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Reinhart GA, Harrison PC, Lincoln K, Chen H, Sun P, Hill J, Qian HS, McHugh MC, Clifford H, Ng KJ, Wang H, Fowler D, Gueneva-Boucheva K, Brenneman JB, Bosanac T, Wong D, Fryer RM, Sarko C, Boustany-Kari CM, Pullen SS. The Novel, Clinical-Stage Soluble Guanylate Cyclase Activator BI 685509 Protects from Disease Progression in Models of Renal Injury and Disease. J Pharmacol Exp Ther 2023; 384:382-392. [PMID: 36507845 DOI: 10.1124/jpet.122.001423] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 10/01/2022] [Accepted: 11/28/2022] [Indexed: 12/12/2022] Open
Abstract
Activation of soluble guanylate cyclase (sGC) to restore cyclic guanosine monophosphate (cGMP) and improve functionality of nitric oxide (NO) pathways impaired by oxidative stress is a potential treatment of diabetic and chronic kidney disease. We report the pharmacology of BI 685509, a novel, orally active small molecule sGC activator with disease-modifying potential. BI 685509 and human sGC α1/β1 heterodimer containing a reduced heme group produced concentration-dependent increases in cGMP that were elevated modestly by NO, whereas heme-free sGC and BI 685509 greatly enhanced cGMP with no effect of NO. BI 685509 increased cGMP in human and rat platelet-rich plasma treated with the heme-oxidant ODQ; respective EC50 values were 467 nM and 304 nM. In conscious telemetry-instrumented rats, BI 685509 did not affect mean arterial pressure (MAP) or heart rate (HR) at 3 and 10 mg/kg (p.o.), whereas 30 mg/kg decreased MAP and increased HR. Ten days of BI 685509 at supratherapeutic doses (60 or 100 mg/kg p.o., daily) attenuated MAP and HR responses to a single 100 mg/kg challenge. In the ZSF1 rat model, BI 685509 (1, 3, 10, and 30 mg/kg per day, daily) coadministered with enalapril (3 mg/kg per day) dose-dependently reduced proteinuria and incidence of glomerular sclerosis; MAP was modestly reduced at the higher doses versus enalapril. In the 7-day rat unilateral ureteral obstruction model, BI 685509 dose-dependently reduced tubulointerstitial fibrosis (P < 0.05 at 30 mg/kg). In conclusion, BI 685509 is a potent, orally bioavailable sGC activator with clear renal protection and antifibrotic activity in preclinical models of kidney injury and disease. SIGNIFICANCE STATEMENT: BI 685509 is a novel small soluble guanylate cyclase (sGC) molecule activator that exhibits an in vitro profile consistent with that of an sGC activator. BI 685509 reduced proteinuria and glomerulosclerosis in the ZSF1 rat, a model of diabetic kidney disease (DKD), and reduced tubulointerstitial fibrosis in a rat 7-day unilateral ureteral obstruction model. Thus, BI 685509 is a promising new therapeutic agent and is currently in phase II clinical trials for chronic kidney disease and DKD.
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Affiliation(s)
- Glenn A Reinhart
- Departments of Cardiometabolic Diseases Research (G.A.R., P.C.H., K.L., H.C., P.S., H.S.Q., M.C.M., H.C., K.J.N., H.W., D.F., R.M.F., C.M.B.-K., S.S.P.), Small Molecule Discovery Research (K.G.-B., J.B.B., T.B., D.W., C.S.), and Global Computational Biology and Data Sciences (J.H.), Boehringer Ingelheim Pharmaceuticals, Inc, Ridgefield, Connecticut
| | - Paul C Harrison
- Departments of Cardiometabolic Diseases Research (G.A.R., P.C.H., K.L., H.C., P.S., H.S.Q., M.C.M., H.C., K.J.N., H.W., D.F., R.M.F., C.M.B.-K., S.S.P.), Small Molecule Discovery Research (K.G.-B., J.B.B., T.B., D.W., C.S.), and Global Computational Biology and Data Sciences (J.H.), Boehringer Ingelheim Pharmaceuticals, Inc, Ridgefield, Connecticut
| | - Kathleen Lincoln
- Departments of Cardiometabolic Diseases Research (G.A.R., P.C.H., K.L., H.C., P.S., H.S.Q., M.C.M., H.C., K.J.N., H.W., D.F., R.M.F., C.M.B.-K., S.S.P.), Small Molecule Discovery Research (K.G.-B., J.B.B., T.B., D.W., C.S.), and Global Computational Biology and Data Sciences (J.H.), Boehringer Ingelheim Pharmaceuticals, Inc, Ridgefield, Connecticut
| | - Hongxing Chen
- Departments of Cardiometabolic Diseases Research (G.A.R., P.C.H., K.L., H.C., P.S., H.S.Q., M.C.M., H.C., K.J.N., H.W., D.F., R.M.F., C.M.B.-K., S.S.P.), Small Molecule Discovery Research (K.G.-B., J.B.B., T.B., D.W., C.S.), and Global Computational Biology and Data Sciences (J.H.), Boehringer Ingelheim Pharmaceuticals, Inc, Ridgefield, Connecticut
| | - Peng Sun
- Departments of Cardiometabolic Diseases Research (G.A.R., P.C.H., K.L., H.C., P.S., H.S.Q., M.C.M., H.C., K.J.N., H.W., D.F., R.M.F., C.M.B.-K., S.S.P.), Small Molecule Discovery Research (K.G.-B., J.B.B., T.B., D.W., C.S.), and Global Computational Biology and Data Sciences (J.H.), Boehringer Ingelheim Pharmaceuticals, Inc, Ridgefield, Connecticut
| | - Jon Hill
- Departments of Cardiometabolic Diseases Research (G.A.R., P.C.H., K.L., H.C., P.S., H.S.Q., M.C.M., H.C., K.J.N., H.W., D.F., R.M.F., C.M.B.-K., S.S.P.), Small Molecule Discovery Research (K.G.-B., J.B.B., T.B., D.W., C.S.), and Global Computational Biology and Data Sciences (J.H.), Boehringer Ingelheim Pharmaceuticals, Inc, Ridgefield, Connecticut
| | - Hu Sheng Qian
- Departments of Cardiometabolic Diseases Research (G.A.R., P.C.H., K.L., H.C., P.S., H.S.Q., M.C.M., H.C., K.J.N., H.W., D.F., R.M.F., C.M.B.-K., S.S.P.), Small Molecule Discovery Research (K.G.-B., J.B.B., T.B., D.W., C.S.), and Global Computational Biology and Data Sciences (J.H.), Boehringer Ingelheim Pharmaceuticals, Inc, Ridgefield, Connecticut
| | - Mark C McHugh
- Departments of Cardiometabolic Diseases Research (G.A.R., P.C.H., K.L., H.C., P.S., H.S.Q., M.C.M., H.C., K.J.N., H.W., D.F., R.M.F., C.M.B.-K., S.S.P.), Small Molecule Discovery Research (K.G.-B., J.B.B., T.B., D.W., C.S.), and Global Computational Biology and Data Sciences (J.H.), Boehringer Ingelheim Pharmaceuticals, Inc, Ridgefield, Connecticut
| | - Holly Clifford
- Departments of Cardiometabolic Diseases Research (G.A.R., P.C.H., K.L., H.C., P.S., H.S.Q., M.C.M., H.C., K.J.N., H.W., D.F., R.M.F., C.M.B.-K., S.S.P.), Small Molecule Discovery Research (K.G.-B., J.B.B., T.B., D.W., C.S.), and Global Computational Biology and Data Sciences (J.H.), Boehringer Ingelheim Pharmaceuticals, Inc, Ridgefield, Connecticut
| | - Khing Jow Ng
- Departments of Cardiometabolic Diseases Research (G.A.R., P.C.H., K.L., H.C., P.S., H.S.Q., M.C.M., H.C., K.J.N., H.W., D.F., R.M.F., C.M.B.-K., S.S.P.), Small Molecule Discovery Research (K.G.-B., J.B.B., T.B., D.W., C.S.), and Global Computational Biology and Data Sciences (J.H.), Boehringer Ingelheim Pharmaceuticals, Inc, Ridgefield, Connecticut
| | - Hong Wang
- Departments of Cardiometabolic Diseases Research (G.A.R., P.C.H., K.L., H.C., P.S., H.S.Q., M.C.M., H.C., K.J.N., H.W., D.F., R.M.F., C.M.B.-K., S.S.P.), Small Molecule Discovery Research (K.G.-B., J.B.B., T.B., D.W., C.S.), and Global Computational Biology and Data Sciences (J.H.), Boehringer Ingelheim Pharmaceuticals, Inc, Ridgefield, Connecticut
| | - Danielle Fowler
- Departments of Cardiometabolic Diseases Research (G.A.R., P.C.H., K.L., H.C., P.S., H.S.Q., M.C.M., H.C., K.J.N., H.W., D.F., R.M.F., C.M.B.-K., S.S.P.), Small Molecule Discovery Research (K.G.-B., J.B.B., T.B., D.W., C.S.), and Global Computational Biology and Data Sciences (J.H.), Boehringer Ingelheim Pharmaceuticals, Inc, Ridgefield, Connecticut
| | - Kristina Gueneva-Boucheva
- Departments of Cardiometabolic Diseases Research (G.A.R., P.C.H., K.L., H.C., P.S., H.S.Q., M.C.M., H.C., K.J.N., H.W., D.F., R.M.F., C.M.B.-K., S.S.P.), Small Molecule Discovery Research (K.G.-B., J.B.B., T.B., D.W., C.S.), and Global Computational Biology and Data Sciences (J.H.), Boehringer Ingelheim Pharmaceuticals, Inc, Ridgefield, Connecticut
| | - Jehrod B Brenneman
- Departments of Cardiometabolic Diseases Research (G.A.R., P.C.H., K.L., H.C., P.S., H.S.Q., M.C.M., H.C., K.J.N., H.W., D.F., R.M.F., C.M.B.-K., S.S.P.), Small Molecule Discovery Research (K.G.-B., J.B.B., T.B., D.W., C.S.), and Global Computational Biology and Data Sciences (J.H.), Boehringer Ingelheim Pharmaceuticals, Inc, Ridgefield, Connecticut
| | - Todd Bosanac
- Departments of Cardiometabolic Diseases Research (G.A.R., P.C.H., K.L., H.C., P.S., H.S.Q., M.C.M., H.C., K.J.N., H.W., D.F., R.M.F., C.M.B.-K., S.S.P.), Small Molecule Discovery Research (K.G.-B., J.B.B., T.B., D.W., C.S.), and Global Computational Biology and Data Sciences (J.H.), Boehringer Ingelheim Pharmaceuticals, Inc, Ridgefield, Connecticut
| | - Diane Wong
- Departments of Cardiometabolic Diseases Research (G.A.R., P.C.H., K.L., H.C., P.S., H.S.Q., M.C.M., H.C., K.J.N., H.W., D.F., R.M.F., C.M.B.-K., S.S.P.), Small Molecule Discovery Research (K.G.-B., J.B.B., T.B., D.W., C.S.), and Global Computational Biology and Data Sciences (J.H.), Boehringer Ingelheim Pharmaceuticals, Inc, Ridgefield, Connecticut
| | - Ryan M Fryer
- Departments of Cardiometabolic Diseases Research (G.A.R., P.C.H., K.L., H.C., P.S., H.S.Q., M.C.M., H.C., K.J.N., H.W., D.F., R.M.F., C.M.B.-K., S.S.P.), Small Molecule Discovery Research (K.G.-B., J.B.B., T.B., D.W., C.S.), and Global Computational Biology and Data Sciences (J.H.), Boehringer Ingelheim Pharmaceuticals, Inc, Ridgefield, Connecticut
| | - Chris Sarko
- Departments of Cardiometabolic Diseases Research (G.A.R., P.C.H., K.L., H.C., P.S., H.S.Q., M.C.M., H.C., K.J.N., H.W., D.F., R.M.F., C.M.B.-K., S.S.P.), Small Molecule Discovery Research (K.G.-B., J.B.B., T.B., D.W., C.S.), and Global Computational Biology and Data Sciences (J.H.), Boehringer Ingelheim Pharmaceuticals, Inc, Ridgefield, Connecticut
| | - Carine M Boustany-Kari
- Departments of Cardiometabolic Diseases Research (G.A.R., P.C.H., K.L., H.C., P.S., H.S.Q., M.C.M., H.C., K.J.N., H.W., D.F., R.M.F., C.M.B.-K., S.S.P.), Small Molecule Discovery Research (K.G.-B., J.B.B., T.B., D.W., C.S.), and Global Computational Biology and Data Sciences (J.H.), Boehringer Ingelheim Pharmaceuticals, Inc, Ridgefield, Connecticut
| | - Steven S Pullen
- Departments of Cardiometabolic Diseases Research (G.A.R., P.C.H., K.L., H.C., P.S., H.S.Q., M.C.M., H.C., K.J.N., H.W., D.F., R.M.F., C.M.B.-K., S.S.P.), Small Molecule Discovery Research (K.G.-B., J.B.B., T.B., D.W., C.S.), and Global Computational Biology and Data Sciences (J.H.), Boehringer Ingelheim Pharmaceuticals, Inc, Ridgefield, Connecticut
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