effects include gastrointestinal effects, hepatotoxicity with large doses, and 10 nephrotoxicity in some patients. This antibiotic class includes tetracycline, chloitetracycline, demeclocycline, doxycycline, methacycline, minocycline and oxytetracycline.

The sulfonamides are derivatives of sulfanilamide, a compound similar in structure to paxa-aminobenzoic acid (PABA), which is an essential precursor for 15 bacterial synthesis of folic acid. The compounds are generally bacteriostatic, and act by competitively inhibiting incorporation of PABA into tetrahydrofolic acid, which is a required cofactor in the synthesis of thymidines, purines and DNA. Sulfonamides have a wide range of activity against gram-positive and gram-negative bacteria, but their usefulness has diminished with increasingly high prevalence of bacterial 20 resistance. The sulfonamide class of antibiotics includes sulfacytine, sulfadiazine, sulfamethizole, sulfisoxazole, sulfamethoxazole, sulfabenzamide and sulfacetamide. Adverse effects include hypersensitivity reactions and occasional hematological toxicity.

Trimethoprim is an inhibitor of the dihydrofolate reductase enzyme, 25 which converts dihydrofolic to tetrahydrofolic acid, a required factor for DNA synthesis. Adverse effects include gastrointestinal distress and rare hematological toxicity. Trimethoprim is also available in combination with sulfamethoxazole (also known as co-trimoxazole). The combination is usually bactericidal, although each agent singly is usually bacteriostatic. The combination is the drug of choice for 30 Salmonella infections, some Shigella infections, E. coli traveler's diarrhea and Pneumocystis carinii pneumonia.

The fluoroquinolones and quinolones are derivatives of nalidixic acid, a naphthyridine derivative. These compounds are bactericidal, and impair DNA replication, transcription and repair by binding to the DNA and interfering with DNA gyrase, an enzyme which catalyzes negative supercoiling of DNA. The 5 fluoroquinolones, which include norfloxacin, ciprofloxacin, and ofloxacin, and the quinolones, which include cinoxacin, have a broad spectrum of antimicrobial activity against gram-negative and gram-positive organisms. These compounds distribute widely through extravascular tissue sites, have a long serum half-life, and present few adverse effects. Because of their effect on DNA, the drugs are contraindicated in 10 pregnant patients and in children whose skeletal growth is incomplete.

Vancomycin is a glycopeptide, with a molecular weight of about 1500, produced by a fungus. It is primarily active against gram-positive bacteria. The drug inhibits one of the final steps in synthesis of the bacterial cell wall, and is thus effective only against growing organisms. It is used to treat serious infections due 15 to gram-positive cocci when penicillin G is not useful because of bacterial resistance or patient allergies. Vancomycin has two major adverse effects, ototoxicity and nephrotoxicity. These toxicities can be potentiated by concurrent administration of another drug with the same adverse effect, such as an aminoglycoside.

The macrolides are bacteriostatic and act by binding to the 50S subunit 20 of 70S ribosomes, resulting in inhibition of protein synthesis. They have a broad spectrum of activity against gram-positive and gram-negative bacteria and may be bacteriostatic or bactericidal, depending on the concentration achieved at sites of infection. The compounds distribute widely in body fluids. Adverse effects include gastrointestinal distress and rare hypersensitivity reactions. The most common 25 macrolide used is erythromycin, but the class includes other compounds such as clarithromycin and azithromycin.

The polymyxins are a group of closely related antibiotic substances produced by strains of Bacillus potymyxa. These drugs, which are cationic detergents, are relatively simple, basic peptides with molecular weights of about 30 1000. Their antimicrobial activity is restricted to gram-negative bacteria. They interact strongly with phospholipids and act by penetrating into and disrupting the structure of cell membranes. Polymyxin B also binds to the lipid A portion of endotoxin and neutralizes the toxic effects of this molecule. Polymyxin B has severe adverse effects, including nephrotoxicity and neurotoxicity, and should not be administered concurrently with other nephrotoxic or neurotoxic drugs. The drug thus has limited use as a therapeutic agent because of high systemic toxicity, but may be 5 used for severe infections, such as Pstudomonas aeruginosa meningitis, that respond poorly to other antibiotics.

Chloramphenicol inhibits protein synthesis by binding to the 50S ribosomal subunit and preventing binding of aminoacyl tRNA. It has a fairly wide spectrum of antimicrobial activity, but is only reserved for serious infections, such 10 as meningitis, typhus, typhoid fever, and Rocky Mountain spotted fever, because of its severe and fatal adverse hematological effects. It is primarily bacteriostatic, although it may be bactericidal to certain species.

Lincomycin and clindamycin are lincosamide antimicrobials. They consist of an amino acid linked to an amino sugar. Both inhibit protein synthesis by 15 binding to the 50S ribosomal subunit. They compete with erythromycin and chloramphenicol for the same binding site but in an overlapping fashion. They may be bacteriostatic or bactericidal, depending on relative concentration and susceptibility. Gastrointestinal distress is the most common side effect. Other adverse reactions include cutaneous hypersensitivity, transient hematological 20 abnormalities, and minor elevations of hepatic enzymes. Clindamycin is often the drug of choice for infections caused by anaerobic bacteria or mixed aerobic/anaerobic infections, and can also be used for susceptible aerobic gram-positive cocci.

Some drugs, e.g. aminoglycosides, have a small therapeutic window. For example, 2 to 4 fig/ml of gentamicin or tobramycin may be required for 25 inhibition of bacterial growth, but peak concentrations in plasma above 6 to 10 fxg/ml may result in ototoxicity or nephrotoxicity. These agents are more difficult to administer because the ratio of toxic to therapeutic concentrations is very low. Antimicrobial agents that have toxic effects on the kidneys and that are also eliminated primarily by the kidneys, such as the aminoglycosides or vancomycin, 30 require particular caution because reduced elimination can lead to increased plasma concentrations, which in turn may cause increased toxicity. Doses of antimicrobial agents that are eliminated by the kidneys must be reduced in patients with unpaired renal function. Similarly, dosages of drugs that are metabolized or excreted by the liver, such as erythromycin, chloramphenicol, or clindamycin, must be reduced in patients with decreased hepatic function.

Antibiotic resistance in bacteria is an increasingly troublesome problem. The accelerating development of antibiotic-resistant bacteria, intensified by the widespread use of antibiotics in farm animals and overprescription of antibiotics by physicians, has been accompanied by declining research into new antibiotics with different modes of action. [Science, 264: 360-374 (1994).] Antibiotic resistance, once acquired, can be rapidly spread to other bacteria, including bacteria of a different species. There are some species of bacteria that are resistant to all but one antibiotic; it may be only a matter of time before the appearance of bacterial strains that are resistant to all antibiotics.

Bacteria acquire resistance to antibiotics through several mechanisms: (1) production of enzymes that destroy or inactivate the antibiotic [Davies, Science, 264:375-381 (1994)]; (2) synthesis of new or altered target sites on or within the cell that are not recognized by the antibiotic [Spratt, Science, 264:388-393 (1994)]; (3) low permeability to antibiotics, which can be reduced even further by altering cell wall proteins, thus restricting access of antibiotics to the bacterial cytoplasmic machinery; (4) reduced intracellular transport of the drug; and (5) increased removal of antibiotics from the cell via membrane-associated pumps [Nikaido, Science, 264:382-387 (1994)].

The susceptibility of a bacterial species to an antibiotic is generally determined by two microbiological methods. A rapid but crude procedure uses commercially available filter paper disks that have been impregnated with a specific quantity of the antibiotic drug. These disks are placed on the surface of agar plates that have been streaked with a culture of the organism being tested, and the plates are observed for zones of growth inhibition. A more accurate technique, the broth dilution susceptibility test, involves preparing test tubes containing serial dilutions of the drug in liquid culture media, then inoculating the organism being tested into the tubes. The lowest concentration of drug that inhibits growth of the bacteria after a suitable period of incubation is reported as the minimum inhibitory concentration.

P CT/DS94/11225 The resistance or susceptibility of an organism to an antibiotic is determined on the basis of clinical outcome, i.e., whether administration of that antibiotic to a subject infected by that organism will successfully cure the subject. While an organism may literally be susceptible to a high concentration of an antibiotic 5 in virro, the organism may in fact be resistant to that antibiotic at physiologically realistic concentrations. If the concentration of drug required to inhibit growth of or kill the organism is greater than the concentration that can safely be achieved without toxicity to the subject, the microorganism is considered to be resistant to the antibiotic. To facilitate the identification of antibiotic resistance or susceptibility 10 using in vitro test results, the National Committee for Clinical Laboratory Standards (NCCLS) has formulated standards for antibiotic susceptibility that correlate clinical outcome to in virro determinations of the minimum inhibitory concentration of antibiotic.

Thus, there exists a desire in the art for new approaches to conventional antibiotic therapy that could act to improve the therapeutic effectiveness of the administered antibiotics.

SUMMARY OF THE INVENTION The present invention generally provides methods for prophylaxis or treatment of gram-negative bacterial infections, using BPI protein 20 products. The methods, in addition to being useful for treatment, are useful for prophylaxis of patients at high risk of gram-negative bacterial infection, e.g., patients who will undergo abdominal or genitourinary surgery, or trauma victims. Specifically, the present invention provides, in a method for treating a gram-negative bacterial infection with an antibiotic, the improvement comprising the step 25 of concurrently administering BPI protein product in an amount effective to improve the therapeutic effectiveness of the antibiotic.

The present invention is based upon the finding that BPI protein product is useful as adjunct therapy with conventional antibiotics, and specifically the finding that concurrent administration, or co-treatment, of a BPI protein product and 30 an antibiotic or combination of antibiotics can improve the therapeutic effectiveness of the antibiotic or combination of antibiotics. BPI protein product may improve the therapeutic effectiveness of antibiotics in a variety of ways, including by increasing susceptibility of gram-negative bacteria to a reduced dosage of antibiotics, by effectively reversing resistance of gram-negative bacteria to antibiotics, by providing synergistic or potentiating effects beyond the individual or additive effects of the BPI protein product or antibiotic alone, or by neutralizing endotoxin released by bacteria killed by antibiotics. Concurrent administration of BPI protein product and antibiotic provides unexpectedly superior therapeutic effects in vivo than either agent provides when administered alone. Concurrent administration of BPI protein product according to this improved method of treatment is effective even when the gram-negative bacteria involved are considered to be resistant to the bactericidal effects of BPI protein product alone and/or antibiotic alone.

The present invention provides a use of a BPI protein product for the manufacture of a medicament for the co-treatment with an antibiotic of a gram-negative bacterial infection in mammals. This aspect of the invention contemplates co-treatment with any antibiotic or combinations of antibiotics, including /S-lactam antibiotics with and without /S-lactamase inhibitors, aminoglycosides, tetracyclines, sulfonamides and trimethoprim, vancomycin, macrolides, fluoroquinolones and quinolones, polymyxins and other antibiotics.

This aspect of the invention also provides the use of a BPI protein product for the manufacture of a medicament for improving the therapeutic effectiveness of antibiotics in a gram-negative bacterial infection, use of a BPI protein product for the manufacture of a medicament for increasing the susceptibility to an antibiotic of gram-negative bacteria involved in the gram-negative bacterial infection, and use of a BPI protein product for the manufacture of a medicament for reversing resistance to an antibiotic of gram-negative bacteria involved in the gram-negative bacterial infection.

The invention utilizes any of the large variety of BPI protein products known to the art including natural BPI protein, recombinant BPI protein, BPI fragments, BPI analogs, BPI variants, and BPI peptides. Concurrent administration of BPI protein product with any antibiotic or combination of antibiotics is contemplated, including /S-lactam antibiotics with or without /S-lactamase inhibitors. aminoglycosides, tetracyclines, sulfonamides and trimethoprim, vancomycin, macrolides, fluoroquinolones and quinolones, polymyxins, and other antibiotics.

Either the BPI protein product or the antibiotic may be administered systemically or topically to a subject suffering from a suspected or confirmed gram-negative bacterial infection. The BPI protein product and antibiotic may be administered by different routes and may be administered simultaneously or sequentially.

The invention also provides pharmaceutical compositions for treatment of gram-negative bacterial infections, comprising an antibiotic and a BPI protein product in an amount effective to improve the therapeutic effectiveness of the antibiotic. Such compositions optionally comprise pharmaceutically acceptable diluents, adjuvants or carriers. The compositions may be formulated for systemic or topical administration to subjects. In addition, compositions comprising BPI protein product and an antibiotic can be used in a variety of in vitro uses, such as use as a bactericide to decontaminate fluids and surfaces and to sterilise surgical and other medical equipment and implantable devices, including prosthetic joints.

In a first aspect there is provided a use of BPI protein in the manufacture of a medicament for treatment of a gram-negative bacterial infection in mammals wherein the medicament is intended for use in co-treatment with an antibiotic other than a penicillin, cephalosporin, rifampicin, or actinomycin D.

In a second aspect there is provided a pharmaceutical composition for treatment of gram-negative bacterial infection comprising an antibiotic and a BPI protein product in an amount effective to improve the therapeutic effectiveness of said antibiotic.

Unless the context requires otherwise, throughout the specification, and the claims which follow, the words "comprise", and the like, are to be construed in an inclusive sense, that is as "including, but not limited to".

Numerous additional aspects and advantages of the invention will become apparent to those skilled in the art upon consideration of the following detailed description of the invention which describes presently preferred embodiments thereof.

BRIEF DESCRIPTION OF THE DRAWINGS Figure 1 depicts survival data after treatment with rBPIn and cefamandole, separately or in combination, in an E. coli 0111 :B4 mouse peritonitis assay. (followed by page 14a) - 14a- Figures 2-4 relate to results from an E. coli 0111 :B4 mouse peritonitis assay with rBPti the cefamandole, separately or in combination. Figure 2 depicts survival data; Figure 3 shows bacterial counts from peritoneal lavage fluid; and Figure 4 shows bacterial counts in blood.

Figures 5 A and 5B display results from two trials of treatment with (followed by page 15) WO 95/0834-4 PCTTUS94/11225 - 15 -■ rBPI2, and cefamandole, separately or in combination, in an E. coli 07:K1 mouse peritonitis assay.

Figures 6-16 relate to results, including cardiovascular and metabolic findings, from an E. coli 07;K1 rabbit bacteremia assay with rBPIj, and cefamandole, 5 separately or in combination. Figure 6 depicts survival data; Figure 7 shows bacterial count in blood, which Figure 8 displays as percentage of bacterial dose; Figure 9 shows blood endotoxin levels; Figures 10 shows mean arterial blood pressure; Figure 11, cardiac index; Figure 12, total peripheral resistance; Figure 13, arterial oxygen tension; Figure 14, alveolar-arterial oxygen gradient; Figure 15, respiration rate; and 10 Figure 16, arterial blood pH.

Figure 17 depicts survival data after treatment with rBPL, and gentamicin, separately or in combination, in an E. coli 07:K1 mouse peritonitis assay.

Figure 18 shows the bactericidal effect of rBPI21 and ceftriaxone, 15 separately or in combination, on growth of ceftriaxone-resistant E. coli.

Figures 19-25 relate to the synergistic effect of rBPI^, on antibiotic killing curves for selected gram-negative organisms. Figure 19 shows the bactericidal effect of rBPI2i alone. Figure 20 shows the effect of rBPL, in combination with trimethoprim/sulfamethoxazole; Figure 21, rBPL, with ciprofloxacin; Figure 22, 20 rBPJo, with piperacillin; Figure 23, rBPI2, with cefotaxime; Figure 24, rBPL, with cefuroxime; and Figure 25, rBPI21 with amikacin.

DFTATT.FD DESCRIPTION .

Described herein are methods and compositions for treating a gram-negative bacterial infection, using a BPI protein product. The invention is 25 based on the unexpected discovery that, when treating a gram-negative bacterial infection with an antibiotic, the concurrent administration of BPI protein product with the antibiotic improves the therapeutic effectiveness of the antibiotic, even at doses at which the BPI protein product alone or antibiotic alone may be inactive. BPI protein product by itself typically has an antibacterial potency less than that of 30 conventional antibiotics. However, because its administration unexpectedly improves the therapeutic effectiveness of conventional antibiotic therapy, BPI protein product WO 95/08344 PCT/US94/11225 is useful as adjunct therapy with conventional antibiotic therapy for the treatment of gram-negative bacterial infections.

"Gram-negative bacterial infection," as used herein, encompasses conditions associated with or resulting from gram-negative bacterial infection (e.g., 5 sequelae). These conditions include gram-negative sepsis, endotoxin-related hypotension and shock, and one or more of the conditions associated therewith, including fever, metabolic acidosis, disseminated intravascular coagulation and related clotting disorders, anemia, thrombocytopenia, leukopenia, adult respiratory distress syndrome and related pulmonary disorders, renal failure and related renal disorders, 10 hepatobiliary disease and central nervous system disorders. These conditions also include translocation of bacteria from the intestines and concomitant release of endotoxin.

BPI protein product may improve the therapeutic effectiveness of the antibiotic in a variety of ways, including by increasing susceptibility of gram-negative 15 bacteria to a reduced dosage of antibiotics, by effectively reversing resistance of gram-negative bacteria to antibiotics, by providing synergistic or potentiating effects beyond the individual or additive effects of the BPI protein product or antibiotic alone, or by neutralizing endotoxin released by bacteria killed by antibiotics. Concurrent administration of BPI protein product and antibiotic is expected to provide 20 more, effective treatment of gram-negative bacterial infection. Concurrent administration of the two agents may provide greater therapeutic effects in vivo than either agent provides when administered singly. It may permit a reduction in the dosage of one or both agents with achievement of a similar therapeutic effect. Alternatively, the concurrent administration may produce a more rapid or complete 25 bactericidal/bacteriostatic effect than could be achieved with either agent alone.

Therapeutic effectiveness is based on a successful clinical outcome, and does not require that the antimicrobial agent or agents kill 100% of the organisms involved in the infection. Success depends on achieving a level of antibacterial activity al the site of infection that is sufficient to inhibit the bacteria in a manner that 30 tips the balance in favor of the host. When host defenses are maximally effective, the antibacterial effect required may be minimal. Reducing organism load by even one log (a factor of 10) may permit the host's own defenses to control the infection.

WO 95/08344 PCT/US94/11225 In addition, augmenting an early bactericidal/bacteriostatic effect can be more important than long-term bactericidal/bacteriostatic effect. These early events are a significant and critical part of therapeutic success, because they allow time for host defense mechanisms to activate. Increasing the bactericidal rate may be particularly 5 important for infections such as meningitis, bone or joint infections. [Stratton, Antibiotics in Laboratory Medicine, 3rd ed. (Lorian, V., Ed.) pp. 849-879, Williams and Wilkins, Baltimore MD (1991)].

The effect of BPI protein product to improve the therapeutic effectiveness of antibiotics in vivo may be demonstrated in in vivo animal models, or 10 may be predicted on the basis of a variety of in vitro tests, including (1) determinations of the minimum inhibitory concentration (MIC) of an antibiotic required to inhibit growth of a gram-negative organism for 24 hours, (2) determinations of the effect of an antibiotic on the kinetic growth curve of a gram-negative organism, and (3) checkerboard assays of the MIC of serial dilutions of 15 antibiotic alone or in combination with serial dilutions of BPI protein product.

Exemplary models or tests are described in Eliopoulos and Moellering In Antibiotics in Laboratory Medicine, 3rd ed. (Lorian, V., Ed.) pp. 432-492, Williams and Wilkins, Baltimore MD (1991).

Using in vitro determinations of antibiotic MIC at 24 hours, a BPI 20 protein product may be shown to reduce the MIC of the antibiotic. With this result, it is expected that concurrent administration of the BPI protein product in vivo will increase susceptibility of the gram-negative organism to the antibiotic. A BPI protein product may also be shown to reduce the MIC of an antibiotic from the range in which the organism is considered clinically resistant to a range in which the organism 25 is considered clinically susceptible. With this result, it is expected that concurrent administration in vivo of the BPI protein product with the antibiotic will reverse resistance and effectively convert the antibiotic-resistant organism into an antibiotic-susceptible organism.

By measuring the effect of antibiotics on the in vitro growth curves of 30 gram-negative organisms, in the presence or absence of a BPI protein product, the BPI protein product may be shown to enhance the early antibacterial effect of antibiotics at 0-24 hours. Enhancement of early bactericidal/growth inhibitory effects is important in determining therapeutic outcome.

The BPI protein product and antibiotic may also be shown to have synergistic or potentiating effects beyond the individual effects of each agent alone 5 or the additive effects of the agents together. In a checkerboard assay, the combination of BPI protein product with antibiotics may be shown to result in a "synergistic" fractional inhibitory concentration index (FIC). The checkerboard method is based on additivity, which assumes that the result observed with multiple drugs is the sum of the separate effects of the drugs being tested; according to this 10 system a FIC of less than 0.5 is scored as synergy, 1 is scored as additive, and greater than 1 but less than 2 is scored as indifferent. In contrast, kinetic assays are based on the idea that only one metabolic pathway at a time can be growth rate-limiting for an organism; according to this system, the combined effect of drugs that do not interact with one another (autonomous or indifferent) is simply the effect of 15 the most active drug alone.

Concurrent administration of BPI protein products and antibiotics is shown herein to lower MICs of a variety of antibiotics for a variety of giam-negative organisms. It is also shown to reverse resistance of a variety of gram-negative organisms to antibiotics. In some cases where BPI protein product does not affect the 20 MIC of antibiotic at 24 hours, BPI protein product is shown herein to enhance the early bactericidal effect of antibiotics on growth curves at 0-7 or 7-24 hours. The BPI protein products exert these effects even on gram-negative organisms that are not considered susceptible to the direct bactericidal or growth inhibitory effects of BPI protein product alone. It is also shown herein that the concurrent administration of 25 BPI protein products with antibiotics in vivo allows a reduction in the dosages of both agents to amounts that, if administered alone, would be insufficient to exert the same clinical effect.

Either the BPI protein product or the antibiotic, or both, may be administered at levels at which neither would alone be therapeutically effective against 30 a gram-negative bacterial infection. Alternatively, according to a preferred method, the antibiotic and BPI protein product can be administered in amounts where each would alone be therapeutically effective against a gram-negative bacterial infection but wherein the combination of the two antibiotics provides even more potent effects. The BPI protein product may be administered in an amount which increases susceptibility of gram-negative bacteria to reduced antibiotic dosage, or in an amount which reverses resistance of the gram-negative bacteria to an antibiotic.

BPI protein product is thought to interact with a variety of host defense elements present in whole blood or serum, including complement, pi5 and LBP, and other cells and components of the immune system. Such interactions may result in potentiation of the activities of BPI protein product. Because of these interactions, BPI protein products can be expected to exert even greater activity in vivo than in virro. Thus, while in vitro tests are predictive of in vivo utility., absence of activity in vitro does not necessarily indicate absence of activity in vivo. For example, BPI has been observed to display a greater bactericidal effect on gram-negative bacteria in whole blood or plasm a assays than in assays using conventional media. [Weiss et al., J. Clin. Invest. 90:1122-1130 (1992)]. This may be because conventional in vitro systems lack the blood elements that facilitate or potentiate BPI's function in vivo, or because, conventional media contain higher than physiological concentrations of magnesium and calcium, which are typically inhibitors of the antibacterial activity of BPI protein products. Furthermore, in the host, BPI protein product is available to neutralize endotoxin released during antibiotic killing of bacteria, a further clinical benefit not seen in or predicted by in vitro tests.

It is also contemplated that the BPI protein product be administered with other products that potentiate the bactericidal activity of BPI protein products. For example, serum complement potentiates the gram-negative bactericidal activity of BPI protein products; the combination of BPI protein product and serum complement provides synergistic bactericidal/growth inhibitory effects. See, e.g., Ooi et al. J. Biol. Chem., 265: 15956 (1990) and Levy et al. J. Biol. Chem., 268: 6038-6083 (1993) which address naturally-occurring 15 kD proteins potentiating BPI antibacterial activity. See also co-owned, co-pending PCT Application No. US94/07834 .

This application which is incorporated herein by reference, describes methods for potentiating gram-negative bactericidal activity of BPI protein products by administering lipopolysaccharide binding protein (LBP) and LBP protein products. LBP protein derivatives and derivative hybrids which lack CD-14 immunostimulatory 5 properties are described in PCT Application No. US94/0693 1, the disclosure of which is hereby incorporated by reference.

An advantage provided by the present invention is the ability to provide more effective treatment of gram-negative bacterial infection by virtue of the improved therapeutic effectiveness of the antibiotic treatment. Another advantage is 10 the ability to treat gram-negative organisms that arc normally resistant to one or more antibiotics. Yet another advantage is the ability to accelerate the killing of gram-negative organisms by antibiotics. An additional advantage is the ability to neutralize endotoxin released during antibiotic killing of bacteria. A further advantage is the ability to use lower concentrations of toxic antibiotics such as gentamicin and 15 polymyxin B, or expensive antibiotics such as vancomycin. Because the use of some antibiotics is limited by their systemic toxicity or prohibitive cost, lowering the concentration of antibiotic required for therapeutic effectiveness reduces toxicity and/or cost of treatment, and thus allows wider use of the antibiotic. The present invention may also provide quality of life benefits due to, e.g., decreased duration of therapy, reduced stay in intensive care units or overall in the hospital, with the concomitant reduced risk of serious nosocomial (hospital-acquired) infections.

The invention further provides pharmaceutical compositions for treatment of gram-negative bacterial infections, comprising an antibiotic and a BPI protein product in an amount effective to improve the therapeutic effectiveness of the 2 5 antibiotic. Such compositions optionally comprise pharmaceuticaliy acceptable diluents, adjuvants or carriers. The compositions may be formulated for systemic or topical administration to subjects. In addition, antiseptic compositions comprising BPI protein product and an antibiotic can be used in a variety of in vitro uses such as use as a bactericide to decontaminate fluids and surfaces and to sterilize surgical and other medical equipment and implantable devices, including prosthetic joints. The invention also provides improved methods of in virro decontamination of fluids and surfaces comprising administering a BPI protein product in combination with an antibiotic.

Either the BPI protein produa or the antibiotics may be administered systemically or topically. Systemic routes of administration include oral, intravenous, intramuscular or subcutaneous injection, intrathecal, intraperitoneal (e.g. by intraperitoneal lavage), transpulmonary using aerosolized or nebulized drug, or transdermal. Topical routes include administration in the form of salves, ophthalmic 10 drops, ear drops, or irrigation fluids (for, e.g., irrigation of wounds).

"Concurrent administration," or co-treatment, as used herein includes administration of the agents together, or before or after each other. The BPI protein product and antibiotics may be administered by different routes. For example, the BPI protein produa may be administered intravenously while the antibiotics are 15 administered intramuscularly, intravenously, subcutaneously, orally or intraperitoneally. Alternatively, the BPI protein produa may be administered intraperitoneally while the antibiotics are administered intraperitoneally or intravenously, or the BPI protein produa may be administered in an aerosolized or nebulized form while the antibiotics are administered, e.g., intravenously. The BPI 20 protein produa and antibiotics are preferably both administered intravenously. The BPI protein produa and antibiotics may be given sequentially in the same intravenous line, after an intermediate flush, or may be given in different intravenous lines. The BPI protein produa and antibiotics may be administered simultaneously or sequentially, as long as they are given in a manner sufficient to allow both agents to 25 achieve effective concentrations at the site of infection.

As used herein, "BPI protein product" includes naturally and recombinantly produced BPI protein; natural, synthetic, and recombinant biologically active polypeptide fragments of BPI protein; biologically active polypeptide variants of BPI protein or fragments thereof, including hybrid fusion proteins and dimers; and 30 biologically active polypeptide analogs of BPI protein or fragments or variants thereof, including cysteine-substituted analogs. The BPI protein products administered according to this invention may be generated and/or isolated by any means known in the art. U.S. Patent No. 5,198,541, the disclosure of which is incorporated herein by reference, discloses recombinant genes encoding and methods for expression of BPI proteins including recombinant BPI holoprotein, referred to as rBPIfo and recombinant fragments of BPI. Co-owned, Australian Patent No. 669723 5 and PCT Application No. US93/04752, which are incorporated herein by reference, disclose novel methods for the purification of recombinant BPI protein products expressed in and secreted from genetically transformed mammalian host cells in culture and discloses how one may produce large quantities of recombinant BPI products suitable for incorporation into stable, homogeneous pharmaceutical 10 preparations.

Biologically active fragments of BPI (BPI fragments) include biologically active molecules that have the same or similar amino acid sequence as a natural human BPI holoprotein, except that the fragment molecule lacks amino-tetthinal amino acids, internal amino acids, and/or carboxy-tenninal amino acids of 15 the holoprotein. Nonlimiting examples of such fragments include a N-terminal fragment of namral human BPI of approximately 25 kD, described in Ooi et al., J. Exp. Med., 174:649 (1991), and the recombinant expression product of DNA encoding N-terminal amino acids from 1 to about 193 or 199 of natural human BPI, described in Gazzano-Santoro et al., Infect. Immun. 60:4754-4161 (1992), and 20 referred to as rBPIj,. In that publication, an expression vector was used as a source of DNA encoding a recombinant expression product (rBFI^) having the 31-residue signal sequence and the first 199 amino acids of the N-terminus of the mature human BPI, as set out in Figure 1 of Gray et al., supra, except that valine at position 151 is specified by GTG rather than GTC and residue 185 is glutamic acid (specified by 25 - GAG) rather than lysine (specified by AAG). Recombinant holoprotein (rBPI) has also been produced having the sequence (SEQ ID NOS: 145 and 146) set out in Figure 1 of Gray et al., supra, with, the exceptions noted for rBPIa and with the exception that residue 417 is alanine (specified by GCT) rather than valine (specified by GTT). Other examples include dimeric forms of BP! fragments, as described in 3 0 co-owned and co-pending Australian Patent Application No. 19969/95 the disclosure of which is incorporated herein by reference. Preferred dimeric products include dimeric BPI protein products wherein the monomers are amino-terminal BPI fragments having the N-terminal residues from about 1 to 175 to about 1 to 199 to BPI holoprotein. A particularly preferred dimeric product is the dimeric form of the BPI 5 fragment having N-terminal residues 1 through 193, designated rBPl42 dimer.

Biologically active variants of BPI (BPI variants) include but are not limited to recombinant hybrid fusion proteins, comprising BPI holoprotein or biologically active fragment thereof and at least a portion of at least one other polypeptide, and dimeric forms of BPI variants. Examples of such hybrid fusion proteins and dimeric forms are 10 described by Theofan et al. in co-owned, Australian Patent Application No. 43821/93 and PCT Application No. US93/04754, which are incorporated herein by reference and include hybrid fusion proteins comprising, at the amino-terminal end, a BPI protein or a biologically active fragment thereof and, at the carboxy-terminal end, at least one constant domain of an immunoglobulin heavy chain or allelic variant thereof. 15 Biologically active analogs of BPI (BPI analogs) include but are not limited to BPI protein products wherein one or more amino acid residues have been replaced by a different amino acid. For example, co-owned, Australia Patent Application No. 61702/94 and PCT Application No. US94/01235,. the disclosures of which are incorporated herein by reference, discloses polypeptide analogs of BPI and BPI 20 fragments wherein a cysteine residue is replaced by a different amino acid. A preferred BPI protein product described by this application is the expression product of DNA encoding from amino acid 1 to approximately 193 or 199 of the N-terminal amino acids of BPI holoprotein, but wherein the cysteine at residue number 132 is substituted with alanine and is designated rBPl2lAcys or rBPl2i. Other examples 25 include dimeric forms of BPI analogs; e.g. co-owned Australian Patent Application No.

XOAiVI.OOC the disclosure of which is incorporated herein by reference.

Other BPI protein products useful according to the methods of the invention are peptides derived from or based on BPI produced by recombinant or synthetic means (BPI-derived peptides), such as those described in co-owned PCT Application No. US94/02465, Australian Patent Applications 16797/95, 16822/95, 63988/94, Australian Patents 681453 and 684503, and PCT Application No. US94/02401, the disclosures of all of which are incorporated herein by reference.

Presently preferred BPI protein products include recombinantly-produced N-terminal fragments of BPI, especially those having a molecular weight of approximately between 21 to 25 kD such as rBPIrj or rBPI^, or dimeric forms of these N-terminal fragments (e.g., rBPIc dimer). Additionally, preferred BPI protein products include rBPIj<, and BPI-derived peptides.

The administration of BPI protein products is preferably accomplished with a pharmaceutical composition comprising a BPI protein produa and a pharmaceutical^ acceptable diluent, adjuvant, or carrier. The BPI protein produa may be administered without or in conjunction with known surfactants, other chemotherapeutic agents or additional known anti-microbial agents. A preferred pharmaceutical composition containing BPI protein products (e.g., rBPIjo, rBPIa) comprises the BPI protein product at a concentration of 1 mg/ml in citrate buffered saline (5 or 20 mM citrate, 150 mM NaCl, pH 5.0) comprising 0.1 % by weight of poloxamer 188 (Pluronic F-68, BASF Wyandotte, Parsippany, NJ) and 0.002% by weight of polysorbate 80 (Tween 80, ICI Americas Inc., Wilmington, DE). Another preferred pharmaceutical composition containing BPI protein produas (e.g., rBPL,) 9 Q tLa ^ ^ -25 comprises the BPI protein product at a concentration of 2 mg/ml in 5 mM citrate, 150 mM NaCl, 0.2% poloxamer 188 and 0.002% polysorbate 80. Such preferred combinations are described in co-owned, PCT Application No. US94/01239, the disclosure of which is incorporated herein by reference.

Suitable antibiotics, and therapeutically effective concentrations thereof when administered with BPI protein products, may be determined in in vivo models or according to irt vitro tests, for example, the in vitro .minimum inhibitory concentration (MIC) and in vivo mouse peritonitis or rabbit bacteremia assays taught herein. Suitable antibiotics are antibiotics that act on the bacterial cell wall, cell membrane, protein metabolism or nucleic acid metabolism. These would include antibiotics or combinations of antibiotics from the following classes: /S-lactam antibiotics with or without ^-lactamase inhibitors, aminoglycosides, tetracyclines, sulfonamides and trimethoprim, vancomycin, macrolides, fluoroquinolones and quinolones, polymyxins, and other antibiotics. Dosage and administration of suitable 15 antibiotics are known in the art, and briefly summarized below.

PENICILLINS When a BPI protein product is concurrently administered with a penicillin, for treatment of a gram-negative bacterial infection, the BPI protein product is generally given parenterally in doses ranging from 1 fig/kg to 100 mg/kg 20 daily, and preferably at doses ranging from 1 mg/kg to 20 mg/kg daily. The penicillin is generally given in doses ranging from 1 fig/kg to 750 mg/kg daily, preferably not to exceed 24 grams daily for adults (or 600 mg/kg daily for children), and is preferably administered as follows: Penicillin G is preferably administered parenterally to adults in doses 25 ranging from 600,000 to 1,000,000 units per day. In conventional administration, it is effective largely against gram-positive organisms. For treatment of pneumococcal meningitis, penicillin G is administered in doses of 20-24 million units daily, in divided doses every 2 or 3 hours. For children, the preferred parenteral dose of penicillin G is 300,000 to 1,000,000 units per day. One unit of penicillin G contains 0.6 fig of pure sodium penicillin G (i.e., 1 mg is 1667 units).

Amoxicillin may be administered parenterally to adults in doses ranging from 750 mg to 1.5 grams per day, in 3 equally divided doses. For children, 5 preferred parenteral doses of amoxicillin range from 20 to 40 mg/kg per day in 3 equally divided doses. Amoxicillin is also available in combination with ciavuianic acid, a /S-lactamase inhibitor. A 250 mg dose of the combination drug amoxiciUin/clavuianate will contain 250 mg of amoxicillin and either 125 or 62.5 mg of ciavuianic acid. The combination is preferably administered to adults orally in 10 doses of 750 mg per day divided into 3 equal doses every 8 hours, with a preferred dose of 1.5 grams per day for severe infections, given in 3 equally divided doses. In children, the preferred oral dose is 20 to 40 mg/kg per day in 3 equally divided doses.

Ampicillin is preferably administered parenterally to adults in doses of 15 6 to 12 grams per day for severe infections, in 3 to 4 equally divided doses. In children, the preferred parenteral dose of ampicillin is 50 to 200 mg/kg per day in 3 to 4 equally divided doses. Larger doses of up to 400 mg/kg per day, for children, or 12 grams per day, for adults, may be administered parenterally for treatment of meningitis. Ampicillin is also available in combination with sulbactam, a /3-lactamase 20 inhibitor. Each 1.5 gram dose of ampicillin/sulbactam contains 1 gram of ampicillin and 0.5 grams of sulbactam. The combination is preferably administered parenterally to adults in doses of 6 to 12 grams per day divided into 4 equal doses every 6 hours, not to exceed a total of 12 grams per day.

Azlocillin is preferably administered parenterally to adults in doses of 25 8 to 18 grams per day, given in 4 to 6 equally divided doses.

Carbenicillin is preferably administered parenterally to adults in doses of 30 to 40 grams per day, given by continuous infusion or in 4 to 6 equally divided doses. Daily doses of up to 600 mg/kg have been used to treat children with life-threatening infections.

Mezlocillin is preferably administered to adults parenterally in doses of 100 to 300 mg/kg per day, given in 4 to 6 equally divided doses. The usual dose is 16 to 18 grams per day; for life threatening infections. 350 mg/kg per day may be administered, but in doses not to exceed 24 grams per day given in 6 equally divided doses every 4 hours. For children, the preferred parenteral dose of mezlocillin is 150 to 300 mg/kg per day.

Nafcillin is preferably administered intravenously to adults in doses of 5 3 grams per day, given in 6 equally divided doses every 4 hours, with doubled doses for very severe infections. In conventional administration, it is effective largely against gram-positive organisms. In children, the preferred parenteral dose is 20 to 50 mg/kg per day, in 2 equally divided doses every 12 hours. The preferred oral dose for nafcillin ranges from 1 gram per day to 6 grams per day in 4 to 6 divided 10 doses.

Oxacillin is preferably administered parenterally to adults in doses of 2 to 12 grams per day, in 4 to 6 equally divided doses. In conventional administration, it is effective largely against gram-positive organisms. In children, oxacillin is preferably administered in doses of 100 to 300 mg/kg per day. 15 Piperacillin is preferably administered parenterally to adults in doses ranging from 100 mg/kg, or 6 grams per day, in 2 to 4 equally divided doses, up to a maximum of 24 grams per day, in 4 to 6 equally divided doses. Higher doses have been used without serious adverse effects.

Ticarciliin is preferably administered parenterally to adults in doses 20 ranging from 4 grams per day to 18 grams per day administered in 4 to 6 equally divided doses. The usual dose is 200 to 300 mg/kg per day. For children, the preferred parenteral dose of ticarciliin ranges from 50 mg/kg per day to 300 mg/kg per day, given in 3, 4 or 6 equally divided doses. The combination ticarcillin/clavulanate is preferably administered parenterally to adults in doses of 200 25 to 300 mg/kg per day (based on ticarciliin content), in 4 to 6 equally divided doses.

For adults, the usual dose is 3.1 grams (which contains 3 grams of ticarciliin and 100 mg of ciavuianic acid) every 4 to 6 hours. The combination is also available in a dose of 3.2 grams, which contains 3 grams of ticarciliin and 200 mg of ciavuianic acid.

In general, it is desirable to limit each intramuscular injection of a penicillin or cephalosporin to 2 grams; larger doses should be administered by multiple injections in different large muscle masses.

CEPHALOSPORINS When a BPI protein product is concurrently administered with a cephalosporin, for treatment of a gram-negative bacterial infection, the BPI protein product is generally given parenterally in doses ranging from 1 fig /kg to 100 mg/kg 5 daily, and preferably at doses ranging from 1 mg/kg to 20 mg/kg daily. The cephalosporin is generally given in doses ranging from 1 ftg/kg to 500 mg/kg daily, preferably not to exceed 16 grams daily, and is preferably administered as follows: Cefamandole is preferably administered parenterally to adults in doses ranging from 1.5 grams per day, given in 3 equally divided doses every 8 hours, to 10 12 grams per day for life-threatening infections, given in 6 equally divided doses every 4 hours. In children, cefamandole is preferably administered in doses ranging from 50 to 150 mg/kg per day, in 3 to 6 equally divided doses, not to exceed a total of 12 grams per day.

Cefazolin is preferably administered parenterally to adults in doses of 15 750 mg per day, given in 3 equally divided doses every 8 hours. In severe, life-threatening infections, it may be administered at doses of 6 grams per day divided into 4 equal doses every 6 hours; in rare instances, up to 12 grams per day have been used. In children, the preferred parenteral dose of cefazolin is 20 to 50 mg/kg per day, divided into 3 or 4 equal doses, with 100 mg/kg per day administered for severe 20 infections.

Cefonicid is preferably administered parenterally to adults in doses ranging from 500 mg once daily, to 2 grams once daily for life-threatening infections. For intramuscular administration, a 2 gram dose should be divided into two 1-gram injections.

Cefoperazone is preferably administered parenterally to adults in doses ranging from 2 grams per day, given in 2 equally divided doses every 12 hours, to 12 grams per day for severe infections, given in 2, 3 or 4 equally divided doses. Doses up to 16 grams per day have been administered without complications.

Cefotetan is preferably administered parenterally to adults in doses of 30 1 to 4 grams per day, in 2 equally divided doses every 12 hours. Cefotetan may be administered in higher doses for life-threatening infections, not to exceed a total dose of 6 grams per day.

PCT/U S94/11225 Cefotaxime is preferably administered parenterally to adults in doses ranging from 1 to 12 grams per day, not to exceed 12 grams per day (2 grams every 4 hours) for life-threatening infections. In children, the parenteral dose of cefotaxime is preferably 50 to 180 mg/kg, divided into 4 to 6 equal doses.

Cefoxitin is preferably administered parenterally to adults in doses ranging from 3 to 12 grams per day, given in 3, 4, or 6 equally divided doses. In children, cefoxitin is preferably administered parenterally in doses of 80 to 160 mg/kg per day, given in 4 or 6 equally divided doses, not to exceed a total dose of 12 grams per day.

Ceftazidime is preferably administered parenterally to adults in doses ranging from 500 mg per day, given in 2 to 3 equally divided doses (every 8 or 12 hours), up to a maximum of 6 grams per day. In children, ceftazidime is preferably administered intravenously in doses of 30 to 50 mg/kg, to a maximum of 6 grams per day.

Ceftizoxime is preferably administered parenterally to adults in doses ranging from 1 gram per day, given in 2 equally divided doses eveiy 12 hours, to 12 grams per day for life-threatening infections, given in 3 equally divided doses every 8 hours. The usual adult dose is 1 to 2 grams every 8 or 12 hours. For children, the preferred parenteral dose is 50 mg/kg every 6 or 8 hours, for a total daily dose of 200 mg/kg.

Ceftriaxone is preferably administered parenterally to adults in doses ranging from 1 to 2 grams per day, given in 2 equally divided doses every 12 hours. It may be given in higher doses, not to exceed a total of 4 grams per day. In children, the preferred parenteral dose of ceftriaxone is 50 to 75 mg/kg per day, not to exceed 2 grams per day. In meningitis, ceftriaxone may be administered in doses of 100 mg/kg per day, not to exceed 4 grams per day.

Cefuroxime is preferably administered parenterally to adults in doses ranging from 2.25 to 4.5 grams per day, in 3 equally divided doses every 8 hours. For life-threatening infections, 6 grams per day may be administered in 4 equally divided doses every 6 hours, and for meningitis, 9 grams per day may be administered in 3 equally divided doses every 8 hours. For children, the preferred parenteral dose of cefuroxime is 50 to 150 mg/kg per day in 3 to 4 equally divided doses, or 240 mg/kg per day for meningitis.

Cephalexin is formulated for oral administration, and is preferably administered orally to adults in doses ranging from 1 to 4 grams per day in 2 to 4 equally divided doses. For children, the preferred dose is 20 to 50 mg/kg per day in divided doses, with doses being doubled for severe infections.

Cephalothin is usually administered parenterally to adults in doses of 8 to 12 grams per day.

OTHER BETA-LACTAMS When a BPI protein product is concurrently administered with an imipenem antibiotic, for treatment of a gram-negative bacterial infection, the BPI protein product is generally given parenterally in doses ranging from 1 jig/kg to 100 mg/kg daily, and preferably at doses ranging from 1 mg/kg to 20 mg/kg daily. The imipenem is generally given in doses ranging from 1 fxg/kg to 100 mg/kg daily, and is preferably administered as follows: Imipenem is available in combination with cilastatin, an inhibitor of the renal dipeptidase enzyme that rapidly inactivates imipenem. The combination is preferably administered intramuscularly to adults in doses of 1 to 1.5 grams per day, given in 2 equally divided doses every 12 hours. Intramuscular doses exceeding 1.5 grams per day are not recommended. The combination is preferably administered intravenously in doses ranging from 1 to 4 grams per day, in 4 equally divided doses every 6 hours; doses exceeding 50 mg/kg per day, or 4 grams per day, are not recommended.

When a BPI protein product is concurrently administered with a monobactam antibiotic, for treatment of a gram-negative bacterial infection, the BPI protein product is generally given parenterally in doses ranging from 1 fig/kg to 100 mg/kg daily, and preferably at doses ranging from 1 mg/kg to 20 mg/kg daily. The monobactam is generally given in doses ranging from 1 fig/kg to 200 mg/kg daily, and is preferably administered as follows: Aztreonam is preferably administered parenterally to adults in doses ranging from 1 gram per day, given in 2 equally divided doses every 12 hours, up to a maximum recommended dose of 8 grams per day in cases of life-threatening infection, given in 3 or 4 equally divided doses.

AMINOGLYCOSIDES When a BPI protein product is concurrently administered with an 5 aminoglycoside, for treatment of a gram-negative bacterial infection, the BPI protein produa is generally given parenterally in doses ranging from 1 jtg/kg to 100 mg/kg daily, and preferably at doses ranging from 1 mg/kg to 20 mg/kg daily. The aminoglycoside is generally given in doses ranging from 1 fxg/kg to 20 mg/kg daily, preferably not to exceed 15 mg/kg daily, and is preferably administered as follows: 10 When administering aminoglycosides, it is desirable to measure serum peak and trough concentrations to ensure the adequacy and safety of the dosage. Dosages should generally be adjusted to avoid toxic peak and trough concentrations. Amikacin is preferably administered parenterally to adults and children in doses of 15 mg/kg per day, divided into two or three equal doses every 8 or 12 hours, and not 15 to exceed a total dose of 1.5 grams per day. For uncomplicated infections, a dose of 500 mg amikacin per day, in 2 equally divided doses, may be administered. Dosages should be adjusted to avoid prolonged serum peak concentrations of amikacin above 35 ng/ml and prolonged trough concentrations greater than 10 fxg/ml.

Gentamicin is preferably administered parenterally to adults in doses 20 of 3 mg/kg per day, in three equally divided doses every 8 hours. For life-threatening infections, up to 5 mg/kg per day in 3 to 4 equally divided doses may be administered, but this dosage should be reduced to 3 mg/kg per day as soon as clinically indicated. For children, gentamicin is preferably administered parenterally in doses of 6 to 7.5 mg/kg per day. Dosages should be adjusted to avoid prolonged 25 serum peak concentrations of gentamicin above 12 fxg/ml and prolonged trough concentrations greater than 2 ^g/ml.

Netilmicin may be administered parenterally to adults in doses ranging from 3 mg/kg per day, in 2 equally divided doses every 12 hours, to 6.5 mg/kg per day for serious systemic infection, in 2 or 3 equally divided doses. In children, the 30 preferred parenteral dose is 5.5 to 8 mg/kg per day, in 2 or 3 equally divided doses.

Dosages should be adjusted to avoid prolonged serum peak concentrations of netilmicin above 16 ng/ml and prolonged serum trough concentrations above 4 ^g/ml.

Tobramycin is preferably administered parenterally to adults in doses of 3 mg/kg per day, given in three equally divided doses every 8 hours. For life-threatening infections, tobramycin may be administered in doses up to 5 mg/kg per day, in 3 or 4 equally divided doses, but this dosage should be reduced to 3 mg/kg 5 per day as soon as clinically indicated. In children, tobramycin is preferably administered parenterally in doses of 6 to 7.5 mg/kg per day. Prolonged serum concentrations of tobramycin above 12 ng/ml should be avoided, and rising trough levels above 2 ftg/ml may indicate tissue accumulation, which may contribute to toxicity.

Concurrent administration of BPI protein product with the aminoglycosides, including amikacin, gentamicin, netilmicin and tobramycin, may permit a lowering of the dose of these toxic antibiotics necessary to achieve a therapeutic effect.

TETRACYCLINES When a BPI protein product is concurrently administered with a tetracycline, for treatment of a gram-negative bacterial infection, the BPI protein produa is generally given parenterally in doses ranging from 1 fig/kg to 100 mg/kg daily, and preferably al doses ranging from 1 mg/kg to 20 mg/kg daily. The tetracycline is generally given in doses ranging from 1 ng/kg to 50 mg/kg daily, and 20 is preferably administered as follows: The tetracycline antibiotics are generally administered to adults in doses of 1 to 2 grams per day. An exception is doxycycline, which is preferably administered intravenously to adults in doses of 100 to 200 mg per day, and to children in doses of 2 mg/lb per day. Tetracycline may be administered parenterally 25 to adults in doses of 0.5 to 2 grams per day, in 2 equally divided doses, and to children in doses of 10 to 20 mg/kg per day.

SULFONAMIDES When a BPI protein produa is concurrently administered with a sulfonamide or trimethoprim, for treatment of a gram-negative bacterial infection, the 30 BPI protein produa is generally given parenterally in doses ranging from 1 ^g/kg to 100 mg/kg daily, and preferably at doses ranging from .1 mg/kg to 20 mg/kg daily. The sulfonamide or trimethoprim is generally given in doses ranging from 1 fig/kg WO 95/08344 PCT/US94/11225 to 150 mg/kg daily, preferably not to exceed a combination dose of 960 mg trimethoprim/4.8g sulfamethoxazole daily, and is preferably administered as follows: The combination trimethoprim/sulfamethoxazole is available in a formulation containing a 1:5 ratio of trimethoprim and sulfamethoxazole (e.g., 16 mg 5 trimethoprim and 80 mg sulfamethoxazole). The combination is preferably administered intravenously to adults or children in doses of 8 to 10 mg/kg (based on the weight of the trimethoprim component) per day, in 2 to 4 equally divided doses. For Pneumocystis carinii infection, the combination can be administered in doses of 20 mg/kg (based on the weight of the trimethoprim component) per day, in 3-4 10 equally divided doses, to a maximum recommended dose of 960 mg trimethoprim/4.8 g sulfamethoxazole per day. Trimethoprim alone is preferably administered orally to adults in doses of 200 mg per day. Sulfamethoxazole alone is preferably administered orally to adults in doses of 2 to 3 grams per day, and to children orally in doses of 50 to 60 mg/kg per day.

FLUOROQUINOLONES When a BPI protein product is concurrently administered with a fluoroquinolone or quinolone, for treatment of a gram-negative bacterial infection, the BPI protein product is generally given parenterally in doses ranging from 1 fig/kg to 100 mg/kg daily, and preferably at doses ranging from 1 mg/kg to 20 mg/kg daily. 20 The fluoroquinolone or quinolone is generally given in doses ranging from 1 pglkg to 50 mg/kg daily, preferably not to exceed 1 gram daily, and is preferably administered as follows: Norfloxacin is preferably administered orally to adults in doses from 400 to 800 mg daily, divided into two doses every 12 hours. Cinoxacin is preferably 25 administered orally to adults in doses of 1 gram per day, given in 2 or 4 equally divided doses. Ciprofloxacin is preferably administered to adults intravenously in doses from 400 to 800 mg daily, or orally in doses from 500 to 1500 mg daily, divided into two doses every 12 hours. Ofloxacin is preferably administered to adults intravenously in doses from 400 to 800 mg daily, or orally in doses from 400 to 800 30 mg daily, divided into two doses every 12 hours.

VANCOMYCIN When a BPI protein product is concurrently administered with vancomycin, for treatment of a gram-negative bacterial infection, the BPI protein product is generally given parenterally in doses ranging from 1 ^g/kg to 100 mg/kg daily, and preferably at doses ranging from 1 mg/kg to 20 mg/kg daily. The 5 vancomycin is generally given in doses ranging from 1 mg/kg to 50 mg/kg daily, and is preferably administered parenterally to adults in doses of 2 grams per day, divided into 2 or 4 doses every 6 or 12 hours. In children it is preferably administered in doses of 40 mg/kg, given in 4 equally divided doses every 6 hours. In conventional administration, vancomycin is effective largely against gram-positive organisms. 10 MACROLIDES When a BPI protein product is concurrently administered with a macrolide, for treatment of a gram-negative bacterial infection, the BPI protein product is generally given parenterally in doses ranging from 1 ftg/kg to 100 mg/kg daily, and preferably at doses ranging from 1 mg/kg to 20 mg/kg daily. The 15 macrolide is generally given in doses ranging from 1 jig/kg to 100 mg/kg daily, and is preferably administered as follows: Erythromycin is preferably administered intravenously to adults and children in doses of 15 to 20 mg/kg per day, given by continuous infusion or in 4 equally divided doses every 6 hours. Erythromycin can be administered at doses up 20 to 4 grams per day in cases of very severe infection.

Clarithromycin is preferably administered orally to adults in doses of 500 mg to 1 gram daily, in equally divided doses every 12 hours.

Azithromycin is preferably administered orally to adults at a dose of 500 mg on the first day of treatment followed by 250 mg once daily for 4 days, for 25 a total dose of 1.5 grams.

OTHERS When a BPI protein product is concurrently administered with other antibiotics, for treatment of a gram-negative bacterial infection, the BPI protein product is generally given parenterally in doses ranging from 1 fxg/kg to 100 mg/kg 30 daily, and preferably at doses ranging from 1 mg/kg to 20 mg/kg daily.

Polymyxin B is generally given in doses ranging from 1 unit/kg to 45.000 units/kg daily, and is preferably administered intravenously to adults and children in doses of 15,000 to 25,000 units/kg per day, divided into 2 equal doses every 12 hours. It may be administered intramuscularly in doses of 25,000 to 30,000 units/kg per day, although these injections are very painful. Doses of polymyxin B as high as 45,000 units/kg per day have been used in limited clinical studies to treat 5 neonates for Pseudomonas aeruginosa sepsis. Polymyxin B is the treatment of choice for P. aeruginosa meningitis, and is preferably administered intrathecally to adults and older children in doses of 50,000 units once daily for 3 to 4 days, followed by 50,000 units every other day; in children under two years old, it is administered intrathecally in doses of 20,000 daily for 3 to 4 days, followed by 25,000 units every 10 other day.

Chloramphenicol is preferably administered intravenously to adults in doses of 50 mg/kg per day, in 4 equally divided doses; in exceptional cases, it can be administered in doses up to 100 mg/kg per day. In children, chloramphenicol is preferably administered intravenously in doses of 25 mg/kg per day, although up to 15 100 mg/kg per day can be administered in cases of severe infection.

Clindamycin is preferably administered parenterally to adults in doses ranging from 600 mg to 4.8 grams per day, given in 2, 3 or 4 equally divided doses. It is recommended that the dose in each intramuscular injection not exceed 600 mg. For children, clindamycin is preferably administered parenterally in doses of 15-40 20 nig/kg per day, given in 3 or 4 equally divided doses.

Dosages of all antimicrobial agents should be adjusted in patients with renal impairment or hepatic insufficiency, due to the reduced metabolism and/or excretion of the drugs in patients with these conditions. Doses in children should also be reduced, generally according to body weight. Those skilled in the art can readily 25 optimize effective dosages and administration regimens for the BPI protein product and the antibiotics in concurrent administration.

Other aspects and advantages of the present invention will be understood upon consideration of the following illustrative examples. Example 1 addresses the bactericidal effect of gentamicin and BPI when administered to two 30 different strains of E. coli. Example 2 addresses the bactericidal effect of gentamicin and BPI for a number of other gram-negative strains. Example 3 addresses the bactericidal effect of polymyxin B and BPI when administered to two different strains WO 95/08344 PCT/DS94/11225 of E. coli. Example 4 addresses the bactericidal effect of polymyxin B and BPI for a number of other gram-negative strains. Example 5 addresses the effect of a BPI protein product with a cephalosporin antibiotic in an in vivo mouse peritonitis E. coli OHl:B4 challenge model. Example 6 also relates to the effect of a BPI protein 5 product with a cephalosporin antibiotic in an in vivo mouse peritonitis E. coli 0111:B4 challenge model. Example 7 relates to the effect of a BPI protein product with a cephalosporin antibiotic in an in vivo mouse peritonitis E. coli 07:K1 challenge model. Example 8 addresses the effect of a BPI protein product with a cephalosporin antibiotic in an in vivo rabbit bacteremia E. coli 07:K1 challenge 10 model. Example 9 addresses the effect of a BPI protein product with an aminoglycoside antibiotic in an in vivo mouse peritonitis E. coli 07:K1 challenge model. Example 10 relates to the effect of a BPI protein product in vitro on the antibiotic susceptibility of ceftriaxone-resistant gram-negative organisms. Examples 11-19 address large-scale screening of the antibiotic susceptibility-increasing effect 15 of a BPI protein product on a variety of gram-negative organisms: Pseudomonas aeruginosa and other Pseudomonas species (Example 11), E. coli (Example 12), Citrobacter (Example 13), Klebsiella (Example 14), Enierobacter (Example 15), Serratia (Example 16), Proteus (Example 17), Providencia (Example 18), Morganella (Example 19), Acinetobacter (Example 20), and Salmonella and Shigella (Example 20 21). Example 22 examines the early in vitro bactericidal effect of BPI protein product and selected antibiotics on E. coli J5, E. coli 07:K1, Enierobacter cloacae and Klebsiella pneumoniae. Example 23 examines the effect of a variety of BPI protein products on several representative organisms, Acinetobacter anitratus, Enierobacter cloacae, and two strains of E. coli. Example 24 relates to the screening 25 of BPI peptides for antibacterial activity against E. coli. Example 25 addresses the effect on E. coli 0111:B4 of concurrent administration of BPI protein product with tetracycline or gentamicin.

Example 1 SYNERGISTIC BACTERICIDAL EFFECTS OF GENTAMICIN AND BPI: ADMINISTRATION TO E. COLI AND E. COLI 0111:B4 GRAM-NEGATIVE ORGANISMS In this example, a micro dilution plate minimum inhibitory concentration (MIC) assay was conducted to determine the sensitivity of E. coli organisms to the bactericidal effects of BPI protein products concurrently administered with the antibiotic gentamicin. The assays were conducted against the BPI sensitive organism E. coli J5 (an Rc rough mutant of E. coli 0111 :B4), and a BPI 10 resistant organism E. coli 0111:B4.

Specifically, organisms were grown overnight on blood agar plates at 37°C in air, single colonies were then sub-cultured in 100 mL of nutrient broth No. 2 (Oxoid CM67) and incubated with gentle agitation on an orbital shaker for 5 1/4 hours until in log phase. Fifty mL of the bacterial suspension was then spun down 15 in a Denley BR401 bench centrifuge at 4000 rpm for 15 minutes and the pellet was resuspended and washed twice using sterile normal saline. Bacteria were then resuspended in saline such that a 1:10 dilution had an optical density of 0.9 (4-/-0.01) at 325 nm (corresponding to approximately 4x10s cells per mL) and diluted to give a final concentration of 4x10* cells per mL in "BPI media" (described below). 20 All assays and dilutions of BPI protein products and gentamicin were performed using "BPI media" consisting of 50% peptone water (Oxoid L37, Lot: 25851279) with 0.1 M MOPS (Sigma M-1254) buffered to pH 6.00 with sodium hydroxide. This provides a nutritive media with a low protein and divalent cation concentration adjusted to a pH which is not inhibitory to bacterial growth and allows 25 for readily measurable (though not optimal) BPI activity. rBPI-vj and gentamicin (Sigma G-1264, Lot: 91H00325) were diluted in BPI media such that 100 ^L of diluted BPI, 50 fih of diluted gentamicin and 50 fiL of bacterial suspension in the final volume of 200 ,uL per well, gave concentrations in serial dilutions from 1000 nM (25 ^g per mL) BPI and 32 fig per 30 mL of gentamicin with a fixed concentration of 106 cells/mL. Checkerboards were then constructed in round bonomed 96 well microtitre plates (Greiner No. 650180) and incubated with non-sealing lids at 37 C in air for 18 hours. Plates were then read by eye and in an automatic plate reader (Titretek Multiscan plus) at 580 nm with visible growth corresponding to an optical density of approximately 0.1 (see Table 1 for E. coli J5, and Table 3 for E. coli 0111:B4). Viable counts were made from the wells adjacent to the cutoff of visible growth for the two E. coli plates (see Table 2 for E. coli J5, and Table 4 for E. coli 0111:B4) by dilution of 10 fiL in 990 fiL of Nutrient Broth No. 2 and spread plates were prepared with 25 /iL on blood agar. The inhibitory activity of BPI protein product with antibiotic was evaluated by the method of Eliopoulos and Moellering In Antibiotics in Laboratory Medicine, 3rd ed. (Lorian, V., Ed.) pp. 432-492, Williams and Wilkins, Baltimore MD (1991), wherein a fractional inhibitory concentration index (FIC) of less than 0.5 was scored as synergy, 1 was scored as additive and greater than 1 but less than 2 was scored as indifferent.

A positive synergistic interaction was demonstrated between rBPI^ and gentamicin using the BPI sensitive E. coli J5 with gentamicin at a concentration of 0.25 fig per mL, reducing the MIC of BPI by approximately eight-fold from 500 nM (12.5 fig per mL) to 62.5 nM (1.56 fig per mL) with similar reductions of the minimum bactericidal concentration (MBC).

Visible Growth (bold line) of E. coli J5 and OD55 (580 nm) Gentamicin (/xg per ml) BPI (nM): 32 16 8 4 2 1 0.5 0.25 1.25 .06 .03 0 1000 .071 .067 .069 .067 .068 .071 .073 .072 .065 .068 .062 .065 500 .055 .050 .052 .055 .053 .056 .054 .059 .106 .054 .056 .054 250 .056 .055 .053 .057 .058 .057 .055 .060 .055 ij .194 .201 125 .058 .053 .051 .053 .055 .062 .064 .061 .060 | .215 .258 .236 62.5 .052 .053 .056 .054 .054 .053 .062 .056 | .172 .196 .262 .261 31 .057 .058 .052 .055 .056 .058 .063 .135 .206 .251 .259 .286 16 .057 .059 .057 .058 .059 .062 .081 .148 .240 .262 .297 .327 0 .060 .053 .060 .057 .054 .058 .071 .151 .252 .285 .330 .326 TABLE 2 Visible Growth (bold line) of E. coli J5 and Viable Counts Gentamicin (jig per ml) BPI (nM): 32 16 8 4 2 1 0.5 0.25 .125 .06 .03 0 1000 NC NC NC NC NC NC NC 0 0 0 0 0 500 NC NC NC NC NC NC 0 0 147 2 0 0 250 NC NC NC NC NC 0 0 0 0 ° 1° NC 125 NC NC NC NC 0 0 0 0 ° 1 + + NC NC 62.5 NC NC NC NC 0 0 121 < l++ NC NC NC 31 NC NC NC NC 0 0 555 + + NC NC NC NC 16 NC NC NC NC 0 0 438 438 NC NC NC NC 0 NC NC NC NC 0 0 267 + + NC NC NC NC Counts expressed as counts per ml, NC = not counted, + +=too numerous to count.

TABLE 3 Visible Growth (bold line) of E. coli 0111:B4 and ODs (580 nm) Gentamicin (^g per ml) BPI (nM): 32 16 8 4 2 1 0.5 0.25 .125 .06 .03 0 1000 .067 .064 .057 .057 .055 .067 .062 .191 .275 .328 .308 .370 500 .054 .051 .049 .052 .050 .050 .048 .179 .245 .282 .276 .342 250 .054 .053 .053 .053 .058 .061 .054 .161 .245 .282 .269 .345 125 .048 .051 .049 .047 .049 .050 1 .109 .198 .239 .267 .261 .328 62.5 .062 .058 .054 .051 .053 .052 .059 .176 .252 .283 .287 .353 31 .059 .054 .054 .052 .051 .051 .054 .192 .250 .287 .278 .357 16 .061 .054 .058 .063 .052 .054 .048 .158 .261 .285 .284 .349 0 .054 .058 .055 .049 .050 .053 .079 .155 .280 •.309 .322 .374 TABLE 4 Visible Growth (bold line) of E. coli 0111:B4 and viable counts Gentamicin (jig per ml) BPI (nM): 32 16 8 4 2 1 0.5 0.25 .125 .06 .03 0 1000 NC NC NC NC 0 0 6 4-4- NC NC NC NC 500 NC NC NC NC 0 0 0 4-4-4- NC NC NC NC 250 NC NC NC NC 0 0 0 4-4-4- NC NC NC NC 125 NC NC NC NC 0 0 0 + 4-4- NC NC NC NC 62.5 NC NC NC NC 0 0 0 + + + NC NC NC NC 31 NC NC NC NC 0 0 I + 4- + NC NC NC NC 16 NC NC NC NC 0 0 0 + + + NC NC NC NC 0 NC NC NC NC 0 0 287 4" 4- 4-.

NC NC NC NC Counts expressed as count per ml, NC = not counted, +4-=too numerous to count. -43 -Example 2 SYNERGISTIC BACTERICIDAL EFFECTS OF GENTAMICIN AND BPI: ADMINISTRATION TO ADDITIONAL GRAM-NEGATIVE ORGANISMS In this example, micro dilution plate MIC assays were conducted 5 according to the method of Example 1 to determine the sensitivity of a variety of gram-negative organisms to the cytotoxic effects of BPI protein products concurrently administered with gentamicin antibiotic. The results of those assays are shown in Table 5 below. Positive synergistic bactericidal interactions were observed against E. coli 15, E. coli 01:K1, E. coli (S2252), K. oxytoca, E. tarda, Salmonella 10 ryphimurium (S2136) and Salmonella arizonae. Possible synergistic bactericidal interactions (indicated as "additive (+)") were observed against E. cloacae (10005), E. gergoviae (11434), P. aeruginosa (10332) and P. aeruginosa (10662). The concurrent administration of gentamicin and rBPI^ had only additive, indifferent or indeterminate effects against the other tested gram-negative bacteria. • TABLE 5 MIC Values and Results of Checkerboard Susceptibility Testing With BPI and Gentamicin Organism (NCTC) MIC of Single Agent BPI23 (nM) MIC of Single Agent Gentamicin Oxg/ml) Lowest MIC of the Agents Together rBPIu/Gentamicin Interpretation (Gentamicin) E. coli J5 250 1.0 62.5/0.125 synergy E. coli 01 :K1 >2000 2.0 31/0.5 synergy E. coli (S2252) NCTC 10418 500 0.5 250/0.25 additive/synergy E. coli Oil 1:B4 >2000 1.0 >2000/1.0 indifferent E. coli (S2216) >500 1.0 >500/1.0 indifferent E. coli H262 >500 — — indifferent E. dispar (S2162) >500 — — indifferent E. alcalescens (S2196) >2000 — — indifferent K. oxytoca >2000 1.0 1000/0.25 synergy K. pneumoniae >2000 0.5 >2000/0.5 indifferent E. cloacae (10005) >2000 1.0 1000/0.5 additive (+) E. gergoviae (11434) >2000 2.0 2000/0.5 additive (+) S. marcescens (10211) >2000 4.0 >2000/4.0 indifferent P. rettgeri (S2253) >500 2.0 1000/1.0 indifferent P. vulgaris (4175) 500 0.25 250/0.125 additive P. morganii (S2161) >2000 2.0 2000/2.0 indifferent P. aeruginosa (10332) >2000 0.5 31/0.25 additive (+) P. aeruginosa (840P) >2000 1.0 >2000/1.0 indifferent TABLE 5 MIC Values and Results of Checkerboard Susceptibility Testing With BPI and Gentamicin Organism (NCTC) MIC of Single Agent BPI23 (nM) MIC of Single Agent Gentamicin Oxg/ml) Lowest MIC of the Agents Together rBPIu/Gentamicin Interpretation (Gentamicin) P. aeruginosa (10662) >2000 0.25 2000/0.125 additive (+) P. aeruginosa (U600) >2000 0.5 62.5/0.25 indifferent K. aerogenes NCTC 9496 >2000 1.0 2000/0.5 indifferent Shigella dysenteriae NCTC 4837 >2000 1.0 >2000/1.0 indifferent E. tarda 500 1.0 31/0.125 synergy K. rhinoscleromatis >500 : .0 >500/1.0 indifferent Salmonella choleresuis >2000 indifferent Salmonella typhimuriwn (S2185) >500 0.25 >500/0.25 indifferent Salmonella typhimurium (S2136) >2000 >4.0 31/4.0 synergy Salmonella arizonae >500 1.0 synergy E. aerogenes (S2164) >2000 1.0 62.5/1.0 indifferent C. freundi >2000 indifferent ( + ) possibility of synergy but FIC incalculable because rfiPI^ MIC outside tested concentration range. - 46 -Example 3 SYNERGISTIC BACTERICIDAL EFFECTS OF POLYMYXIN B AND BPI: ADMINISTRATION TO E. COU J5 AND E. COU 0111:B4 GRAM-NEGATIVE ORGANISMS In this example, micro dilution plate MIC assays were conducted according to the method of Example 1 to determine the sensitivity of E. coli J5 and E. coli 0111:B4 to the cytotoxic effects of BPI protein products concurrently administered with the antibiotic polymyxin B. Polymyxin B solution with an activity of 10240 units/mL was prepared by preparing a solution of 1.595 mg of polymyxin 10 B sulfate stock powder per mL, and diluting it in sterile water for injection as 20 fig in 12.54 mL.

A positive synergistic interaction was demonstrated between rBPI^ and polymyxin B using E. coli 0111:B4 (see Tables 8 and 9) but the administration of polymyxin B with BPI did not have synergistic bactericidal effects with BPI when 15 applied to E. coli J5 as illustrated by the results shown in Tables 6 and 7.

TABLE 6 Visible Growth (bold line) of E. coli J5 and ODs (580 nm) Polymyxin B (^g/ml) BPI (nM): 2.5 1.25 .6 .3 .15 .075 .075 0 2000 .071 .006 .001 .001 .002 .001 .011 .002 .006 1000 .069 .003 .002 .004 .003 .001 .001 .009 .007 500 .055 .000 .018 .001 .001 .007 .012 .012 .006 250 .049 .000 .001 .001 .012 .026 .025 .013 .006 125 .047 .002 .095 .123 .114 .107 .130 .093 .157 62.5 .047 .002 .047 .131 .144 .164 .141 .124 .185 31 .044 .001 .094 .160 .163 .184 .183 .168 .238 0 .046 .002 .128 .230 .254 .282 .270 .245 .307 TABLE 7 Visible Growth (bold line) of E. coli J5 and Viable Counts Polymyxin B (/xg/ml) BPI (nM): 2.5 1.25 .6 .3 .15 .075 .075 0 2000 NC NC 0 0 0 0 0 0 0 1000 NC NC 0 1 0 0 0 0 500 NC NC 12 + *4" 4-4- 264 379 0 250 NC 81 + + 4- + +++ 4-4-4- + + + 4-4-4- 496 125 0 0 NC NC NC NC NC NC NC 62.5 0 0 NC NC NC NC NC NC NC 31 0 0 NC NC NC NC NC NC NC 0 0 0 NC NC NC NC NC NC NC Counts expressed as counts per ml, NC = not counted, -f+ =too numerous to count.

TABLE 8 Visible Growth (bold line) of E. coli Oil 1:B4 and ODS (580 nM) Polymyxin B (^g/ml) BPI (nM): 2.5 1.25 .6 .3 .15 .075 0 2000 0 .015 .009 .01 .011 .011 | .295 .379 .360 1000 0 .003 | .035 .109 .148 .217 .261 .305 .286 500 0 .006 .008 .145 .166 .280 .238 .292 .282 250 0 .006 .012 .146 .216 .265 .254 .294 .260 125 0 .016 | .101 .193 .228 .269 .233 .298 .269 62.5 0 .050 .012 | .212 .201 .277 .246 .288 .281 31 0 .002 .054 .245 .223 .260 .234 .291 .271 0 0 .001 .144 .267 .265 .295 .272 .309 .290 TABLE 9 Visible Growth (bold line) of E. coli 0111-.B4 and Viable Counts BPI (nM): 2.5 Polymyxin B (/ig/ml) 1.25 .6 .3 .15 .075 0 2000 NC 0 0 0 0 > 1 + + + NC NC 1000 0 0 1 NC + + + + + + + + NC NC NC 500 0 0 0 + + + NC NC NC NC NC 250 0 0 89 + + + NC NC NC NC NC 125 0 7 | +++ + + + NC NC NC NC NC 62.5 0 80 1 1 + + + NC NC NC NC NC 31 0 0 + + + NC NC NC NC NC NC 0 0 0 + + + NC NC NC NC NC NC Counts expressed as counts per ml, NC = not counted, + + =too numerous to count. -51 -Example 4 SYNERGISTIC BACTERICIDAL EFFECTS OF POLYMYXIN B AND BPI: ADMINISTRATION TO ADDITIONAL GRAM-NEGATIVE ORGANISMS In this example, micro dilution MIC assays were conducted according 5 to the method of Example 1 to determine the sensitivity of a variety of gram-negative organisms to the cytotoxic effects of BPI protein products concurrently administered with polymyxin B antibiotic. The results of those assays are shown in Table 10 below.

These assay results show additive or synergistic effects with the use of 10 polymyxin B at concentrations of 0.3 ng/mL, a level of which is 10-20 times lower than when that antibiotic is used conventionally.

TABLE 10 MIC Values and Results of Checkerboard Susceptibility Testing With BPI and Polymyxin B (PB) Organism (NCTC) MIC of Single Agent BPIJ3 (nM) MIC of Single Agent PB ) Lowest MIC of the Agents Together rBPI^/PB Interpretation (Polymyxin B) E. coli J5 250 2.5 250/2.5 indifferent E. coli (S2252) NCTC 10418 500 .0 250/2.5 indifferent E. coli 0111 :B4 >2000 .0 250/2.5 synergy E. cloacae (10005) >500 0.5 500/0.5 indifferent E. gergoviae (11434) >2000 .0 125/2.5 additive (+) S. marcescens (10211) >2000 >10.0 >2000/10.0 indifferent P. reltgeti (S2253) >2000 2.5 125/1.25 synergy P. aeruginosa (10332) >2000 1.25 250/0.6 synergy P. aeruginosa (840P) >2000 1.25 1000/0.6 synergy P. aeruginosa (10662) >2000 1.25 125/0.6 synergy P. aeruginosa (U600) >2000 1.25 2000/0.3 synergy E. aerogenes (S2164) >2000 >10.0 >2000/10.0 indifferent -53 -Example 5 SYNERGISTIC EFFECTS OF CEFAMANDOLE AND BPI PROTEIN PRODUCT IN VIVO IN MICE CHALLENGED INTRAPERITONEALLY WITH LIVE E. COU 0111:B4 BACTERIA: 5 EFFECT ON SURVIVAL In this example, the protective effect of cefamandole nafate antibiotic (MANDOL®, Lilly) a semisynthetic broad-spectrum cephalosporin antibiotic with and without a BPI protein product was evaluated by means of challenging ICR mice with an LD^o, dose level of live E. coli 0111:B4 bacteria, 10 a strain that is not susceptible to the bactericidal/growth inhibitory effects of BPI protein product. Specifically, four groups of 15 ICR mice were treated such that each ICR mouse received an injection of bacteria (1.8 x 109 CFU/mouse) intraperitoneally; an intraperitoneal injection of cefamandole nafate (MANDOL®, 100 mg/kg) or saline; and then an intraperitoneal injection of rBPI2l 15 (500fig/mouse) or BPI buffer. Survival of the mice was then evaluated over a period of 7 days with the results illustrated in Figure 1.

Concurrent administration of BPI protein product with cefamandole, or administration of cefamandole alone, showed significant protection in mice challenged with E. coli 0111:B4 when compared to the buffer control (pS0.001 20 and p:S0.05 respectively). The protective effect of the BPI protein product when administered without cefamandole was not evident. When compared to treatment with cefamandole alone, concurrent administration of BPI protein product with cefamandole showed improved protection at p:£ 0.1. These results indicate that the concurrent administration of cefamandole and a BPI protein product has 25 synergistic therapeutic effects against E. coli 0111:B4.

Example 6 SYNERGISTIC EFFECTS OF CEFAMANDOLE AND BPI PROTEIN PRODUCT IN VIVO IN MICE CHALLENGED 30 INTRAPERITONEALLY WITH LIVE E. COU 0111 :B4 BACTERIA: EFFECT ON SURVIVAL AND ON BACTERIAL CLEARANCE FROM BLOOD AND PERITONEAL LAVAGE FLUID The protective effects of a cephalosporin antibiotic and a BPI protein product were evaluated in mice challenged intraperitoneally with E. coli 0111:B4, a strain that is resistant to the bactericidal effects of BPI protein product. The assay was conducted using the following procedure. Male ICR mice (Simonsen Laboratories, Gilroy California), 5-7 weeks old, were housed under controlled climate and dark/light cycles and were allowed free access to food and 5 water. Mice received an intraperitoneal injection of 0.5 ml of bacteria in doses near an LD^ (2 x 109 CFU/mouse). Immediately after bacterial challenge the animals received an intraperitoneal injection of (1) vehicle only, (2) 500 jxg/mouse rBPIj, and vehicle, (3) 100 mg/kg cefamandole nafate (Mandof in phosphate buffered saline; Eli Lilly, Indianapolis, IN) and vehicle, or (4) 500 fig rBPL, and 10 100 mg/kg cefamandole.

Survival of the four groups was monitored for 7 days. Survival ■data was statistically analyzed using the Chi-square test. In a separate experiment using a bacterial challenge of 2.5 x 109 CFU E. coli 0111:B4, blood and peritoneal lavage fluid were collected for culture at different time points following 15 bacterial challenge. Blood was obtained from the retro-orbital sinus. At least 1 ml of peritoneal Lavage fluid was obtained after intraperitoneal injection of 3 ml of phosphate buffered saline. Bacterial counts (expressed as CFU/ml) were determined by inoculating trypticase soy agar plates with 10-fold dilutions of blood or peritoneal lavage samples, incubating the plates overnight at 37°C, and counting 20 the colonies. Statistical comparisons of this data were performed with the analysis of variance.

Figure 2 shows effects on survival of cefamandole (100 mg/kg), rBPI21 (500 fig) or the concurrent administration of the two agents. The BPI protein product alone had no effect, while cefamandole treatment alone increased 25 survival, although not significantly. In contrast, the concurrent administration of rBPI21 with cefamandole resulted in a significant increase in survival (p<0.05) above that achieved by either treatment alone. Figures 3 and 4 show that rBPI2l alone failed to reduce counts in either peritoneal lavage fluid or blood after challenge with bacteria, while cefamandole treatment alone significantly reduced 30 counts in both (p<0.01 vs. vehicle). However, the concurrent administration of rBPl21 and cefamandole reduced bacterial counts in the peritonea] lavage fluid by more than two orders of magnitude below that achieved by cefamandole alone (p<0.01 of concurrent administration vs. cefamandole only) at the 2 and 6 hour time points, and entirely eliminated counts after 24 hours. Blood of mice that received concurrent administration of rBPL, and cefamandole was completely free of bacteria at all time points.

Thus, the concurrent administration of a BPI protein product, rBPI21, with a suboptimal dose of a cephalosporin antibiotic, cefamandole, resulted in a superior therapeutic effect. The data indicates that BPI protein products and cephalosporin antibiotics produce a synergistic therapeutic effect. Since cefamandole alone reduced counts by approximately two orders of magnitude 10 compared to vehicle-treated animals, another experiment was conducted to determine if rBPI21 alone reduced bacterial counts when the inoculum was reduced to 107 CFU. Data from this experiment showed that rBPI2, (500 fig) did not significantly reduce bacterial counts in blood or peritoneal lavage fluid after a challenge of 107 CFU. This suggests that an antibiotic-mediated reduction in the 15 magnitude of the bacterial count cannot, in itself, explain the protection associated with concurrent administration of BPI protein product and antibiotic.

Example 7 SYNERGISTIC EFFECTS OF CEFAMANDOLE AND 20 BPI PROTEIN PRODUCT IN VIVO IN MICE CHALLENGED INTRAPERITONEALLY WTIH LIVE E. COU 07:K1 BACTERIA: EFFECT ON SURVIVAL The protective effects of a cephalosporin antibiotic and a BPI protein product were evaluated in mice challenged intraperitoneally with E. coli 25 07:K1 (ATCC Accession No. 23503), a strain that is susceptible to the bactericidal effects of BPI protein product. The general procedure described above in Example 5 was followed. Four groups of 20 mice were challenged intraperitoneally with 2 x 107 E. coli 07:K1 bacteria and then treated with (1) vehicle, (2) 50 ng rBPI21 only, (3) 20 mg/kg cefamandole only, or (4) both 50 ^g 30 rBPL, and 20 mg/kg cefamandole. Survival of the mice was followed over a period of 7 days; results of two trials are displayed in Figures 5A and 5B.

In one trial, rBPL, alone protected 11 % of the survivors compared to vehicle controls, cefamandole protected 47% of the survivors compared to vehicle controls (p<0.05 vs. vehicle), and the concurrent administration of rBPL, and cefamandole protected 100% of the survivors compared to vehicle controls (p<0.001 vs. vehicle, p<0.01 vs. cefamandole alone). In the second trial, rBPI,, alone protected 0% of the survivors compared to vehicle, cefamandole protected 5 12% compared to vehicle, and the concurrent administration of rBPI21 and cefamandole protected 59% compared to vehicle (p<0.01 vs. vehicle, p<0.05 vs. cefamandole alone). In both trials, the increase in survival associated with the concurrent administration of rBPI2] and cefamandole was greater than the sum of the increases in survival due to the individual therapies. Thus, there appears to be 10 synergy (a greater than additive effect) between cefamandole and BPI protein product in this model.

Example 8 SYNERGISTIC EFFECTS OF CEFAMANDOLE AND 15 BPI PROTEIN PRODUCT IN VIVO IN RABBITS CHALLENGED INTRAVENOUSLY WTIH LIVE E. COU 07:K1 BACTERIA: EFFECT ON BACTERIAL CLEARANCE AND ON CARDIOVASCULAR, RESPIRATORY AND METABOLIC PARAMETERS Adult male New Zealand White rabbits (Charles River Laboratories, 20 St. Constant, Canada) weighing between 1.8 and 2.3 kilograms were fasted for 24 hours before the experiment. Each rabbit was anesthetized with an intramuscular injection of 80/4 mg/kg Ketamine/xylazine. The left femoral artery was catheterized for blood pressure determinations and blood sample collection. A catheter was placed adjacent the right atrium via the right jugular vein and a 25 thermistor-tipped catheter was placed in the aortic arch via the right carotid artery. The rabbits were allowed to stabilize for 90-120 minutes following catheterization to normalize hemodynamic and blood gas parameters.

The rabbits were divided into four treatment groups with 4 animals per group: (1) vehicle alone, (2) cefamandole and vehicle, (3) rBPI21 and vehicle, 30 and (4) cefamandole and rBPL,. The rabbits were administered cefamandole (Mandol*; Eli Lilly, Indianapolis, IN) or vehicle intravenously 5 minutes before the stan of the bacterial infusion (considered to be T=0). At T=0, 2 x 10'° CFU/rabbit of E. coli 07:K1 was infused intravenously over 10 minutes into the ear vein. Simultaneously (at T=0), 10 mg/kg tBPI2I or vehicle was infused over 10 minutes via the right jugular catheter. After the ten minute infusion, rBPI21 was slowly infused at 10 mg/kg/hr for 2 hours (resulting in a total dose of 30 mg/kg rBPL,,).

Arterial blood samples for determination of bacterial counts and endotoxin levels were collected at the end of the 10 minute bacterial infusion and at 30 minutes, 1, 2, 3 and 4 hours. The whole blood was 10-fold serially diluted in sterile PBS and aliquots were plated onto tryptic soy agar plates, incubated at 37°C overnight, and the plates were counted for colony forming units (CFU). The 10 results were expressed as CFU/ml blood and percent bacteria dose per ml blood. The remaining portion of the blood was centrifuged, the plasma removed and passed through a 0.2 micron Whatman syringe filter to remove the bacteria. The endotoxin levels were determined using a modified limulus amoebocyte lysate assay (Pyrochrome LAL Assay, Associates of Cape Cod, Woods Hole, MA). 15 These results were expressed as ng LPS per ml plasma.

Cardiovascular, respiratory and metabolic parameters were measured every 30 minutes. Mean arterial blood pressure (MABP) and heart rate were monitored continuously throughout the experiments and displayed on a cardiac output computer (Columbus Instruments Cardiomax II) ot on a chart 20 recorder. Heart rate was derived from the arterial pressure wave. Cardiac output was determined in duplicate with the thermodilution technique: Changes in blood temperature resulting from injection of 900 fil of room temperature PBS were recorded with the thermistor-tipped catheter in the aortic arch. The cardiac output computer then generated thermodilution curves that were visualized on the chart 25 recorder, and derived cardiac output from the temperature-time curves. Cardiac index (CI) was then calculated as cardiac output per kg body weight. In addition, total peripheral resistance (TPR) was determined by dividing blood pressure by cardiac output.

Blood samples for blood gas determinations were drawn from the 30 femoral artery catheter every 30 minutes throughout the study. Blood gases were measured with a Ciba-Cornmg Blood Gas System, Model 278 (Ciba-Coming Diagnostics Corp., Medfield, MA). The blood gas system directly measures blood pH, partial pressure of pC02, and partial pressure of pG;. Other parameters including the alveolar-arterial oxygen gradient, arterial oxygen content, estimated oxygen saturation, standard bicarbonate, and in vivo base excess were calculated using the formulas provided by Ciba-Coming Diagnostic Corp. Plasma levels of 5 glucose and lactate were determined using a Glucose/L-lactate Analyzer (2300 STAT, YSI, Yellow Springs, OH).

Survival data is shown in Figure 6. Two of the four animals (50%) treated with vehicle alone died before the end of the experiment. None of the animals concurrently treated with rBPL,, and cefamandole died. Bacterial counts 10 in blood, expressed as CFU/ml or percent bacteria dose/ml, are shown in Figures 7 and 8, respectively. In Figure 7, the squares represent treatment with vehicle alone, the diamonds represent cefamandole alone, the circles represent rBPL, alone, and the triangles represent the concurrent administration of rBPI2, and cefamandole. In Figure 8, the bar with horizontal hatching indicates treatment 15 with cefamandole alone, the hollow bar indicates the concurrent administration of rBPI21 and cefamandole, the bar with vertical hatching indicates rBPI21 alone, and the solid bar indicates buffer alone. The group concurrently treated with rBPI;i and cefamandole demonstrated a higher clearance of bacteria compared to the groups treated with either rBPI2t alone or cefamandole alone. There appears to be 20 a synergistic effect at 30 and 60 minutes; at 30 minutes, the concurrent administration of rBPI21 and cefamandole resulted in a higher percentage clearance of bacteria than the sum of the separate treatments.

Endotoxin levels are displayed in Figure 9. The open diamonds indicate treatment with vehicle alone, filled diamonds indicate rBPI2I alone, the 25 filled squares indicate cefamandole alone, and the open squares indicate concurrent administration of rBPI2, and cefamandole. Animals administered cefamandole alone have a much higher LPS level than animals treated with vehicle alone, due to release of LPS as cefamandole kills bacteria. The concurrent administration of rBPI2, and cefamandole produced a dramatic decrease in LPS levels compared to 30 cefamandole therapy alone.

Cardiovascular/pulmonary parameters (MABP. CI. TPR. arterial oxygen tension, alveolar-arterial 0: gradient, respiration rate, and arterial blood pH) are shown in Figures 10-16, respectively. These figures only display results for the groups treated with cefamandole alone (indicated by open squares) and concurrent treatment with rBPL, and cefamandole (indicated by filled squares). Single stars indicate that the concurrent administration of both agents provided 5 statistically significant (p<0.05) improvement over antibiotic alone, while two stars indicate p<0.01. Cefamandole alone or rBPL, alone failed to protect the animals; cardiovascular and respiratory dysfunction began during the bacterial infusion and the animals were in circulatory shock by the end of the infusion. Cardiovascular shock lasted for the rest of the experiment. Arterial blood pH 10 began to decrease at 60 minutes in the group treated with cefamandole alone, and was at its lowest level by the end of the experiment. In contrast, concurrent administration of rBPI2, and cefamandole preserved cardiopulmonary function and prevented septic shock. Thus, the concurrent administration of BPI protein product with antibiotic protected the animals against the lethal effect of bacteremia 15 and preserved cardiopulmonary function when antibiotic alone failed to do so.

Example 9 SYNERGISTIC EFFECTS OF GENTAMICIN AND BPI PROTEIN PRODUCT IN VIVO IN MICE CHALLENGED 20 INTRAPERITONEALLY WITH LIVE E. COU 07:K1 BACTERIA: EFFECT ON SURVIVAL The synergistic effects of an aminoglycoside antibiotic and a BPI protein product were evaluated in mice challenged intraperitoneally with E. coli 07:K1 (ATCC Accession No. 23503), a smooth encapsulated strain that is 25 susceptible to the bactericidal effects of BPI protein product. The general procedure described above in Example 4 was followed. Six groups of 20 mice were challenged intraperitoneally with 2x101 E. coli 07:K1 bacteria and treated immediately with (1) vehicle, (2) 0.03 mg/kg gentamicin, (3) 0.1 mg/kg of gentamicin, (4) 50 fj.g of rBPI21, (5) 0.03 mg/kg gentamicin followed by 50 fig of 30 rBPI21, or (6) 0.1 mg/kg of gentamicin followed by 50 fig of rBPI21. Survival was followed over 7 days. Results are shown in Figure 17. Neither antibiotic alone nor rBPL, alone had any effect on mortality other than to shghtiy retard the death rate. However, the concurrent administration of rBPL, with low-dose gentamicin significantly increased survival (p<0.5 vs. vehicle). Concurrent administration of rBPI21 with high-dose gentamicin dramatically increased survival (p< 0.001 vs. vehicle, and p<0.05 vs. 0.03 mg/kg gentamicin with rBPI21)> protecting all but two of the mice from the lethal effects of bacterial challenge. The results clearly 5 indicate synergism between gentamicin and BPI protein product. The greater synergistic effect of the concurrent administration of BPI protein product with gentamicin, compared to the effect of the concurrent administration of BPI protein product with cefamandole, may be related to the fart that aminoglycosides, which inhibit protein synthesis, have a different mechanism of action than BPI protein 10 product.

Example 10 EFFECT OF BPI PROTEIN PRODUCT IN VITRO ON ANTIBIOTIC SUSCEPTIBILITY OF 15 CEFTRIAXONE-RESISTANT GRAM-NEGATIVE ORGANISMS The ability of BPI protein product, BPI21, to reverse the resistance of a variety of gram-negative organisms to ceftriaxone (Roche Laboratories) was evaluated in virro.

The strain of gram-negative bacteria to be tested was grown 20 overnight at 37"C on Trypticase soy agar (TSA) plates. Colonies from the plate were then inoculated into nutrient broth (or triethanolamine-buffered minimal salts medium), grown overnight to stationary growth phase, diluted 1:10 in fresh medium, and grown to mid-late logarithmic growth phase (3 to 4 hours at 3TC) to an approximate concentration of 6 to 10 x 10* organisms/mL. Organism counts 25 were performed by making serial dilutions, plating in triplicate on TSA plates, incubating at 37°C overnight, and counting colonies by visual inspection.

Following development of a standard curve, counts were made by measuring ODm0 and confirming by plating. The bacteria were sedimented by centrifugation at 6,000g for 10 min. and resuspended in sterile saline to the desired 30 concentration.

Ceftriaxone solutions were prepared from standard powder (Roche Laboratories). Solutions of BPI protein product were prepared from rBPI:i. Hanks solution, vitamin-free casamino acid, and TRIS-HC1 buffer. pH 7.0. Broth MIC WO 95/08344 PCT/US94/11225 studies were performed as follows: U-bottom, disposable, microtiter array plates (Dynatech) containing 100 ^L/well of broth and serial dilutions of 1:1 proportion rBPI2i and ceftriaxone were prepared using a multichannel pipetting instrument, inoculated with organisms diluted to approximately 2.5 x 105 CFU/ml, and 5 incubated overnight at 3TC. Media controls containing no organism and growth controls containing organisms but no ceftriaxone or rBPI21 were also prepared. The MIC was determined as the lowest drug concentration (jig/mL) that inhibited bacterial growth. Agar MIC studies were performed as follows: The organism was grown in Mueller-Hinton broth (Difco Laboratories) overnight at 37°C, 10 transferred and grown to logarithmic phase, counted by optical densitometry, diluted with buffer and rBPI21 and ceftriaxone, and incubated for 30 minutes at 37°C. After the 30 minutes of incubation, samples were serially diluted in sterile saline and plated onto TSA agar for bacterial counts after overnight incubation at 31'C.

A variety of different bacterial species were tested, including Pseudomonas, Enierobacter, Citrobacter, Klebsiella, and Escherichia species. A summary of the results is displayed in Table 11 below, which reports the minimum inhibitory concentration (MIC) of BPI protein product alone, the MIC of ceftriaxone alone, and the MIC of both agents together (in a fixed 1:1 proportion 20 of rBPI21 and ceftriaxone). The experiments were replicated, and each number given in the table represents the highest, or worst-case, MIC for the group. wo 95/08344 TABLE 11 Synergistic Effect of rBPI-j, and Ceftriaxone on Ceftriaxone-Resistant Organisms Organism MIC of BPI alone Og/mL) MIC of Ceftriaxone alone Og/mL) MIC of BPI -+• Ceftriaxone (jig/mL) PA 589 64 >64 4 PA 631 >64 >64 4 PA 672 32 32 2 PA 677 >64 >64 4 EA 658 >64 >64 4 CF 595 4 >64 1 CF 596 4 >64 1 CF 597 >64 >64 8 CF 598 8 32' 2 CF 642 4 16 8 CF 661 32 16 1 KP 601 64 >64 8 EC 004 >64 > 64 <0.1 EC 600 >64 32 8 EC 664 64 >64 32 ECL 03 16 >64 16 ECL05 16 > 64 16 ECL 07 >64 64 16 ECL 13 >64 >64 16 ECL 14 16 >64 32 ECL 15 >64 >64 32 ECL 19 >64 >64 32 PA 001 >64 >64 8 PA 003 >64 >64 8 PA 004 >64 64 16 PA 005 >64 >64 64 PA 012 >64 >64 16 PA 014 >64 >64 8 TABLE 11 Synergistic Effect of rBPI2l and Ceftriaxone on Ceftriaxone-Resistant Organisms Organism MIC of BPI alone (jig/mL) MIC of Ceftriaxone alone 0ig/mL) MIC of BPI 4- Ceftriaxone Oxg/mL) PA 017 >64 >64 32 PA 023 >64 >64 32 PA 026 64 64 8 PA 027 64 64 8 PA 028 >64 >64 16 PA = Pseudomonas aeruginosa EA = Enterobaaer aerogenes CF = Citrobaaer freundii 5 KP = Klebsiella pneumoniae EC = Escherichia coli ECL - Enterobaaer cloacae PCT/US94/U225 Checkerboard synergy studies on selected strains were performed as follows. Microplates were prepared using the following organization: Column 1, control organisms (growth control); Columns 2 through 9, serial dilutions of ceftriaxone; Column 10, ceftriaxone alone; Column 11, rBPI21 alone; Column 12, 5 control media; Rows 1 through 8, serial dilutions of rBPI21. Columns 2 through 9 thus contained a serial array of various proportions of ceftriaxone and BPI concentrations. All wells, except the media control, were inoculated with suspended organisms and incubated overnight at 3TC. Turbidity was recorded at 24 and 48 hours.

Results of a representative synergy study of the effects of the concurrent administration of rBPI2, and ceftriaxone on ceftriaxone-resistant E. coli are shown in the checkerboard in Table 12 below. In this checkerboard assay, rBPIj, and ceftriaxone were each serially diluted to concentrations ranging from 100 fig/ml to 0.8 fig/ml. These results show that the concurrent administration of 15 both agents is synergistic. There was uniform growth in all growth control wells (containing bacteria, no rBPI2, and no antibiotic), while there was no growth in the media control wells (containing no bacteria). There was uniform growth in all ceftriaxone control wells (bacteria with ceftriaxone alone). In the BPI control wells (bacteria with rBPI^, alone) there was growth in the wells with a 20 concentration of 6.2 jig/ml rBPL, or less, and no growth at higher concentrations of BPI protein product.

Survival (or kill) curve studies were performed as follows. Tubes containing (1) media alone, (2) media plus ceftriaxone, (3) media plus rBPL,,, and (4) media plus ceftriaxone and rBPI21, were prepared, inoculated with the desired 25 organism, and incubated as described above. At 0, 1, 2, 4, 8 and 24 hours, diluted aliquots from each tube were plated, incubated and counted as described above. Growth curves over 24 hours (plots of log10 CFU/mL versus time) were constructed to demonstrate the dynamics of antibiotic-BPI protein product interactions on bacterial growth and survival.

Results of a representative killing curve study of the effects of the concurrent administration of rBPL, and ceftriaxone on ceftriaxone-resistant E. coli are shown in Figure 18. The filled square is the control (neither rBPL, nor ceftriaxone), the open square is rBPI21 alone, the filled diamond is ceftriaxone alone, and the open diamond is the concurrent administration of ceftriaxone and rBPI21 . Ceftriaxone or rBPI21 alone have some early bactericidal effect at 4-8 hours, but organism growth for both almost reaches that of the control curve by 24 hours (about a 1 log difference from control). In contrast, the concurrent administration of rBPI21 and ceftriaxone produces a significantly greater bactericidal effect that is sustained at 24 hours (a more than 6 log difference from control).

TABLE 12 Checkerboard Synergy Study for Ceftriaxone-Resistant E. coli Using Ceftriaxone and rBPlj, 0.8 /ig/mL Ceftriaxone 1.5 figlmL Ceftriaxone 3.1 /ig/mL Ceftriaxone 6.2 ng/mL Ceftriaxon e 12.5 ng/mL Ceftriaxone ng/mL Ceftriaxone 50 ng/mL Ceftriaxone 100 /ig/mL Ceftriaxone 0.8 pg/mL BPI -f 0 0 0 0 0 0 1.5 fig/mL BPI + 0 0 0 0 0 0 0 3.1 jtg/mL BPI 0 0 0 0 0 0 0 0 6.2 ng/mL BPI 0 0 0 0 0 0 0 0 12.5 jig/mL BPI 0 0 0 0 0 0 0 0 fig/tnL BP! 0 0 0 0 0 0 0 0 50 /tg/mL BPI 0 0 0 0 0 0 0 0 100 ng/mL BPI 0 0 0 0 0 0 0 0 KEY: 4- Growth 0 No Growth Exarople 11 EFFECTS OF BPI PROTEIN PRODUCT AND ANTIBIOTICS IN VITRO ON PSEUDOMONAS SPECIES The effects of a BPI protein product, rBPI21, on the antibiotic susceptibility of clinical isolates of Pseudomonas aeruginosa and other Pseudomonas species (from Baxter Microscan® library, Sacramento, CA) was evaluated using Microscan® panel plates (Baxter Diagnostics, Inc., Deerfield, IL) that allow simultaneous determination of minimum inhibitory 10 concentrations for a number of different antibiotics. Control assays confirmed that the formulation buffer for rBPI21 had no effect on the antibiotic susceptibility of various organisms.

The antimicrobial susceptibility tests performed on the Microscan® panel plates are miniaturizations of the broth dilution 15 susceptibility test. Antimicrobial agents are serially diluted in Mueller- Hinton broth (supplemented with calcium and magnesium, or with sodium chloride for oxacillin, or with thymidine phosphorylase for trimethoprim, sulfamethoxazole and trimethoprim/ sulfamethoxazole) to concentrations bridging the range of clinical interest. One well on the 96-well Microscan® 20 plate is a growth control well that contains dehydrated broth only. The remaining wells contain dehydrated broth and antibiotic (or broth and biochemical reagent indicator), which is rehydrated to the desired concentration by inoculation of a standardized suspension of test organism. The chromogenic biochemical agent indicators are used to identify and 25 characterize the species of bacteria based on detection of pH changes and substrate utilization. After incubation overnight, the minimum inhibitory concentration (MIC) of an antibiotic foT the test organism is determined by observing the well with the lowest concentration of the antibiotic that shows inhibition of growth. Gram-negative organisms were tested using Neg 30 Combo Type 16, MIC Plus Type 2, or Neg Breakpoint Combo Type 9 pane] plates (Microscan®, Baxter Diagnostics. Inc.. Deerfield. IL). The concentrations of antibiotics tested in these panel plates are shown below in Tables 13, 14 and 15, respectively. The antibiotic susceptibility standards (interpretation of an MIC as resistant, intermediate or susceptible according to Micro scan®'s NCCLS-derived standards) applicable to the gram-negative organisms tested in each panel plate appear in Tables 13A, 14A and 15A, respectively.

TABLE 13 ANTIBIOTIC CONCENTRATIONS TESTED IN NEG COMBO TYPE 16 PANEL PLATE Antibiotic Two-Fold Serial Dilutions Tested pg/ml Amikacin 2-16 Ampicillin 2-16 Ampicillin/Sulbactam 8/4-16/8 Aztreonam 8-16 Cefazolin 2-16 Cefotaxime 4-32 Cefoxitin 2-16 Ceftazidime 2-16 Ceftriaxone 4-32 Cefuroxime 2-16 Ciprofloxacin 1-2 Gentamicin 1-4, 6 Imipenem 4-8 Ofloxacin 2-4 Piperacillin 8-64 Ticarciliin 8-64 Tobramycin 1-4, 6 Trimethoprim/Sulfamethoxazole 0.5/9.5, 2/38 TABLE 13 A MICROSCAN NEG COMBO PANEL 16 ANTEBIOUC SUSCEPTIBILITy RANGES FOR GRAM-NEGAITVE BACTERIA MIC Otg/ml) Antibiotic Resistant Intermediate Susceptible Amikacin >16 .<16 Ampicillin£ >16 16 _< 8 Ampicillin/SulbactamE >16/8 16/8 _<_8/4 Aztreonam >16 16 <.8 Cefazolin >16 16 _< 8 Cefotaxime >32 16-32 <% Cefoxitin >16 16 <_8 Ceftazidime >16 16 <.8 Ceftriaxone >32 16-32 <_8 Cefuroxime >16 16 ^8 Ciprofloxacin >2 2 <.1 Gentamicin >6 6 <4 Imipenem >8 8 <.4 Ofloxacin >4 4 <2 PiperacillinE >64 32-64 <.16 Piperacillin p >64 <JA TicarcillinE >64 32-64 JC16 Ticarcillinp > 64 <.64 Tobramycin >6 6 <_4 Trimethoprim/Sulfamethoxazole >2/38 _<2/38 £ Eruerobacteriaceae only ? Pseudomonas only PCT/TJS94/11225 TABLE 14 ANTffilOTIC CONCENTRATIONS TESTED IN MIC PLUS TYPE 2 PANEL PLATE Antibiotic Two-Fold Serial Dilutions Tested (/ig/ml) Amoxicillin/K Clavulanate 1/0.5-32/16 Ampicillin/Sulbactam 1/0.5-32/16 Azlocillin 64 Aztreonam 1-32 Carbeniciliin 16-128 Cefamandole 4-32 Cefonicid 2-16 Cefoperazone 4-32 Cefotaxime 2-64 Cefotetan 4-32 Ceftazidime 1-32 Ceftizoxime 2-32 Ceftriaxone 2-64 Chloramphenicol 2-16 Ciprofloxacin 0.25-4 Imipenem 0.5-16 Mezlocillin 16-128 Netilmicin 2-16 Ticarciliin 16-128 Ticarcillin/K Clavulanate 16-128 TABLE 14A MICROSCAN MIC PLUS TYPE 2 ANTIBIOTIC SUSCEPTIBILITY RANGES FOR GRAM-NEGATIVE BACTERIA Antibiotic MIC (pg/ml) Resistant Intermediate Susceptible Amoxicillin/K Clavulanate 2:32/16 16/8 £8/4 Ampicillin/ Sulbactam 2:32/16 16/8 £8/4 Azlocillinp >64 £64 Aztreonam £32 16 £8 CarbenicillinE 2:64 32 £16 Carbenicillinp >128 £128 Cefamandole 2:32 16 £8 Cefonicid >16 16 £8 Cefoperazone >32 32 £16 Cefotaxime :64 16-32 £8 Cefotetan >32 32 £16 Ceftazidime 232 16 £8 Ceftizoxime >32 16-32 £8 Ceftriaxone 264 16-32 £8 Chloramphenicol >16 16 £8 Ciprofloxacin 2:4 2 £1 Imipenem • 216 8 £4 MezlocillinE 2128 32-64 £16 MezIocillinp 2:128 £64 Netilmicin >16 16 £8 TicarcilliiiE 2:128 32-64 £16 TicaicilLinp 2:128 £64 Ticarcillin/K ClavuianateE £128 32-64 £16 Ticarcillin/K Clavulanatep 2:128 £64 E Enterobacieriaceae only p Pseudomonas only TABLE 15 ANTIBIOTIC CONCENTRATIONS TESTED IN NEG BREAKPOINT COMBO TYPE 9 PANEL PLATE Antibiotic Dilutions Tested Oig/ml) Nitrofurantoin 32 & 64 CcphaJothin 8 & 16 Ampicillin 8 & 16 Ofloxacin 2 & 4 Ticarciliin 16 &64 Piperacillin 16 &64 Mezlocillin 16 & 64 Tetracycline 4 & 8 Ampi ciliin/Sul bactam 8/4 & 16/8 Amoxiciliin/K Clavulanate 8/4 &. 16/8 Ticarcillin/K Clavulanate 16 & 64 Gentamicin 4 & 8 Tobramycin 4 & 8 Amikacin 16 & 32 Ciprofloxacin 1 & 2 Imipenem 4 & 8 Cefazolin 8 & 16 Cefamandole 8 & 16 Cefuroxime 8 & 16 Cefotetan 16 &32 Cefoxitin 8 & 16 Aztreonam 8 & 16 Ceftriaxone 8 & 32 Ceftazidime 8 & 16 Cefoperazone 16 & 32 Cefotaxime 8 & 32 Chloramphenicol 8 & 16 Trimethoprim/Sulfamethoxazole 2/38 & 8/152 Norfloxacin 4&8 Cinoxacin 16 Trimethoprim 8 Sulfamethoxazole 256 TABLE 15A MICROSCAN NEG BREAKPOINT COMBO TYPE 9 ANTIBIOTIC SUSCEPTIBILITY RANGES FOR GRAM-NEGATIVE BACTERIA Antibiotic MIC Oig/ml) Resistant Intermediate Susceptible Nitrofurantoin >64 64 £32 Cephalothin >16 16 £8 AmpicillinE >16 16 £8 Ofloxacin >4 4 £2 Ticarciliin6 >64 64 £16 Ticarcillinp >64 £64 Pipcracillin E >64 64 £16 Piperacillin'' >64 £64 MezlocillinE >64 64 16 Mexlociliinp >64 £64 Tetracycline >8 8 £4 Ampicillin/ Sulbactam6 >16/8 16/8 £8/4 Amoxiciliin/K Clavulanate >16/8 16/8 £8/4 Ticarcillin/K Clavulanate6 >64 64 £16 Ticarcillin/K Clavulanate1" >64 £64 Gentamicin >8 8 £4 Tobramycin >8 8 £4 Amikacin >32 32 £16 Ciprofloxacin >2 2 £1 Imipenem >8 8 £4 Cefazolin >16 16 £8 Cefamandole >16 16 £8 Cefuroxime >16 16 £8 Cefotetan >32 32 £16 Cefoxitin > 16 16 £8 Aztreonam > 16 16 £8 Ceftriaxone >32 32 £8 Ceftazidime >16 16 £8 Cefoperazone >32 32 £16 Cefotaxime >32 32 £8 Chloramphenicol > 16 16 £8 Trimcthoprim/Sulfamethoxaz ole >8/152 8/152 £2/38 Norfloxacin >8 8 £4 Cinoxacin >16 <16 Trimethoprim >8 £8 Sulfamethoxazol e >256 £256 Enterobacteriacaeae only p Pseudomonas only For each experimental run, the following procedure was performed: The organism was streaked onto 5% sheep blood agar plates (Remel, Lenexa, Kansas) and incubated for 18-24 hours overnight. Well-isolated colonies from the plates were emulsified in 3 ml of sterile Inoculum 5 Water (catalog no. B1015-2, MicroScan® system, Baxter Diagnostics, Inc., Deerfield, IL) to a final turbidity equivalent to 0.5 McFarland Barium Sulfate standard. This cell suspension was vortexed for 2 to 3 seconds and 100 fil was transferred to glass tubes containing 25 ml of Inoculum Water with Pluronic-D (catalog no. B1015-7, MicroScan® system, Baxter Diagnostics, 10 Inc., Deerfield, IL) (hereinafter "Pluronic Inoculum Water"), or 25 ml of Pluronic Inoculum Water into which rBPI21 (in formulation buffer) had been diluted to the desired concentration between 0.5 to 64 jxg/ml rBPL,,.

The 25 ml of this inoculum containing rBPI21 was mixed by inversion and poured into a tray. The inoculum was drawn up into a manual 15 96-well pipetting system (RENOK" rehydrator-inoculator system, Baxter Health Care Corporation, West Sacramento, CA) designed for use with the Microscan® panel plates, and 110^1 of the inoculum was delivered to each well of a Microscan® Neg Combo Type 16 panel plate. When added to the wells, this inoculum achieves a final bacterial concentration of 4 x 105 to 7 x 20 103 CFU/ml. The panel plates were then incubated al 35°C for 15-24 hours and read visually for cell growth.

No growth was defined as a slight whiteness in the well or a clear broth. Growth appeared as turbidity which could take the form of a white haze throughout the well, a white button in the center of the well, or a 25 fine granule growth throughout the well. All wells were read against a black indirectly lighted background. Visual results of the biochemical reactions were read into a database for bacterial identification. The MICs for each antibiotic tested were determined by identifying the lowest concentration of antibiotic which inhibited visible growth. 30 The clinical isolates of Pseudomonas aeruginosa and other Pseudomonas species were tested using the Neg Combo Type 16 panel plate. Tables 16. 17 and 18 below display a summary of the resuits of the antibiotic screening panels, reported for each strain tested as the MIC of the tested antibiotics at the various concentrations of rBPI2I indicated. Results are reported for each strain tested, but susceptibility data is listed for only those antibiotics for which BPI protein product altered susceptibility. The antibiotic susceptibility standards (interpretation of an MIC as resistant, intermediate or susceptible according to Microscan®'s NCCLS-derived standards) applicable to the organism tested appear in Table 13A. Stars after the antibiotic name in the "antibiotic tested" column indicate whether rBPI21 reversed the resistance of that organism to the antibiotic tested (two stars) or converted an indifferent MIC into a susceptible MIC (one star). These data show that BPI protein product reversed resistance to ticarciliin, cefazolin, cefoxitin, cefuroxime, ofloxacin, aztreonam, piperacillin, and amikacin for some strains of P. aeruginosa and increased the susceptibility of some P. aeruginosa strains to ticarciliin, aztreonam, imipenem, piperacillin, ofloxacin, ceftazidime, amikacin, ceftriaxone, cefotaxime, cefuroxime, tobramycin, ciprofloxacin, trimethoprim/sulfamethoxazole, gentamicin, and cefazolin. BPI protein product reversed resistance of some P. cepacia strains to cefazolin, cefoxitin, cefuroxime, ceftriaxone, ticarciliin, and increased the susceptibility of some P. cepacia strains to ampicillin, ticarciliin, piperacillin, cefazolin, cefoxitin, cefuroxime, ceftriaxone, ampicillin/sulbactam, cefotaxime, gentamicin, tobramycin, and amikacin. BPI protein product reversed resistance of Xanthamonas mahophilia to trimethoprim/sulfamethoxazole, piperacillin and amikacin, and increased susceptibility to ciprofloxacin.

Tables 16, 17 and 18 also show the presence or absence of bacterial growth in the growth control wells, which contained varying concentrations of rBPI-j, alone without antibiotic. "G" indicates growth, while "NG" indicates no growth. These results indicate that rBPI21 at a concentration of 32 fig/ml has direct bactericidal/growth inhibitory effects on some of the tested Pseudomonas isolates.

TABLE 16 EFFECTS OF rBPI21 ± ANTIBIOTICS ON Pseudomonas aeruginosa Minimum Inhibitory Concentration of Antibiotic (ftg/mL) Microscan Library ID No.

Antibiotic Tested With 0 ftg/mL rBPI21 With 8 ftg/mL rBPI21 With 32 ftg/mL rBFI2I BPI G G G Ticarciliin** >64 64 64 Aztreonam* 16 <8 <8 19610 Piperacillin 32 16 <8 Ofloxacin** >4 4 <2 Ceftazidime 8 8 4 Amikacin 16 8 8 BPI G G NG Aztreonam* 16 <8 — Ceftriaxone >32 32 — 18433 Cefotaxime >32 32 — Cefuroxime* 16 4 — Tobramycin 2 <1 — Amikacin 16 8 — BPI G G G Ciprofloxacin >2 >2 2 12892 Ofloxacin >4 >4 4 Ceftazidime 4 4 <2 Cefotaxime >32 >32 32 Amikacin 16 16 8 TABLE 16 EFFECTS OF rBPL, ± ANTIBIOTICS ON Pseudomonas aeruginosa Minimum Inhibitory Concentration of Antibiotic (pg/mL) Microscan Library ID No.

Antibiotic Tested With 0 fig/mL rBPI21 With 8 pg/mL rBPI21 With 32 fig/mL rBPI21 BPI G G G Trimethoprim/ Sulfamethoxazole >2 >2 2 Ticarciliin 64 16 16 19054 Ceftriaxone* 16 32 8 Gentamicin 4 4 2 Amikacin 16 8 4 Cefazolin >16 >16 16 19672 BPI G G G Tobramycin >6 >6 6 BPI G G G Aztreonam** >16 <8 <8 Piperacillin** >64 <8 <8 19551 Ceftriaxone 32 16 16 Gentamicin 4 <1 <1 Tobramycin 2 <1 <1 Amikacin** >16 <2 <2 TABLE 16 EFFECTS OF rBPL, ± ANTIBIOTICS ON Pseudomonas aeruginosa Minimum Inhibitory Concentration of Antibiotic (jtglmL) Microscan Library ID No.

Antibiotic Tested With 0 pg/mL rBPI21 With 8 ftg/mL rBPI21 With 32 (tg/mL rBPL, BPI G G NG 19660 Trimethoprim/ Sulfamethoxazole >2 2 — Ceftriaxone* 16 8 ~ Cefotaxime 16 16 — BPI G G G Ampicillin1 >16 >16 4 Trimethoprim/ Sulfamethoxazole >2 >2 2 Ticarciliin 16 16 <8 Opalb Cefazolin** >16 >16 <2 Cefoxitin** >16 >16 <2 Cefuroxime** >16 >16 <2 Ceftriaxone* 16 8 <4 Ampicillin/ Sulbactam' >16 >16 <8 Cefotaxime* 16 8 <4 * The Microscan® worksheet did not supply antibiotic susceptibility ranges, but there was reversal of antibiotic indifference according to NCCLS standards, Publication M7-A3, Table 2 (1993). b Strain 12.4.4, provided by S.M. Opal, Brown University, Providence, RI.

TABLE 17 EFFECTS OF rBPI21 ± ANTIBIOTICS ON Pseudomonas aeruginosa Microscan library ID No.

Antibiotic Tested Minimum Inhibitory Concentration of Antibiotic (jig/mL) With 0 f.ig/mL rBPI31 With 4 jtg/mL rBPI21 With 16 pglmL rBPI21 N113-100 BPI G G G Ofloxacin* 4 4 <2 Gentamicin >6 6 6 Tobramycin 2 2 <1 N113-101 BPI G G G Aztreonam >16 >16 <8 Ofloxacin* 4 4 <2 Gentamicin >6 6 6 Tobramycin 4 2 <1 N113-102 BPI G G G Piperacillin 64 <8 <8 Ceftriaxone* 32 16 8 Cefotaxime 32 16 16 Gentamicin 4 4 <1 Amikacin 8 8 <2 N113-103 BPI G G G Ticarciliin 16 16 32 Amikacin 4 8 4 TABLE 17 EFFECTS OF rBPI21 +. ANTIBIOTICS ON Pseudomonas aeruginosa Minimum Inhibitory Concentration of Antibiotic (jtgfmL) Microscan Library ID No.

Antibiotic Tested With 0 fxg/mL rBPI21 With 4 jig/mL rBPI,, With 16 ftg/mL iBPI21 BPI G G G N113-104 Ceftazidime <2 <2 4 Ceftriaxone* 16 8 8 BPI G G G Ticarciliin 64 32 32 N113-105 Aztreonam* 16 <8 <8 Ceftriaxone 32 32 16 Cefotaxime 32 32 16 Gentamicin 2 2 <1 BPI G G G Ticarciliin 16 16 <8 Ceftriaxone* 32 16 8 N113-106 Cefotaxime* 16 16 8 Gentamicin 4 2 2 Amikacin 8 4 4 BPI G G G Ticarciliin >64 >64 64 Ciprofloxaci n* 2 2 <1 N113-107 Ceftazidime 8 4 4 Ceftriaxone 32 32 >32 Imipenem >8 8 >8 TABLE 18 EFFECTS OF rBPI21 ± ANTIBIOTICS ON Pseudomonas SPECIES Minimum Inhibitory Concentration of Antibiotic (/ig/mL) Microscan Library ID No.

Antibiotic Tested With 0 pg/mL rBPI21 With 8 ftg/mL rBPI21 With 32 ng/mL rBPI,! BPI G G NG Ampicillin >16 16 — Ticarciliin 32 <8 — Piperacillin 32 <8 — Cefazolin** >16 8 — Cefoxitin** >16 <2 — 31142 Cefuroxime** >16 <2 — (P. cepacia) Ceftriaxone** >32 8 — Ampicillin/ Sulbactam' 16 <8 — Cefotaxime* 32 <4 — Gentamicin* 6 <1 — Tobramycin 2 <1 — Amikacin 8 <2 — BPI G G G Ticarciliin** >64 64 32 12122 Piperacillin 16 <8 <8 (P. cepacia) Cefuroxime 4 <2 <2 Amikacin 4 4 <2 TABLE 18 EFFECTS OF rBPL, ± ANTIBIOTICS ON Pseudomonas SPECIES Microscan Library ID No.

Antibiotic Tested Minimum Inhibitory Concentration of Antibiotic (/tg/mL) With 0 ftg/mL rBPI21 1 ti 00 With 32 ftg/mL rBPI2I 17211 (Xaruhamonas maltophilia) BPI G G NG Trimethoprim/ Sulfamethoxazole** >2 2 — Piperacillin** >64 16 — Amikacin** >16 16 — Ciprofloxacin 2 2 — * The Microscan® worksheet did not supply antibiotic susceptibility ranges for this organism, but there was reversal of antibiotic indifference according to NCCLS standards, Publication M7-A3, Table 2 (1993). - 84-E2£8B3I2ieJ2 EFFECTS OF BPI PROTEIN PRODUCT AND ANTIBIOTICS IN VITRO ON STRAINS OF E. COU The effect of a BPI protein product, rBPI21, on the antibiotic susceptibility of various strains of E. coli was evaluated in the Microscan® antibiotic susceptibility screening assay of Example 11 using the Neg Combo Type 16 panel plate. The direct growth inhibitory effect of rBPI2, on these strains was also evaluated in the same assay. Assays were conducted on clinical isolates of E. coli (from Baxter Microscan® library, Sacramento, CA).

A summary of the results of the antibiotic screening panels, reported as MICs (jxg/ml) of the antibiotic tested, is shown in Table 19 below. Results are reported for each strain tested, but susceptibility data is listed for only those antibiotics for which BPI protein product altered susceptibility. The antibiotic susceptibility standards (interpretation of an MIC as resistant, intermediate or susceptible according to Microscan®'s NCCLS-derived standards) applicable to the organism tested appear in Table 13A. These results show that BPI protein product reversed the resistance of some strains to cefazolin and increased the susceptibility of other strains to ampicillin, cefuroxime, cefazolin, amikacin, and cefoxitin.

TABLE 19 EFFECTS OF rBPI2i ± ANTIBIOTICS ON Escherichia coli Minimum Inhibitory Concentration of Antibiotic (ftg/mL) Microscan Library ID No.

Antibiotic Tested With 0 ftg/mL rBPI21 With 4 ftg/mL rBPI,, With 16 ftg/mL rBPL, 19536 Ampicillin* 16 16 8 Cefuroxime 4 8 4 F101-309 Cefoxitin 4 <2 4 Cefuroxime 8 4 4 Cefazolin** >16 >16 8 19612 Amikacin 16 8 8 Cefoxitin <2 4 <2 17164 Ampicillin 8 8 4 Cefoxitin 8 8 4 19522 Cefazolin 8 8 4 Cefoxitin >16 >16 16 * The Microscan® worksheet did not supply antibiotic susceptibility ranges for this organism, but there was reversal of antibiotic indifference according to NCCLS standards, Publication M7-A3, Table 2 (1993).

Kxamplf, 13 EFFECTS OF BPI PROTEIN PRODUCT AND ANTIBIOTICS IN VITRO ON OTROBACTER SPECIES The effect of a BPI protein product, rBPI21, on the antibiotic susceptibility of various Gtrobacter species was evaluated in the Microscan® antibiotic susceptibility screening assay of Example 11 using the Neg Combo Type 16 panel plate. The direct growth inhibitory effect of rBPI21 on these strains was also evaluated in the same assay. Assays were conducted on clinical isolates of Citrobacter species (from Baxter Microscan® library, Sacramento, CA).

A summary of the results of the antibiotic screening panels, reported as MICs (/xg/ml) of the antibiotic tested, is shown in Table 20 below. Results are reported for each strain tested, but susceptibility data is listed for only those antibiotics for which BPI protein product altered susceptibility. The antibiotic susceptibility standards (inteipretation of an MIC as resistant, intermediate or susceptible according to Microscan®'s NCCLS -derived standards) applicable to the organism tested appear in Table 13A. These results show that BPI protein product increased the susceptibility of the tested Citrobacter species to aztreonam, cefotaxime, tobramycin, amikacin, cefuroxime, ampicillin, ticarciliin, piperacillin, and cefuroxime.

TABLE 20 EFFECTS OF rBPI,, ± ANTIBIOTICS ON Citrobacter SPECIES Microscan Library ID No.

Antibiotic Tested Minimum Inhibitory Concentration of Antibiotic (ftg/mL) With 0 ftg/mL rBPI21 With 4 ftg/mL rBPI,, With 16 pg/mL rBPI,, 18419 (C. freundii) Aztreonam >16 >16 16 Cefotaxime >32 32 32 Tobramycin 4 2 <1 Amikacin 4 <2 4 18420 (C. freundii') Cefuroxime >16 >16 16 Amikacin >2 >2 >2 F052-007 (C. diversus) Ampicillin >16 >16 16 Ticarciliin >64 >64 64 Piperacillin* 32 16 <8 Cefuroxime 8 4 4 * The Microscan® worksheet did not supply antibiotic susceptibility ranges for this organism, but there was reversal of antibiotic indifference according to NCCLS standards, Publication M7-A3, Table 2 (1993). - 88 -Example. 14 EFFECTS OF BPI PROTEIN PRODUCT AND ANTIBIOTICS IN VITRO ON KLEBSIELLA SPECIES The effect of a BPI protein product, rBPI21, on the antibiotic susceptibility of various Klebsiella species was evaluated in the Microscan® antibiotic susceptibility screening assay of Example 11 using the Neg Combo Type 16 panel plate. The direct growth inhibitory effect of rBPI21 on these strains was also evaluated in the same assay. Assays were conducted on clinical isolates of Klebsiella species (from Baxter Microscan® library, Sacramento, CA).

A summary of the results of the antibiotic screening panels, reported as MICs (fig/ml) of the antibiotic tested, is shown in Table 21 below. Results are reported for each strain tested, but susceptibility data is listed for only those antibiotics for which BPI protein product altered susceptibility. The antibiotic susceptibility standards (interpretation of an MIC as resistant, intermediate or susceptible according to Microscan®'s NCCLS-derived standards) applicable to the organism tested appear in Table 13A. These results show that BPI protein product reversed the resistance of one strain of K. pneumoniae to trimethoprim/sulfamethoxazole and increased the susceptibility of the tested species to cefoxitin, ampicillin/sulbactam, trimethoprim/sulfamethoxazole, cefazolin, and cefuroxime.

WO 95/08344 PCT/US94/11225 TABLE 21 EFFECTS OF rBPL, ± ANTIBIOTICS ON Klebsiella SPECIES Minimum Inhibitory Concentration of Antibiotic (ftg/mL) Microscan Library ID No.

Antibiotic Tested With 0 ftg/mL rBPI21 With 4 ftg/mL rBPI21 With 16 ftg/mL rBPL, 19645 Cefoxitin 8 <2 4 (K. pneumoniae) Ampicillin/ Sulbactam >16 >16 >16 18427 Cefazolin <2 4 <2 (K. pneumoniae) Ampicillin/ Sulbactam* 16 16 <8 16135 Trimethoprim/ Sulfamethoxazole** >2 >2 <0.5 (K. pneumoniae) Cefazolin* 16 16 8 30434 Cefazolin* 16 16 8 (K. oxytoca) Cefoxitin 4 <2 4 Cefuroxime 8 4 8 Ampicillin/ Sulbactam <8 16 <8 1 The Microscan® worksheet did not supply antibiotic susceptibility ranges for this organism, but there was reversal of antibiotic indifference according to NCCLS standards, Publication M7-A3, Table 2 (1993). - 90 -Example 15 EFFECTS OF BPI PROTEIN PRODUCT AND ANTIBIOTICS IN VITRO ON ENTEROBACTER SPECIES The effect of a BPI protein product, rBPI21, on the antibiotic susceptibility of various Enterobaaer species was evaluated in the Microscan® antibiotic susceptibility screening assay of Example 11 using the Neg Combo Type 16 panel plate. The direct growth inhibitory effect of rBPI21 on these strains was also evaluated in the same assay. Assays were conducted on clinical isolates of Enierobacter species (from Baxter Microscan® library, Sacramento, CA).

A summary of the results of the antibiotic screening panels, reported as MICs (/xg/ml) of the antibiotic tested, is shown in Table 22 below. Results are reported for each strain tested, but susceptibility data is listed for only those antibiotics for which BPI protein product altered susceptibility. The antibiotic susceptibility standards (interpretation of an MIC as resistant, intermediate or susceptible according to Microscan®'s NCCLS-derived standards) applicable to the organism tested appear in Table 13A. These results show that BPI protein product reversed the resistance of one strain of E. cloacae to ticarciliin, cefuroxime, ceftazidime and cefotaxime. BPI protein product also increased the susceptibility of some Enierobacter species to ticarciliin, aztreonam, piperacillin, ciprofloxacin, cefotaxime, trimethoprim/sulfamethoxazole, cefuroxime, ceftazidime, ceftriaxone, and ampicillin/sulbactam.

TABLE 22 EFFECTS OF rBPL, ± ANTIBIOTICS ON Enierobacter SPECIES Minimum Inhibitory Concentration of Antibiotic (ftg/mL) Microscan Library ID No.

Antibiotic Tested With 0 ftg/mL rBPI21 With 4 ftg/mL rBPL, With 16 ftg/mL rBPI2, Ticarciliin 64 >64 64 Aztreonam"' 16 <8 <8 19565 Piperacillin >64 >64 64 (E. aerogenes) Ciprofloxacin* 2 <1 <1 Cefotaxime* 16 8 8 19626 Piperacillin >64 64 64 (E. aerogenes) Ticarciliin >64 >64 >64 19625 Trimethoprim/ Sulfamethoxazole* 2 <0.5 <0.5 (E. aerogenes) Piperacillin >64 >64 >64 Ticarciliin** >64 >64 <8 Aztreonam >16 16 <8 Piperacillin* 64 32 <8 19680 Cefuroxime** >16 >16 8 (E. cloacae) Ceftazidime** >32 32 <4 Ceftriaxone >16 >16 16 Ampicillin/ Sulbactam >16 >16 16 Cefotaxime** >32 >32 <4 19686 Ceftriaxone 32 32 16 (E. cloacae) Piperacillin >64 >64 >64 Example 16 EFFECTS OF BPI PROTEIN PRODUCT AND ANTIBIOTICS IN VITRO ON SERRATTA MARCESCENS The effect of a BPI protein product, rBPI2], on the antibiotic susceptibility of Serraiia marcescens was evaluated in the Microscan® antibiotic susceptibility screening assay of Example 11 using the Neg Combo Type 16 panel plate. The direct growth inhibitory effect of rBPI21 on these strains was also evaluated in the same assay. Assays were conducted on clinical isolates of Serraiia marcescens (from Baxter Microscan® library, Sacramento, CA).

A summary of the results of the antibiotic screening panels, reported as MICs (/ig/ml) of the antibiotic tested, is shown in Table 23 below. Results are reported for each strain tested, but susceptibility data is listed for only those antibiotics for which BPI protein product altered susceptibility. The antibiotic susceptibility standards (interpretation of an MIC as resistant, intermediate or susceptible according to Microscan®'s NCCLS-derived standards) applicable to the organism tested appear in Table 13A. These results show that BPI protein product reversed the resistance of some strains to ceftazidime and cefotaxime, and increased the susceptibility of other strains to piperacillin, cefoxitin, ceftazidime, ceftriaxone, cefotaxime, tobramycin, ampicillin/sulbactam, and ampicillin.

TABLE 23 EFFECTS OF rBPI21 ± ANTIBIOTICS ON Serraiia marcescens Minimum Inhibitory Concentration of Antibiotic (ftg/mL) Microscan Library ID No.

Antibiotic Tested With 0 ftg/mL rBPI21 00 With 32 ftg/mL rBPL, Piperacillin >64 >64 32 Cefoxitin 16 >16 8 19646 Ceftazidime** >16 >16 8 Ceftriaxone* 32 16 8 Cefotaxime** >32 32 <4 Tobramycin* 6 6 4 Piperacillin* >64 64 16 Cefoxitin 8 8 4 Ceftazidime* 16 16 4 19647 Ceftriaxone 8 <4 <4 Ampicillin/ Sulbactam >16 >16 16 Cefotaxime 8 <4 <4 Tobramycin 2 2 <1 18443 AmpiciUin* 16 16 8 Ampicillin/ Sulbactam >16 >16 16 * The Microscan® worksheet did not supply antibiotic susceptibility ranges for this organism, but there was reversal of antibiotic indifference according to NCCLS standards, Publication M7-A3, Table 2 (1993).

Example. 17 EFFECTS OF BPI PROTEIN PRODUCT AND ANTIBIOTICS IN VITRO ON PROTEUS MIRABILIS The effect of a BPI protein product, rBPI21, on the antibiotic susceptibility of Proteus mirabilis was evaluated in the Microscan® antibiotic susceptibility screening assay of Example 11 using the Neg Combo Type 16 panel plate. The direct growth inhibitory effect of rBPI21 on these strains was also evaluated in the same assay. Assays were conducted on clinical isolates of Proteus mirabilis (from Baxter Microscan® library, Sacramento, CA).

A summary of the results of the antibiotic screening panels, reported as MICs (fig/ml) of the antibiotic tested, is shown in Table 24 below. Results are reported for each strain tested, but susceptibility data is listed for only those antibiotics for which BPI protein product altered susceptibility. The antibiotic susceptibility standards (interpretation of an MIC as resistant, intermediate or susceptible according to Microscan®'s NCCLS-derived standards) applicable to the organism tested appear in Table 13A. These results show that BPI protein product increased the susceptibility of some strains to trimethoprim/sulfamethoxazole, cefazolin, cefoxitin, imipenem, tobramycin, and amikacin.

TABLE 24 EFFECTS OF rBPI2] ± ANTIBIOTICS ON Proteus mirabilis Minimum Inhibitory Concentration of Antibiotic (jig/mL) Microscan Library ID No.

Antibiotic Tested With 0 ftg/mL rBPI21 With 8 ftg/mL rBPI21 With 32 ftg/mL rBPI21 Trimethoprim/ Sulfamethoxazole* 2 <0.5 <0.5 Cefazolin 4 <2 4 19593 Cefoxitin 8 <2 <2 Imipenem* 8 <4 <4 Tobramycin 2 2 <1 Amikacin 8 4 4 Cefoxitin 4 <2 4 F231-129 Imipenem* 8 <4 <4 Amikacin 4 <2 <2 - 96-Examplc 18 EFFECTS OF BPI PROTEIN PRODUCT AND ANTIBIOTICS IN VITRO ON PROVIDENCIA SPECIES The effect of a BPI protein product, rBPI21, on the antibiotic susceptibility of various Providencia species was evaluated in the Microscan® antibiotic susceptibility screening assay of Example 11 using the Neg Combo Type 16 panel plate. The direct growth inhibitory effect of rBPI21 on these strains was also evaluated in the same assay. Assays were conducted on clinical isolates of Providencia species (from Baxter Microscan® library, Sacramento, CA).

A summary of the results of the antibiotic screening panels, reported as MICs (/ig/ml) of the antibiotic tested, is shown in Table 25 below. Results are reported for each strain tested, but susceptibility data is listed for only those antibiotics for which BPI protein product altered susceptibility. The antibiotic susceptibility standards (interpretation of an MIC as resistant, intermediate or susceptible according to Microscan®'s NCCLS-derived standards) applicable to the organism tested appear in Table 13A. These results show that BPI protein product reversed the resistance of P. stuarai to cefazolin and cefuroxime, and increased its susceptibility to piperacillin, ceftazidime, ampicillin/sulbactam, imipenem, and amikacin. BPI protein product also increased susceptibility of P. rettgeri to cefoxitin and cefuroxime.

TABLE 25 EFFECTS OF rBPL, ± ANTIBIOTICS ON Providencia SPECIES Minimum Inhibitory Concentration of Antibiotic (/ig/mL) Microscan Library ID No.

Antibiotic Tested With 0 ftg/mL rBPI21 With 8 ftg/mL rBPL, With 32 ftg/mL rBPL, 19614 Cefoxitin >16 8 >16 (P. rengeri) Cefuroxime*' 16 8 <2 Amikacin 16 16 16 Piperacillin* >64 32 16 Cefazolin** >16 >16 8 18435 Cefuroxime** >16 >16 8 (P. stuartii) Ceftazidime 4 <2 <2 Ampicillin/ Sulbactam >16 16 16 Imipenem* 8 <4 <4 Amikacin 16 16 8 * The Microscan® worksheet did not supply antibiotic susceptibility ranges for this organism, but there was reversal of antibiotic indifference according to NCCLS standards, Publication M7-A3, Table 2 (1993).

Example. 1Q EFFECTS OF BPI PROTEIN PRODUCT AND ANTIBIOTICS IN VITRO ON MORGANELLA MORGANII The effect of a BPI protein product, rBPI2i, on the antibiotic susceptibility of Morganella morganii was evaluated in the Microscan® antibiotic susceptibility screening assay of Example 11 using the Neg Combo Type 16 panel plate. The direct growth inhibitory effect of rBPI2I on these strains was also evaluated in the same assay. Assays were conducted on clinical isolates of Morganella morganii (from Baxter Microscan® library, Sacramento, CA).

A summary of the results of the antibiotic screening panels, reported as MICs (/xg/ml) of the antibiotic tested, is shown in Table 26 below. Results are reported for each strain tested, but susceptibility data is listed for only those antibiotics for which BPI protein product altered susceptibility. The antibiotic susceptibility standards (interpretation of an MIC as resistant, intermediate or susceptible according to Microscan® 's NCCLS-derived standards) applicable to the organism tested appear in Table 13A. These results show that BPI protein product increased the susceptibility of the tested strains to ampicillin/sulbactam, amikacin and piperacillin.

TABLE 26 EFFECTS OF rBPI,, ± ANTIBIOTICS ON Morganella morganii Microscan Library ID No.

Antibiotic Tested Minimum Inhibitory Concentration of Antibiotic (/ig/mL) With 0 ftg/mL rBPI21 £ 00 With 32 ftg/mL rBPI,, F19-004 Ampicillin/ Sulbactam >16 16 16 Amikacin 4 <2 4 F19-005 Ampicillin/ Sulbactam" >16 <8 <8 Amikacin 4 <2 <2 F19-006 Piperacillin >64 64 64 Amikacin <2 <2 4 1 The Microscan® worksheet did not supply antibiotic susceptibility ranges for this organism, but there was reversal of antibiotic indifference according to NCCLS standards, Publication M7-A3, Table 2 (1993). - 100 -Fxampl^. 70 EFFECTS OF BPI PROTEIN PRODUCT AND ANTIBIOTICS IN VITRO ON ACINETOBACTER SPECIES The effect of a BPI protein product, rBPI21, on the antibiotic susceptibility of various Acinetobacter species was evaluated in the Microscan® antibiotic susceptibility screening assay of Example 11 using the Neg Combo Type 16 and MIC Plus Type 2 panel plate. The direct growth inhibitory effect of rBPI21 on these strains was also evaluated in the same assay. Assays were conducted on clinical isolates of Acinetobacter species (from Baxter Microscan® library, Sacramento, CA). Different production lots of rBPL,, that had been formulated with surfactant or unformulated (without surfactant) were tested, but no difference was seen in results for formulated or unformulated rBPI21.

A summary of the results of the antibiotic screening panels, reported as MICs (^g/ml) of the antibiotic tested, is shown in Tables 27 and 28 below. Results are reported for each strain tested, but susceptibility data is listed for only those antibiotics for which BPI protein product altered susceptibility. The antibiotic susceptibility standards (interpretation of an MIC as resistant, intermediate or susceptible according to Microscan®'s NCCLS-derived standards) applicable to the organism tested appear in Tables 13A and 14A. For interpretation purposes, when antibiotic susceptibility standards were given only for Enierobacter or Pseudomonas, the standards for Acinetobacter were considered to be the same as for Enierobacter.

These results show that BPI protein product reversed resistance of A. aniiraius strains to amoxicillin/K clavulanate, ampicillin/sulbactam, aztreonam, carbenicillin, cefamandole, cefazolin, cefonicid, cefoperazone, cefotaxime, cefotetan, cefoxitin, ceftazidime, ceftizoxime, ceftriaxone, chloramphenicol, ciprofloxacin, gentamicin, mezlocillin, netilmicin, ticarciliin, ticarcillin/K clavulanate, and trimethoprim/sulfamethoxazole, and increased susceptibility of some A. anitraius strains to amikacin. amoxicillin/K clavulanate. ampicillin. ampicillin/sulbactam, azlocillin, aztreonam, caxbenicillin, cefamandole, cefazolin, cefonicid, cefoperazone, cefotaxime, cefotetan, cefoxitin, ceftazidime, ceftizoxime, ceftriaxone, cefuroxime, chloramphenicol, ciprofloxacin, gentamicin, imipenem, mezlocillin, netilmicin, ofloxacin, piperacillin, ticarciliin, ticarcillin/K clavulanate, tobramycin and trimethoprim/sulfamethoxazole.

BPI protein product reversed resistance of A. twoffii strains to aztreonam, cefazolin, cefuroxime, ceftazidime, cefoxitin, trimethoprim/sulfamethoxazole and piperacillin, and increased susceptibility of A. Iwoffii strains to ampicillin, ampicillin/sulbactam, aztreonam, cefazolin, cefotaxime, cefoxitin, ceftazidime, ceftriaxone, cefuroxime, piperacillin, ticarciliin and trimethoprim/sulfamethoxazole.

These results also show that rBPI2I at a concentration of 16 Hg/ral has direct bactericidal/growth inhibitory effects on some of the tested Acinetobacter isolates.

TABLE 27 EFFECTS OF rBPL, ± ANTIBIOIICS ON Acinetobacter SPECIES Microscan library ID No.

Antibiotic Tested Minimum Inhibitory Concentration of Antibiotic (ftg/mL) With 0 ftg/mL rBPI21 With 4 fig/mL rBPI21 With 16 ftg/mL iBPI21 N011-002 (A. amtraxus) BPI G G G Ampicillin >16 16 16 Amikacin 4 <2 <2 N011-003 (A. anitratus) BPI G G G Ampicillin 4 <2 4 Ticarciliin 16 <8 <8 Cefazolin*"" >16 >16 8 Cefoxitin** >16 8 8 Cefuroxime 8 4 8 N011-070 (A. arutraius) BPI G Reduced NG Ampicillin 8 8 <2 Trimeth/Sulfa** >2 2 <0.5 Cefazolin** >16 >16 <2 Cefoxitin* 16 16 <2 Cefuroxime* 16 8 <2 Ceftazidime 4 <2 <2 PCT/TJS94/11225 TABLE 27 EFFECTS OF rBPI21 + ANTIBIOTICS ON Acinetobacter SPECIES Microscan Library Antibiotic Minimum Inhibitory Concentration of Antibiotic (/zg/mL) ID No.

Tested With 0 ftg/mL rBPI21 With 4 fig/mL rBPI21 With 16 Hg/mL IBPI21 BPI G G Very reduced Ticarciliin* 32 <8 <8 Aztreonam >16 16 16 Piperacillin* 32 16 <8 Ciprofloxacin** >2 2 <1 Ofloxacin* 4 <2 <2 N011-071 Ceftazidime 8 8 4 (A. anitratus) Ceftriaxone 32 16 16 Cefotaxime 32 16 16 Gentamicin** >6 >6 2 Tobramycin* 6 4 4 Amikacin** >16 16 8 BPI G Reduced NG Ampicillin* 16 16 <2 Trimeth/Sulfa** >2 >2 <0.5 Cefazolin** >16 >16 <2 N011-072 Cefoxitin* 16 16 <2 Cefuroxime 8 8 <2 (A. aniTrams) Gentamicin* 6 4 <1 Tobramycin 2 <1 <1 Amikacin 8 4 <2 TABLE 27 EFFECTS OF rBPI21 ± ANTIBIOTICS ON Acinetobacter SPECIES Microscan library ID No.

Antibiotic Tested Minimum Inhibitory Concentration of Antibiotic (jig/mL) With 0 ng/mL rBPI21 With 4 fig/mL rBPI21 With 16 fxg/mL rBPI21 N012-001 (A. Iwoffii) BPI G G G Aztreonam** >16 >16 <8 Cefazolin** >16 8 <2 Cefuroxime** >16 4 <2 Ceftazidime** >16 4 <2 Ampicill/Sulbact >16 >16 16 Cefotaxime 8 <4 <4 NO 12-002 {A. Iwoffii) BPI G NG NG Ampicillin 4 <2 <2 Trimeth/Sulfa** >2 2 <0.5 Aztreonam** >16 <8 <8 Cefazolin** >16 <2 <2 Cefoxitin** >16 <2 <2 Cefuroxime 8 <2 <2 Ceftazidime 4 <2 <2 PCT7US94/11225 TABLE 27 EFFECTS OF rBPI,, + ANTIBIOTICS ON Acinetobacter SPECIES Microscan Library Antibiotic Minimum Inhibitory Concentration of Antibiotic (jig/mL) ID No.

Tested With 0 ftg/mL rBPI21 With 4 jig/mL rBPI,, With 16 ftg/mL rBPI,, BPI G G NG Ampicillin* >16 4 <2 Trimeth/Sulfa* 2 <0.5 <0.5 Ticarciliin* 64 <8 <8 Aztreonam** >16 <8 <8 Piperacillin** >64 <8 <8 N012-003 Cefazolin** >16 >16 <2 (A. Iwoffii) Cefoxitin** >16 8 <2 Cefuroxime** >16 <2 <2 Ceftazidime* 16 <2 <2 Ceftriaxone* 16 <4 <4 Cefotaxime 8 <4 <4 BPI G G G Ampicillin 4 <2 4 N012-004 Trimeth/Sulfa* 2 2 <0.5 Cefazolin >16 16 16 (A. Iwoffii) Cefoxitin* 16 <2 4 Cefuroxime 4 <2 <2 PCTAJS94/11225 TABLE 27 EFFECTS OF rBPL, + ANTIBIOTICS ON AcinetobacteT SPECIES Microscan Library ID No.

Antibiotic Tested Minimum Inhibitory ' Concentration of Antibiotic (ftg/mL) With 0 ftg/mL rBPI21 With 4 ftg/mL rBPI21 With 16 ftg/mL rBPI,, N012-005 (A. Iwoffii) BPI G G NG Ampicillin 4 <2 <2 Trimeth/Sulfa* 2 <0.5 <0.5 Cefazolin** >16 >16 4 Cefoxitin* 16 8 4 Cefuroxime 4 4 <2 TABLE 28 EFFECTS OF rBPI21 ± ANTIBIOTICS ON AcinetobacteT SPECIES Microscan library ID No.

Antibiotic Tested Minimum Inhibitory Concentration of Antibiotic (ftg/mL) With 0 ftg/mL rBPI21 With 4 ftg/mL rBPI21 With 16 fig/mL rBPI21 12292 (A. amiraius) Ceftizoxime** >32 <2 <2 Ceftazidime** >32 32 <1 Cefotaxime** >64 8 <2 Ceftriaxone** >64 <2 <2 Cefoperazone** >32 8 <4 Cefonicid** >16 16 <2 Cefotetan** >32 32 <4 Netilmicin** >16 <2 <2 Cefamandole** >32 <4 <4 Chloramphenicol ** >16 <2 <2 Ticarciliin* 64 32 <16 Azlocillin >64 <64 <64 Imipenem 4 <0.5 <0.5 Amp/Sulbact** 32 4 <1 Aztreonam** 32 4 <1 Amox/K Clavulanate* 16 <1 <1 Ciprofloxacin** >4 1 <25 Ticar/K Clavulanate** 64 <16 <16 Mezlocillin** >128 <16 <16 Carbenicillin** >128 <16 <16 TABLE 28 EFFECTS OF rBPI21 + ANTIBIOTICS ON Acinetobacter SPECIES Microscan library ID No.

Antibiotic Tested Minimum Inhibitory Concentration of Antibiotic (fig/mL) With 0 ftg/mL rBPI21 With 4 ftg/mL rBPI21 With 16 ftg/mL rBH21 12300 (A. amrraxus) Ceftizoxime** >32 >32 <8 Ceftazidime 8 8 2 Cefotaxime** 64 64 <2 Ceftriaxone* 32 32 <2 Cefoperazone >32 >32 32 Cefonicid >16 >16 >16 Cefotetan >32 >32 >32 Netilmicin >16 16 16 Cefamandole** >32 >32 <4 Chloramphenicol * * >16 >16 8 Ticarciliin <16 <16 <16 Azlocillin >64 <64 <64 Imipenem <0.5 <0.5 <0.5 Amp/Sulbact 2 2 <1 Aztreonam 8 8 4 Amox/K Clavulanate* 16 16 <1 Ciprofloxacin** >4 >4 1 Ticar/K Clavulanate <16 <16 <16 Mezlocillin** 128 128 <16 Caibenicillin <16 <16 <16 TABLE 28 EFFECTS OF rBPI21 +. ANTIBIOTICS ON AcinetobacteT SPECIES Microscan library ID No.

Antibiotic Tested Minimum Inhibitory Concentration of Antibiotic (ftg/mL) With 0 ftg/mL rBPI21 With 4 ftg/mL rBPI2, With 16 ftg/mL rBPI21 12487 (A. anitrarus) Ceftizoxime** >32 >32 <2 Ceftazidime** >32 2 8 Cefotaxime** >64 64 4 Ceftriaxone** >64 >64 <2 Cefoperazone* * >32 >32 <4 Cefonicid >16 >16 >16 Cefotetan >32 >32 32 Netilmicin** >16 <2 <2 Cefamandole** >32 <4 <4 Chloramphenicol** >16 8 <2 Ticarciliin** 128 32 <16 Azlocillin >64 <64 <64 Imipenem 2 <0.5 <0.5 Amp/Sulbact* 16 2 <1 Aztreonam** 32 16 <1 Amox/K Clavulanate 8 <1 2 Ciprofloxacin* 2 1 <0.25 Ticar/K Clavulanate 32 <16 <16 Mezlocillin** >128 32 <16 Caibenicillin** 128 <16 <16 PCT7US94/11225 TABLE 28 EFFECTS OF rBPIai ± ANTIBIOIICS ON AcinetobacteT SPECIES Microscan Library ID No.

Antibiotic Tested Minimum Inhibitory Concentration of Antibiotic (jig/mL) With 0 fxg/mL rBPI21 With 4 ftg/mL rBPI21 With 16 ftg/mL rBPI21 19687 (A. anitratus) Ceftizoxime >32 >32 >32 Ceftazidime >32 >32 >32 Cefotaxime >64 >64 >64 Ceftriaxone >64 >64 >64 Cefoperazone >32 >32 >32 Cefonicid >16 >16 >16 Cefotetan >32 >32 >32 Netilmicin* 16 8 <2 Cefamandole >32 >32 >32 Chloramphenicol** >16 16 8 Ticarciliin >128 <16 128 Azlocillin >64 >64 >64 Imipenem 4 2 <0.5 Amp/Sulbact** 32 8 2 Aztreonam >32 >32 >32 Amox/K Clavulanate** 32 16 8 Ciprofloxacin** >4 >4 0.5 Ticar/K Clavulanate >128 128 <16 Mezlocillin >128 64 32 Carbenicillin * * >128 64 <16 - Ill - TABLE 28 EFFECTS OF rBPI21 ± ANTIBIOTICS ON Acinetobacter SPECIES Microscan Library ID No.

Antibiotic Tested Minimum Inhibitoiy Concentration of Antibiotic (/xg/mL) With 0 ft g/mL rBPI21 With 4 /xg/mL rBPI2] With 16 jxg/mL rBPI21 19693 (A. anitraius) Ceftizoxime** >32 >32 4 Ceftazidime >32 >32 >32 Cefotaxime >64 64 32 Ceftriaxone >64 64 16 Cefoperazone** >32 >32 8 Cefonicid** >16 >16 <2 Cefotetan** >32 >32 <4 Netilmicin >16 >16 >16 Cefamandole >32 >32 16 Chloramphenicol * * >16 >16 <2 Ticarciliin** >128 >128 <16 A7.lnr.iHin >64 >64 <64 Imipenem 2 2 <0.5 Amp/Sulbact** 32 32 2 Aztreonam** 32 16 <1 Amox/K Clavulanate* 16 8 4 Ciprofloxacin >4 >4 >4 Ticar/K Clavulanate** >128 32 <16 Mezlocillin** >128 128 <16 Carbenicillin** >128 >128 <16 TABLE 28 EFFECTS OF rBPI,, + ANTIBIOTICS ON Acinetobacter SPECIES Microscan library ID No.

Antibiotic Tested Minimum Inhibitory Concentration of Antibiotic (/zg/mL) With 0 fig/mL rBPI21 With 4 ftg/mL rBPI21 With 16 ftg/mL rBPI21 19694 (A. anitratus) Ceftizoxime >32 >32 32 Ceftazidime* 16 16 8 Cefotaxime 64 64 64 Ceftriaxone 64 64 32 Cefoperazone >32 >32 >32 Cefonicid** >16 >16 8 Cefotetan** >32 >32 8 Netilmicin** >16 >16 4 Cefamandole >32 >32 >32 Chloramphenicol >16 >16 16 Ticarciliin >128 >128 32 Azlocillin >64 >64 >64 Imipenem 1 1 <0.5 Amp/Sulbact 32 32 16 Aztreonam 8 8 8 Amox/K Clavulanate** 32 8 4 Ciprofloxacin >4 >4 >4 Ticar/K Clavulanate** >128 <16 <16 Mezlocillin >128 >128 64 Carbenicilliri** >128 >128 <16 - 113 -Example 21 EFFECTS OF BPI PROTEIN PRODUCT AND ANTIBIOTICS IN VITRO ON SALMONELLA AND SHIGELLA SPECIES Ten clinical isolates of Salmonella (F270-001 through -010) and 10 5 clinical isolates of Shigella (F321-010 and F325-002 through -010) (all isolates from Baxter Microscan® library, Sacramento, CA), were evaluated in the Microscan® antibiotic susceptibility screening assay of Example 11 using the Neg Breakpoint Combo Type 9 panel plate. Essentially no effect was seen at rBPI21 concentrations of 0, 4 and 16 ftg/mL.

Frample. ?? EFFECTS OF BPI PROTEIN PRODUCT ON ANTIBIOTIC KILLING CURVES FOR E. COU 15, E COU 07.K1, ENTEROBACTER CLOACAE, 5 AND KLEBSIELLA PNEUMONIAE The effect of a BPI protein product, rBPI21, on the killing curves of selected antibiotics was determined for selected organisms. Microscan® panel plates were prepared for E. coli J5, E. coli 07:K1, Enierobacter cloacae (Microscan library ID no. 19680) and Klebsiella pneumoniae (Microscan library 10 ID no. 16135), according to Example 11. Cell suspensions were added to 25 ml Pluronic Inoculum Water containing 0 or 16 fig/ml rBPI2]. After inoculation, the panel plates were incubated at 35°C for 24 hours. At 0, 4, 7 and 24 hours after inoculation, 5 fi\ samples were removed from each growth control well (containing culture media without antibiotic) and from each well containing: 2/38 ftg/ml 15 trimethoprim/sulfamethoxazole, 2 fig/ml ciprofloxacin, 64 jig/ml piperacillin, 32 ^g/ml cefotaxime, 6 ftg/ml cefuroxime, and 16 fxg/ml amikacin. These 5 fx 1 samples were diluted in sterile water and inoculated onto Trypticase Soy agar plates (Remel, Lenexa, Kansas). After 48 hours of incubation at 355C, the plates were counted and the number of colony forming units of bacteria in the well was 20 calculated.

The results are shown below in Figures 19-25. In all of the figures the growth, in the presence of antibiotic but without rBPI21, is indicated for: E. coli J5 (a filled square); E. coli 07:K1 (a filled diamond); E. cloacae (a filled triangle); and K. pneumoniae (an "X"). Also, in all figures, the growth in the presence of antibiotic with rBPI-j, is indicated for E. coli J5 (an open square); E. coli 07:K1 (an open diamond); E. cloacae, (an open triangle); and K. pneumoniae (a star).

Figure 19 shows the kinetic growth curve of organisms with rBPIj, (and without antibiotic) and without rBPI21 (and without antibiotic). In Figure 19, the growth curves for E. coli J5 without rBPI2, (filled squares), E. coli 07:K1 with rBPI2, (open diamonds), E. coli 07:K1 without rBPI2, (filled diamonds), and K. pneumoniae without rBPI21 ("X"s) overlap substantially, while the growth 10 curves for E. coli J5 with rBPI21 (open squares) and E. cloacae with rBPI,, (open triangles) overlap at 0-7 hours but diverge by 24 hours. Figure 19 demonstrates that BPI protein product alone has a bactcricidal effect al 0-7 hours on E. coli J5 and K. pneumoniae, and a bactericidal effect on E. cloacae throughout the 24 hour period studied.

In Figure 20, the growth curves for E. coli J5 with rBPI2, (open squares), E. cloacae with rBPI21 (open triangles) and K. pneumoniae with rBPL, (stars) overlap. Figure 20 shows that rBPI2, enhanced the bactericidal effect of trimethoprim/sulfamethoxazole on E. cloacae and K. pneumoniae at 0-24 hours, and slightly enhanced the antibiotics' effect on E. coli J5 and E. coli 07:K1. 20 In Figure 21, the growth curves for E. coli J5 with rBPL, (open squares), E. coli J5 without rBPI2, (filled squares), E. coli 07:K1 with rBPI21 (open diamonds), E. coli 07:K1 without rBPI2, (filled diamonds), E. cloacae with rBPI}, (open triangles), E. cloacae without rBPL, (filled triangles), and K. pneumoniae with rBPI2, (stars) overlap. Figure 21 shows that rBPI2, reversed 25 resistance of K. pneumoniae to ciprofloxacin at 0-24 hours; the other organisms were already very susceptible to ciprofloxacin.

In Figure 22, the growth curves for E. coli 07:K1 without rBPL, (filled diamonds) and E. cloacae without rBPI2, (filled triangles) overlap, while the growth curves for E. coli J5 with rBPI2, (open squares), E. coli J5 without rBPI2, 30 (filled squares), E. coli 07:K1 with rBPI2, (open diamonds), E. cloacae with rBPL, (open triangles), K. pneumoniae without rBPI2, ("X"s) and K. pneumoniae with rBPL, (stars) overlap. Figure 22 shows that rBPL, enhanced the bactericidal effect of piperacillin on E. coli 07:K1 and E. cloacae', the other organisms were already susceptible to the drug.

In Figure 23, the growth curves for E. coli J5 with rBPI^ (open squares), E. coli 07:K1 with rBPI21 (open diamonds), E. coli 07:K1 without rBPI21 (filled diamonds), K. pneumoniae without rBPI21 ("X"s) and K. pneumoniae with rBPI21 (stars) overlap. Figure 23 shows that rBPI21 enhanced the bactericidal effect of cefotaxime on J5 and E. cloacae; the other organisms were susceptible to the drug.

In Figure 24, all of the curves overlap. Figure 24 shows the effect of rBPI21 and cefuroxime; addition of rBPI21 had no effect on the killing curves because all of the tested species were very susceptible to the antibiotic.

In Figure 25, all of the curves overlap. Figure 25 shows the effect of rBPI21 and amikacin; again, all tested species were very susceptible to the antibiotic.

Example 23 EFFECTS OF A VARIETY OF BPI PROTEIN PRODUCTS : AND ANTIBIOTICS IN VITRO ON REPRESENTATIVE GRAM-NEGATIVE ORGANISMS The effects of a variety of BPI protein products, rBPI2), rBPI^, rBPIJ0 and rBPI,2 dimer on the antibiotic susceptibility of various representative gram-negative organisms was evaluated in the Microscan® antibiotic susceptibility screening assay of Example 11 using the MIC Plus Type 2 panel plate. Assays were conducted on clinical isolates of Acinetobacter anitraius and Enierobacter cloacae (from Baxter Microscan® library, Sacramento, CA), and on E. coli J5-L and 07:K1.

The results, reported as MICs (jig/ml) of the antibiotic tested at the various concentrations of BPI protein product indicated, are shown in Tables 29, 30, 31 and 32 below.

TABLE 29 EFFECTS OF BPI PROTEIN PRODUCTS ± ANTIBIOTICS ON A. anitratuj (Microscan ID No. 12292) | ANTIBIOTIC TESTED Minimum Inhibitory Concentration of Antibiotic (/xg/ml) With: 0 /xg/mL BPI 4 /xg/mL BPI„ 4 /xg/mL BPI* 4 /xg/mL BPIjo 4 /xg/mL BPI« dimer 16 /xg/mL BPI„ 16 /xg/mL BPIU 16 /xg/mL BPIjo 16 /xg/mL | BPIo dimer Certizoxime >32 >32 >32 >32 >32 >32 >32 >32 >32 Ceftazidime >32 16 >32 >32 >32 32 >32 >32 32 Cefotaxime >64 >64 >64 >64 >64 16 >64 >64 >64 Ceftriaxone >64 8 >64 >64 > 64 4 >64 >64 >64 Cefoperazone >32 >32 >32 >32 >32 32 >32 >32 >32 Cefonicid >16 >16 > 16 >16 >16 8 >16 >16 >16 Cefotetan >32 32 >32 >32 >32 <4 >32 >32 >32 Netilmicin >16 <2 > 16 >16 > 16 >16 >16 >16 >16 Cefamandole >32 8 >32 >32 >32 <4 >32 >32 >32 Chloramphenicol >16 <2 > 16 16 >16 <2 16 16 16 Ticarciliin 128 <16 128 64 64 <16 64 32 64 Atlocillin >64 >64 >64 >64 >64 <64 >64 >64 >64 Imipenem 4 <0.5 2 2 2 <0.5 2 2 2 TABLE 29 | EFFECTS OF BPI PROTEIN PRODUCTS ± ANTIBIOTICS ON A. onilratus (Microscan ID No. 12292) | ANTIBIOTIC TESTED Minimum Inhibitory Concentration of Antibiotic (/xg/ml) With: | 0 /ig/mL BPI 4 Hg/mL BPI,, 4 /ig/mL BPIJ3 4 /xg/mL BPIjo 4 /xg/mL bpi,2 dimer 16 /xg/mL bpi21 16 /xg/mL BPI* 16 /xg/mL BPIjo 16 /xg/mL I bpi« dimer | Ampicillin/ Sulbactam 32 4 16 32 16 <1 8 16 8 I Aztreonam 32 16 32 32 32 4 32 32 32 Amoxicillin/K Clavulanate 16 2 16 16 8 4 8 8 4 1 Ciprofloxacin 4 2 4 4 4 2 4 4 2 1 Ticarcillin/K Clavulanate 64 < 16 64 64 32 32 32 32 32 I Mezlocillin > 128 128 >128 > 128 > 128 <16 >128 >128 >128 Carbenicillin 128 < 16 128 128 64 <16 64 64 64 | TABLE 30 EFFECTS OF BPI PROTEIN PRODUCTS ± ANTIBIOTICS ON E. cloacae (Microscan ID No. 19680) ANTIBIOTIC TESTED Minimum Inhibitory Concentration of Antibiotic (/xg/ml) With: 0 ftg/mL BPI 4 Mg/mL BPIj, 4 ftg/mL BPI« 4 ftg/mL BPIjo 4 pg/mL BPI« dimer 16 ftg/mL BPI,, 16 ftg/mL BPI,, 16 ftg/mL BPIjo 16 ftg/mL j BPI« dimer j Ceftizoxime 32 32 32 16 32 <2 <2 <2 8 Ceftazidime 32 16 16 32 16 <1 <1 <1 4 ! Cefotaxime 64 32 32 32 32 <2 <2 <2 16 Ceftriaxone 32 4 32 32 32 <2 <2 <2 16 Cefoperazone 32 16 16 16 32 <4 <4 <4 <4 Cefonicid > 16 >16 > 16 >16 >16 <2 <2 8 >16 Cefotetan 32 >32 >32 >32 >32 <4 <4 <4 >32 Netilmicin <2 <2 <2 <2 <2 <2 <2 <2 <2 Cefamandole >32 >32 32 >32 >32 <4 <4 <4 16 Chloramphenicol 8 4 4 4 4 <2 <2 <2 <2 Ticarciliin > 128 64 64 128 128 <16 <16 <16 64 Azlocillin >64 >64 <64 >64 >64 <64 <64 <64 <64 | Imipenem 1 <0.5 <0.5 <0.5 <0.5 <0.5 <0.5 <0.5 <0.5 | TABLE 30 1 EFFECTS OF BPI PROTEIN PRODUCTS ± ANTIBIOTICS ON E. cloacae (Microscan ID No. 19680) | ANTIBIOTIC TESTED Minimum Inhibitory Concentration of Antibiotic Otg/ml) With: J 0 Mg/mL BPI 4 /xg/mL BPI,, 4 /xg/mL BPI* 4 /xg/mL BPIjo 4 /xg/mL BPI« dimer 16 Mg/mL BPI,, 16 Mg/mL BPI* 16 mg/mL BPIjo 16 /xg/mL BPI« dimer Ampicillin/ Sulbactam >32 >32 >32 32 >32 2 2 4 32 Aztreonam 32 8 4 32 16 <1 <1 <1 16 Amoxicillin/K Clavulanate 32 32 32 32 32 8 8 16 >32 1 Ciprofloxacin <.25 <.25 <.25 <.25 <.25 <.25 <.25 <.25 <.25 Ticarcillin/K Clavulanate >128 64 128 128 128 <16 <16 <16 32 Mezlocillin <16 <16 <16 <16 <16 <16 <16 <16 <16 Carbenicillin >128 128 64 128 128 <16 <16 <16 128 TABLE 31 EFFECTS OF BPI PROTEIN PRODUCTS ± ANTIBIOTICS ON E. coli J5-L ANTIBIOTIC TESTED Minimum Inhibitory Concentration of Antibiotic (jiglmY) With: | 0 /ig/mL BPI 4 /xg/mL BPI,, 4 /ig/mL BPI* 4 /ig/mL BPIjo 4 /ig/mL BPI,, dimer 16 /ig/mL BPI,, 16 /ig/mL BPIU 16 /ig/mL BPIjo 16 /ig/mL BPI« dimer Ceftizoxime <2 <2 <2 <2 <2 <2 <2 <2 <2 Ceftazidime <1 <1 <1 <1 <1 <1 <1 <1 <1 Cefotaxime <2 <2 <2 <2 <2 <2 <2 <2 <2 Ceftriaxone <2 <2 <2 <2 <2 <2 <2 <2 <2 Cefoperazone <4 <4 <4 <4 <4 <4 <4 <4 <4 Cefonicid <2 <2 <2 <2 <2 <2 <2 <2 <2 Cefotetan <4 <4 <4 <4 <4 <4 <4 <4 <4 Netilmicin <2 <2 <2 <2 <2 <2 <2 <2 <2 Cefamandole <4 <4 <4 <4 <4 <4 <4 <4 <4 | Chloramphenicol <2 <2 <2 <2 <2 <2 <2 <2 <2 I Ticarciliin <16 < 16 <16 <16 <16 <16 <16 <16 <16 Azlocillin <64 <64 <64 <64 <64 <64 <64 <64 <64 Imipenem <0.5 <0.5 <0.5 <0.5 <0.5 <0.5 <0.5 <0.5 <0.5 TABLE 31 EFFECTS OF BPI PROTEIN PRODUCTS ± ANTIBIOTICS ON E. coli J5-L ANTIBIOTIC TESTED 1 Minimum Inhibitory Concentration of Antibiotic (/ig/ml) With: 0 /ig/mL BPI 4 /ig/mL BPI„ 4 /ig/mL BPI* 4 Hg/mL BPIjo 4 /tg/mL BPI4, dimer 16 /tg/mL BPI„ 16 /ig/mL BPI* 16 /ig/mL BPIjo 16 /ig/mL bpi« dimer Ampicillin/ Sulbactam 2 2 2 2 2 <1 <1 <1 2 Aztreonam <1 < 1 <1 <1 <1 <1 <1 <1 <1 Amoxicillin/K Clavulanate 4 < 1 2 4 2 <1 <1 2 2 Ciprofloxacin <.25 <.25 <.25 <.25 <.25 <.25 <.25 <.25 <.25 Ticarcillin/K Clavulanate <16 < 16 <16 <16 <16 <16 <16 <16 <16 Mezlocillin <16 <16 <16 <16 <16 <16 <16 <16 <16 Carbenicillin <16 <16 <16 <16 <16 <16 <16 <16 <16 TABLE 32 EFFECTS OF BPI PROTEIN PRODUCTS ± ANTIBIOTICS ON E. coU 07:K1 ANTIBIOTIC TESTED Minimum Inhibitory Concentration of Antibiotic (/tg/ml) With: 0 /xg/mL BPI 4 /xg/mL BPI,, 4 /ig/mL BPIU 4 /ig/mL BPIjo 4 /ig/mL BPI« dimer 16 /ig/mL BPI,, 16 /ig/mL BPI* 16 /ig/mL BPIjo 16 /ig/mL BPI« dimer Ceftizoxime <2 <2 <2 <2 <2 <2 <2 <2 <2 Ceftazidime <1 <1 <1 <1 <1 <1 <1 <1 <1 Cefotaxime <2 <2 <2 <2 <2 <2 <2 <2 <2 Ceftriaxone <2 <2 <2 <2 <2 <2 <2 <2 <2 Cefoperazone <4 <4 <4 <4 <4 <4 <4 <4 <4 Cefonicid <2 <2 <2 <2 <2 <2 <2 <2 <2 Cefotetan <4 <4 <4 <4 <4 <4 <4 <4 <4 Netilmicin <2 <2 <2 <2 <2 <2 <2 <2 <2 Cefamandole <4 <4 <4 <4 <4 <4 <4 <4 <4 Chloramphenicol <2 <2 <2 <2 <2 <2 <2 <2 <2 Ticarciliin <16 <16 <16 <16 <16 <16 <16 <16 <16 Azlocillin <64 <64 <64 <64 <64 <64 <64 <64 <64 Imipenem <0.5 <0.5 <0.5 <0.5 <0.5 <0.5 <0.5 <0.5 <0.5 TABLE 32 EFFECTS OF BPI PROTEIN PRODUCTS ± ANTIBIOTICS ON E. coli 07:K1 Minimum Inhibitory Concentration of Antibiotic (/xg/ml) With: ANTIBIOTIC TESTED 0 /xg/mL BPI 4 /xg/mL BPI„ 4 /xg/mL BPI* 4 /xg/mL BPIjo 4 /xg/mL BPL»j dimer 16 /xg/mL BPI,, 16 /xg/mL BPI* 16 /xg/mL BPI,o 16 /xg/mL BPI« dimer Ampicillin/ Sulbactam <1 < 1 <1 <1 <1 <1 <1 <1 <1 Aztreonam <1 < 1 <1 <1 <t <1 <t <1 <1 Amoxicillin/K Clavulanate <1 < 1 < 1 <1 < 1 <1 <1 <1 <1 Ciprofloxacin <.25 <.25 <.25 <.25 <.25 <.25 <.25 <.25 <.25 Ticarcillin/K | Clavulanate <16 <16 <16 <16 <16 <16 <16 <16 <16 j Mezlocillin <16 < 16 <16 <16 <16 <16 <16 <16 <16 j Carbenicillin <16 <16 <16 <16 <16 <16 <16 <16 <16 EXAMPLE 24 GRAM-NEGATIVE BACTERICIDAL ACTIVITY OF BPI PEPTIDES BPI peptides were produced according to co-owned PCT Application No. US94/02465, PCT Application No. US94/02401, Australian Patent Applications 5 63988/94, 16797/95, 16822/95 and Australian Patents 681453 and 684503, the disclosures of all of which are incorporated herein by reference.

The BPI peptides were screened for bactericidal effects on E. coli 15 and E. Coli- 0111:B4 bacteria in a radial diffusion assay. Specifically, an overnight culture of the bacteria was diluted 1:50 into fresh tryptic soy broth and incubated for 10 3 hours at 3TC to attain log phase growth of the culture. Bacteria were then pelleted at 3,000 rpm for 5 minutes in a Sorvall RT6000B centrifuge (Sorvall Instruments, Newton, TC). 5 mL of 10 mM sodium phosphate buffer (pH 7.4) was added and the preparation was re-pelleted. The supernatant was decanted and 5 mL of fresh buffer was added, the bacteria were resuspended and their concentration was determined by measurement of absorbance at 590 nm (an Absorbance value of 1.00 at this wavelength equals a concentration of about 1.25 x 109 CFU/mL in suspension). The bacteria were diluted to 4 x 106 CFU/mL in 10 mL of molten underlayer agarose (at approximately 45°C) and inverted repeatedly to mix in 15 mL polypropylene tubes conventionally used for this purpose.

The entire contents of such tubes were then poured into a level square petri dish and distributed evenly by rocking the dish side-to-side. The agarose hardened in less than 30 seconds and had a uniform thickness of about 1 mm. A series of wells were then punched into the hardened agarose using a sterile 3 mm punch attached to a vacuum apparatus. The punch was sterilized with 100% alcohol and allowed to air dry prior to use to avoid contaminating the bacterial culture. or 10 fj.L of each of the BPI peptides were carefully pipetted into each well. As a negative control, dilution buffer (pH 8.3) was added to a separate well, and rBPI^ at concentrations of 5 ftg/mL and 1 ftg/mL were also added as positive controls. Each plate was incubated at 37°C for 3 hours, and then 10 mL of molten overlayer agarose (at approximately 45°C) was added into the level petri dish, allowed to harden and incubated overnight at 3TC. The next day, a clear zone was seen against the lawn of bacteria in those wells having bactericidal activity. In order to visually enhance this zone, a dilute Coomassie solution (consisting of 0.002% Coomassie Brilliant Blue, 27% methanol, 15% formaldehyde (37% stock solution) and water) was poured over the agar and allowed to stain for 24 hours. The bacterial zones were measured with a micrometer. The assay results for exemplary peptides (BPI.l through BPI. 169) are summarized in Table 33 for the Gram-negative bacteria E. coli J5 (rough) and E. coli 0113 (smooth). The bactericidal activities are expressed as the amount of peptide (pmol/well and ^g/well) required to generate a 30 mm2 bactericidal zone. Additional exemplary BPI peptides include BPI.221 through BPI.281. BPI peptides which retain antibacterial activity are expected to improve the therapeutic effectiveness of antibiotics when concurrently administered therewith. The peptides are screened for such activity in an in vivo model or according to in virro tests, including models and tests described herein.

Table 33 Bactericidal Activity* BPI Peptide Sequence ID No.

E. coli .15 E. coli OHl:B4 (pmol/well) Oxg/well) (pmol/well) Oxg/well) BPI.l 4 _b - - - BPI. 2 7 > 2733.5 > 5 - - BPI. 3 11 696 2.14 - - BPI.4 3 - - - - BPI. 5 67 398 1.05 > 1904 > 5 BPI. 7 54 175 0.46 > 1890.6 > 5 BPI. 8 8 > 3797.1 > 5 - - BPI. 9 51 479 1.02 > 2345.9 > 5 BPI. 10 102 0.41 697 2.76 BPI. 11 13 638 1.06 - - BPI. 12 14 525 1.78 - - BPI. 13 441 0.75 > 2923.9 > 5 BPI. 14 2 - - - - BPI. 15 16 > 2797.8 > 5 - - BPI. 16 17 > 2821.5 > 5 - - Table 33 Bactericidal Activity* BPI PeDtide Sequence ID No.

E. coli .T5 E. coli OHl:B4 (pmol/well) Oxg/well) (pmol/well) (fig/well) BPI, 17 18 > 2807.2 > 5 - - BPI. 18 19 > 2757.6 > 5 - - BPI. 19 > 2712.8 > 5 - - BPI.20 21 > 2821.5 > 5 - - BPI. 21 22 > 2917 > 5 - - BPI. 22 23 > 2821.50 > 5 - - BPI. 23 24 1330 2.36 > 2821.15 > 5 BPI. 24 655 1.16 > 2821.50 > 5 BPI. 25 26 > 2866.8 > 5 - - BPI.26 27 > 2852.1 > 5 - - BPI. 27 28 > 2797.8 > 5 - - BPI.28 29 > 2821.5 > 5 - - BPI.29 56 442 1.5 > 1469.2 > 5 BPI.30 52 76 0.23 608 1.84 BPI. 31 33 938 1.55 - - BPI. 32 34 614 1.04 - - Table 33 Bactericidal Activity* BPI Peptide Sequence ID No.

E. coli .15 E. coli 0111:B4 (pmol/well) (fig/well) (pmol/well) (fxg/well) BPI.33 575 0.95 - - BPI.34 36 916 1.54 - - BPI.35 37 263 0.45 - - BPI.36 38 1652 2.64 - - BPI. 37 39 1284 2.14 - - BPI. 3 8 40 1698 2.83 - - BPI.39 41 316 0.52 - - BPI.40 42 1760 2.94 - - BPI.41 43 2465 4.03 - - BPI. 42 44 265 0.44 > 3041.3 > 5 BPI.43 45 729 1.21 > 3024.8 > 5 BPI. 44 46 481 0.8 2983 4.93 BPI. 45 31 1302 2.23 > 1696.7 > 5 BPI.46 57 186 0.47 > 1811.2 > 5 BPI.47 58 98 0.25 577 1.46 BPI.48 59 42 0.1 254 0.61 Table 33 Bactericidal Activity* BPI PeDtide Sequence ID No.

E. coli .T5 E. coli OHl:B4 (pmol/well) (pig/well) (pmol/well) (/xg/well) BPI.54 - - - - BPI.55 61 299 0.75 > 1592.2 > 5 BPI.56 47 1387 2.54 - - BPI.57 99 514 1.05 - - BPI.5 8 9 1050 2.03 - - BPI.59 > 2312.3 > 5 - - BPI. 60 32 > 2136.5 > 5 - - BPI. 61 48 > 2093.5 > 5 - - BPI. 63 53 87 0.31 512 OO BPI. 65 oxidized 895 1.82 - - BPI. 65 reduced 68 1362 2.77 - - BPI. 66 49 > 3496.7 > 5 - - BPI. 67 50 > 1901.8 > 5 - - BPI. 69 60 57 0.21 244 0.88 Table 33 Bactericidal Activity* BPI Peotide Sequence ID No.

E. coli .T5 E. coli 0111:B4 (pmol/well) (fig/well) (pmol/well) Oxg/well) BPI.70 63 - - - - BPI. 71 64 2297 4.53 - BPI. 72 66 > 1911.2 > 5 - - BPI. 73 62 57 0.11 > 1810.9 > 5 BPI. 74 70 732 2.21 > 2148.2 > 5 BPI.75 100 2030.8 4.96 - - BPI.76 71 > 3906.5 > 5 - - BPI. 77 72 455 0.85 - - BPI.79 73 > 2282.9 > 5 - - BPI. 80 74 655 1.24 - - BPI. 81 75 284 0.52 > 2344.9 > 5 BPI. 82 76 171 0.32 > 1197.8 > 5 BPI. 83 77 155 0.27 > 2033.5 > 5 BPI. 84 78 12 0.02 > 2016.9 > 5 BPI. 85 79 227 0.4 > 1881.2 > 5 BPI. 86 80 1520 2.58 - - Table 33 Bactericidal Activity" BPI PeDtide Sequence ID No.

E. coli .15 E. coli Olll:B4 (pmol/well) (/xg/well) (pmol/well) Oxg/well) BPI. 87 81 189 0.32 > 1535.8 > 5 BPI. 88 82 70.32 0.13 540.15 1 BPI. 89 84 229.09 0.43 > 1882.4 > 5 BPI. 90 85 83.11 0.16 1763 3.32 BPI. 91 86 > 3843.5 > 5 - - BPI. 92 87 331.8 0.57 - - BPI.93 88 212.87 0.76 > 980.3 > 5 BPI. 94 89 922.54 1.59 > 922.5 > 5 BPI.95 90 330.88 0.6 > 1397.6 > 5 BPI. 96 101 378.33 0.65 > 2048.5 > 5 BPI. 97 92 296.58 0.53 - - BPI. 98 83 > 1626.1 > 5 > 1626.1 > 5 BPI. 99 93 722.9 2.99 > 1064.1 > 5 BPI. 100 94 407.74 0.73 > 2655 > 5 BPI. 101 95 1329.3 4.79 > 1329.3 > 5 BPI. 102 96 > 2635.6 > 5 > 2635.6 > 5 Table 33 Bactericidal Activity* BPI Peptide Sequence ID No.

E. coli .T5 E. coli OHl:B4 (pmol/well) Oxg/well) (pmol/well) Oxg/well) BPI. 103 102 165.18 0.31 415.19 0.78 BPI. 104 103 385.85 0.64 1376.42 2.30 BPI 105 104 65.35 0.12 206.98 0.39 BPI. 106 105 427.12 0.72 > 3413.80 > 5 BPI. 107 106 384.67 0.68 > 2795.70 > 5 BPI. 108 107 661.05 1.17 > 3219.02 > 5 BPI. 109 108 306.80 0.54 > 2822.90 > 5 BPI. 110 109 812.33 1.44 > 2950.15 > 5 BPI. Ill 110 959.00 1.71 > 2808.69 > 5 BPI. 112 111 1485.92 2.84 - - BPI. 113 112 270.66 0.50 > 2950.15 > 5 BPI. 114 113 2329.68 3.10 - - BPI. 116 114 73.82 0.13 > 2788.19 > 5 BPI. 119 115 106.70 0.20 536.44 1.02 BPI. 120 116 - - - - BPI. 121 117 154.35 0.3 1856.40 3.55 PCTAJS94/11225 Table 33 Bactericidal Activity* PPJ Peptide Sequence ID No.

E. coli J5 E. coli OHl:B4 (pmol/well) Oxg/well) (pmol/well) Oxg/well) BPI. 122 118 179.89 0.36 2123.57 4.2 BPI. 123 119 247.20 0.43 > 2865.02 > 5 BPI. 124 120 91.23 0.17 > 2580.12 > 5 BPI. 125 121 428.85 0.75 > 3149.74 > 5 BPI. 126 122 1979.97 3.39 - - BPI. 127 123 406.01 0.68 - - BPI. 128 124 2271.14 3.80 - - BPI. 129 125 1685.10 2.90 - - BPI. 130 126 325.75 0.68 > 2903.34 > 5 BPI. 131 127 1438.21 2.48 - - BPI. 132 128 > 2988.50 > 5 - - BPI. 133 129 2316.59 3.91 - - BPI. 134 130 162.5 0.30 580.11 1.05 BPI. 135 131 1052.02 1.74 3321.69 > 5 BPI. 136 132 > 3030.74 > 5 - - BPI. 137 133 N.T.

N.T.

N.T.

N.T.

Table 33 Bactericidal Activity* BPI Peptide Sequence ID No.

E. coli.T5 E. coli OHl:B4 (pmol/well) Oxg/well) (pmol/well) Oxg/well) BPI. 138 134 64.57 0.11 995.40 1.74 BPI. 139 135 1261.37 2.13 3793.91 > 5 BPI. 140 136 84.76 0.26 605.34 1.89 BPI. 141 137 > 2809.51 > 5 - - BPI. 142 138 922.21 1.76 - - BPI. 143 139 > 2838.99 > 5 - - BPI. 144 140 - 510.02 0.86 - - BPI. 145 141 N.T.

N.T.

N.T.

N.T.

BPI. 146 142 - - - - BPI. 147 143 > 2558.17 > 5 - - BPI. 148 144 > 2805.45 > 5 - - BPI. 149 147 44.00 0.57 391.00 .00 BPI. 150 148 220.00 0.58 > 2380.67 > 5 BPI. 151 N.T.

N.T.

N.T.

N.T.

BPI. 152 N.T.

N.T.

N.T.

N.T.

BPI. 153 149 N.T.

N.T.

N.T.

N.T.

PCT/DS94/3 2225 Table 33 Bactericidal Activity* BPI Peptide Sequence ID No.

E. coli .15 E. coli OHl:B4 (pmol/well) Gig/well) (pmol/well) Oig/well) BPI. 154 150 197.00 0.55 2977.76 > 5 BPI. 155 151 > 1795.66 > 5 > 1795.66 > 5 BPI. 156 152 N.T.

N.T.

N.T.

N.T.

BPI. 157 153 N.T.

N.T.

N.T.

N.T.

BPI. 158 154 N.T.

N.T.

N.T.

N.T.

BPI. 159 155 765.43 2.41 > 1589.88 > 5 BPI. 160 156 288.78 0.81 > 1781.59 > 5 BPI. 161 157 1201.79 2.00 - - BPI. 162 158 N.T.

N.T.

N.T.

N.T.

BPI. 163 159 N.T.

N.T.

N.T.

N.T.

BPI. 164 160 N.T.

N.T.

N.T.

N.T.

BPI. 165 161 N.T.

N.T.

N.T.

N.T.

BPI. 166 162 514.00 0.83 > 3078.72 > 5 BPI. 167 163 > 4585.73 > 5 - - BPI. 168 164 1460.98 2.87 > 1948.48 > 5 Table 33 Bactericidal Activity* BPI Peptide Sequence ID No. £• cqH,is E, coli OHl:B4 (pmol/well) (fig/well) (pmol/well) (fig/well) BPI. 169 165 4893.83 > 5 > 4974.43 > 5 BPI. 170 227 3693.06 > 5 - - MAP. 1* 106 0.82 552.79 4.27 MAP.2** > 690.9 > 5 > 690.9 >5 a Amount added to well to achieve a 30 mm2 hole as determined by • PROBIT analysis as described in Examples 15 and 16. b No detectable activity up to 5 ^g/well. c N.T. = not tested * MAP. 1 = f3-A\a-Na,NE-[Na,N£ (BPI.2)Lys]Lys ** MAP.2 = fi-Ala.-Na,N£-[Na,N€: (BPI.13)Lys]Lys EXAMPLE 25 EFFECTS OF CONCURRENT ADMINISTRATION OF BPI PROTEIN PRODUCT AND TETRACYCLINE OR GENTAMICIN ON E. COU OHl:B4 Additional MIC assays were performed to determine the sensitivity of E. coli 0111:B4 (as described in Example 1) to the effects of BPI protein products concurrently administered with the antibiotic tetracycline or with the antibiotic gentamicin.

For these experiments, organisms were grown overnight at 3TC in 5 mL of Mueller-Hinton broth. This overnight culture was diluted 1:50 into 5 mL of fresh broth and incubated for an additional 3 hours at 37°C to attain log-phase growth. Bacteria were pelleted for 5 minutes at 1500 x g and resuspended in fresh broth to give a final concentration of 2 x 106 cells per mL. rBPI^ and antibiotic (either tetracycline or gentamicin) were diluted such that lOOfd bacterial suspension, 50 fd antibiotic and 50 fd diluted rBPIM, gave concentrations in serial dilutions from 10 /ig/mL tetracycline or 2.5 ftg/mL gentamicin and from 30 ftg/mL rBPI23 with a fixed concentration of 10* cells/mL. Incubation was carried out in flat bottom 96 well microtiter plates for 18 hours at 37°C, and the plates were read in an automatic plate reader (Titretek Multiscan) at 590 nm.

A 4-6 fold decrease in absorbance was observed with tetracycline or gentamicin with certain concentrations of BPI protein product. The MIC of tetracycline without rBPI^ of 10 ftg/mL and was reduced by rBPI^ to 5 ftg/mL. The MIC of gentamicin without rBPI23 was 0.6 ftg/mL and was reduced by rBPI23 to 0.3 ftg/mL.

A partial summary of the data described in the foregoing examples, grouped by general classes of antibiotics, appears below in Table 34 and is displayed as the effects of BPI protein products on the therapeutic effectiveness of antibiotics for various gram-negative organisms.

TABLE 34 ANTIBIOTIC CLASS EFFECTS OF BPI PROTEIN PRODUCT WHEN C ON CURRENTLY ADMINISTERED WITH ANTIBIOTICS WITHIN CLASS ^-lactams: penicillins and cephalosporins reversed resistance of Pseudomonas aeruginosa, other Pseudomonas, Xanthamonas, E. coli, Citrobacter, Klebsiella, Enierobacter, Serraiia, Providencia, Acinetobacter increased susceptibility of Pseudomonas aeruginosa, other Pseudomonas, E. coli, Citrobacter, Klebsiella, Enierobacter, Serratia, Proteus, Providencia, Morganella, Acinetobacter enhanced early bactericidal effect for E. coli, Enierobacter in killing curves in vivo synergy shown for treatment of E. coli infection in mouse and rabbit models ^-lactams other than penicillins and cephalosporins: aztreonam and imipenem aztreonam: reversed resistance of Pseudomonas aeruginosa, Acinetobacter increased susceptibility of Acinetobacter increased susceptibility of Pseudomonas aeruginosa, Citrobacter, Enterobacter imipenem: increased susceptibility of Pseudomonas aeruginosa, Proteus, Providencia, Acinetobacter TABLE 34 ANTIBIOTIC CLASS EFFECTS OF BPI PROTEIN PRODUCT WHEN CONCURRENTLY ADMINISTERED WITH ANTIBIOTICS WITHIN CLASS aminoglycosides reversed resistance of Pseudomonas aeruginosa, Xanthamonas, Acinetobacter increased susceptibility of Pseudomonas aeruginosa, other Pseudomonas, E. coli, Citrobacter, Serraiia, Proteus, Providencia, Morganella, Acinetobacter checkerboard synergy (FIC < 0.5) for E. coli, Salmonella, Klebsiella, Edwardsiella\ greater than additive interaction (FIC < 1.0) for Pseudomonas aeruginosa, Enierobacter in vivo synergy shown for treatment of E. coli infection in mouse model sulfonamides and trimethoprim reversed resistance of Pseudomonas aeruginosa, Xanthamonas, Klebsiella, Acinetobacter increased susceptibility of Enierobacter, Proteus, Acinetobacter enhanced early bactericidal effect for Klebsiella, Enierobacter in killing curves; slight early enhancement for E. coli fluoroquinolones and quinolones reversed resistance of Pseudomonas aeruginosa, Acinetobacter increased susceptibility of Pseudomonas aeruginosa, Xanthamonas, Enierobacter, Acinetobacter reversed resistance of Klebsiella in antibiotic killing curves polymyxins checkerboard synergy (FIC < 0.5) for Pseudomonas aeruginosa, E. coli, Providencia; additive interaction (FIC < 1.0) for Enierobacter chloramphenicol reversed resistance and increased susceptibility for Acinetobacter PCI7US94/11225 Numerous modifications and variations in the practice of the invention are expected to occur to those skilled in the art upon consideration of the foregoing description of the presently preferred embodiments thereof.

Consequently, the only limitations which should be placed upon the scope of the present invention are those which appear in the appended claims. 141 SEQUENCE LISTING (1) GENERAL INFORMATION: (i) APPLICANTS: Cohen, Jonathan Kung, Ada H-C.

Lambert, Jr., Lewis H. (ii) TITLE OF INVENTION: Method for Treating Gram-Negative Bacterial Infection by Administration of Bactericidal/Permeability-Increasing (BPI) Protein Product and Antibiotic (iii) NUMBER OF SEQUENCES: 227 (iv) CORRESPONDENCE ADDRESS: (A) ADDRESSEE: Marshall, O'Toole, Gerstein, Murray & Borun (B) STREET: 6300 Sears Tower, 233 South Wacker Drive (C) CITY: Chicago (D) STATE: Illinois (.E) COUNTRY: USA (F) ZIP: 60606-6402 (v) COMPUTER READABLE FORM: (A) MEDIUM TYPE: Floppy disk (B) COMPUTER: IBM PC compatible (C) OPERATING SYSTEM: PC-DOS/MS-DOS (D) SOFTWARE: Patentln Release #1.0, Version #1.25 (vi) CURRENT APPLICATION DATA: (A) APPLICATION NUMBER: (B) FILING DATE: (vii) PRIOR APPLICATION DATA: (A) APPLICATION NUMBER: 08/273,401 (B) FILING DATE: ll-JUL-1994 (vii) PRIOR APPLICATION DATA: (A) APPLICATION NUMBER: 08/125,651 (B) FILING DATE: 22-SEP-1993 (viii) ATTORNEY/AGENT INFORMATION: (A) NAME: Sharp, Jeffrey S.

(B) REGISTRATION NUMBER: 31,879 (C) REFERENCE/DOCKET NUMBER: 32251 (ix) TELECOMMUNICATION INFORMATION: (A) TELEPHONE: 312/474-6300 (B) TELEFAX: 312/474-0448 (C) TELEX: 25-3856 (2) INFORMATION FOR SEQ ID NO:l: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 29 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "Domain I" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:l: 142 Ala Ser GIti Gin Gly Thr Ala Ala Leu Gin Lys Glu Leu Lys Arg 15 10 15 lie Lys lie Pro Asp Tyr Ser Asp Ser Phe Lys lie Lys His 20 25 (2) INFORMATION FOR SEQ ID NO:2: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 30 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: niisc_feature (D) OTHER INFORMATION: "BPI.14" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:2: Gly Thr Ala Ala Leu Gin Lys Glu Leu Lys Arg lie Lys lie Pro 15 10 15 Asp Tyr Ser Asp Ser Phe Lys lie Lys His Leu Gly Lys Gly His 20 25 30 (2) INFORMATION FOR SEQ ID NO: 3: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 22 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.4" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:3: Leu Gin Lys Glu Leu Lys Arg lie Lys lie Pro Asp Tyr Ser Asp 15 10 15 Ser Phe Lys lie Lys His Leu 20 (2) INFORMATION FOR SEQ ID NO:4: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 15 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.l" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:4: Gin Gin Gly Thr Ala Ala Leu Gin Lys Glu Leu Lys Arg lie Lys 15 10 IS 143 (2) INFORMATION FOR SEQ ID NO:5: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 15 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.54" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:5: Gly Thr Ala Ala Leu Gin Lys Glu Leu Lys Arg lie Lys lie Pro 15 10 15 (2) INFORMATION FOR SEQ ID NO:6: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 35 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: raisc_feature (D) OTHER INFORMATION: "Domain II" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:6: Ser Ser Gin lie Ser Met Val Pro Asn Val Gly Leu Lys Phe Ser 15 10 15 lie Ser Aen Ala Asn lie Lys lie Ser Gly Lys Trp Lye Ala Gin Lys 20 25 30 Arg Phe Leu Lys 35 (2) INFORMATION FOR SEQ ID NO: 7: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 15 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.2" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:7: lie Lys lie Ser Gly Lys Trp Lys Ala Gin Lys Arg Phe Leu Lys 1 5 10 15 (2) INFORMATION FOR SEQ ID NO:8: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 10 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear 144 (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.8" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:8: Lys Trp Lys Ala Gin Lys Arg Phe Leu Lys 15 10 (2) INFORMATION FOR SEQ ID NO:9: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 16 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.58" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:9: Cys lie Lys lie Ser Gly Lys Trp Lys Ala Gin Lys Arg Phe Leu 15 10 15 Lys (2) INFORMATION FOR SEQ ID NO:10: {X) SEQUENCE CHARACTERISTICS: (A) LENGTH: 17 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.65 oxidized" (Xi) SEQUENCE DESCRIPTION: SEQ ID NO:10: Cys lie Lys lie Ser Gly Lys Trp Lys Ala Gin Lys Arg Phe Leu 15 10 15 Lys Cys (2) INFORMATION FOR SEQ ID NO:11: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 27 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.3" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:11: 145 Asn Val Gly Leu Lys Phe Ser lie Ser Asn Ala Asn lie Lys lie 15 10 15 Ser Gly Lys Trp Lys Ala Gin Lys Arg Phe Leu Lys 20 25 (2) INFORMATION FOR SEQ ID NO:12: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 28 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "Domain III" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:12: Val His Val His lie Ser Lys Ser Lys Val Gly Trp Leu lie Gin 1.5 10 15 Leu Phe His Lys Lys lie Glu Ser Ala Leu Arg Asn Lys 20 25 (2) INFORMATION FOR SEQ ID NO:13: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 13 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.11" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:13: Lys Ser Lys Val Trp Leu lie Gin Leu Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:14: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 29 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.12" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:14: Ser Val His Val His lie Ser Lys Ser Lys Val Gly Trp Leu lie 15 10 15 Gin Leu Phe His Lys Lys lie Glu Ser Ala Leu Arg Asn Lys 20 25 146 (2) INFORMATION FOR SEQ ID NO:15: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH^ 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.13" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:15: Lys Ser Lys Val Gly Trp Leu lie Gin Leu Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:16: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 15 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: miacjeature (D) OTHER INFORMATION: "BPI.15" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:16: Ala Lys lie Ser Gly Lys Trp Lys Ala Gin Lys Arg Phe Leu Lys 15 10 15 (2) INFORMATION FOR SEQ ID NO:17: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 15 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.16" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:17: lie Ala lie Ser Gly Lys Trp Lys Ala Gin Lys Arg Phe Leu Lys 15 10 15 (2) INFORMATION FOR SEQ ID NO:18: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 15 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.17" 147 (xi) SEQUENCE DESCRIPTION: SEQ ID NO:18: lie Lys Ala Ser Gly Lys Trp Lys Ala Gin Lys Arg Phe Leu Lys 15 10 15 (2) INFORMATION FOR SEQ ID NO:19: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 15 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.18" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:19: lie Lys lie Ala Gly Lys Trp Lys Ala Gin Lys Arg Phe Leu Lys 15 10 15 (2) INFORMATION FOR SEQ ID NO:20: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 15 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: raisc_feature (D) OTHER INFORMATION: "BPI.19" (xi) SEQUENCE DESCRIPTION: SEQ ID N0:20: lie Lys lie Ser Ala Lys Trp Lys Ala Gin Lys Arg Phe Leu Lye 15 10 15 (2) INFORMATION FOR SEQ ID NO:21: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 15 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.20" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:21: lie Lys lie Ser Gly Ala Trp Lys Ala Gin Lys Arg Phe Leu Lys 15 10 15 (2) INFORMATION FOR SEQ ID NO:22: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 15 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear 148 (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.21" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:22: lie Lys lie Ser Gly Lys Ala Lys Ala Gin Lys Arg Phe Leu Lys 15 10 15 (2) INFORMATION FOR SEQ ID NO;23: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 15 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.22" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:23: lie Lys lie Ser Gly Lys Trp Ala Ala Gin Lys Arg Phe Leu Lya 15 10 15 (2) INFORMATION FOR SEQ ID NO:24: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 15 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.23" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:24: lie Lys lie Ser Gly Lys Trp Lys Ala Ala Lys Arg Phe Leu Lys 1 5 10 15 (2) INFORMATION FOR SEQ ID NO:25: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 15 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.24" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:25: lie Lys lie Ser Gly Lys Trp Lys Ala Gin Ala Arg Phe Leu Lys 15 10 15 PCT7US94/11225 149 (2) INFORMATION FOR SEQ ID NO:26: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 15 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.25" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:26: lie Lys lie Ser Gly Lys Trp Lys Ala Gin Lys Ala Phe Leu Lys 15 10 15 (2) INFORMATION FOR SEQ ID NO:27: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 15 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.26" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:27: lie Lys lie Ser Gly Lys Trp Lya Ala Gin Lys Arg Ala Leu Lys 15 10 15 (2) INFORMATION FOR SEQ ID NO:28: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 15 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.27" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:28: lie Lys lie Ser Gly Lys Trp Lys Ala Gin Lys Arg Phe Ala Lys 15 10 15 (2) INFORMATION FOR SEQ ID NO:29: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 15 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature 150 (D) OTHER INFORMATION: "BPI.28" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:29: lie Lys lie Ser Gly Lys Trp Lys Ala Gin Lys Arg Phe Leu Ala 15 10 15 (2) INFORMATION FOR SEQ ID NO:30: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 15 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.59" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:30: lie Lys lie Ser Gly Ala Trp Ala Ala Gin Lys Arg Phe Leu Lys 1"5 10 15 (2) INFORMATION FOR SEQ ID NO:31: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 15 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.45" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:31: lie Lys lie Ser Gly Lys Trp Lys Ala Ala Ala Arg Phe Leu Lys 15 10 15 (2) INFORMATION FOR SEQ ID NO:32: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 15 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.60" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:32: lie Ala lie Ser Gly Lys Trp Lys Ala Gin Lys Arg Phe Leu Ala 15 10 15 (2) INFORMATION FOR SEQ ID NO:33: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid 151 (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.31" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:33: Ala Ser Lys Val Gly Trp Leu lie Gin Leu Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:34: ( i) SEQUENCE CHARACTERISE CS : (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.32" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:34: Lys Ala Lys Val Gly Trp Leu lie Gin Leu Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:35: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.33" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:35: Lys Ser Ala Val Gly Trp Leu lie Gin Leu Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:36: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.34" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:36: Lys Ser Lys Ala Gly Trp Leu lie Gin Leu Phe His Lys Lys 15 10 PCT/U S94/11225 152 (2) INFORMATION FOR SEQ ID NO:37: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.35" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:37: Lys Ser Lys Val Ala Trp Leu lie Gin Leu Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:38: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.36" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:38: Lys Ser Lys Val Gly Ala Leu lie Gin Leu Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:39: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.37" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:39: Lys Ser Lys Val Gly Trp Ala lie Gin Leu Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:40: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.38" 153 (xi) SEQUENCE DESCRIPTION: SEQ ID N0:40: Lya Ser Lys Val Gly Trp Leu Ala Gin Leu Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:41: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: roisc_feature (D) OTHER INFORMATION: "BPI.39" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:41: Lys Ser Lys Val Gly Trp Leu lie Ala Leu Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:42: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.40" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:42: Lys Ser Lys Val Gly Trp Leu lie Gin Ala Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:43: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.41" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:43: Lys Ser Lys Val Gly Trp Leu lie Gin Leu Ala His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:44: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide 154 (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.42" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:44: Lys Ser Lys Val Gly Trp Leu lie Gin Leu Phe Ala Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:45: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.43" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:45: Lys Ser Lys Val Gly Trp Leu lie Gin Leu Phe His Ala Lys 15 10 (2) INFORMATION FOR SEQ ID NO:46: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.44" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:46: Lys Ser Lys Val Gly Trp Leu lie Gin Leu Phe His Lys Ala 15 10 (2) INFORMATION FOR SEQ ID NO:47: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 15 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.56" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:47: lie Lys lie Ser Gly Lys Trp Lys Ala Lys Gin Arg Phe Leu L-^s 15 10 15 (2) INFORMATION FOR SEQ ID NO:48: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 15 amino acids 155 (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.61" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:48: lie Lys lie Ser Gly Lys Phe Lys Ala Gin Lys Arg Phe Leu Lys 15 10 15 (2) INFORMATION FOR SEQ ID NO:49: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 15 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.66" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 7 (D) OTHER INFORMATION: /label= D—Trp /note= "The amino acid at position 7 is D-tryptophan" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:49: lie Lys lie Ser Gly Lys Trp Lys Ala Gin Lys Arg Phe Leu Lys 15 10 15 (2) INFORMATION FOR SEQ ID NO:50: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 15 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.67" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 6..8 (D) OTHER INFORMATION: /label= Substituted-Ala /note= "The alanine at position 7 is beta-l-naphthyl-substituted" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:50: lie Lys lie Ser Gly Lys Ala Lys Ala Gin Lys Arg Phe Leu Lys 15 10 15 (2) INFORMATION FOR SEQ ID NO:51: 156 (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 15 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.9" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:51: Lys Arg Phe Leu Lys Lys Trp Lys Ala Gin Lys Arg Phe Leu Lys 15 10 15 (2) INFORMATION FOR SEQ ID NO:52: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 24 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: miscjeature (D) OTHER INFORMATION: "BPI.30" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:52: Lys Trp Lys Ala Gin Lys Arg Phe Leu Lys Lys Ser Lys Val Gly 15 10 15 Trp Leu He Gin Leu Phe His Lys Lys 20 (2) INFORMATION FOR SEQ ID NO:53: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 29 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.63" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:53: lie Lys He Ser Gly Lys Trp Lys Ala Gin Lys Arg Phe Leu Lys 15 10 15 Lys Ser Lys Val Gly Trp Leu lie Gin Leu Phe His Lys Lys 20 25 (2) INFORMATION FOR SEQ ID NO:54: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 20 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide 157 (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.7" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:54: Lys Trp Lys Ala Gin Lys Arg Phe Leu Lys Lys Trp Lys Ala Gin 15 10 15 Lys Arg Phe Leu Lys 20 (2) INFORMATION FOR SEQ ID NO:55: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 25 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.10.1" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:55: Lys Arg Phe Leu Lys Lys Trp Lys Ala Gin Lys Arg Phe Leu Lys 15 10 15 Lys Trp Lys Ala Gin Lys Arg Phe Leu Lys 20 25 (2) INFORMATION FOR SEQ ID NO:56: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 28 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.29" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:56: Lys Ser Lys Val Gly Trp Leu lie Gin Leu Phe His Lys Lys Lys 15 10 15 Ser Lys Val Gly Trp Leu lie Gin Leu Phe His Lys Lys 20 25 (2) INFORMATION FOR SEQ ID NO:57: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 20 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.46" WO 95/08344 PCT/US94/11225 158 (xi) SEQUENCE DESCRIPTION: SEQ ID NO:57: Lys Trp Lys Ala Ala Ala Arg Phe Leu Lys Lys Trp Lys Ala Gin 15 10 15 Lys Arg Phe Leu Lys 20 (2) INFORMATION FOR SEQ ID NO:58: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 20 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.47" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:58: Lys Trp Lys Ala Gin Lys Arg Phe Leu Lys Lys Trp Lys Ala Ala 15 10 15 Ala Arg Phe Leu Lys 20 (2) INFORMATION FOR SEQ ID NO:59: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 20 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.48" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:59: Lys Trp Lys Ala Ala Ala Arg Phe Leu Lys Lys Trp Lys Ala Ala 15 10 15 Ala Arg Phe Leu Lys (2) INFORMATION FOR SEQ ID NO:60: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 30 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.69" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:60: PCI7US94/11225 159 Lys Trp Lys Ala Ala Ala Arg Phe Leu Lys Lys Trp Lys Ala Ala 15 10 15 Ala Arg Phe Leu Lys Lys Trp Lys Ala Ala Ala Arg Phe Leu Lys 20 25 30 (2) INFORMATION FOR SEQ ID NO:61: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 21 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.55" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:61: Gly Trp Leu lie Gin Leu Phe His Lys Lys lie Glu Ser Ala Leu 15 10 15 Arg Asn Lys Met Asn Ser 20 (2) INFORMATION FOR SEQ ID NO:62: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 15 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.73" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:62: lie Lys lie Ser Gly Lys Trp Lys Ala Gin Phe Arg Phe Leu Lys 15 10 15 (2) INFORMATION FOR SEQ ID NO:63: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 15 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.70" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 8..10 (D) OTHER INFORMATION: /label= Substituted-Ala /note= "The alanine at position 7 is beta-3-pyridyl-substituted" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:63: 160 lie Lys lie Ser Gly Lys Ala Lys Ala Gin Lys Arg Phe Leu Lys 15 10 15 (2) INFORMATION FOR SEQ ID NO:64: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 15 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.71" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 13..15 (D) OTHER INFORMATION: /label= Substituted-Ala /note= "The alanine at position 13 is beta-3-pyridyl-eubstituted" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:64: lie Lys lie Ser Gly Lys Trp Lys Ala Gin Lys Arg Ala Leu Lys 15 10 15 (2) INFORMATION FOR SEQ ID NO:65: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 26 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.10.2" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:65: Gin Lys Arg Phe Leu Lys Lys Trp Lys Ala Gin Lys Arg Phe Leu 15 10 15 Lys Lys Trp Lys Ala Gin Lys Arg Phe Leu Lys 20 25 (2) INFORMATION FOR SEQ ID NO:66: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 17 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.72" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 1..3 (D) OTHER INFORMATION: /label= D-alanine 161 /note= "The position 1 and position 2 alanine residues are both D-alanine" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:66: Ala Ala lie Lys lie Ser Gly Lys Trp Lys Ala Gin Lys Arg Phe 15 10 15 Leu Lys (2) INFORMATION FOR SEQ ID NO:67: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 22 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.5" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:67: Val His Val His lie Ser Lys Ser Lys Val Gly Trp Leu lie Gin 15 10 15 Leu Phe His Lys Lys lie Glu 20 (2) INFORMATION FOR SEQ ID NO:68: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 17 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI. 65 reduced" (ix) FEATURE: (A) NAME/KEY: Disulfide-bond (B) LOCATION: 1..17 (xi) SEQUENCE DESCRIPTION: SEQ ID NO:68: Cys lie Lys lie Ser Gly Lys Trp Lys Ala Gin Lys Arg Phe Leu 15 10 15 Lys Cys (2) INFORMATION FOR SEQ ID NO:69: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 487 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: protein (ix) FEATURE: (A) NAME/KEY: misc_feature 162 (D) OTHER INFORMATION: "rBPI" (xi) SEQUENCE DESCRIPTION: • SEQ ID NO:69: Met Arg Glu Asn Met Ala Arg Gly Pro Cys Asn Ala Pro Arg Trp Val -31 -30 -25 -20 Ser Leu Met Val Leu Val Ala lie Gly Thr Ala Val Thr Ala Ala Val -15 -10 -5 1 Asn Pro Gly Val Val Val Arg lie Ser Gin Lys Gly Leu Asp Tyr Ala 5 10 15 Ser Gin Gin Gly Thr Ala Ala Leu Gin Lys Glu Leu Lys Arg lie Lys 20 25 30 lie Pro Asp Tyr Ser Asp Ser Phe Lys lie Lys His Leu Gly Lys Gly 35 40 45 His Tyr Ser Phe Tyr Ser Met Asp lie Arg Glu Phe Gin Leu Pro Ser 50 55 60 65 Ser Gin lie Ser Met Val Pro Asn Val Gly Leu Lys Phe Ser lie Ser 70 75 80 Asn Ala Asn lie Lys lie Ser Gly Lys Trp Lys Ala Gin Lys Arg Phe 85 90 95 Leu Lys Met Ser Gly Asn Phe Asp Leu Ser lie Glu Gly Met Ser lie 100 105 110 Ser Ala Asp Leu Lys Leu Gly Ser Asn Pro Thr Ser Gly Lys Pro Thr 115 120 125 lie Thr Cys Ser Ser Cys Ser Ser His lie Asn Ser Val His Val His 130 135 140 145 lie Ser Lys Ser Lys Val Gly Trp Leu lie Gin Leu Phe His Lys Lys 150 155 160 lie Glu Ser Ala Leu Arg Asn Lys Met Asn Ser Gin Val Cys Glu Lys 165 170 175 Val Thr Asn Ser Val Ser Ser Lys Leu Gin Pro Tyr Phe Gin Thr Leu 180 185 190 Pro Val Met Thr Lys lie Asp Ser Val Ala Gly lie Asn Tyr Gly Leu 195 200 205 Val Ala Pro Pro Ala Thr Thr Ala Glu Thr Leu Asp Val Gin Met Lys 210 215 220 225 Gly Glu Phe Tyr Ser Glu Asn His His Asn Pro Pro Pro Phe Ala Pro 230 235 240 Pro Val Met Glu Phe Pro Ala Ala His Asp Arg Met Val Tyr Leu Gly 245 250 255 Leu Ser Asp Tyr Phe Phe Asn Thr Ala Gly Leu Val Tyr Gin Glu Ala 260 265 270 Gly Val Leu Lys Met Thr Leu Arg Asp Asp Met lie Pro Lys Glu Ser 275 280 285 163 Lys Phe Arg Leu Thr Thr Lys Phe Phe Gly Thr Phe Leu Pro Glu Val 290 295 300 305 Ala Lys Lys Phe Pro Asn Met Lys lie Gin lie His Val Ser Ala Ser 310 315 320 Thr Pro Pro His Leu Ser Val Gin Pro Thr Gly Leu Thr Phe Tyr Pro 325 330 335 Ala Val Asp Val Gin Ala Phe Ala Val Leu Pro Asn Ser Ser Leu Ala 340 345 350 Ser Leu Phe Leu lie Gly Met His Thr Thr Gly Ser Met Glu Val Ser 355 360 365 Ala Glu Ser Asn Arg Leu Val Gly Glu Leu Lys Leu Asp Arg Leu Leu 370 375 380 385 Leu Glu Leu Lys His Ser Asn lie Gly Pro Phe Pro Val Glu Leu Leu 390 395 400 Gin Asp lie Met Asn Tyr lie Val Pro lie Leu Val Leu Pro Arg Val 405 410 415 Asn Glu Lys Leu Gin Lys Gly Phe Pro Leu Pro Thr Pro Ala Arg Val 420 425 430 Gin Leu Tyr Asn Val Val Leu Gin Pro His Gin Asn Phe Leu Leu Phe 435 440 445 Gly Ala Asp Val Val Tyr Lys 450 455 (2) INFORMATION FOR SEQ ID NO:70: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 24 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: raisc_feature (D) OTHER INFORMATION: "BPI.74" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:70: Lys Ser Lys Val Gly Trp Leu lie Gin Leu Phe His Lys Lys Lys 15 10 15 Trp Lys Ala Gin Lys Arg Phe Leu Lys 20 (2) INFORMATION FOR SEQ ID NO:71: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 15 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.76" 164 (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 10..12 (D) OTHER INFORMATION: /label= D-Phe /note= "The amino acid at position 11 is D-phenylalanine" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:71: lie Lys lie Ser Gly Lys Trp Lys Ala Gin Phe Arg Phe Leu Lys 15 10 15 (2) INFORMATION FOR SEQ ID NO:72: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 15 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.77" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:72: lie Lys lie Ser Gly Lys Trp Lys Ala Gin Trp Arg Phe Leu Lys 15 10 15 (2) INFORMATION FOR SEQ ID NO:73: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 15 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.79" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:73: lie Lys lie Ser Gly Lys Trp Lys Ala Lys Lys Arg Phe Leu Lys 15 10 15 (2) INFORMATION FOR SEQ ID NO:74: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 15 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.80" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 10..12 165 (D) OTHER INFORMATION: /label= Substituted-Ala /note= "The alanine at position 11 is beta-l-naphthyl-substituted" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:74: lie Lys lie Ser Gly Lys Trp Lys Ala Gin Ala Arg Phe Leu Lys 15 10 15 (2) INFORMATION FOR SEQ ID NO:75: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 15 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.81" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:75: lie Lys Il'e Ser Gly Lys Trp Lys Ala Phe Lys Arg Phe Leu Lys 15 10 15 (2) INFORMATION FOR SEQ ID NO:76: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.82" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:76: Lys Ser Lys Val Gly Trp Leu lie Gin Leu Trp His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:77: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.83" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 10..12 (D) OTHER INFORMATION: /label= Substituted-Ala /note= "The alanine at position 6 is beta-1—naphthyl—substituted" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:77: 166 Lys Ser Lys Val Gly Ala Lys lie Gin Leu Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:76: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 15 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.84" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 6..8 (D) OTHER INFORMATION: /label= Substituted-Ala /note= "The alanine at position 7 is beta-l-naphthyl-substituted" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:78: lie Lys lie Ser Gly Lys Ala Lys Ala Gin Phe Arg Phe Leu Lys 15 10 15 (2) INFORMATION FOR SEQ ID NO:79: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc__f eature (D) OTHER INFORMATION: "BPI.85" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:79: Lys Ser Lys Val Leu Trp Leu lie Gin Leu Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:80: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.86" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:80: Lys Ser Lys Val Gly Trp Leu lie Leu Leu Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:81: 167 (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.87" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:81: Lys Ser Lys Val Gly Trp Leu lie Gin Leu Phe Leu Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:82: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 15 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.88" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:82: lie Lys lie Ser Gly Lys Trp Lys Ala Phe Phe Arg Phe Leu Lya 15 10 15 (2) INFORMATION FOR SEQ ID NO:83: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 24 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.98" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 2 (D) OTHER INFORMATION: /label= Substituted-Trp /note= "The alanine at position 2 is beta-l-naphthyl-substituted" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:83: Lys Trp Lys Ala Gin Phe Arg Phe Leu Lys Lys Ser Lys Val Gly 15 10 15 Trp Leu lie Phe Leu Phe His Lys Lys 20 168 (2) INFORMATION FOR SEQ ID NO:84: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 15 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.89" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 6..8 (D) OTHER INFORMATION: /label= Substituted-Ala /note= "The alanine at position 7 is beta-l-naphthyl-substituted" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:84: lie Lys lie Ser Gly Lys Ala Lys Ala Phe Lys Arg Phe Leu Lys 1-5 10 15 (2) INFORMATION FOR SEQ ID NO:85: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 15 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.90" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 6..8 (D) OTHER INFORMATION: /label= Substituted-Ala /note= "The alanine at position 7 is beta-l-naphthyl-substituted" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:85: lie Lys lie Ser Gly Lys Ala Lys Ala Phe Phe Arg Phe Leu Lys 15 10 15 (2) INFORMATION FOR SEQ ID NO:86: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.91" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:66: 169 Lys Ser Lys Val Gly Trp Leu lie Phe Leu Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:87: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.92" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:87: Lye Ser Lye Val Gly Trp Leu lie Lys Leu Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:88: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 29 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.93" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 6..8 (D) OTHER INFORMATION: /label= Substituted-Ala /note= "The alanine at position 7 is beta-l-naphthyl-substituted" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:88: lie Lys lie Ser Gly Lys Ala Lys Ala Gin Phe Arg Phe Leu Lys 15 10 15 Lys Ser Lys Val Gly Trp Leu lie Gin Leu Phe His Lys Lys 20 25 (2) INFORMATION FOR SEQ ID NO:89: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: mj.sc_feature (D) OTHER INFORMATION: "BPI.94" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:89: Lys Ser Lys Val Gly Trp Leu lie Gin Leu Phe Phe Lye Lys 15 10 170 (2) INFORMATION FOR SEQ ID NO:90: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.95" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:90: Lye Ser Lys Val Phe Trp Leu lie Gin Leu Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:91: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.96" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:91: Lys Ser Lys Val Gly Trp Leu lie Gin Leu Phe His Lys Phe 15 ID (2) INFORMATION FOR SEQ ID NO:92: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.97" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:92: Lys Ser Lys Val Lys Trp Leu lie Gin Leu Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:93: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 30 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.99" WO 95/08344 PCT/US94/11225 171 (xi) SEQUENCE DESCRIPTION: SEQ ID NO:93: Lys Trp Lys Ala Gin Trp Arg Phe Leu Lys Lys Trp Lye Ala Gin 15 10 15 Trp Arg Phe Leu Lys Lys Trp Lys Ala Gin Trp Arg Phe Leu Lys 20 25 30 (2) INFORMATION FOR SEQ ID NO:94: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acide (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.100" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:94: Lys Ser Lys Val Lys Trp Leu lie Lys Leu Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:95: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 28 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.101" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:95: Lys Ser Lys Val Lys Trp Leu lie Lys Leu Phe Phe Lys Phe Lys 15 10 15 Ser Lys Val Lys Trp Leu lie Lys Leu Phe Phe Lys Phe 20 25 (2) INFORMATION FOR SEQ ID NO:96: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 24 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.102" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:96: Lys Trp Lys Ala Gin Phe Arg' Phe Leu Lys Lys Ser Lys Val Gly 15 10 15 WO 95/08344 PCI7CS94/11225 172 Trp Leu lie Leu Leu Phe His Lys Lys 20 (2) INFORMATION FOR SEQ ID NO:97: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 1443 base pairs (B) TYPE: nucleic acid (C) STRANDEDNESS: single (D) TOPOLOGY: linear (ii) MOLECULE TYPE: DNA (ix) FEATURE: (A) NAME/KEY: CDS (B) LOCATION: 1..1443 (ix) FEATURE: (A) NAME/KEY: mat_peptide (B) LOCATION: 76..1443 (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "rLBP" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:97: ATG GGG GCC TTG GCC AGA GCC CTG CCG TCC ATA CTG CTG GCA TTG CTG 48 Met Gly Ala Leu Ala Arg Ala Leu Pro Ser lie Leu Leu Ala Leu Leu -25 -20 -15 -10 CTT ACG TCC ACC CCA GAG GCT CTG GGT GCC AAC CCC GGC TTG GTC GCC 96 Leu Thr Ser Thr Pro Glu Ala Leu Gly Ala Asn Pro Gly Leu Val Ala -5 15 AGG ATC ACC GAC AAG GGA CTG CAG TAT GCG GCC CAG GAG GGG CTA TTG 144 Arg lie Thr Asp Lys Gly Leu Gin Tyr Ala Ala Gin Glu Gly Leu Leu 10 15 20 GCT CTG CAG AGT GAG CTG CTC AGG ATC ACG CTG CCT GAC TTC ACC GGG 192 Ala Leu Gin Ser Glu Leu Leu Arg lie Thr Leu Pro Asp Phe Thr Gly 25 30 35 GAC TTG AGG ATC CCC CAC GTC GGC CGT GGG CGC TAT GAG TTC CAC AGC 24 0 Asp Leu Arg lie Pro His Val Gly Arg Gly Arg Tyr Glu Phe His Ser 40 45 50 55 CTG AAC ATC CAC AGC TGT GAG CTG CTT CAC TCT GCG CTG AGG CCT GTC 288 Leu Asn lie His Ser Cye Glu Leu Leu His Ser Ala Leu Arg Pro Val 60 65 70 CCT GGC CAG GGC CTG AGT CTC AGC ATC TCC GAC TCC TCC ATC CGG GTC 33 6 Pro Gly Gin Gly Leu Ser Leu Ser lie Ser Asp Ser Ser lie Arg Val - 75 80 85 CAG GGC AGG TGG AAG GTG CGC AAG TCA TTC TTC AAA CTA CAG GGC TCC 384 Gin Gly Arg Trp Lys Val Arg Lys Ser Phe Phe Lys Leu Gin Gly Ser 90 95 100 TTT GAT GTC AGT GTC AAG GGC ATC AGC ATT TCG GTC AAC CTC CTG TTG 432 Phe Asp Val Ser Val Lys Gly lie Ser lie Ser Val Asn Leu Leu Leu 105 110 115 GGC AGC GAG TCC TCC GGG AGG CCC ACA GTT ACT GCC TCC AGC TGC AGC Gly Ser Glu Ser Ser Gly Arg Pro Thr Val Thr Ala Ser Ser Cys Ser 120 125 130 135 480 173 AGT GAC ATC GCT GAC GTG GAG GTG GAC ATG TCG GGA GAC TTG GGG TGG Ser Asp lie Ala Asp Val Glu Val Asp Met Ser Gly Asp Leu Gly Trp 140 145 150 528 CTG TTG AAC CTC TTC CAC AAC CAG ATT GAG TCC AAG TTC CAG AAA GTA Leu Leu Asn Leu Phe His Asn Gin lie Glu Ser Lys Phe Gin Lys Val 155 160 165 576 CTG GAG AGC AGG ATT TGC GAA ATG ATC CAG AAA TCG GTG TCC TCC GAT Leu Glu Ser Arg lie Cys Glu Met lie Gin Lys Ser Val Ser Ser Asp 170 175 180 624 CTA CAG CCT TAT CTC CAA ACT CTG CCA GTT ACA ACA GAG ATT GAC AGT Leu Gin Pro Tyr Leu Gin Thr Leu Pro Val Thr Thr Glu lie Asp Ser 185 190 195 672 TTC GCC GAC ATT GAT TAT AGC TTA GTG GAA GCC CCT CGG GCA ACA GCC Phe Ala Asp lie Asp Tyr Ser Leu Val Glu Ala Pro Arg Ala Thr Ala 200 205 210 215 720 CAG ATG CTG GAG GTG ATG TTT AAG GGT GAA ATC TTT CAT CGT AAC CAC Gin Met Leu Glu Val Met Phe Lys Gly Glu lie Phe His Arg Asn His 220 225 230 768 CGT TCT CCA GTT ACC CTC CTT GCT GCA GTC ATG AGC CTT CCT GAG GAA Arg Ser Pro Val Thr Leu Leu Ala Ala Val Met Ser Leu Pro Glu Glu 235 240 245 816 CAC AAC AAA ATG GTC TAC TTT GCC ATC TCG GAT TAT GTC TTC AAC ACG His Asn Lys Met Val Tyr Phe Ala lie Ser Asp Tyr Val Phe Asn Thr 250 255 260 864 GCC AGC CTG GTT TAT CAT GAG GAA GGA TAT CTG AAC TTC TCC ATC ACA Ala Ser Leu Val Tyr His Glu Glu Gly Tyr Leu Asn Phe Ser lie Thr 265 270 275 912 GAT GAG ATG ATA CCG CCT GAC TCT AAT ATC CGA CTG ACC ACC AAG TCC Asp Glu Met lie Pro Pro Asp Ser Asn lie Arg Leu Thr Thr Lys Ser 280 285 290 295 960 TTC CGA CCC TTC GTC CCA CGG TTA GCC AGG CTC TAC CCC AAC ATG AAC Phe Arg Pro Phe Val Pro Arg Leu Ala Arg Leu Tyr Pro Asn Met Asn 300 305 310 1008 CTG GAA CTC CAG GGA TCA GTG CCC TCT GCT CCG CTC CTG AAC TTC AGC Leu Glu Leu Gin Gly Ser Val Pro Ser Ala Pro Leu Leu Asn Phe Ser 315 320 325 1056 CCT GGG AAT CTG TCT GTG GAC CCC TAT ATG GAG ATA GAT GCC TTT GTG Pro Gly Asn Leu Ser Val Asp Pro Tyr Met Glu lie Asp Ala Phe Val 330 335 340 1104 CTC CTG CCC AGC TCC AGC AAG GAG CCT GTC TTC CGG CTC AGT GTG GCC Leu Leu Pro Ser Ser Ser Lys Glu Pro Val Phe Arg Leu Ser Val Ala 345 350 355 1152 ACT AAT GTG TCC GCC ACC TTG ACC TTC AAT ACC AGC AAG ATC ACT GGG Thr Asn Val Ser Ala Thr Leu Thr Phe Asn Thr Ser Lys lie Thr Gly 360 365 370 375 1200 TTC CTG AAG CCA GGA AAG GTA AAA GTG GAA CTG AAA GAA TCC AAA GTT Phe Leu Lys Pro Gly Lys Val Lys Val Glu Leu Lys Glu Ser Lys Val 380 385 390 1248 PCI7US94/11225 174 GGA CTA TTC AAT GCA GAG CTG TTG GAA GCG CTC CTC AAC TAT TAC ATC 1296 Gly Leu Phe Asn Ala Glu Leu Leu Glu Ala Leu Leu Asn Tyr Tyr lie 395 400 405 CTT AAC ACC TTC TAC CCC AAG TTC AAT GAT AAG TTG GCC GAA GGC TTC 1344 Leu Asn Thr Phe Tyr Pro Lys Phe Asn Asp Lys Leu Ala Glu Gly Phe 410 415 420 CCC CTT CCT CTG CTG AAG CGT GTT CAG CTC TAC GAC CTT GGG CTG CAG 1392 Pro Leu Pro Leu Leu Lys Arg Val Gin Leu Tyr Asp Leu Gly Leu Gin 425 430 435 ATC CAT AAG GAC TTC CTG TTC TTG GGT GCC AAT GTC CAA TAC ATG AGA 1440 lie His Lys Asp Phe Leu Phe Leu Gly Ala Asn Val Gin Tyr Met Arg 440 445 450 455 GTT 1443 Val (2) INFORMATION FOR SEQ ID NO:98: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 481 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: protein (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "rLBP" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:98: Met Gly Ala Leu Ala Arg Ala Leu Pro Ser lie Leu Leu Ala Leu Leu -25 -20 -15 -10 Leu Thr Ser Thr Pro Glu Ala Leu Gly Ala Asn Pro Gly Leu Val Ala -5 15 Arg lie Thr Asp Lys Gly Leu Gin Tyr Ala Ala Gin Glu Gly Leu Leu 10 15 20 Ala Leu Gin Ser Glu Leu Leu Arg lie Thr Leu Pro Asp Phe Thr Gly 25 30 35 Asp Leu Arg lie Pro His Val Gly Arg Gly Arg Tyr Glu Phe His Ser 40 45 50 55 Leu Asn lie His Ser Cys Glu Leu Leu His Ser Ala Leu Arg Pro Val 60 65 70 Pro Gly Gin Gly Leu Ser Leu Ser lie Ser Asp Ser Ser lie Arg Val 75 80 85 Gin Gly Arg Trp Lys Val Arg Lys Ser Phe Phe Lys Leu Gin Gly Ser 90 95 100 Phe Asp Val Ser Val Lys Gly lie Ser lie Ser Val Asn Leu Leu Leu 105 110 115 Gly Ser Glu Ser Ser Gly Arg Pro Thr Val Thr Ala Ser Ser Cys Ser 120 125 130 135 PCT/US94/U225 175 Ser Asp lie Ala Asp Val Glu Val Asp Met Ser Gly Asp Leu Gly Trp 140 145 150 Leu Leu Asn Leu Phe His Asn Gin lie Glu Ser Lys Phe Gin Lys Val 155 160 165 Leu Glu Ser Arg lie Cys Glu Met lie Gin Lys Ser Val Ser Ser Asp 170 175 180 Leu Gin Pro Tyr Leu Gin Thr Leu Pro Val Thr Thr Glu lie Asp Ser 185 190 195 Phe Ala Asp lie Asp Tyr Ser Leu Val Glu Ala Pro Arg Ala Thr Ala 200 205 210 215 Gin Met Leu Glu Val Met Phe Lys Gly Glu lie Phe His Arg Asn His 220 225 230 Arg Ser Pro Val Thr Leu Leu Ala Ala Val Met Ser Leu Pro Glu Glu 235 240 245 His Asn Lys Met Val Tyr Phe Ala lie Ser Asp Tyr Val Phe Asn Thr 250 255 260 Ala Ser Leu Val Tyr His Glu Glu Gly Tyr Leu Asn Phe Ser lie Thr 265 270 275 Asp Glu Met lie Pro Pro Asp Ser Asn lie Arg Leu Thr Thr Lys Ser 280 285 290 295 Phe Arg Pro Phe Val Pro Arg Leu Ala Arg Leu Tyr Pro Asn Met Asn 300 305 310 Leu Glu Leu Gin Gly Ser Val Pro Ser Ala Pro Leu Leu Asn Phe Ser 315 320 325 Pro Gly Asn Leu Ser Val Asp Pro Tyr Met Glu lie Asp Ala Phe Val 330 335 340 Leu Leu Pro Ser Ser Ser Lys Glu Pro Val Phe Arg Leu Ser Val Ala 345 350 355 Thr Asn Val Ser Ala Thr Leu Thr Phe Asn Thr Ser Lys lie Thr Gly 360 365 370 375 Phe Leu Lys Pro Gly Lys Val Lys Val Glu Leu Lys Glu Ser Lys Val 380 385 390 Gly Leu Phe Asn Ala Glu Leu Leu Glu Ala Leu Leu Asn Tyr Tyr lie 395 400 405 Leu Asn Thr Phe Tyr Pro Lys Phe Asn Asp Lys Leu Ala Glu Gly Phe 410 415 420 Pro Leu Pro Leu Leu Lys Arg Val Gin Leu Tyr Asp Leu Gly Leu Gin 425 430 435 lie His Lys Asp Phe Leu Phe Leu Gly Ala Asn Val Gin Tyr Met Arg 440 445 450 455 Val (2) INFORMATION FOR SEQ ID NO:99: 176 (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 16 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: roisc_feature (D) OTHER INFORMATION: "BPI.57" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:99: Cys lie Lys lie Ser Gly Lys Trp Lys Ala Gin Lys Arg Pro Leu 15 10 15 Cys (2) INFORMATION FOR SEQ ID NO:100: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 15 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.75" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:100: lie Lys Lye Arg Ala lie Ser Phe Leu Gly Lys Lys Trp Gin Lys 15 10 15 (2) INFORMATION FOR SEQ ID NO:101: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 20 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI. 282" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:101: Lys Trp Lys Ala Phe Phe Arg Phe Leu Lys Lys Trp Lys Ala Phe 15 10 15 Phe Arg Phe Leu Lys 20 (2) INFORMATION FOR SEQ ID NO:102: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 16 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide 177 (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.103" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:102: lie Lya lie Ser Gly Lys Trp Lys Ala Trp Lys Arg Phe Leu Lye 15 10 15 Lys (2) INFORMATION FOR SEQ ID NO:103: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.104" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:103: Lys Ser Lys Val Gly Trp Leu lie Ser Leu Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:104: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 16 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.105" (ix).FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 13 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "The alanine at position 13 is beta-l-naphthyl-substituted. " (xi) SEQUENCE DESCRIPTION: SEQ ID NO:104: lie Lys lie Ser Gly Lys Trp Lys Ala Trp Lys Arg Ala Leu Lys 15 10 15 Lys (2) INFORMATION FOR SEQ ID NO:105: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide 178 (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.106" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:105: Lys Ser Lys Val Gly Trp Leu lie Thr Leu Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:106: (i) (ii) (ix) (xi) Lys 1 (2) INFORMATION FOR SEQ ID NO:107: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino a'cids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.108" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:107: Lys Ser Lys Val Gly Trp Leu lie Gin Leu Phe His Lys Trp 15 10 (2) INFORMATION FOR SEQ ID NO:108: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.109" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 11 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "The alanine at position 11 is beta-l-naphthyl-substituted. " (xi) SEQUENCE DESCRIPTION: SEQ ID NO:108: SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear MOLECULE TYPE: peptide FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.107" SEQUENCE DESCRIPTION: SEQ ID NO:106: Ser Lya Val Gly Trp Leu lie Gin Leu Phe Trp Lya Lys 5 10 179 Lys Ser Lys Val Gly Trp Leu lie Gin Leu Ala His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:109: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.110" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 12 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "The alanine at position 12 is beta-l-naphthyl-substituted. " (xi) SEQUENCE DESCRIPTION: SEQ ID NO:109: Lys Ser Lys Val Gly Trp Leu lie Gin Leu Phe Ala Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:110: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.Ill" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 14 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "The alanine at position 14 is beta-l-naphthyl-substituted. " (xi) SEQUENCE DESCRIPTION: SEQ ID NO:110: Lys Ser Lys Val Gly Trp Leu lie Gin Leu Phe His Lys Ala 15 10 (2) INFORMATION FOR SEQ ID NO:111: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 15 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.112" 180 (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 7 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "The alanine at position 7 is beta-l-naphthyl-substituted ." (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 11 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "The alanine at position 11 is beta-l-naphthyl-substituted. " (xi) SEQUENCE DESCRIPTION: SEQ' ID NO:lll: lie Lys lie Ser Gly Lys Ala Lys Ala Gin Ala Arg Phe Leu Lys 15 10 15 (2) INFORMATION FOR SEQ ID NO:112: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (Bj TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.113" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:112: Lys Ser Lya Val Gly Trp Leu lie Gin Phe Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:113: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 15 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.114" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:113: Lys Trp Gin Leu Arg Ser Lys Gly Lys lie Lys lie Phe Lys Ala 15 10 15 (2) INFORMATION FOR SEQ ID NO:114: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: 181 (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.116" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 6 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "The alanine at position 6 is beta-l-naphthyl-substituted. " (xi) SEQUENCE DESCRIPTION: SEQ ID NO:114: Lys Ser Lys Val Lys Ala Leu lie Gin Leu Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:115: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 15 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.119" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 7 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "The alanine at position 7 is beta-l-naphthyl-substituted. " (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 10 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "The alanine at position 10 is beta-l-naphthyl-substituted. " (xi) SEQUENCE DESCRIPTION: SEQ ID NO:115: lie Lys lie Ser Gly Lys Ala Lys Ala Ala Lys Arg Phe Leu Lys 15 10 15 (2) INFORMATION FOR SEQ ID NO:116: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 15 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.120" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:116: lie Lys lie Ser Gly Lys Trp Lys Ala Gin Lys Arg Lys Leu Lys 15 10 15 (2) INFORMATION FOR SEQ ID NO:117: 182 (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 15 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.121" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 10 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "The alanine at position 10 is beta-l-naphthyl-substituted. " (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 11 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "The alanine at position 11 is beta-l-naphthyl-substituted." (xi) SEQUENCE DESCRIPTION: SEQ ID NO:117: lie Lys lie Ser Gly Lys Trp Lys Ala Ala Ala Arg Phe Leu Lya 15 10 15 (2) INFORMATION FOR SEQ ID NO:118: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 15 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.122" (ix) FEATURE: (A") NAME/KEY: Modif ied-site (B) LOCATION: 7 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "The alanine at position 7 is beta-l-naphthyl-substituted. " (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 10 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "The alanine at position 10 is beta-l-naphthyl-substituted. " (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 11 (C) OTHER INFORMATION: /label-= Substituted-Ala /note= "The alanine at position 11 is beta-l-naphthyl-substituted. " (xi) SEQUENCE DESCRIPTION: SEQ ID NO:118: PCT7US94/11225 183 lie Lys lie Ser Gly Lys Ala Lys Ala Ala Ala Arg Phe Leu Lys 15 10 15 (2) INFORMATION FOR SEQ ID NO:119: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.123" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 9 (C) OTHER INFORMATION: /label= Substituted-Phe /note= "The phenylalanine at position 9 is p—amino-substituted." (xi) SEQUENCE DESCRIPTION: SEQ ID NO:119: Lys Ser Lys Val Gly Trp Leu lie Phe Leu Phe His Lys Lys 10 (2) INFORMATION FOR SEQ ID NO:120: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.124" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:120: Lys Ser Lys Val Lys Trp Leu lie Gin Leu Trp His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:121: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.125" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:121: Lys Ser Lys Val Gly Trp Leu lie Tyr Leu Phe His Lys Lys 10 (2) INFORMATION FOR SEQ ID NO:122: 184 (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.126" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 6 (C) OTHER INFORMATION: /label= D-Trp /note= "The amino acid at position 6 is D-tryptophan." (xi) SEQUENCE DESCRIPTION: SEQ ID NO:122: Lys Ser Lys Val Gly Trp Leu lie Gin Leu Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:123: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.127" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:123: Lys Ser Lys Val Gly Phe Leu lie Gin Leu Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:124: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.128" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 6 (C) OTHER INFORMATION: /label= D-Phe /note= "The amino acid at position 6 is D-phenylalanine." (xi) SEQUENCE DESCRIPTION: SEQ ID NO:124: Lys Ser Lys Val Gly Phe Leu lie Gin Leu Pro His Lys Lys 15 10 185 (2) INFORMATION FOR SEQ ID NO:125: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.129" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 6 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "The alanine at position 6 is D-l-beta-l-naphthyl-substituted." (xi) SEQUENCE DESCRIPTION: SEQ ID NO:125: Lys Ser Lys Val Gly Ala Leu lie Gin Leu Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO;126: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.130" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 6 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "The alanine at position 6 is 2-beta-l-naphthyl-substituted." (xi) SEQUENCE DESCRIPTION: SEQ ID NO:126: Lys Ser Lys Val Gly Ala Leu lie Gin Leu Phe His Lys Lye 15 10 (2) INFORMATION FOR SEQ ID NO:127: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.131" (ix) FEATURE: 186 (A) NAME/KEY: Modified-site (B) LOCATION: 6 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "The alanine at position 6 is D-2-beta-l-naphthyl-substituted." (xi) SEQUENCE DESCRIPTION: SEQ ID NO:127: Lys Ser Lys Val Gly Ala Leu lie Gin Leu Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:128: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D.) OTHER INFORMATION: "BPI.132" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 6 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "The alanine at position 6 is pyridyl-substituted." (xi) SEQUENCE DESCRIPTION: SEQ ID NO:128: Lys Ser Lys Val Gly Ala Leu lie Gin Leu Phe His Lys Lys 10 (2) INFORMATION FOR SEQ ID NO:129: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.133" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 6 (C) OTHER INFORMATION: /label= Substituted-Phe /note= "The phenylalanine at position 6 is para-amino-substituted." (xi) SEQUENCE DESCRIPTION: SEQ ID NO:129: Lys Ser Lys Val Gly Phe Leu lie Gin Leu Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:130: (i) SEQUENCE CHARACTERISTICS: 187 (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.134" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 5 (C) OTHER INFORMATION: /label= Substituted-Phe /note= "The phenylalanine at position 5 is para-amino-substituted." (xi) SEQUENCE DESCRIPTION: SEQ ID NO:130: Lys Ser Lys Val Phe Trp Leu lie Gin Leu Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:131: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.135" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:131: Lys Ser Lys Val Gly Lys Leu lie Gin Leu Pro His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:132: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 15 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.136" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:132: lie Lys lie Ser Gly Lys Trp Lys Ala Gin Glu Arg Phe Leu Lys 15 10 15 (2) INFORMATION FOR SEQ ID NO:133: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 16 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear 188 (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.137" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:133: Cys Lys Ser Lys Val Gly Trp Leu lie Gin Leu Phe His Lys Lys 15 10 15 Cys (2) INFORMATION FOR SEQ ID NO:134: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.138" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:134: Lys Ser Lys Val Lys Phe Leu lie Gin Leu Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:135: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.139" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:135: Lys Ser Lys Val Gly Tyr Leu lie Gin Leu Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:136: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 7 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.140" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 1 189 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "The alanine at position 1 is beta-l-naphthyl-substituted." (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 2 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "The alanine at position 2 is beta-1—naphthyl-substituted." (xi) SEQUENCE DESCRIPTION: SEQ ID NO:136: Ala Ala Arg Phe Leu Lys Phe 1 5 (2) INFORMATION FOR SEQ ID NO:137: (i) SEQUENCE CHARACTERISTICS: ' (A) LENGTH: 15 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.141" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:137: lie Lys lie Ser Gly Lys Trp Lys Ala Gin Lys Arg Trp Leu Lys 15 10 15 (2) INFORMATION FOR SEQ ID NO:138: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.142" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:138: Lys Ser Lys Val Gly Trp Leu lie Gin Trp Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:139: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.143" 190 (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 10 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "The alanine at position 10 is beta-l-naphthyl-substituted." (xi) SEQUENCE DESCRIPTION: SEQ ID NO:139: Lys Ser Lys Val Gly Trp Leu lie Gin Ala Phe His Lys Lys 1 5 10 (2) INFORMATION FOR SEQ ID NO:140: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.144" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 6 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "The alanine at position 6 is cyclohexyl-substituted." (xi) SEQUENCE DESCRIPTION: SEQ ID NO:140: Lys Ser Lys Val Gly Ala Leu lie Gin Leu Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:141: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 24 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.145" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:141: Lys Trp Lys Ala Ala Ala Arg Phe Leu Lys Lys Ser Lys Val Gly 15 10 15 Trp Leu lie Gin Leu Phe His Lys Lys 20 (2) INFORMATION FOR SEQ ID NO:142: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide PCT7US94/11225 191 (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.146" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 12 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "The alanine at position 12 is beta-l-naphthyl-substituted." (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 14 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "The alanine at position 14 is beta-l-naphthyl-substituted." (xi) SEQUENCE DESCRIPTION: SEQ ID NO:142: Lys Ser Lys Val Gly Trp Leu lie Gin Leu Phe Ala Lys Ala 15 10 (2) INFORMATION FOR SEQ ID NO:143: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 15 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: miac_feature (D) OTHER INFORMATION: "BPI.147" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:14 3: lie Lys lie Ser Gly Lys Trp Lys Ala Glu Lys Lys Phe Leu Lys 15 10 15 (2) INFORMATION FOR SEQ ID NO:144: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.148" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 6 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "The alanine at position 6 is beta-l-naphthyl-substituted." (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 12 192 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "The alanine at position 12 is beta-l-naphthyl-substituted." (xi) SEQUENCE DESCRIPTION: SEQ ID NO:144: Lys Ser Lys Val Gly Ala Leu lie Gin Leu Phe Ala Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:145: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 1813 base pairs (B) TYPE: nucleic acid (C) STRANDEDNESS: single (D) TOPOLOGY: linear (ii) MOLECULE TYPE: cDNA (ix) FEATURE: (A) NAME/KEY: CDS (B) LOCATION: 31..1491 (ix) FEATURE: (A) NAME/KEY: mat_peptide (B) LOCATION: 124..1491 (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "rBPI" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:145: CAGGCCTTGA GGTTTTGGCA GCTCTGGAGG ATG AGA GAG AAC ATG GCC AGG GGC 54 Met Arg Glu Asn Met Ala Arg Gly -31 -30 -25 CCT TGC AAC GCG CCG AGA TGG GTG TCC CTG ATG GTG CTC GTC GCC ATA 102 Pro Cys Asn Ala Pro Arg Trp Val Ser Leu Met Val Leu Val Ala lie -20 -15 -10 GGC ACC GCC GTG ACA GCG GCC GTC AAC CCT GGC GTC GTG GTC AGG ATC 150 Gly Thr Ala Val Thr Ala Ala Val Asn Pro Gly Val Val Val Arg lie -5 15 TCC CAG AAG GGC CTG GAC TAC GCC AGC CAG CAG GGG ACG GCC GCT CTG 198 Ser Gin Lys Gly Leu Asp Tyr Ala Ser Gin Gin Gly Thr Ala Ala Leu 10 15 20 25 CAG AAG GAG CTG AAG AGG ATC AAG ATT CCT GAC TAC TCA GAC AGC TTT 24 6 Gin Lys Glu Leu Lys Arg lie Lys lie Pro Asp Tyr Ser Asp Ser Phe 30 35 40 AAG ATC AAG CAT CTT GGG AAG GGG CAT TAT AGC TTC TAC AGC ATG GAC 2 94 Lys lie Lys His Leu Gly Lys Gly His Tyr Ser Phe Tyr Ser Met Asp 45 50 55 ATC CGT GAA TTC CAG CTT CCC AGT TCC CAG ATA AGC ATG GTG CCC AAT 342 lie Arg Glu Phe Gin Leu Pro Ser Ser Gin lie Ser Met Val Pro Asn 60 65 70 GTG GGC CTT AAG TTC TCC ATC AGC AAC GCC AAT ATC AAG ATC AGC GGG Val Gly Leu Lys Phe Ser lie Ser Asn Ala Asn lie Lys lie Ser Gly 75 80 85 390 193 AAA TGG AAG GCA CAA AAG AGA TTC TTA AAA ATG AGC GGC AAT TTT GAC Lys Trp Lys Ala Gin Lys Arg Phe Leu Lys Met Ser Gly Asn Phe Asp §0 95 100 105 438 CTG AGC ATA GAA GGC ATG TCC ATT TCG GCT GAT CTG AAG CTG GGC AGT Leu Ser lie Glu Gly Met Ser lie Ser Ala Asp Leu Lys Leu Gly Ser 110 115 120 486 AAC CCC ACG TCA GGC AAG CCC ACC ATC ACC TGC TCC AGC TGC AGC AGC Asn Pro Thr Ser Gly Lys Pro Thr He Thr Cys Ser Ser Cys Ser Ser 125 130 135 534 CAC ATC AAC AGT GTC CAC GTG CAC ATC TCA AAG AGC AAA GTC GGG TGG His lie Asn Ser Val His Val His lie Ser Lys Ser Lys Val Gly Trp 140 145 150 582 CTG ATC CAA CTC TTC CAC AAA AAA ATT GAG TCT GCG CTT CGA AAC AAG Leu lie Gin Leu Phe His Lys Lys lie Glu Ser Ala Leu Arg Asn Lys 155 160 165 630 ATG AAC AGC CAG GTC TGC GAG AAA GTG ACC AAT TCT GTA TCC TCC AAG Met Asn Ser Gin Val Cys Glu Lys Val Thr Asn Ser Val Ser Ser Lys 170 175 180 185 678 CTG CAA CCT TAT TTC CAG ACT CTG CCA GTA ATG ACC AAA ATA GAT TCT Leu Gin Pro Tyr Phe Gin Thr Leu Pro Val Met Thr Lys lie Asp Ser 190 195 200 726 GTG GCT GGA ATC AAC TAT GGT CTG GTG GCA CCT CCA GCA ACC ACG GCT Val Ala Gly lie Asn Tyr Gly Leu Val Ala Pro Pro Ala Thr Thr Ala 205 210 215 774 GAG ACC CTG GAT GTA CAG ATG AAG GGG GAG TTT TAC AGT GAG AAC CAC Glu Thr Leu Asp Val Gin Met Lys Gly Glu Phe Tyr Ser Glu Asn His 220 225 230 822 CAC AAT CCA CCT CCC TTT GCT CCA CCA GTG ATG GAG TTT CCC GCT GCC His Asn Pro Pro Pro Phe Ala Pro Pro Val Met Glu Phe Pro Ala Ala 235 240 245 870 CAT GAC CGC ATG GTA TAC CTG GGC CTC TCA GAC TAC TTC TTC AAC ACA His Asp Arg Met Val Tyr Leu Gly Leu Ser Asp Tyr Phe Phe Asn Thr 250 255 260 265 918 GCC GGG CTT GTA TAC CAA GAG GCT GGG GTC TTG AAG ATG ACC CTT AGA Ala Gly Leu Val Tyr Gin Glu Ala Gly Val Leu Lys Met Thr Leu Arg 270 275 280 966 GAT GAC ATG ATT CCA AAG GAG TCC AAA TTT CGA CTG ACA ACC AAG TTC Asp Asp Met lie Pro Lys Glu Ser Lys Phe Arg Leu Thr Thr Lys Phe 285 290 295 1014 TTT GGA ACC TTC CTA CCT GAG GTG GCC AAG AAG TTT CCC AAC ATG AAG Phe Gly Thr Phe Leu Pro Glu Val Ala Lys Lys Phe Pro Asn Met Lys 300 305 310 1062 ATA CAG ATC CAT GTC TCA GCC TCC ACC CCG CCA CAC CTG TCT GTG CAG lie Gin lie His Val Ser Ala Ser Thr Pro Pro His Leu Ser Val Gin 315 320 325 1110 CCC ACC GGC CTT ACC TTC TAC CCT GCC GTG GAT GTC CAG GCC TTT GCC Pro Thr Gly Leu Thr Phe Tyr Pro Ala Val Asp Val Gin Ala Phe Ala 330 335 340 345 1158 194 GTC CTC CCC AAC TCC TCC CTG GCT TCC CTC TTC CTG ATT GGC ATG CAC 1206 Val Leu Pro Asn Ser Ser Leu Ala Ser Leu Phe Leu lie Gly Met His 350 355 360 ACA ACT GGT TCC ATG GAG GTC AGC GCC GAG TCC AAC AGG CTT GTT GGA 1254 Thr Thr Gly Ser Met Glu Val Ser Ala Glu Ser Asn Arg Leu Val Gly 365 370 375 GAG CTC AAG CTG GAT AGG CTG CTC CTG GAA CTG AAG CAC TCA AAT ATT 1302 Glu Leu Lys Leu Asp Arg Leu Leu Leu Glu Leu Lys His Ser Asn lie 380 385 390 GGC CCC TTC CCG GTT GAA TTG CTG CAG GAT ATC ATG AAC TAC ATT GTA 135 0 Gly Pro Phe Pro Val Glu Leu Leu Gin Asp lie Met Asn Tyr lie Val 395 400 405 CCC ATT CTT GTG CTG CCC AGG GTT AAC GAG AAA CTA CAG AAA GGC TTC 1398 Pro lie Leu Val Leu Pro Arg Val Asn Glu Lys Leu Gin Lys Gly Phe 410 415 420 425 CCT CTC CCG ACG CCG GCC AGA GTC CAG CTC TAC AAC GTA GTG CTT CAG 1446 Pro Leu Pro Thr Pro Ala Arg Val Gin Leu Tyr Asn Val Val Leu Gin 430 435 440 CCT CAC CAG AAC TTC CTG CTG TTC GGT GCA GAC GTT GTC TAT AAA 1491 Pro His Gin Asn Phe Leu Leu Phe Gly Ala Asp Val Val Tyr Lys 445 450 455 TGAAGGCACC AGGGGTGCCG GGGGCTGTCA GCCGCACCTG TTCCTGATGG GCTGTGGGGC 1551 ACCGGCTGCC TTTCCCCAGG GAATCCTCTC CAGATCTTAA CCAAGAGCCC CTTGCAAACT 1611 TCTTCGACTC AGATTCAGAA ATGATCTAAA CACGAGGAAA CATTATTCAT TGGAAAAGTG 1671 CATGGTGTGT ATTTTAGGGA TTATGAG CTT CTTTCAAGGG CTAAGGCTGC AG AGATATTT 1731 CCTCCAGGAA TCGTGTTTCA ATTGTAACCA AGAAATTTCC ATTTGTGCTT CATGAAAAAA 17 91 AACTTCTGGT TTTTTTCATG TG 1813 (2) INFORMATION FOR SEQ ID NO:146: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 487 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: protein (xi) SEQUENCE DESCRIPTION: SEQ ID NO:146: Met Arg Glu Asn Met Ala Arg Gly Pro Cys Asn Ala Pro Arg Trp Val -31 -30 -25 -20 Ser Leu Met Val Leu Val Ala lie Gly Thr Ala Val Thr Ala Ala Val -15 -10 -5 1 Asn Pro Gly Val Val Val Arg lie Ser Gin Lys Gly Leu Asp Tyr Ala 5 10 15 Ser Gin Gin Gly Thr Ala Ala Leu Gin Lys Glu Leu Lys Arg lie Lys 20 25 30 lie Pro Asp Tyr Ser Asp Ser Phe Lys lie Lys His Leu Gly Lys Gly 35 40 45 195 His Tyr Ser Phe Tyr Ser Met Asp lie Arg Glu Phe Gin Leu Pro Ser 50 55 60 65 Ser Gin lie Ser Met Val Pro Asn Val Gly Leu Lys Phe Ser lie Ser 70 75 80 Asn Ala Asn lie Lys lie Ser Gly Lys Trp Lys Ala Gin Lys Arg Phe 85 90 95 Leu Lys Met Ser Gly Asn Phe Asp Leu Ser lie Glu Gly Met Ser lie 100 105 110 Ser Ala Asp Leu Lys Leu Gly Ser Asn Pro Thr Ser Gly Lys Pro Thr 115 120 125 lie Thr Cys Ser Ser Cys Ser Ser His lie Asn Ser Val His Val His 130 135 140 145 lie Ser Lys Ser Lys Val Gly Trp Leu lie Gin Leu Phe His Lys Lys 150 155 160 lie Glu Ser Ala Leu Arg Asn Lys Met Asn Ser Gin Val Cys Glu Lys 165 170 175 Val Thr Asn Ser Val Ser Ser Lys Leu Gin Pro Tyr Phe Gin Thr Leu 180 185 190 Pro Val Met Thr Lys lie Asp Ser Val Ala Gly lie Asn Tyr Gly Leu 195 200 205 Val Ala Pro Pro Ala Thr Thr Ala Glu Thr Leu Asp Val Gin Met Lya 210 215 220 225 Gly Glu Phe Tyr Ser Glu Asn His His Asn Pro Pro Pro Phe Ala Pro 230 235 240 Pro Val Met Glu Phe Pro Ala Ala His Asp Arg Met Val Tyr Leu Gly 245 250 255 Leu Ser Asp Tyr Phe Phe Asn Thr Ala Gly Leu Val Tyr Gin Glu Ala 260 265 270 Gly Val Leu Lys Met Thr Leu Arg Asp Asp Met lie Pro Lys Glu Ser 275 280 285 Lys Phe Arg Leu Thr Thr Lys Phe Phe Gly Thr Phe Leu Pro Glu Val 290 295 300 305 Ala Lys Lys Phe Pro Asn Met Lys lie Gin lie His Val Ser Ala Ser 310 315 320 Thr Pro Pro His Leu Ser Val Gin Pro Thr Gly Leu Thr Phe Tyr Pro 325 330 335 Ala Val Asp Val Gin Ala Phe Ala Val Leu Pro Asn Ser Ser Leu Ala 340 345 350 Ser Leu Phe Leu lie Gly Met His Thr Thr Gly Ser Met Glu Val Ser 355 360 365 Ala Glu Ser Asn Arg Leu Val Gly Glu Leu Lys Leu Asp Arg Leu Leu 370 375 380 385 Leu Glu Leu Lys His Ser Asn lie Gly Pro Phe Pro Val Glu Leu Leu 390 395 400 196 Gin Asp lie Met Asn Tyr lie Val Pro lie Leu Val Leu Pro Arg Val 405 410 415 Asn Glu Lys Leu Gin Lys Gly Phe Pro Leu Pro Thr Pro Ala Arg Val 420 425 430 Gin Leu Tyr Asn Val Val Leu Gin Pro His Gin Asn Phe Leu Leu Phe 435 440 445 Gly Ala Asp Val Val Tyr Lys 450 455 (2) INFORMATION FOR SEQ ID NO:147: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 24 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.149" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:147: Lys Trp Lys Val Phe Lys Lys lie Glu Lys Lys Ser Lys Val Gly 15 10 15 Trp Leu lie Gin Leu Phe His Lys Lys 20 (2) INFORMATION FOR SEQ ID NO:148: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 20 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.150" (Xi) SEQUENCE DESCRIPTION: SEQ ID NO:148: Lys Trp Ala Phe Ala Lys Lys Gin Lys Lys Arg Leu Lys Arg Gin 15 10 15 Trp Leu Lys Lys Phe 20 (2) INFORMATION FOR SEQ ID NO:149: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 30 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.153" 197 (xi) SEQUENCE DESCRIPTION: SEQ ID NO:149: Lys Trp Lys Ala Gin Lys Arg Phe Leu Lys Lys Trp Lys Ala Gin 15 10 15 Lys Arg Phe Leu Lys Lys Trp Lys Ala Gin Lys Arg Phe Leu Lys 20 25 30 (2) INFORMATION FOR SEQ ID NO:150: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 20 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.154" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 5 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 5 is beta-l-naphthyl-substituted." (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 6 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 6 is beta—1-naphthyl-substituted." (xi) SEQUENCE DESCRIPTION: SEQ ID NO:150: Lys Trp Lys Ala Ala Ala Arg Phe Leu Lys Lys Trp Lys Ala Gin 15 10 15 Lys Arg Phe Leu Lys (2) INFORMATION FOR SEQ ID NO:151: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 20 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.15 5" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 15 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 15 is beta-l-naphthyl-substituted." (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 16 198 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 16 is beta-l-naphthyl-substituted." (xi) SEQUENCE DESCRIPTION: SEQ ID NO:151: Lys Trp Lys Ala Gin Lys Arg Phe Leu Lys Lys Trp Lys Ala Ala 15 10 15 Ala Arg Phe Leu Lys . 20 (2) INFORMATION FOR SEQ ID NO:152: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 20 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.156" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 5 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 5 is beta-l-naphthyl-substituted." (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 6 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 6 is beta-l-naphthyl-substituted." (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 15 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 15 is beta-l-naphthyl-substituted." (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 16 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 16 is beta-l-naphthyl-substituted." (xi) SEQUENCE DESCRIPTION: SEQ ID NO:152: Lys Trp Lys Ala Ala Ala Arg Phe Leu Lys Lys Trp Lys Ala Ala 15 10 15 Ala Arg Phe Leu Lys 20 (2) INFORMATION FOR SEQ ID NO:153: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 30 amino acids (B) TYPE: amino acid WO 95/08344 PCT/US94/11225 199 (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.157' (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 5 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 5 is beta-l-naphthyl-substituted." (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 6 (C) OTHER INFORMATION: /label= Subetituted-Ala /note= "Position 6 is beta-l-naphthyl-substituted." (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 15 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 15 is beta-l-naphthyl-substituted." (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 16 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 16 is beta-l-naphthyl-substituted." (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 25 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 25 is beta-l-naphthyl-substituted." (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 2 6 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 26 is beta-l-naphthyl-substituted." (xi) SEQUENCE DESCRIPTION: SEQ ID NO:153: Lys Trp Lys Ala Ala Ala Arg Phe Leu Lys Lys Trp Lys Ala Ala 15 10 15 Ala Arg Phe Leu Lys Lys Trp Lys Ala Ala Ala Arg Phe Leu Lys 20 25 30 (2) INFORMATION FOR SEQ ID NO:154: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 29 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide 200 (ix) FEATURE: (A) NAME/KEY: trvisc_feature (D) OTHER INFORMATION: "BPI.158" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 10 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 10 is beta-l-naphthyl-substituted." (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 11 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 11 is beta-l-naphthyl-substituted." (xi) SEQUENCE DESCRIPTION: SEQ ID NO:154: lie Lys lie Ser Gly Lys Trp Lys Ala Ala Ala Arg Phe Leu Lys 15 10 15 Lys Ser Lys Val Gly Trp Leu lie Gin Leu Phe His Lys Lys 20 25 (2) INFORMATION FOR SEQ ID NO:155: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 24 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.159" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 2 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 2 is beta-l-naphthyl-substituted." (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 6 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 6 is beta-l-naphthyl-substituted." (xi) SEQUENCE DESCRIPTION: SEQ ID NO:155: Lys Ala Lys Ala Gin Ala Arg Phe Leu Lys Lys Ser Lys Val Gly 15 10 15 Trp Leu lie Gin Leu Trp His Lys Lys 20 (2) INFORMATION FOR SEQ ID NO:156: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 20 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear 201 (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.160" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 2 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 2 is beta-l-naphthyl-substituted." (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 6 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 6 is beta-l-naphthyl-substituted." (ix) FEATURE: (A) NAME/KEY: Modified-site (B).LOCATION: 12 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 12 is beta-l-naphthyl-substituted." (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 16 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 16 is beta-l-naphthyl-substituted." (xi) SEQUENCE DESCRIPTION: SEQ ID NO:156: Lys Ala Lys Ala Gin Ala Arg Phe Leu Lye Lys Ala Lyc Ala Gin 15 10 15 Ala Arg Phe Leu Lys 20 (2) INFORMATION FOR SEQ ID NO:157: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.161" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:157: Lys Ser Lys Val Lys Ala Leu lie Gin Leu Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:158: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 24 amino acids (B) TYPE: amino acid 202 (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.162" (xi) SEQUENCE DESCRIPTION: SEQ ID NO.-158: Lys Trp Lya Ala Gin Trp Arg Phe Leu Lys Lys Ser Lys Val Gly 15 10 15 Trp Leu lie Gin Leu Phe His Lys Lys 20 (2) INFORMATION FOR SEQ ID NO:159: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 20 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.163" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:159: Lys Trp Lye Ala Gin Trp Arg Phe Leu Lys Lys Trp Lye Ala Gin 15 10 15 Trp Arg Phe Leu Lys 20 (2) INFORMATION FOR SEQ ID NO:160: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 20 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.164" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 5 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 5 is beta-l-naphthyl-substituted." (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 15 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 15 is beta-1—naphthyl-substituted." (xi) SEQUENCE DESCRIPTION: SEQ ID NO:160: 203 Lys Trp Lys Ala Ala Lys Arg Phe Leu Lys Lys Trp Lys Ala Ala 15 10 15 Lys Arg Phe Leu Lys 20 (2) INFORMATION FOR SEQ ID NO:161: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 20 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.165" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 2 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 2 is beta-l-naphthyl-substituted." (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 12 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 12 is beta-l-naphthyl-substituted." (xi) SEQUENCE DESCRIPTION: SEQ ID NO:161: Lys Ala Lys Ala Gin Phe Arg Phe Leu Lys Lys Ala Lys Ala Gin 15 10 15 Phe Arg Phe Leu Lys 20 (2) INFORMATION FOR SEQ ID NO:162: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.166" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:162: Lys Ser Lys Val Gly Val Leu lie Gin Leu Phe His Lys Lys 1 5 10 (2) INFORMATION FOR SEQ ID NO:163: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 8 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear WO 95*08344 PCI7US94/11225 204 (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.167" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:163: Lys Trp Lys Ala Gin Lys Arg Phe 1 5 (2) INFORMATION FOR SEQ ID NO:164: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: circular (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.168" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:164: Cys Lys Trp Lys Ala Gin Lys Arg Phe Leu Lys Met Ser Cys 15 10 (2) INFORMATION FOR SEQ ID NO:165: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 10 amino acids (B) TYPE: amino acid (D) TOPOLOGY: circular (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.169" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:165: Cys Lys Trp Lys Ala Gin Lys Arg Phe Cys 15 10 (2) INFORMATION FOR SEQ ID NO:166: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 15 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.221" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 13 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 13 is beta-l-naphthyl-substituted." PCTAJS94/11225 205 (xi) SEQUENCE DESCRIPTION: SEQ ID NO:166: lie Lys lie Ser Gly Lys Trp Lys Ala Gin Lys Arg Ala Leu Lys 15 10 15 (2) INFORMATION FOR SEQ ID NO:167: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.222" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 6 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 6 is beta-l-naphthyl-substituted." (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 14 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 14 is beta-l-naphthyl-substituted." (xi) SEQUENCE DESCRIPTION: SEQ ID NO:167: Lys Ser Lys Val Gly Ala Leu lie Gin Leu Phe His Lys Ala 15 10 (2) INFORMATION FOR SEQ ID NO:168: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.223" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 6 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 6 is beta-l-naphthyl-substituted." (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 10 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 10 is beta-l-naphthyl-substituted." (xi) SEQUENCE DESCRIPTION: SEQ ID NO:168: "WO 95/08344 PCTAJS94/11225 206 Lys Ser Lys Val Gly Ala Leu lie Gin Ala Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:169: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.224" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 6 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 6 is beta-l-naphthyl-substituted." (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 9 (C) OTHER INFORMATION: /label= Substituted-Phe /note= "Position 9 is para-amino-substituted." (xi) SEQUENCE DESCRIPTION: SEQ ID NO:169: Lys Ser Lys Val Gly Ala Leu lie Phe Leu Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:170: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.225" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 6 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 6 is beta-l-naphthyl-substituted." (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 5 (C) OTHER INFORMATION: /label= Substituted-Phe /note= "Position 5 is para-amino-substituted." (xi) SEQUENCE DESCRIPTION: SEQ ID NO:170: Lys Ser Lys Val Phe Ala Leu lie Gin Leu Phe His Lys Lys 15 10 207 (2) INFORMATION FOR SEQ ID NO:171: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.226" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 6 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 6 is beta-l-naphthyl-substituted." (xi) SEQUENCE DESCRIPTION: SEQ ID NO:171: Lys Ser Lys Val Gly Ala Leu lie Gin Leu Trp His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:172: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.227" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 10 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 10 is beta-l-naphthyl-substituted." (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 14 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 14 is beta-l-naphthyl-substituted." (xi) SEQUENCE DESCRIPTION: SEQ ID NO:172: Lys Ser Lys Val Gly Trp Leu lie Gin Ala Phe His Lys Ala 15 10 (2) INFORMATION FOR SEQ ID NO:173: 208 (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.228" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 9 (C) OTHER INFORMATION: /label= Substituted-Phe /note= "Position 9 is para-amino-substituted." (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 14 (C)- OTHER INFORMATION: /label= Substituted-Ala /note= "Position 14 is beta-l-naphthyl-substituted." (xi) SEQUENCE DESCRIPTION: SEQ ID NO:173: Lys Ser Lys Val Gly Trp Leu lie Phe Leu Phe His Ly9 Ala 15 10 (2) INFORMATION FOR SEQ ID NO:174: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.229" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 5 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 5 is para-amino-substituted." (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 14 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 14 is beta-l-naphthyl-substituted." (Xi) SEQUENCE DESCRIPTION: SEQ ID NO:174: Lys Ser Lys Val Phe Trp Leu lie Gin Leu Phe His Lys Ala 15 10 209 (2) INFORMATION FOR SEQ ID NO:175: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.230" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 14 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 14 is beta-l-naphthyl-substituted." (xi) SEQUENCE DESCRIPTION: SEQ ID NO:175: Lys Ser Lys Val Gly Trp Leu lie Gin Leu Trp His Lys Ala 15 10 (2) INFORMATION FOR SEQ ID NO:176: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.231" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 10 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 10 is beta-l-naphthyl-substituted." (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 12 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 12 is beta-l-naphthyl-substituted." (xi) SEQUENCE DESCRIPTION: SEQ ID NO:176: Lys Ser Lys Val Gly Trp Leu lie Gin Ala Phe Ala Lys Lys 1 5 10 (2) INFORMATION FOR SEQ ID NO:177: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: 210 (A) NAME/KEY: misc feature (D) OTHER INFORMATION: "BPI.232" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 9 (C) OTHER INFORMATION: /label= Substituted-Phe /note= "Position 9 is para-amino-substituted." (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 12 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 12 is beta-l-naphthyl-substituted." (xi) SEQUENCE DESCRIPTION: SEQ ID NO:177: Lys Ser Lys Val Gly Trp Leu lie Phe Leu Phe Ala Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:178: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.233" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 5 (C) OTHER INFORMATION: /label= Substituted-Phe /note= "Position 5 is para-amino-substituted." (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 12 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 12 is beta-l-naphthyl-substituted." (xi) SEQUENCE DESCRIPTION: SEQ ID NO:178: Lys Ser Lys Val Phe Trp Leu lie Gin Leu Phe Ala Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:179: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.234" 211 (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 12 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 12 is beta-l-naphthyl-substituted." (xi) SEQUENCE DESCRIPTION: SEQ ID NO:179: Lys Ser Lys Val Gly Trp Leu lie Gin Leu Trp Ala Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:180: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.235" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 9 (C) OTHER INFORMATION: /label= Substituted-Phe /note= "Position 9 is para-amino-substituted." (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 10 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 10 is beta-l-naphthyl-substituted." (xi) SEQUENCE DESCRIPTION: SEQ ID NO:180: Lys Ser Lys Val Gly Trp Leu lie Phe Ala Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:181: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.236" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 5 (C) OTHER INFORMATION: /label= Substituted-Phe /note= "Position 5 is para-amino-substituted." (ix) FEATURE: (A) NAME/KEY: Modified-site 212 (B) LOCATION: 10 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 10 is beta-l-naphthyl-substituted." (xi) SEQUENCE DESCRIPTION: SEQ ID NO:181: Lys Ser Lys Val Phe Trp Leu lie Gin Ala Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:182: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.237" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 10 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 10 is beta-l-naphthyl-substituted." (xi) SEQUENCE DESCRIPTION: SEQ ID NO:182: Lys Ser Lys Val Gly Trp Leu lie Gin Ala Trp His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:183: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.238" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 5 (C) OTHER INFORMATION: /label= Substituted-Phe /note= "Position 5 is para-amino-substituted." (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 9 (C) OTHER INFORMATION: /label= Substituted-Phe /note= "Position 9 is para-amino-substituted." (xi) SEQUENCE DESCRIPTION: SEQ ID NO:183: Lys Ser Lys Val Phe Trp Leu lie Phe Leu Phe His Lys Lys 15 10 213 (2) INFORMATION FOR SEQ ID NO:184: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.239" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 9 (C) OTHER INFORMATION: /label= Substituted-Phe /note= "Position 9 is para-amino-substituted." (xi) SEQUENCE DESCRIPTION: SEQ ID NO:184: Lys Ser Lys Val Gly Trp Leu lie Phe Leu Trp His Lys Lys 1 5 10 (2) INFORMATION FOR SEQ ID NO:185: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (a) name/key: misc_feature (D) OTHER INFORMATION: "BPI.240" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 5 (C) OTHER INFORMATION: /label= Substituted-Phe /note= "Position 5 is para-amino-substituted." (xi) SEQUENCE DESCRIPTION: SEQ ID NO:185: Lys Ser Lys Val Phe Trp Leu lie Gin Leu Trp His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:186: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 24 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.247" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 2 214 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 2 is beta-l-naphthyl-substituted." (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 6 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 6 is beta-l-naphthyl-substituted." (xi) SEQUENCE DESCRIPTION: SEQ ID NO:186: Lys Ala Lys Ala Gin Ala Arg Phe Leu Lys Lys Ser Lys Val Gly 15 10 15 Trp Leu lie Leu Leu Phe His Lys Lys 20 (2) INFORMATION FOR SEQ ID NO:187: (i) SEQUENCE CHARACTERISTICS: ' (A) LENGTH: 24 amino acids (B)' TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.245" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:187: Lys Trp Lys Ala Gin Phe Arg Phe Leu Lys Lys Ser Lys Val Gly 15 10 15 Trp Leu lie Gin Leu Trp His Lye Lys 20 (2) INFORMATION FOR SEQ ID NO:188: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 24 amino acids (B) TYPE: amino acid (D) TOPOLOG Y: 1inear (ii) MOLECULE TYPE: peptide (ix) FEATURE : (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.24 6" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 16 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 16 is D-beta-2-naphthyl-substituted." (xi) SEQUENCE DESCRIPTION: SEQ ID NO:188: Lys Trp Lys Ala Gin Phe Arg Phe Leu Lys Lys Ser Lys Val Gly 15 10 15 215 Ala Leu lie Gin Leu Phe His Lys Lys 20 (2) INFORMATION FOR SEQ ID NO:189: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 24 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.248" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 2 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 2 is beta-l-naphthyl-substituted." (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 6 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 6 is beta-l-naphthyl-substituted." (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 16 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 16 is D-beta-2-naphthyl-substituted." (xi) SEQUENCE DESCRIPTION: SEQ ID NO:lB9: Lys Ala Lys Ala Gin Ala Arg Phe Leu Lys Lys Ser Lys Val Gly 15 10 15 Ala Leu lie Gin Leu Phe His Lys Lys 20 (2) INFORMATION FOR SEQ ID NO:190: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.242" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 6 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 6 is D-beta-2-naphthyl-substituted." (xi) SEQUENCE DESCRIPTION: SEQ ID NO:190: 216 Lys Ser Lys Val Gly Ala Leu lie Leu Leu Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:191: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 28 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.272" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:191: Lys Ser Lys Val Gly Trp Leu lie Leu Leu Phe His Lys Lys Lys 15 10 15 Ser Lys Val Gly Trp Leu lie Leu Leu Phe His Lys Lys 20 25 (2) INFORMATION FOR SEQ ID NO:192: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 28 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (a) name/key: misc_feature (D) OTHER INFORMATION: "BPI.275" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:192: Lys Ser Lys Val Gly Trp Leu lie Phe Leu Phe His Lys Lys Lys 15 10 15 Ser Lys Val Gly Trp Leu lie Phe Leu Phe His Lys Lys 20 25 (2) INFORMATION FOR SEQ ID NO:193: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 28 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide ( ix ) FEATURE.: (A) NAME/KEY: miac_feature (D) OTHER INFORMATION: "BPI.270" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:193: Lys Ser Lys Val Gly Trp Leu lie Leu Leu Phe His Lys Lys Lys 15 10 15 Ser Lys Val Gly Trp Leu lie Gin Leu Phe His Lys Lys 20 25 217 (2) INFORMATION FOR SEQ ID NO:194: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 28 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.271" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:194: Lys Ser Lys Val Gly Trp Leu lie Gin Leu Phe His Lys Lys Lys 15 10 15 Ser Lys Val Gly Trp Leu lie Leu Leu Phe His Lys Lys 20 25 (2) INFORMATION FOR SEQ ID NO:195: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 28 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI-273" (xi) SEQUENCE DESCRIPTION: SEQ ID NO;195: Lys Ser Lys Val Gly Trp Leu lie Phe Leu Phe His Lys Lys Lys 15 10 15 Ser Lys Val Gly Trp Leu lie Gin Leu Phe His Lys Lys 20 25 (2) INFORMATION FOR SEQ ID NO:196: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 28 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.274" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:196: Lys Ser Lys Val Gly Trp Leu lie Gin Leu Phe His Lys Lys Lys 15 10 15 Ser Lys Val Gly Trp Leu lie Phe Leu Phe His Lys Lys 20 25 (2) INFORMATION FOR SEQ ID NO:197: (i) SEQUENCE CHARACTERISTICS: 218 (A) LENGTH: 24 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.276" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:197: Lys Trp Lys Ala Gin Phe Arg Phe Leu Lys Lys Ser Lys Val Gly 15 10 15 Trp Leu lie Phe Leu Phe His Lys Lys 20 (2) INFORMATION FOR SEQ ID NO:198: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B). TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.241" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:198: Lys Ser Lys Val Gly Trp Leu lie Leu Leu Trp His Lys Lys IS 10 (2) INFORMATION FOR SEQ ID NO:199: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.243" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 6 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 6 is D-beta-2-naphthyl-substituted. " (xi) SEQUENCE DESCRIPTION: SEQ ID NO:199: Lys Ser Lys Val Gly Ala Leu lie Gin Leu Trp His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO;200: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid 219 (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.244" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 6 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "Position 6 is D-beta-2-naphthyl-substituted." (xi) SEQUENCE DESCRIPTION: SEQ ID N0:200: Lys Ser Lys Val Gly Ala Leu lie Leu Leu Trp His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:201: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.249" (xi) SEQUENCE DESCRIPTION: SEQ ID N0:201: Lys Ser Lys Val Gly Gly Leu lie Gin Leu Phe His Lys Lys 1 5 10 (2) INFORMATION FOR SEQ ID NO:202: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.250" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:202: Lys Ser Lys Val Gly Leu Leu lie Gin Leu Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:203: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: 220 (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.251" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:203: Lys Ser Lys Val Gly lie Leu lie Gin Leu Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:204: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.252" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 6 (D) OTHER INFORMATION: /label= D-Ala /note= "The amino acid at position 6 is D-alanine" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:204: Lys Ser Lys Val Gly Ala Leu lie Gin Leu Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:205: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acidB (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.253" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 6 (D) OTHER INFORMATION: /label= D-Val /note= "The amino acid at position 6 is D-valine" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:205: Lys Ser Lys Val Gly Val Leu lie Gin Leu Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:206: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide 221 (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.254" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 6 (D) OTHER INFORMATION: /label= beta-Ala /note= "The amino acid at position 6 is beta—alanine" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:206: Lys Ser Lys Val Gly Ala Leu lie Gin Leu Phe His Lys Ly 15 10 INFORMATION FOR SEQ ID NO:207: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.255" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 6 (D) OTHER INFORMATION: /label= delta-aba /note= "The amino acid at position 6 is delta-aminobutyric acid" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:207: Lys Ser Lys Val Gly Xaa Leu lie Gin Leu Phe His Lys Ly 15 10 INFORMATION FOR SEQ ID NO:208: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.256" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 6 (D) OTHER INFORMATION: /label= gaba /note= "The amino acid at position 6 is gamma-aminobutyric acid" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:2D8: Lys Ser Lys Val Gly Xaa Leu lie Gin Leu Phe His Lys Ly 15 10 222 (2) INFORMATION FOR SEQ ID NO:209: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.257" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 6 (D) OTHER INFORMATION: /label= d-methyl-A /note= "The amino acid at position 6 is delta-Methy1-alanine" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:209: Lys Ser Lys Val Gly Ala Leu lie Gin Leu Phe His Lys Lys 1-5 10 (2) INFORMATION FOR SEQ ID NO;210: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION; "BPI.258" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 6 (D) OTHER INFORMATION: /label= t-butyl-G /note= "The amino acid at position 6 is tert-butyl-glycine" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:210: Lys Ser Lys Val Gly Gly Leu lie Gin Leu Phe His Lys Lys 1 5 10 (2) INFORMATION FOR SEQ ID NO:211: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE; peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.259" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 6 223 (D) OTHER INFORMATION: /label= N-methyl-G /note= "The amino acid at position 6 is N-Methyl-glycine " (xi) SEQUENCE DESCRIPTION: SEQ ID NO:211: Lys Ser Lys Val Gly Gly Leu lie Gin Leu Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:212: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.260" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 6 (D) OTHER INFORMATION: /label= N-methyl-V /note= "The amino acid at position 6 is N-Methyl-valine" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:212: Lys Ser Lys Val Gly Val Leu lie Gin Leu Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:213: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.261" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 6 (D) OTHER INFORMATION: /label= N-methyl-L /note= "The amino acid at position 6 is N-Methyl-leucine" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:213: Lys Ser Lys Val Gly Leu Leu lie Gin Leu Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:214: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear 224 (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.262" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:214: Lya Ser Lys Val Gly Trp Leu lie Asn Leu Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:215: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.263" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:215: Lys Ser Lys Val Gly Trp Leu lie Glu Leu Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:216: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.264" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:216: Lys Ser Lys Val Gly Trp Leu lie Asp Leu Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:217: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.265" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:217: Lys Ser Lys Val Gly Trp Leu lie Lys Leu Phe His Lye Lys 15 10 (2) INFORMATION FOR SEQ ID NO:216: 225 (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.266" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:218: Lys Ser Lys Val Lys Val Leu lie Gin Leu Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:219: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid ■(D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI-267" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:219: Lys Ser Lys Val Lys Trp Ala lie Gin Leu Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID N0:220: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.268" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:220: Lys Ser Lys Val Gly Val Ala lie Gin Leu Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:221: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 14 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.269" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:221: 226 Lys Ser Lys Val Lys Val Ala lie Gin Leu Phe His Lys Lys 15 10 (2) INFORMATION FOR SEQ ID NO:222: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 24 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.277" (ix) FEATURE: (A) NAME/KEY: Modified-site {B) LOCATION: 2 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "The alanine at position 2 is beta-l-naphthyl-substituted." (xi) SEQUENCE DESCRIPTION: SEQ ID NO:222: Lya Ala Lys Ala Gin Phe Arg Phe Leu Lys Lys Ser Lya Val Gly 15 10 15 Trp Leu lie Leu Leu Phe His Lys Lys 20 (2) INFORMATION FOR SEQ ID NO:223: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 15 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.278" (xi) SEQUENCE DESCRIPTION: SEQ ID NO;223: lie Lys lie Ser Gly Lys Trp Lys Ala Ala Trp Arg Phe Leu Lys 15 10 15 (2) INFORMATION FOR SEQ ID NO;224: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 15 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.279" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 10 (C) OTHER INFORMATION: /label= Substituted-Ala 227 /note= "The alanine at position 10 is beta-l-naphthyl-substituted." (xi) SEQUENCE DESCRIPTION: SEQ ID NO:224: lie Lys lie Ser Gly Lys Trp Lys Ala Ala Phe Arg Phe Leu Lys 1 5 10 15 (2) INFORMATION FOR SEQ ID NO:225: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 15 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.280" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:225: lie Lys lie Ser Gly Lys Trp Lys Ala Ala Phe Arg Phe Leu Lys 15 10 15 (2) INFORMATION FOR SEQ ID NO:226: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 15 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.281" (ix) FEATURE: (A) NAME/KEY: Modified-site (B) LOCATION: 10 (C) OTHER INFORMATION: /label= Substituted-Ala /note= "The alanine at position 10 is beta-l-naphthyl-substituted." (xi) SEQUENCE DESCRIPTION: SEQ ID NO:226: lie Lys lie Ser Gly Lys Trp Lys Ala Ala Ala Arg Phe Leu Lys 10 15 (2) INFORMATION FOR SEQ ID NO:227: (i) SEQUENCE CHARACTERISTICS: (A) LENGTH: 12 amino acids (B) TYPE: amino acid (D) TOPOLOGY: linear (ii) MOLECULE TYPE: peptide (ix) FEATURE: (A) NAME/KEY: misc_feature (D) OTHER INFORMATION: "BPI.170" (xi) SEQUENCE DESCRIPTION: SEQ ID NO:227: Lys Trp Lys Ala Gin Lye Arg Phe Leu Lys Met Ser 15 10

Claims (28)

THE CLAIMS DEFINING THE INVENTION ARE AS FOLLOWS:-

1. Use of a BPI protein product in the manufacture of a medicament for treatment of a gram-negative bacterial infection in mammals, wherein the medicament is intended for use in co-treatment with an antibiotic other than a penicillin, cephalosporin, rifampicin, 5 or actinomycin D.

2. Use according to claim 1, wherein the antibiotic is an aminoglycoside antibiotic.

3. Use according to claim 1, wherein the antibiotic is a sulfonamide or trimethoprim antibiotic.

4. Use according to claim 1, wherein the antibiotic is a fluoroquinolone or quinolone 10 antibiotic.

5. Use according to claim 1 wherein the antibiotic is a P-lactam antibiotic other than a penicillin or cephalosporin.

6. Use according to claim 1, wherein the antibiotic is a polymyxin antibiotic.

7. Use according to claim 1 wherein the antibiotic is a tetracycline antibiotic. 15

8. Use according to any one of claims 1 to 7, wherein the therapeutic effectiveness in gram-negative bacterial infection of said antibiotic is improved.

9. Use according to claim 8, wherein susceptibility to said antibiotic of gram-negative bacteria involved in the gram-negative bacterial infection is increased.

10. Use according to claim 8, wherein resistance to said antibiotic of gram-negative 20 bacteria involved in the gram-negative bacterial infection is reversed.

11. Use according to any one of claims 2 or 8 to 10, wherein the aminoglycoside antibiotic is selected from the group consisting of amikacin, gentamicin and tobramycin.

12. Use according to any one of claims 2 or 8 to 11, wherein the causative agent of the gram-negative bacterial infection is a bacterial species selected from the group 25 consisting of Citrobacter, Edwardsiella, Enterobacter, Escherichia, Klebsiella, Morganella, Providencia, Proteus, Pseudomonas, Xanthamonas, Salmonella, and Serratia species.

13. Use according to any one of claims 3 or 8 to 10, wherein the sulfonamide or trimethoprim antibiotic is the combination antibiotic trimethoprim/sulfamethoxazole. 30

14. Use according to any one of claims 3, 8 to 10 or 13, wherein the causative agent of the gram-negative bacterial infection is a bacterial species selected from the group consisting of Pseudomonas, Xanthamonas, Klebsiella, Enterobacter, and Proteus species.

15. Use according to any one of claims 4 or 8 to 10, wherein the fluoroquinolone antibiotic is selected from the group consisting of ciprofloxacin, norfloxacin and ofloxacin.

16. Use according to any one of claims 4, 8 to 10 or 15, wherein the causative agent of 5 the gram-negative bacterial infection is a bacterial species selected from the group consisting of Pseudomonas, Xanthamonas, Klebsiella and Enterobacter species.

17. Use according to any one of claims 5 or 8 to 10, wherein the P-lactam antibiotic is selected from the group consisting of aztreonam and imipenem.

18. Use according to any one of claims 5, 8 to 10 or 17, wherein the causative agent of 10 the gram-negative bacterial infection is a bacterial species selected from the group consisting of Pseudomonas, Citrobacter, Enterobacter, Proteus and Providencia species.

19. Use according to any one of claims 6 or 8 to 10, wherein the causative agent of the gram-negative bacterial infection is a bacterial species selected from the group 15 consisting of Pseudomonas, Escherichia, Enterobacter, and Providencia species.

20. Use according to any one of claims 6 or 8 to 10 wherein the polymyxin antibiotic is polymixin B.

21. Use of any one of claims 1 to 20, wherein the BPI protein product is an N-terminal fragment with a molecular weight of approximately 21 to 25 1<D, or a dimeric form 20 thereof.

22. Use of any one claims 1 to 20, wherein the BPI protein product is rBPl23, rBPl2i or rBPIso-

23. Use according to any one of claims 1 to 22, wherein the BPI protein product is administered in a dose of greater than 1 mg/kg and up to 100 mg/kg. 25

24. A pharmaceutical composition comprising an antibiotic and a BPI protein product in an amount effective to improve the therapeutic effectiveness of said antibiotic.

25. A pharmaceutical composition according to claim 24, wherein the antibiotic is selected from the group consisting of an aminoglycoside antibiotic, a sulfonamide or trimethoprim antibiotic, a fluoroquinolone or quinolone antibiotic, a (3-lactam antibiotic 30 other than penicillin or cephalosporin, a polymyxin antibiotic and a tetracycline antibiotic.

26. A pharmaceutical composition according to claim 25, wherein the antibiotic is selected from the group consisting of amikacin, gentamicin, tobramycin, trimethoprim/sulfamethoxazole combination, aztreonam, imipenem, polymyxin B, ciprofloxacin, norfloxacin and ofloxacin.

27. Use of a BPI protein product for the manufacture of a medicament for treatment of a gram-negative bacterial infection in mammals, substantially as herein described with reference to any one of the Examples thereof.

28. A pharmaceutical composition for treatment of gram-negative bacterial infection, substantially as herein described with reference to any one of the Examples thereof. END OF CLAIMS