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Nirogi R, Jayarajan P, Benade V, Abraham R, Goyal VK. Hits and misses with animal models of narcolepsy and the implications for drug discovery. Expert Opin Drug Discov 2024; 19:755-768. [PMID: 38747534 DOI: 10.1080/17460441.2024.2354293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 05/08/2024] [Indexed: 05/22/2024]
Abstract
INTRODUCTION Narcolepsy is a chronic and rare neurological disorder characterized by disordered sleep. Based on animal models and further research in humans, the dysfunctional orexin system was identified as a contributing factor to the pathophysiology of narcolepsy. Animal models played a larger role in the discovery of some of the pharmacological agents with established benefit/risk profiles. AREAS COVERED In this review, the authors examine the phenotypes observed in animal models of narcolepsy and the characteristics of clinically used pharmacological agents in these animal models. Additionally, the authors compare the effects of clinically used pharmacological agents on the phenotypes in animal models with those observed in narcolepsy patients. EXPERT OPINION Research in canine and mouse models have linked narcolepsy to the O×R2mutation and orexin deficiency, leading to new diagnostic criteria and a drug development focus. Advancements in pharmacological therapies have significantly improved narcolepsy management, with insights from both clinical experience and from animal models having led to new treatments such as low sodium oxybate and solriamfetol. However, challenges persist in addressing symptoms beyond excessive daytime sleepiness and cataplexy, highlighting the need for further research, including the development of diurnal animal models to enhance understanding and treatment options for narcolepsy.
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Nirogi R, Grandhi VR, Medapati R, Ganuga N, Abraham R, Thentu JB, Palacharla VRC, Petlu S, Srirangavaram M, Subramanian R, Ravella SR, Gagginapally SR, Benade V, Jayarajan P, Mohammed AR. Usmarapride (SUVN-D4010), a 5-HT4 receptor partial agonist for the potential treatment of Alzheimer's disease: Behavioural, neurochemical and pharmacological profiling. Eur J Pharmacol 2023; 947:175625. [PMID: 36997046 DOI: 10.1016/j.ejphar.2023.175625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 02/24/2023] [Accepted: 02/24/2023] [Indexed: 03/30/2023]
Abstract
Alzheimer's disease (AD) is a progressive neurodegenerative disorder which affects cognitive functions with negative impact on day to day activities and an ultimate loss of independent living. Current standard of care (SOC) for AD, viz. donepezil, rivastigmine, galantamine, memantine etc. either alone or in combination show modest efficacy without changing the course of the disease. On prolonged treatment, side effects are more common with an eventual loss of efficacy. Aducanumab, a monoclonal antibody is a disease modifying therapeutic agent targeting the toxic amyloid beta (Aβ) proteins for its clearance. However, it is found to have only modest efficacy in AD patients and its approval by FDA is controversial. Alternate, effective and safe therapeutics are need of the hour, as AD cases are expected to be doubled by 2050. Recently, 5-HT4 receptors have been envisioned as target for alleviating AD associated cognitive impairment with potential disease modifying ability impacting disease progression. Usmarapride is a 5-HT4 receptor partial agonist, being developed for the possible treatment of AD with symptomatic and disease modifying potential. Usmarapride demonstrated promising effects in ameliorating cognitive deficits in diverse animal models of episodic, working, social, and emotional memories. Usmarapride produced elevation in cortical acetylcholine in rats. Furthermore, usmarapride increased levels of soluble amyloid precursor protein alpha, a potential mechanism to reverse toxic Aβ peptide pathology. Usmarapride also potentiated the pharmacological effects of donepezil in animal models. To conclude, usmarapride may be a promising intervention for alleviating the cognitive dysfunction in AD patients with disease modifying potential.
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Nirogi R, Jayarajan P, Shinde A, Mohammed AR, Grandhi VR, Benade V, Goyal VK, Abraham R, Jasti V, Cummings J. Progress in Investigational Agents Targeting Serotonin-6 Receptors for the Treatment of Brain Disorders. Biomolecules 2023; 13:309. [PMID: 36830678 PMCID: PMC9953539 DOI: 10.3390/biom13020309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 02/03/2023] [Accepted: 02/04/2023] [Indexed: 02/10/2023] Open
Abstract
Serotonin (5-HT) plays an important role in the regulation of several basic functions of the central and peripheral nervous system. Among the 5-HT receptors, serotonin-6 (5-HT6) receptor has been an area of substantial research. 5-HT6 receptor is a G-protein-coupled receptor mediating its effects through diverse signaling pathways. Exceptional features of the receptors fueling drug discovery efforts include unique localization and specific distribution in the brain regions having a role in learning, memory, mood, and behavior, and the affinity of several clinically used psychotropic agents. Although non-clinical data suggest that both agonist and antagonist may have similar behavioral effects, most of the agents that entered clinical evaluation were antagonists. Schizophrenia was the initial target; more recently, cognitive deficits associated with Alzheimer's disease (AD) or other neurological disorders has been the target for clinically evaluated 5-HT6 receptor antagonists. Several 5-HT6 receptor antagonists (idalopirdine, intepirdine and latrepirdine) showed efficacy in alleviating cognitive deficits associated with AD in the proof-of-concept clinical studies; however, the outcomes of the subsequent phase 3 studies were largely disappointing. The observations from both non-clinical and clinical studies suggest that 5-HT6 receptor antagonists may have a role in the management of neuropsychiatric symptoms in dementia. Masupirdine, a selective 5-HT6 receptor antagonist, reduced agitation/aggression-like behaviors in animal models, and a post hoc analysis of a phase 2 trial suggested potential beneficial effects on agitation/aggression and psychosis in AD. This agent will be assessed in additional trials, and the outcome of the trials will inform the use of 5-HT6 receptor antagonists in the treatment of agitation in dementia of the Alzheimer's type.
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Abraham R, Subramanian R, Rasheed MA, Ravella SR, Malleshwari D, Thentu JB, Nirogi R. Usmarapride Oxalate (SUVN‐D4010): A Serotonin‐4 Receptor Partial Agonist for the Treatment of Cognitive Disorders. Alzheimers Dement 2022. [DOI: 10.1002/alz.062167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Nirogi R, Jayarajan P, Abraham R, Tadiparthi J, Benade V, Shinde AK, Rasheed MA, Badange RK, Goyal VK, Palacharla VRC, Ravulu J, Jetta S, Subramanian R. Effects of Masupirdine (SUVN‐502) on Agitation/Aggression and Psychosis in Patients with Probable Alzheimer’s Disease: A Post Hoc Analysis. Alzheimers Dement 2022. [DOI: 10.1002/alz.062695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Coletta C, Brooks C, Thomas MZ, Curtis C, Abraham R. THE ROLE OF LABORATORY EVALUATION IN THE DIAGNOSIS AND MANAGEMENT OF NLRP12- ASSOCIATED AUTOINFLAMMATORY DISEASE. Ann Allergy Asthma Immunol 2022. [DOI: 10.1016/j.anai.2022.08.886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Nirogi R, Jayarajan P, Benade V, Shinde A, Goyal VK, Jetta S, Ravula J, Abraham R, Grandhi VR, Subramanian R, Pandey SK, Badange RK, Mohammed AR, Jasti V, Ballard C, Cummings J. Potential beneficial effects of masupirdine (SUVN-502) on agitation/aggression and psychosis in patients with moderate Alzheimer's disease: Exploratory post hoc analyses. Int J Geriatr Psychiatry 2022; 37:10.1002/gps.5813. [PMID: 36168659 PMCID: PMC9828442 DOI: 10.1002/gps.5813] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 09/14/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVES The effects of masupirdine on the neuropsychiatric symptoms were explored. METHODS Masupirdine (SUVN-502) was evaluated for its effects on cognition in patients with moderate AD. The prespecified primary outcome showed no drug-placebo difference. Post hoc analyses of domains of the 12-item neuropsychiatric inventory scale were carried out. RESULTS In a subgroup of patients (placebo, n = 57; masupirdine 50 mg, n = 53; masupirdine 100 mg, n = 48) with baseline agitation/aggression symptoms ≥1, a statistically significant reduction in agitation/aggression scores was observed in masupirdine 50 mg (95% confidence interval (CI), -1.9 to -0.5, p < 0.001) and masupirdine 100 mg (95% CI, -1.7 to -0.3, p = 0.007) treated arms at Week 13 in comparison to placebo and the effect was sustained for trial duration of 26 weeks in the masupirdine 50 mg treatment arm (95% CI, -2.3 to -0.8, p < 0.001). Similar observations were noted in the subgroup of patients (placebo, n = 29; masupirdine 50 mg, n = 30; masupirdine 100 mg, n = 21) with baseline agitation/aggression symptoms ≥3. In the subgroup of patients (placebo, n = 28; masupirdine 50 mg, n = 28; masupirdine 100 mg, n = 28) who had baseline psychosis symptoms and/or symptom emergence, a significant reduction in psychosis scores was observed in the masupirdine 50 mg (Week 4: 95% CI, -2.8 to -1.4, p < 0.001; Week 13: 95% CI, -3.3 to -1.3, p < 0.001) and masupirdine 100 mg (Week 4: 95% CI, -1.4 to 0, p = 0.046; Week 13: 95% CI, -1.9 to 0.1, p = 0.073) treatment arms in comparison to placebo. CONCLUSION Further research is warranted to explore the potential beneficial effects of masupirdine on NPS.
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Nirogi R, Abraham R, Jayarajan P, Goura V, Kallepalli R, Medapati RB, Tadiparthi J, Goyal VK, Pandey SK, Subramanian R, Petlu S, Thentu JB, Palacharla VRC, Gagginapally SR, Mohammed AR, Jasti V. Ropanicant (SUVN-911), an α4β2 nicotinic acetylcholine receptor antagonist intended for the treatment of depressive disorders: pharmacological, behavioral, and neurochemical characterization. Psychopharmacology (Berl) 2022; 239:2215-2232. [PMID: 35298691 DOI: 10.1007/s00213-022-06108-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 01/16/2022] [Indexed: 11/26/2022]
Abstract
RATIONALE Ropanicant (SUVN-911) (3-(6-Chloropyridine-3-yloxymethyl)-2-azabicyclo (3.1.0) hexane hydrochloride) is a novel α4β2 nicotinic acetylcholine receptor (nAChR) antagonist being developed for the treatment of depressive disorders. OBJECTIVES Pharmacological and neurochemical characterization of Ropanicant to support a potential molecule for the treatment of depressive disorders. METHODS Ropanicant was assessed for antidepressant-like activity using the rat forced swimming test (FST) and differential reinforcement of low rate -72 s (DRL-72 s). Alleviation of anhedonia was assessed in chronic mild stress model using sucrose preference test. To understand the mechanism of action, serotonin levels, ionized calcium-binding adaptor molecule 1 (Iba1), and brain-derived neurotrophic factor (BDNF) were determined. The onset of antidepressant-like activity was determined using the reduction in submissive behavior assay. The effects on cognition and sexual functions were assessed using the object recognition task and sexual dysfunction assay respectively. Interaction of Ropanicant, TC-5214, and methyllycaconitine (MLA) with citalopram was investigated individually in mice FST. RESULTS Ropanicant exhibited antidepressant like properties in the FST and DRL-72 s. A significant reduction in anhedonia was observed in the sucrose preference test. Oral administration of Ropanicant produced a significant increase in serotonin and BDNF levels, with a reduction in the Iba1 activity. The onset of antidepressant like effect with Ropanicant was within a week of treatment, and was devoid of cognitive dulling and sexual dysfunction. While Ropanicant potentiated the effect of citalopram in FST, such an effect was not observed with MLA or TC-5214. CONCLUSIONS Preclinical studies with Ropanicant support the likelihood of its therapeutic utility in the treatment of depressive disorders.
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Abraham R, Davis R, Lewandowski R, Liu D, Gordon A, Collins Z, Westcott M, Nutting C, Karnia J, Kim D, Gregoire M, Verma A, Dobrowski D, Bryan J. Abstract No. 310 Novel radiopaque Y-90 glass microspheres (Eye90 microspheres) for canine hepatocellular carcinoma: correlation of microsphere radiopacity with TOF PET radioactivity and mRECIST and pathologic tumor response determination. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Benade V, Abraham R, Palacharla RC, Thentu JB, Petlu S, Mekala VR, Pandey SK, Badange RK, Bojja K, Reballi V, Achanta PK, Choudakari PK, Nirogi R. 0265 Samelisant (SUVN-G3031), a Histamine H3 Receptor Inverse Agonist in Animal Models of Narcolepsy. Sleep 2022. [DOI: 10.1093/sleep/zsac079.263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Samelisant (SUVN-G3031) is a potent and selective H3 receptor (H3R) inverse agonist with hKi of 8.7 nM. It lacks measurable affinity against 70 other targets which includes GPCRs, ion channels, transporters, enzymes, peptides, steroids, second messengers, growth factors and prostaglandins. Samelisant exhibited desired pharmacokinetic properties and favorable brain penetration in preclinical species. Samelisant blocked R-α-methylhistamine induced dipsogenia in rats and increased tele-methylhistamine levels in brain and cerebrospinal fluid as well. Samelisant is currently being evaluated in a Phase-2 study as monotherapy for the treatment of excessive daytime sleepiness (EDS) in patients with narcolepsy with and without cataplexy (ClinicalTrials.gov Identifier: NCT04072380).
Methods
In brain microdialysis, samelisant was evaluated for its effects on modulation of neurotransmitters like histamine and norepinephrine in prefrontal cortex. In male orexin knockout mice, electroencephalography (EEG), electromyography and activity were monitored using telemetric device. Effects of samelisant on sleep/ wake profile and cataplexy episodes were evaluated during active period of animals. Animals were allowed three weeks of recovery from surgery prior to EEG recording.
Results
Samelisant significantly increased histamine, dopamine and norepinephrine levels in the prefrontal cortex. Samelisant did not change dopamine levels in the striatal and accumbal. These suggest that samelisant may not have propensity to induce abuse liability. Samelisant produced a significant increase in wakefulness with concomitant decrease in non-rapid eye movement sleep in orexin knockout mice. It also significantly decreased number of cataplectic episodes in orexin knockout mice.
Conclusion
The results from non-clinical studies presented here provide a strong evidence for the potential utility of samelisant for the treatment of EDS and cataplexy in patients with narcolepsy.
Support (If Any)
None
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Abraham R, Subramanian R, Grandhi VR, Muddana N, Kamuju V, Badange RK, Reballi V, Nirogi R. SUVN‐I6107: Efficacy and safety assessments of a true muscarinic M1‐positive allosteric modulator for the treatment of dementia. Alzheimers Dement 2021. [DOI: 10.1002/alz.051652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Riley D, Abraham R, Alaklabi S, Devitt M, Hall R, Horton B, Gentzler R. P40.04 CNS Adverse Events and Survival in Patients with NSCLC Brain Metastases Treated With Concurrent Radiation and Immunotherapy. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Janzen I, Abraham R, Seyyedi S, Ho C, Melosky B, Martin M, Lam S, Yuan R, Macaulay C. P57.04 Predicting Treatment Response to 1st- line Pembrolizumab in Advanced Non-Small Cell Lung Cancer (NSCLC) Patients with High PDL1 Expression. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Nirogi R, Mohammed AR, Shinde AK, Gagginapally SR, Kancharla DM, Ravella SR, Bogaraju N, Middekadi VR, Subramanian R, Palacharla RC, Benade V, Muddana N, Abraham R, Medapati RB, Thentu JB, Mekala VR, Petlu S, Lingavarapu BB, Yarra S, Kagita N, Goyal VK, Pandey SK, Jasti V. Discovery and Preclinical Characterization of Usmarapride (SUVN-D4010): A Potent, Selective 5-HT 4 Receptor Partial Agonist for the Treatment of Cognitive Deficits Associated with Alzheimer's Disease. J Med Chem 2021; 64:10641-10665. [PMID: 34251799 DOI: 10.1021/acs.jmedchem.1c00703] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
A series of oxadiazole derivatives were synthesized and evaluated as 5-hydroxytryptamine-4 receptor (5-HT4R) partial agonists for the treatment of cognitive deficits associated with Alzheimer's disease. Starting from a reported 5-HT4R antagonist, a systematic structure-activity relationship was conducted, which led to the discovery of potent and selective 5-HT4R partial agonist 1-isopropyl-3-{5-[1-(3-methoxypropyl) piperidin-4-yl]-[1,3,4]oxadiazol-2-yl}-1H-indazole oxalate (Usmarapride, 12l). It showed balanced physicochemical-pharmacokinetic properties with robust nonclinical efficacy in cognition models. It also showed disease-modifying potential, as it increased neuroprotective soluble amyloid precursor protein alpha levels, and dose-dependent target engagement and correlation of efficacy with oral exposures. Phase 1 clinical studies have been completed and projected efficacious concentration was achieved without any major safety concerns. Phase 2 enabling long-term safety studies have been completed with no concerns for further development.
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Nirogi R, Grandhi VR, Medapati RB, Ganuga N, Benade V, Gandipudi S, Manoharan A, Abraham R, Jayarajan P, Bhyrapuneni G, Shinde A, Badange RK, Subramanian R, Petlu S, Jasti V. Histamine 3 receptor inverse agonist Samelisant (SUVN-G3031): Pharmacological characterization of an investigational agent for the treatment of cognitive disorders. J Psychopharmacol 2021; 35:713-729. [PMID: 33546570 DOI: 10.1177/0269881120986418] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Central histamine H3 receptors are a family of presynaptic auto and heteroreceptors. Blockade of the presynaptic H3 receptors activates the downstream pathway(s) involved in the processes of learning and memory, making it a potential therapeutic option for ameliorating cognitive dysfunction. Samelisant (SUVN-G3031) is a potent and selective inverse agonist at the H3 receptors. AIM The aim of this research is to study the effects of Samelisant in diverse animal models of cognitive functions. METHODS The effects of Samelisant on cognitive functions were studied using social recognition, object recognition and Morris water maze tasks. Neurochemical and electrophysiological effects of Samelisant were monitored using microdialysis and electroencephalography techniques. RESULTS Samelisant showed procognitive effects in diverse animal models of cognition at doses ranging from 0.3 to 3 mg/kg, per os (p.o.) (social recognition and object recognition task). Samelisant significantly increased the brain acetylcholine levels in the cortex at doses of 10 and 20 mg/kg, p.o. In the Morris water maze task, combined administration of suboptimal doses of Samelisant and donepezil resulted in procognitive effects significantly larger than the either treatment. Similarly, Samelisant significantly potentiated the effects of donepezil on pharmacodynamic biomarkers of cognition i.e. acetylcholine levels in brain and neuronal theta oscillations. CONCLUSION Samelisant may have potential utility in the treatment of cognitive deficits associated with hypocholinergic state.
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Shinde A, Subramanian R, Palacharla R, Benade V, Abraham R, Kamuju V, Pandey S, Badange R, Achanta PK, Nirogi R. 004 Samelisant (SUVN-G3031), Differentiating features over current treatments of narcolepsy. Sleep 2021. [DOI: 10.1093/sleep/zsab072.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Majority of pharmacological agents used in the treatment of narcolepsy have several limitations. Both nonclinical and clinical evidences suggest usefulness of the histamine H3 receptor (H3R) inverse agonists for the treatment of narcolepsy addressing several of the current limitations.
Methods
Extensive nonclinical studies were carried out for Samelisant (SUVN-G3031) and other pharmacological agents that are currently being used for the treatment of narcolepsy. The nonclinical parameters like inter-species binding affinity, selectivity profile, in vivo and in vitro ADME features, nonclinical efficacy, neurochemistry and safety were compared.
Results
Samelisant has no inter-species variation in binding affinity at H3R with less than 50% inhibition at 1 µM against 70 other targets. Unlike pitolisant, Samelisant has no significant binding affinity at sigma 1 and 2 receptor. Samelisant has no inhibition and induction liability towards major CYP enzymes and transporters. Pitolisant is reported to be a CYP3A4, CYP2B6, and CYP1A2 inducer and a CYP2D6 and OCT1 inhibitor. Samelisant has robust wake promoting effects. Samelisant showed negligible affinity towards hERG channel with IC50 > 10 µM and had no effects on heart rate or ECG parameters in dog telemetry study. Samelisant did not show convulsion in rats up to the tested dose of 100 mg/kg, p.o. Most of the pharmacological agents used for the treatment of narcolepsy have abuse liability; Samelisant produced no change in the striatal and accumbal dopamine levels in rats suggesting no propensity to induce abuse liability. Unlike competing H3R inverse agonists, Samelisant has no effects on fertility and embryo-fetal development up to the highest tested doses.
Conclusion
Nonclinical studies demonstrated superiority of Samelisant over pharmacological agents used in the treatment of narcolepsy. Samelisant is currently being evaluated in a Phase 2 study as monotherapy for the treatment of narcolepsy with and without cataplexy (ClinicalTrials.gov Identifier: NCT04072380).
Support (if any):
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Cheung B, Levy C, Cheung M, Dhanaraja A, Abraham R, Duvoor C. Acute suppurative thyroiditis seeded from infective endocarditis and intravenous drug use. IDCases 2021; 25:e01221. [PMID: 34295645 PMCID: PMC8282969 DOI: 10.1016/j.idcr.2021.e01221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 07/06/2021] [Accepted: 07/06/2021] [Indexed: 11/30/2022] Open
Abstract
AST is a rare infection of the thyroid gland and usually requires empiric antimicrobial therapy. Patients with AST can present with euthyroidism, hypothyroidism, or hyperthyroidism. Antithyroid drugs are not indicated in patients with AST.
Acute suppurative thyroiditis (AST) is a rare infection of the thyroid gland, and most patients are euthyroid upon presentation. We present an interesting case of a 42-year-old man with a history of intravenous drug use (IVDU) and poorly controlled type 2 diabetes mellitus who was admitted for sepsis and thyrotoxicosis from infective endocarditis (IE), AST, prostate abscess, and pyelonephritis. He suffered from a cerebral vascular accident (CVA) from septic embolic showering. Thyroid-stimulating hormone (TSH) was <0.10 mIU/L, and free thyroxine (T4) levels were>90 pmol/L. Methicillin-resistant Staphylococcus aureus (MRSA) was cultured in the patient’s blood and urine. He was treated with prompt intravenous (IV) antimicrobials and source control from a transurethral resection of the prostate. This case demonstrates that AST can be a potential complication of IE and IVDU.
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Abraham R, Goura V, Grandhi VR, Tadiparthi J, Ganuga N, Medapati RB, Muddana NR, Palacharla VRC, Bhyrapuneni G, Bojja K, Mekala VR, Srirangavaram M, Badange RK, Reballi V, Goyal VK, Pandey SK, Jayarajan P, Nirogi R. SUVN‐I6107: A novel muscarinic M1 receptor‐positive allosteric modulator (M1‐PAM) for the treatment of cognitive deficits. Alzheimers Dement 2020. [DOI: 10.1002/alz.039288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Nirogi R, Jayarajan P, Shinde AK, Abraham R, Goyal VK, Benade V, Ravulu J, Jasti V. Masupirdine (SUVN‐502): Novel treatment option for the management of behavioral and psychological symptoms in patients with Alzheimer’s disease. Alzheimers Dement 2020. [DOI: 10.1002/alz.039303] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Kraft M, Kahwash B, Mustillo P, Abu-Arja R, Abraham R, Scherzer R. M234 FEBRILE NEUTROPENIA, LYMPHOPENIA, AND FAILURE-TO-THRIVE IN A PREVIOUSLY HEALTHY 9 MONTH-OLD. Ann Allergy Asthma Immunol 2020. [DOI: 10.1016/j.anai.2020.08.262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Jayarajan P, Subramanian R, Kamuju V, Muddana N, Palacharla R, Mekala V, Abraham R, Reballi V, Achanta P, Nirogi R. 0072 Preclinical Characterization of SUVN-G3031, a Histamine H3 Receptor Inverse Agonist for the Treatment of Narcolepsy. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Narcolepsy is a chronic sleep disorder characterized by overwhelming daytime drowsiness, sudden attacks of sleep and sometimes accompanied by cataplexy. Although the orexin deficiency is considered to be the primary cause of this disorder, lot of attention has been focused recently on targeting histaminergic neurotransmission by blockade of histamine H3 receptor (H3R). SUVN-G3031 is one of the potent and selective H3R inverse agonist currently being evaluated in a Phase 2 study as monotherapy for the treatment of narcolepsy with and without cataplexy (ClinicalTrials.gov Identifier: NCT04072380).
Methods
Binding of SUVN-G3031 in human and rat histamine H3R was evaluated in in vitro radioligand binding assay and functionality was assessed in GTPγS assay. Pharmacokinetic properties were evaluated after oral administration in rat and dog. Neurotransmitters like histamine, dopamine and norepinephrine were estimated in rat cortex using microdialysis.
Results
SUVN-G3031 is an inverse agonist at histamine H3R with hKi of 8.7 nM and showed minimal binding against over 70 target sites. SUVN-G3031 exhibited desired pharmacokinetic properties in rat and dog with excellent brain penetration in rats. SUVN-G3031 produced significant increase in histamine, dopamine and norepinephrine levels in cortex. SUVN-G3031 produced no change in the striatal and accumbal dopamine levels in rats, suggesting no propensity to induce abuse liability. SUVN-G3031 blocked R-α-methylhistamine induced water intake and produced dose dependent increase in tele-methylhistamine levels in various brain regions and in cerebrospinal fluid of male Wistar rats.
Conclusion
SUVN-G3031 is an inverse agonist at histamine H3 receptor and results from the preclinical studies presented here provide a strong evidence for the potential utility of SUVN-G3031 in the treatment of narcolepsy with and without cataplexy.
Support
None
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22
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Nirogi R, Mohammed AR, Shinde AK, Ravella SR, Bogaraju N, Subramanian R, Mekala VR, Palacharla RC, Muddana N, Thentu JB, Bhyrapuneni G, Abraham R, Jasti V. Discovery and Development of 3-(6-Chloropyridine-3-yloxymethyl)-2-azabicyclo[3.1.0]hexane Hydrochloride (SUVN-911): A Novel, Potent, Selective, and Orally Active Neuronal Nicotinic Acetylcholine α4β2 Receptor Antagonist for the Treatment of Depression. J Med Chem 2020; 63:2833-2853. [PMID: 32026697 DOI: 10.1021/acs.jmedchem.9b00790] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
A series of chemical optimizations guided by in vitro affinity at the α4β2 receptor in combination with selectivity against the α3β4 receptor, pharmacokinetic evaluation, and in vivo efficacy in a forced swim test resulted in identification of 3-(6-chloropyridine-3-yloxymethyl)-2-azabicyclo[3.1.0]hexane hydrochloride (9h, SUVN-911) as a clinical candidate. Compound 9h is a potent α4β2 receptor ligand with a Ki value of 1.5 nM. It showed >10 μM binding affinity toward the ganglionic α3β4 receptor apart from showing selectivity over 70 other targets. It is orally bioavailable and showed good brain penetration in rats. Marked antidepressant activity and dose-dependent receptor occupancy in rats support its potential therapeutic utility in the treatment of depression. It does not affect the locomotor activity at doses several folds higher than its efficacy dose. It is devoid of cardiovascular and gastrointestinal side effects. Successful long-term safety studies in animals and phase-1 evaluation in healthy humans for safety, tolerability, and pharmacokinetics paved the way for its further development.
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Bhayrapuneni G, Kamuju V, Gandipudi S, Jayarajan P, Abraham R, Bojja K, Pandey S, Mekala V, Nirogi R. SUVN-G3031, A histamine H3 receptor inverse agonist for the treatment of narcolepsy with or without cataplexy: a preclinical characterization. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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24
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Nirogi R, Bhyrapuneni G, Abraham R, Subramanian R, Goyal V, Pandey S, Badange R, Shinde A. SUVN-G3031, a potent and selective histamine H3 receptor inverse agonist for the treatment of narcolepsy with or without cataplexy – Differentiating factors with competitor clinical candidates. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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25
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Flores C, Wildes T, Dean BD, Moore G, Drake J, Abraham R, Gil J, Yegorov O, Yang C, Dean J, Moneypenny C, Shin D, Pham C, Krauser J, King J, Grant G, Driscoll T, Kurtzberg J, McLendon R, Gururangan S, Mitchell D. Massive clonal expansion of medulloblastoma-specific T cells during adoptive cellular therapy. SCIENCE ADVANCES 2019; 5:eaav9879. [PMID: 31807694 PMCID: PMC6881165 DOI: 10.1126/sciadv.aav9879] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 09/17/2019] [Indexed: 05/04/2023]
Abstract
In both human and murine systems, we have developed an adoptive cellular therapy platform against medulloblastoma and glioblastoma that uses dendritic cells pulsed with a tumor RNA transcriptome to expand polyclonal tumor-reactive T cells against a plurality of antigens within heterogeneous brain tumors. We demonstrate that peripheral TCR Vβ repertoire analysis after adoptive cellular therapy reveals that effective response to adoptive cellular therapy is concordant with massive in vivo expansion and persistence of tumor-specific T cell clones within the peripheral blood. In preclinical models of medulloblastoma and glioblastoma, and in a patient with relapsed medulloblastoma receiving adoptive cellular therapy, an early and massive expansion of tumor-reactive lymphocytes, coupled with prolonged persistence in the peripheral blood, is observed during effective therapeutic response to immunotherapy treatment.
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