Hemagglutinin Polypeptides, and Reagents and Methods Relating Thereto

• US 20090269342A1
• Filed: 01/02/2009
• Published: 10/29/2009
• Est. Priority Date: 08/14/2006
• Status: Abandoned Application

• Current Assignee: Massachusetts Institute of Technology
• Original Assignee: Massachusetts Institute of Technology
• Inventors: Sasisekharan, Ram, Viswanathan, Karthik, Raman, Rahul, Srinivasan, Aravind, Sasisekharan, Viswanathan, Raguram, S., Chandrasekaran, Aarthi
• Application Number:
  US12/348,266
• Publication Number:
  US 20090269342A1
• Time in Patent Office: Days
• US Class Current: 514/1.100
• CPC Class Codes: C07K 14/005 from viruses
• CPC Class Codes: C12N 2760/16122 New viral proteins or individual genes, new structural or functional aspects of known viral proteins or genes
• CPC Class Codes: G01N 2333/11 Orthomyxoviridae, e.g. influenza virus
• CPC Class Codes: G01N 2400/10 Polysaccharides, i.e. having more than five saccharide radicals attached to each other by glycosidic linkages; Derivatives thereof, e.g. ethers, esters
• CPC Class Codes: G01N 2500/02 Screening involving studying the effect of compounds C on the interaction between interacting molecules A and B (e.g. A = enzyme and B = substrate for A, or A = receptor and B = ligand for the receptor)
• CPC Class Codes: G01N 33/56983 Viruses

Abstract

The present invention provides a system for analyzing interactions between glycans and interaction partners that bind to them. The present invention also provides HA polypeptides that bind to umbrella-topology glycans, and reagents and methods relating thereto.

Claims

1. An engineered binding agent that binds to umbrella-topology glycans.

2. The engineered binding agent of claim 1, wherein the umbrella-topology glycans comprise α

2-6 sialylated glycans.

3. The engineered binding agent of claim 1 or claim 2, wherein the binding agent binds to the umbrella-topology glycans with high affinity.

4. The engineered binding agent of claim 3, wherein the binding agent binds to the umbrella-topology glycans with an affinity comparable to that of a wild-type human adapted HA that mediates infection of humans.

5. The engineered binding agent of claim 3, wherein the binding agent binds to the umbrella-topology glycans with an affinity that is at least 50% that of a wild-type HA that mediates infection of humans.

6. The engineered binding agent of claim 3, wherein the binding agent binds to the umbrella-topology glycans with an affinity that is at least 70% that of a wild-type HA that mediates infection of humans.

7. The engineered binding agent of claim 3, wherein the binding agent binds to the umbrella-topology glycans with an affinity that is at least 80% that of a wild-type HA that mediates infection of humans.

8. The engineered binding agent of claim 3, wherein the binding agent binds to the umbrella-topology glycans with an affinity that is at least 90% that of a wild-type HA that mediates infection of humans.

9. The engineered binding agent of claim 3, wherein the binding agent binds to the umbrella-topology glycans with an affinity that is at least 100% that of a wild-type HA that mediates infection of humans.

10. The engineered binding agent of claim 1 or claim 2, wherein the binding agent binds to the umbrella-topology glycans preferentially as compared with cone-topology glycans.

11. The engineered binding agent of claim 10, wherein the binding agent binds to umbrella-topology glycans vs cone-topology glycans with a relative affinity of at least 2.

12. The engineered binding agent of claim 10, wherein the binding agent binds to umbrella-topology glycans vs cone-topology glycans with a relative affinity of at least 3.

13. The engineered binding agent of claim 10, wherein the binding agent binds to umbrella-topology glycans vs cone-topology glycans with a relative affinity of at least 4.

14. The engineered binding agent of claim 10, wherein the binding agent binds to umbrella-topology glycans vs cone-topology glycans with a relative affinity of at least 5.

15. The engineered binding agent of claim 10, wherein the binding agent binds to umbrella-topology glycans vs cone-topology glycans with a relative affinity of at least 10.

16. An isolated binding agent that binds to umbrella-topology glycans other than, which binding agent is not an H1 protein from any of the strains:

A/South Carolina/1/1918;

A/Puerto Rico/8/1934;

A/Taiwan/1/1986;

A/Texas/36/1991;

A/Beijing/262/1995;

A/Johannesburg/92/1996;

A/New Caledonia/20/1999;

A/Solomon Islands/3/2006, or an H2 protein from any of the strains;

A/Japan/305+/1957;

A/Singapore/1/1957;

A/Taiwan 1/1964;

A/Taiwan 1/1967, or an H3 protein from any of the strains;

A/Aichi/2/1968;

A/Phillipines/2/1982;

A/Mississippi/1/1985;

A/Leningrad/360/1986;

A/Sichuan/2/1987;

A/Shanghai/11/1987;

A/Beijing/353/1989;

A/Shandong/9/1993;

A/Johannesburg/33/1994;

A/Nanchang/813/1995;

A/Sydney/5/1997;

A/Moscow/10/1999;

A/Panama/2007/1999;

A/Wyoming/3/2003;

A/Oklahoma/323/2003;

A/California/7/2004;

A/Wisconsin/65/2005.

17. A characteristic portion of an engineered binding agent that binds to umbrella-topology glycans.

19. A polypeptide comprising the characteristic portion of claim 17 or claim 18.

20. A nucleic acid encoding the characteristic portion of claim 17 or claim 18.

21. A nucleic acid encoding the polypeptide of claim 19.

22. A vector containing the nucleic acid of claim 20.

23. A vector containing the nucleic acid of claim 21.

24. A host cell containing the nucleic acid of claim 20.

25. A host cell containing the nucleic acid of claim 21.

26. A host cell containing the vector of claim 22.

27. A host cell containing the vector of claim 23.

35. A method for identifying or characterizing binding agents, the method comprising steps of:

providing a sample containing a test binding agent;

contacting the sample with the glycan array of claim 26; and

detecting binding of the test binding agent to one or more glycans on the array.

36. The method of claim 35, wherein the binding agent is an HA polypeptide.

18. A characteristic portion of a binding agent, which binding agent is not an H1 protein from any of the strains:

A/South Carolina/1/1918;

A/Puerto Rico/8/1934;

A/Taiwan/1/1986;

A/Texas/36/1991;

A/Beijing/262/1995;

A/Johannesburg/92/1996;

A/New Caledonia/20/1999;

A/Solomon Islands/3/2006, or an H2 protein from any of the strains;

A/Japan/305+/1957;

A/Singapore/1/1957;

A/Taiwan/1/1964;

A/Taiwan/1/1967, or an H3 protein from any of the strains;

A/Aichi/2/1968;

A/Phillipines/2/1982;

A/Mississippi/1/1985;

A/Leningrad/360/1986;

A/Sichuan/2/1987;

A/Shanghai/11/1987;

A/Beiging/353/1989;

A/Shandong/9/1993;

A/Johannesburg/33/1994;

A/Nanchang/813/1995;

A/Sydney/5/1997;

A/Moscow/10/1999;

A/Panama/2007/1999;

A/Fujian/411/2002;

A/Wyoming/3/2003;

A/Oklahoma/323/2003;

A/California/7/2004;

A/Wisconsin/65/2005, wherein the characteristic portion binds to umbrella-topology glycans.

28. An antibody that binds to an engineered binding agent that binds to umbrella-topology glycans.

30. The antibody of claim 28 or claim 29, which antibody is polyclonal.

31. The antibody of claim 28 or claim 29, which antibody is monoclonal.

29. An antibody that binds to a binding agent, which binding agent is not an H1 protein from any of the strains:

A/South Carolina/1/1918;

A/Puerto Rico/8/1934;

A/Taiwan/1/1986;

A/Texas/36/1991;

A/Beijing/262/1995;

A/Johannesburg/92/1996;

A/New Caledonia/20/1999;

A/Solomon Islands/3/2006, or an H2 protein from any of the strains;

A/Japan/305+/1957;

A/Singapore/1/1957;

A/Taiwan/1/1964;

A/Taiwan/1/1967, or an H3 protein from any of the strains;

A/Aichi/2/1968;

A/Phillipines/2/1982;

A/Mississippi/1/1985;

A/Leningrad/360/1986;

A/Sichuan/2/1987;

A/Shanghai/11/1987;

A/Beiging/353/1989;

A/Shandong/9/1993;

A/Johannesburg/33/1994;

A/Nanchang/813/1995;

A/Sydney/5/1997;

A/Moscow/10/1999;

A/Panama/2007/1999;

A/Fujian/411/2002;

A/Wyoming/3/2003;

A/Oklahoma/323/2003;

A/California/7/2004;

A/Wisconsin/65/2005, wherein the binding agent binds to umbrella-topology glycans.

32. A viral particle including an engineered binding agent that binds to umbrella-topology glycans.

33. A method of treating influenza infection by administering a composition comprising an engineered binding agent that binds to umbrella-topology glycans, a polypeptide comprising a characteristic fragment of an engineered binding agent that binds to umbrella-topology glycans, an antibody that binds to an engineered binding agent that binds to umbrella-topology glycans, or characteristic portion thereof, a nucleic acid that encodes an engineered binding agent that binds to umbrella-topology glycans or characteristic portion thereof, or combinations thereof.

34. A glycan array comprising glycan structures of at least about 10%, 15%, 20%, 25%, 30%, 35%, 40%, 45%, 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90% 95%, or more of glycans found on HA receptors in human upper respiratory tract tissues.

37. A method of any of, inhibiting, in a subject, binding of an influenza virus to a hemagglutinin receptor having an umbrella topology, minimizing the risk of infection of a subject by an influenza virus which binds a hemagglutinin receptor having an umbrella topology, or treating a subject, comprising:

identifying a subject susceptible to or suffering from infection by an influenza virus (optionally on the basis of need for blocking an influenza virus which binds a hemagglutinin receptor having an umbrella topology, or on the basis of being at risk for infection by an influenza virus which binds a hemagglutinin receptor having an umbrella topology);

optionally, selecting a binding agent on the basis of the binding agent being able to bind a hemagglutinin receptor having umbrella topology glycans;

optionally, providing a binding agent;

administering an effective amount of the binding agent to the subject, so that binding by the virus to hemagglutinin receptors having umbrella topology glycans is reduced, the risk is minimized, or the patient is treated.

38. The method of claim 37, wherein the binding agent is an LSBA

39. The method of claim 37, wherein the binding agent is a UTBA.

40. The method of claim 37, wherein the binding agent is a UTSBA.

41. The method of claim 40, wherein the UTSBA is administered to the subject prior to exposure to the virus.

42. The method of claim 40, wherein the UTSBA is administered to the subject after exposure to the virus.

43. The method of claim 40, wherein amount administered is sufficient to saturate the subject'"'"'s HA receptors containing umbrella topology glycans.

44. The method of claim 40, wherein the UTSBA is administered by inhalation.

45. The method of claim 44, wherein the UTSBA is administered as an aerosol.

46. The method of claim 44, wherein the UTSBA is administered as a preparation of particles having a mean particle size of at least 4, 5, 6, 7, 8, 9, 10, 11, 12 or 13 microns.

47. The method of claim 44, wherein the UTSBA is administered as a dry powder.

48. The method of claim 44, wherein the UTSBA is administered as a powder treated with a wetting agent.

49. The method of claim 48, wherein the wetting agent is water, saline, or of physiological pH.

50. The method of claim 44 wherein the UTSBA is administered with an excipient.

51. The method of claim 44, wherein less than 1%, 2%, 5%, 10%, 20%, or 30%, by dry weight or number, of the UTSBA administered is present in an aggregate.

52. The method of claim 44, wherein less than 1%, 2%, 5%, 10%, 20%, or 30%, by dry weight or number, of the UTSBA administered is denatured.

53. The method of claim 44, wherein less than 1%, 2%, 5%, 10%, 20%, or 30%, by dry weight or number, of the UTSBA administered is inactive.

54. The method of claim 40, wherein the UTSBA is administered as drops to the nasal or buccal cavity, e.g., in a dose of 1-100, 1-50, or 1-20 drops.

55. The method of claim 44, wherein the UTSBA is administered from a device which delivers a metered dosage of the UTSBA.

56. The method of claim 40, wherein the UTSBA is an HA polypeptide.

57. The method of claim 37, wherein the binding agent is a peptide, e.g., a recombinant polypeptide, having substantial homology with a naturally occurring HA, or fragment thereof, which naturally occurring HA binds an HA receptor having umbrella topology glycans, e.g., an UTHAr having the umbrella topology glycan 6′

SLN-LN, with at least 2, 4, 5, or 10 times the affinity with which it binds to an HA receptor having cone topology glycans, e.g., having the cone topology glycan 3′

SLN-LN.

58. The method of claim 57, wherein the naturally occurring HA is a H1, H2, or H3.

59. The method of claim 58, wherein the naturally occurring HA is from the H3 Wyoming isolate.

60. The method of claim 57, wherein the blocking agent is a recombinant naturally occurring HA or fragment thereof.

61. The method of claim 57, wherein the blocking agent is a recombinant H1, H2, H3, or fragment thereof.

62. The method of claim 57, wherein the blocking agent is a recombinant HA from the H3 Wyoming isolate or fragment thereof.

63. The method of claim 57, wherein the naturally occurring HA is from the H_NY198 isolate.

64. The method of claim 57, wherein the blocking agent is a recombinant HA from the NY1918 isolate or fragment thereof.

65. The method of claim 40, wherein the USTBA is a recombinant HA, or fragment thereof, having substantial homology with the naturally occurring HA, which differs from the naturally occurring HA sequence by at least one amino acid, and wherein the naturally occurring HA binds an HA receptor having cone topology glycans, e.g., a CTHAr having the cone topology glycan, 3′

SLN-LN, with at least 2, 4, 5, or 10 time the affinity with which it binds to a HA receptor having umbrella topology glycans (e.g., having the umbrella topology glycan, 6′

SLN-LN.

66. The method of claim 65, wherein the naturally occurring HA is H5, H7, H9.

67. The method of claim 65, wherein the USTBA differs from a parent naturally occurring HA at one or more of residues 137, 145, 156, 159, 186, 187, 189, 190, 192, 193, 196, 222, 225, 226, and 228.

68. The method of claim 65, wherein the USTBA differs from a parent naturally occurring HA at positions corresponding to one or more of residues 156, 159, 189, 192, 193, and 196;

and/or at positions corresponding to one or more of residues 186, 187, 189, and 190; and

/or at positions corresponding to one or more of residues 190, 222, 225, and 226; and

/or at positions corresponding to one or more of residues 137, 145, 190, 226 and 228.

69. The method of claim 65, wherein the USTBA differs from a parent naturally occurring HA in that the USTBA has sequence substitutions at positions corresponding to one or more of residues 190, 225, 226, and 228.

70. The method of claim 65, wherein the USTBA differs from a parent naturally occurring HA in that the USTBA has one or more amino acid substitutions at residues selected from the group consisting of residues 98, 136, 138, 153, 155, 159, 183, 186, 187, 190, 193, 194, 195, 222, 225, 226, 227, and 228.

71. The method of claim 65, wherein the USTBA differs from a parent naturally occurring HA in that the USTBA has one or more amino acid substitutions at residues selected from the group consisting of residues 98, 136, 153, 155, 183, 190, 193, 194, 222, 225, 226, 227, and 228.

72. The method of claim 65, wherein the USTBA differs from a parent naturally occurring HA in that the USTBA has one or more amino acid substitutions at residues selected from the group consisting of residues 98, 138, 186, 187, 195, and 228.

73. The method of claim 65, wherein the USTBA differs from a parent naturally occurring HA in that the USTBA has one or more amino acid substitutions at residues selected from the group consisting of residues 138, 186, 187, 190, 193, 222, 225, 226, 227 and 228.

74. The method of claim 65, wherein the USTBA differs from a parent naturally occurring HA in that the USTBA has one or more amino acid substitutions at residues selected from the group consisting of residues 190, 193, 222, 225, 226, 227, and 228.

75. The method of claim 65, wherein the USTBA differs from a parent naturally occurring HA in that the USTBA has one or more amino acid substitutions at residues selected from the group consisting of residues 138, 186, 187, and 228.

76. The method of claim 65, wherein the USTBA differs from a parent naturally occurring HA in that the USTBA has one or more amino acid substitutions at residues selected from the group consisting of residues 98, 136, 153, 155, 183, 194, and 195.

77. The method of claim 65, wherein the USTBA differs from a parent naturally occurring HA in that the USTBA has one or more amino acid substitutions at residues selected from the group consisting of residues 98, 136, 153, 155, 183, and 194.

78. The method of claim 65, wherein the USTBA differs from a parent naturally occurring HA in that the USTBA has one or more amino acid substitutions at residues selected from the group consisting of residues 98 and 195.

79. The method of claim 65, wherein the USTBA differs from a parent naturally occurring HA in that the USTBA has one or more amino acid substitutions at residues selected from the group consisting of residues 98, 138, 186, 187, 195, and 228.

80. The method of claim 65, wherein the USTBA differs from a parent naturally occurring HA in that the USTBA has one or more amino acid substitutions at residues selected from the group consisting of residues 138, 186, 187, and 228.

81. The method of claim 65, wherein the USTBA differs from a parent naturally occurring HA in that the USTBA has one or more amino acid substitutions at residues selected from the group consisting of residues 98 and 195.

82. The method of claim 65, wherein the USTBA differs from a parent naturally occurring HA in that the USTBA has one or more amino acid substitutions at residue 159.

83. The method of claim 65, wherein the USTBA differs from a parent naturally occurring HA in that the USTBA has one or more amino acid substitutions at residues selected from the group consisting of residues 190, 193, 226, and 228.

84. The method of claim 65, wherein the USTBA differs from a parent naturally occurring HA in that the USTBA has one or more of the following amino acid substitutions:

Ser137Ala, Lys156Glu, Asn186Pro, Asp187Ser, Asp187Thr, Ala189Gln, Ala189Lys, Ala189Thr, Glu190Asp, Glu190Thr, Lys193Arg, Lys193Asn, Lys193His, Lys193Ser, Gly225Asp, Gln226Ile, Gln226Leu, Gln226Val, Ser227Ala, Gly228Ser.

85. The method of claim 65, wherein the USTBA differs from a parent naturally occurring HA in that the USTBA has one or more of the following amino acid substitutions:

86. The method of claim 65, wherein the USTBA is an HA polypeptide having an amino acid sequence that includes D190, D225, L226, and/or S228.

87. The method of claim 65, wherein the USTBA is an HA polypeptide having an amino acid sequence that includes D190 and D225.

88. The method of claim 65, wherein the USTBA is an HA polypeptide having an amino acid sequence that includes L226 and S228.

89. The method of any one of claims 67-88 wherein the USTBA is an H5 polypeptide.

90. The method of claim 40, wherein the antibody is a monoclonal, monospecific, chimeric, CDR grafted, humanized, human, cameloid, IgNAR, single chain, IgA, IgM, IgG, etc.

91. The method of claim 40, wherein the UTSBA is a lectin, e.g., SNA-1.

92. The method of claim 40, wherein the UTSBA is a non-HA polypeptide.

93. The method of claim 40, wherein the UTSBA is a small molecule.

94. The method of claim 40, wherein the UTSBA is a lectin.

95. The method of claim 40, wherein the blocking agent is provided in a preparation which is formulated for delivery by inhalation.

96. The method of claim 40, wherein the UTSBA agent is provided in a preparation which is essentially free of adjuvants, e.g., an alum adjuvant.

97. The method of claim 40, wherein the UTSBA is provided in a preparation which is essentially free of other HA polypeptides, e.g., other HA polypeptides which bind to HA receptor glycans other than an umbrella topology glycan.

98. The method of claim 40, wherein the UTSBA is provided in a preparation having no more than 50, 40, 30, 20, 10, 5, or 1% by number or weight, an agent which binds to HA receptor glycans other than and umbrella topology glycans.

99. The method of claim 40, wherein the umbrella topology glycan comprises oligosaccharides of the following form:

100. The method of claim 40, wherein said UTSBA is administered in combination with administration of a second therapeutic, e.g., an anti-viral agent, e.g., Oseltamivir (Tamiflu), Zanamavir (Releza), or a sialydase.

101. The method of claim 40, wherein the UTSBA is associated with, e.g., bound to a polymer, e.g., PEG or carboxymethyl cellulose, the UTSBA has additional glycosylation, or the UTSBA, e.g., to minimize an immune response to the UTSBA.

102. The method of claim 40, wherein the UTSBA is administered so as to minimize an immune response.

103. The method of claim 40, wherein the UTSBA is administered continuously, e.g., administered without a period of less than therapeutic level interposed between two periods of therapeutic level.

104. The method of claim 40, wherein the UTSBA is administered continuously, e.g., daily or multi daily doses for each day of treatment.

105. The method of claim 40, wherein at least one amino acid residue has been altered so as to reduce immunogenicity.

106. The method of claim 40, wherein the UTSBA is multivalent.

107. The claim of claim 40, wherein the UTSBA is multivalent and binds 2, 3, 4, 6, 7, 8, 9, or 10 or more umbrella topology glycans.

108. The method of claim 40, further comprising administering a second USTBA, e.g., administering an H1 and an H3 based UTSBA.

109. A method of selecting a subject for treatment with a blocking agent comprising:

identifying a subject suffering from or susceptible to influenza infection, or optionally, identifying a subject on the basis of need for blocking an HA receptor having an umbrella topology glycan or on the basis of being at risk for infection by an influenza virus which binds an HA receptor having an umbrella topology glycan;

administering the blocking agent to the subject or selecting a dosage of the blocking agent for the subject;

thereby selecting a subject for treatment with a bl-ocking agent.

110. The method of claim 109, wherein the blocking agent is an LSBA.

111. The method of claim 109, wherein the blocking agent is a UTBA.

112. The method of claim 109, wherein the blocking agent is a UTSBA.

113. The method of claim 109, further comprising memorializing the selection of the subject.

114. The method of claim 109, further comprising classifying a dose of UTSBA as being for use of said subject.

115. The method of claim 109, further comprising notifying the subject of the selection.

116. A method of selecting a patient for treatment with blocking agent comprising:

optionally, identifying a subject suffering from or susceptible to influenza infection;

determining if the subject has antibodies that react with a blocking agent;

if the subject lacks antibodies to the a blocking agent, selecting the subject for treatment, thereby selecting a patient for treatment with a blocking agent.

117. The method of claim 116, wherein the blocking agent is an LSBA.

118. The method of claim 116, wherein the blocking agent is a UTBA.

119. The method of claim 116, wherein the blocking agent is a UTSBA.

120. The method of claim 119, further comprising administering the UTSBA to the subject.

121. The method of claim 119, further comprising classifying a dose of UTSBA as being for use of said subject.

122. A method of selecting a dosage of a blocking agent, comprising:

optionally, identifying a subject suffering from or susceptible to influenza infection, e.g., identifying a subject on the basis of need for blocking an HA receptor having an umbrella topology glycan or on the basis of being at risk for infection by an influenza virus which binds an HA receptor having an umbrella topology glycan;

determining if the subject has antibodies that react with a blocking agent;

selecting a subject or dose based on the determination, thereby selecting a dosage for treatment with a blocking agent.

123. The method of claim 122, wherein the blocking agent is an LSBA.

124. The method of claim 122, wherein the blocking agent is a UTBA.

125. The method of claim 122, wherein the blocking agent is a UTSBA.

126. The method of claim 125, further comprising administering the UTSBA to the subject.

127. The method of claim 126, further comprising classifying a dose of UTSBA as being for use of said subject.

128. A method of selecting a drug for administration to a subject comprising:

identifying a subject suffering from or susceptible to influenza infection, or optionally, identifying a subject on the basis of need for blocking an HA receptor having an umbrella topology glycan or on the basis of being at risk for infection by an influenza virus which binds an HA receptor having an umbrella topology glycan;

selecting a blocking agent on the basis that it blocks an UTHAr;

optionally, providing a unit dose of a blocking agent to the subject or to a health care provider for administration to the subject.

thereby selecting a drug for administration to a subject.

129. The method of claim 128, wherein the blocking agent is an LSBA.

130. The method of claim 128, wherein the blocking agent is a UTBA.

131. The method of claim 128, wherein the blocking agent is a UTSBA

132. The method of claim 131, further comprising administering the UTSBA to the subject.

133. The method of claim 132, further comprising classifying a dose of UTSBA as being for use of said subject.

134. The method of claim 132, further comprising memorializing the selection of the USTBA.

135. A method of evaluating a test binding agent, e.g., a polypeptide, e.g., naturally occurring or mutant HA, or an antibody, e.g., for use in minimizing risk of infection with by avian influenza comprising,

determining the ability of the agent to bind, e.g., specifically bind, to a HA having an umbrella topology glycan,

thereby evaluating the agent.

136. A device containing a blocking agent and configured to administer a dose, e.g., a metered dose, of the blocking agent, to the respiratory tract of a subject.

137. The device of claim 136, wherein the blocking agent is provided in the form of a pharmaceutical composition described herein.

138. The device of claim 136, further containing a second agent, e.g., an anti-viral agent, e.g., Oseltamivir (Tamiflu), Zanamavir (Releza), or a sialydase.

139. A kit comprising an initial unit dose and a subsequent unit dose of a binding agent, e.g., an HA polypeptide, a LSBA, an UTBA, an UTSBA, wherein the initial unit dose is greater than the subsequent unit dose or where the two doses are equal.

140. The kit of claim 139, further comprising at least one component of a delivery device, e.g., an inhaler.

141. A kit comprising at least one component of a delivery device, e.g., an inhaler and a dose of an of a binding agent.

143. The kit of claim 141 or 142, further comprising instructions for use.

142. A kit comprising a dose of an of a binding agent.

144. A pharmaceutical composition comprising a binding agent.

145. The pharmaceutical composition of claim 144, wherein the binding agent is the binding agent of claim 57.

146. The pharmaceutical composition of claim 144, wherein the binding agent is the binding agent of claim 65.

147. The pharmaceutical composition of claim 144, wherein the binding agent is the binding agent of claim 70.

148. The pharmaceutical composition of claim 144, wherein the antibody is a monoclonal, monospecific, chimeric, CDR grafted, humanized, human, cameloid, IgNAR, single chain, IgG, etc.

149. The pharmaceutical composition of claim 144, wherein said composition is suitable for inhalation.

150. The pharmaceutical composition of claim 144, wherein said composition further comprises a second agent, e.g., an anti-viral agent, e.g., Oseltamivir (Tamiflu), Zanamavir (Releza), or a sialydase.

151. The pharmaceutical composition of claim 144, wherein said composition is substantially free of an adjuvant.

152. The pharmaceutical composition of claim 144, wherein the blocking agent is an HA polypeptide and the composition is substantially free of any other HA polypeptides, e.g., other HA polypeptides which bind to HA receptor glycans other than an umbrella topology glycan.

153. The pharmaceutical composition of claim 144, wherein the blocking agent is provided in a preparation having no more than 50, 40, 30, 20, 10, 5, or 1% by number or weight, an agent which binds to HA receptor glycans other than and umbrella topology glycans.

154. The pharmaceutical composition of claim 144, wherein the blocking agent has a preselected affinity for a 2-6 glycan having an umbrella topology and a preselected affinity for 2-6 glycan having a cone topology.

155. A pharmaceutical composition comprising a first binding agent and a second binding agent.

156. A pharmaceutical compositions comprising an umbrella topology binding agent and a cone topology binding agent, e.g., a recombinant HA or fragment thereof which binds an HA receptor having a cone topology glycan, e.g., a 2-6 glycan having a cone topology.