Nangibotide is an inhibitor of TREM-1, a receptor found on certain white blood cells. Activation of TREM-1 stimulates inflammation. Nangibotide is therefore being investigated as a treatment for the overwhelming inflammation typically seen in severe sepsis.
Clinical data | |
---|---|
Routes of administration | Intravenous; intraperitoneal |
Physiological data | |
Receptors | TREM-1 |
Metabolism | Enzymatic in bloodstream |
Pharmacokinetic data | |
Metabolism | Enzymatic in bloodstream |
Elimination half-life | 3 minutes |
Identifiers | |
| |
CAS Number | |
ChemSpider | |
UNII | |
ChEMBL | |
Chemical and physical data | |
Formula | C54H82N14O22S2 |
Molar mass | 1343.439 |
3D model (JSmol) | |
| |
|
Chemistry
editNangibotide is a 12-amino-acid polypeptide derived from TLT-1.[1]
Mode of action
editTREM-1 is a receptor found on neutrophils, macrophages and monocytes, key elements of the immune system. Activation of TREM-1 results in expression of NF-κB, which promotes systemic inflammation. Nangibotide inhibits TREM-1, thereby preventing the inflammatory activation. Absence of TREM-1 results in vastly reduced inflammation without impairing the ability to fight infection.[2]
Animal models
editLR17, a mouse equivalent of nangibotide, improves survival in mouse models of severe sepsis.[3] In a pig model of sepsis, LR12 - another animal equivalent of nangibotide - resulted in significantly improved haemodynamics and less organ failure.[4] In monkeys, LR12 also reduced the inflammatory and hypotensive effects of sepsis.[5]
Human studies
editNangibotide has demonstrated safety in Phase 1 (healthy volunteers)[6] and Phase 2 (sick patients with septic shock)[7] studies. The ASTONISH trial will examine clinical efficacy in 450 patients with septic shock.[8]
References
edit- ^ Cuvier V, Lorch U, Witte S, Olivier A, Gibot S, Delor I, Garaud JJ, Derive M, Salcedo-Magguilli M (2018). "A first-in-man safety and pharmacokinetics study of nangibotide, a new modulator of innate immune response through TREM-1 receptor inhibition". British Journal of Clinical Pharmacology. 84 (10): 2270–2279. doi:10.1111/bcp.13668. PMC 6138490. PMID 29885068.
- ^ Weber B, Schuster S, Zysset D, Rihs S, Dickgreber N, Schürch C, Riether C, Siegrist M, Schneider C, Pawelski H, Gurzeler U, Ziltener P, Genitsch V, Tacchini-Cottier F, Ochsenbein A, Hofstetter W, Kopf M, Kaufmann T, Oxenius A, Reith W, Saurer L, Mueller C (2014). "TREM-1 deficiency can attenuate disease severity without affecting pathogen clearance". PLOS Pathog. 10 (1): e1003900. doi:10.1371/journal.ppat.1003900. PMC 3894224. PMID 24453980.
- ^ Derive M, Bouazza Y, Sennoun N, Marchionni S, Quigley L, Washington V, Massin F, Max JP, Ford J, Alauzet C, Levy B, McVicar DW, Gibot S (1 June 2012). "Soluble TREM-like transcript-1 regulates leukocyte activation and controls microbial sepsis". Journal of Immunology. 188 (11): 5585–5592. doi:10.4049/jimmunol.1102674. PMC 6382278. PMID 22551551.
- ^ Derive M, Boufenzer A, Bouazza Y, Groubatch F, Alauzet C, Barraud D, Lozniewski A, Leroy P, Tran N, Gibot S (Feb 2013). "Effects of a TREM-like transcript 1-derived peptide during hypodynamic septic shock in pigs". Shock. 39 (2): 176–182. doi:10.1097/SHK.0b013e31827bcdfb. PMID 23324887. S2CID 23583753.
- ^ Derive M, Boufenzer A, Gibot S (April 2014). "Attenuation of responses to endotoxin by the triggering receptor expressed on myeloid cells-1 inhibitor LR12 in nonhuman primate". Anesthesiology. 120 (4): 935–942. doi:10.1097/ALN.0000000000000078. PMID 24270127. S2CID 10347527.
- ^ Cuvier V, Lorch U, Witte S, Olivier A, Gibot S, Delor I, Garaud JJ, Derive M, Salcedo-Magguilli M (2018). "A first-in-man safety and pharmacokinetics study of nangibotide, a new modulator of innate immune response through TREM-1 receptor inhibition". Br J Clin Pharmacol. 84 (10): 2270–2279. doi:10.1111/bcp.13668. PMC 6138490. PMID 29885068.
- ^ François B, Wittebole X, Ferrer R, Mira JP, Dugernier T, Gibot S, Derive M, Olivier A, Cuvier V, Witte S, Pickkers P, Vandenhende F, Garaud JJ, Sánchez M, Salcedo-Magguilli M, Laterre PF (July 2020). "Nangibotide in patients with septic shock: a Phase 2a randomized controlled clinical trial". Intensive Care Medicine. 46 (7): 1425–1437. doi:10.1007/s00134-020-06109-z. PMID 32468087. S2CID 218912723.
- ^ "Efficacy, Safety and Tolerability of Nangibotide in Patients With Septic Shock (ASTONISH)". ClinicalTrials.gov. US National Library of Medicine. Retrieved 13 July 2020.