1
|
Zhu H, Hua H, Dong Y, Zhang J, Xu H, Ge X, Lu Q, Feng J. Long-Term Strategies for Poorly Water-Soluble Peptides: Combining Fatty Acid Modification with PAS Fusion. Bioconjug Chem 2023; 34:2366-2374. [PMID: 38037956 DOI: 10.1021/acs.bioconjchem.3c00464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
Bulevirtide, an entry inhibitor for the hepatitis B virus (HBV) and hepatitis D virus (HDV), is currently available on the European market. However, its clinical application is constrained by its short half-life and poor water solubility, rendering it unsuitable for fatty acid modification, aimed at achieving long-term effects. To address this limitation, we integrated a polypeptide chain consisting of Pro, Ala, and Ser at the C-terminus, which increased its hydrophilicity. To obtain the fusion sequence of A1 and A2, encompassing amino acids 1-47 of Bulevirtide and PAS, we used Escherichia coli fermentation expression. Subsequently, the N-terminal myristoyl groups of A1 and A2 were modified to yield Myr-A1 and Myr-A2, respectively. Five fatty acid moieties with the same hydrophilic spacers and different fatty acids were conjugated to analogs, generating 10 bioconjugations. The bioconjugates were then evaluated for their anti-HBV activity. Among them, HB-10 was selected for pharmacokinetic analysis and demonstrated a significantly prolonged half-life, with 5.88- and 13.18-fold increases in beagle dogs and rats, respectively. Additionally, higher drug doses resulted in substantially elevated liver concentrations. In conclusion, via fatty acid incorporation and PASylation, we successfully developed a novel Bulevirtide bioconjugate, HB-10, that exhibits an extended action duration. This compound holds substantial promise as a prospective long-acting entry inhibitor, warranting further investigation.
Collapse
Affiliation(s)
- Hongxiang Zhu
- China State Institute of Pharmaceutical Industry, Shanghai 201203, China
| | - Haoju Hua
- China State Institute of Pharmaceutical Industry, Shanghai 201203, China
- Shanghai Duomirui Biotechnology Co. Ltd., Shanghai 201203, China
| | - Yanzhen Dong
- China State Institute of Pharmaceutical Industry, Shanghai 201203, China
- Shanghai Duomirui Biotechnology Co. Ltd., Shanghai 201203, China
| | - Jinhua Zhang
- China State Institute of Pharmaceutical Industry, Shanghai 201203, China
| | - Hongjiang Xu
- Chia tai Tianqing Pharmaceutical Group Co. Ltd., Nanjing 211100, China
| | - Xingfeng Ge
- Chia tai Tianqing Pharmaceutical Group Co. Ltd., Nanjing 211100, China
| | - Qin Lu
- Chia tai Tianqing Pharmaceutical Group Co. Ltd., Nanjing 211100, China
| | - Jun Feng
- China State Institute of Pharmaceutical Industry, Shanghai 201203, China
| |
Collapse
|
2
|
Lazarus JV, Al-Rifai A, Sanai FM, Alghamdi AS, Sharara AI, Saad MF, van Selm L, Alqahtani SA. Hepatitis delta virus infection prevalence, diagnosis and treatment in the Middle East: A scoping review. Liver Int 2023; 43 Suppl 1:116-123. [PMID: 35689428 DOI: 10.1111/liv.15338] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 05/27/2022] [Accepted: 06/08/2022] [Indexed: 01/03/2023]
Abstract
Hepatitis D virus (HDV) infection is a global public health concern, especially because of its unique existence in the presence of hepatitis B virus infection. HDV infection is estimated to affect 12 million people globally. Having a clearer understanding of its prevalence in all regions of the world is essential for helping direct preventive and early interventional treatment. This mini-review assessed the literature over the last 10 years to determine the prevalence, diagnostic means and treatment guidelines available for HDV in the Middle East. The search found limited data available in 21 articles, of which 18 were studies focused on Iran. Prevalence rates ranged dramatically among the countries, and none of the 12 countries included in the search had specific HDV guidelines. This review highlights the urgent need for more precise data for the Middle East region to help establish early diagnosis and treatment options for HDV.
Collapse
Affiliation(s)
- Jeffrey V Lazarus
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
- Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | - Ahmad Al-Rifai
- Department of Gastroenterology and Hepatology, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | - Faisal M Sanai
- Gastroenterology Unit, Department of Medicine, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Abdullah Saeed Alghamdi
- Gastroenterology Unit, Department of Medicine, King Fahad General Hospital, Jeddah, Saudi Arabia
| | - Ala I Sharara
- Division of Gastroenterology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Motaz Fathy Saad
- Department of Gastroenterology and Hepatology, Mubarak Al-Kabier Hospital, Jabriya, Kuwait
| | - Lena van Selm
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Saleh A Alqahtani
- Liver Transplant Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
- Division of Gastroenterology & Hepatology, Johns Hopkins University, Baltimore, Maryland, USA
| |
Collapse
|
3
|
Lotto M, Fontaine H, Marcellin F, Périères L, Bureau-Stoltmann M, Carrat F, Pol S, Zoulim F, Carrieri P. Hepatitis Delta virus in migrants: The challenge of elimination (ANRS CO22 HEPATHER cohort). Liver Int 2022; 42:249-252. [PMID: 34825765 DOI: 10.1111/liv.15106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 11/17/2021] [Accepted: 11/18/2021] [Indexed: 02/13/2023]
Abstract
Novel treatments for hepatitis Delta virus (HDV) infection provide promising opportunities to treat patients with hepatitis B virus (HBV) and HDV co-infection. However, current clinical trials on HDV treatment rarely explore patients' barriers to treatments. In Europe, HDV infection mostly affects young migrants from HDV-endemic areas who experience early liver-related mortality. Migrants are more likely to face multiple situations of statutory and socioeconomic insecurity and structural barriers than non-migrants. These obstacles may impact their quality of life and can (i) lead them to give secondary importance to certain HDV care options, (ii) delay treatment initiation and (iii) affect their adherence and commitment to care. Preliminary results from the ANRS CO22 HEPATHER cohort show that the majority (61.6%) of HBV-HDV co-infected migrants live in poverty. Moreover, half were diagnosed and a quarter of those who initiated HBV treatment had been in France for no more than two years, a period when language skills are often still poor and when knowledge of the health and administrative system may be lacking. We advocate for increased social science research, in particular qualitative studies, to investigate the effects that multiple forms of precarity (weak access to social rights, language barriers, housing insecurity, unexpected expenditures and other difficulties) may have on HDV screening opportunities, follow-up, and treatment pathways in migrants. This will help adapt communication and care around viral hepatitis, as well as inform and orient medical services and public health actors about the difficulties that migrants encounter.
Collapse
Affiliation(s)
- Marta Lotto
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | - Hélène Fontaine
- Département d'Hépatologie, AP-HP, Hôpital Cochin, Paris, France.,INSERM U1223, Institut Pasteur, Université Paris Descartes, Paris, France
| | - Fabienne Marcellin
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | - Lauren Périères
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | - Morgane Bureau-Stoltmann
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | - Fabrice Carrat
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France.,Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint-Antoine, Unité de Santé Publique, Paris, France
| | - Stanislas Pol
- Département d'Hépatologie, INSERM U1223, Université de Paris, AP-HP, Hôpital Cochin, Institut Pasteur, Paris, France
| | - Fabien Zoulim
- Département d'hépatologie, Université de Lyon, Hospices Civils de Lyon, INSERM U1052, Lyon, France
| | - Patrizia Carrieri
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
| |
Collapse
|
5
|
Bogomolov PO, Ivashkin VT, Bueverov AO, Maev IV, Sagalova OI, Sleptsova SS, Yushuk ND, Gusev DA, Zhdanov KV, Chulanov VP. Efficacy and safety of bulevirtide in patients with chronic hepatitis D and compensated cirrhosis. TERAPEVT ARKH 2021; 93:1290-1299. [DOI: 10.26442/00403660.2021.11.201163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 01/26/2022] [Indexed: 11/22/2022]
Abstract
Aim. To study the efficacy and safety of bulevirtide, the HBV and HDV entry inhibitor.
Materials and methods. Analysis of the results of using bulevirtide in randomized controlled open-label comparative studies MYR202 and MYR203 in 56 patients with chronic hepatitis D and compensated cirrhosis, in monotherapy and combination with pegylated interferon alpha-2a (PEG-IFN).
Results. Monotherapy with bulevirtide for 24 weeks in the MYR202 study in 46 patients with compensated liver cirrhosis demonstrated: 1) a high rate of virological (100%) and biochemical response (alanine aminotransferase normalization rate 45.7%), 2) superiority of bulevirtide in efficacy over the control group (tenofovir), 3) comparability of treatment efficacy in patients with and without cirrhosis, 4) no progression of liver fibrosis with elastometry in most patients.
Treatment with bulevirtide in monotherapy and combination with PEG-IFN for 48 weeks in 10 patients with compensated liver cirrhosis in the MYR203 study was accompanied by a high rate of virological response (80%) and normalization of alanine aminotransferase (70%).
Bulevirtide was well tolerated, there was no deterioration in tolerability compared with patients without cirrhosis, there were no serious adverse events and cases of treatment cancellation due to adverse events.
Conclusion. Bulevirtide is recommended as the first line of treatment for chronic hepatitis D in patients with compensated cirrhosis in monotherapy and combination with PEG-IFN.
Collapse
|
6
|
Soriano V, Mendoza CD, Barreiro P, Treviño A, Corral O. Envisioning a hepatitis delta cure with new antivirals. Future Microbiol 2021; 16:927-930. [PMID: 34406066 DOI: 10.2217/fmb-2021-0177] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
| | - Carmen de Mendoza
- Puerta de Hierro Research Institute & University Hospital, Majadahonda, Madrid, Spain
| | | | - Ana Treviño
- UNIR Health Sciences School & Medical Center, Madrid, Spain
| | - Octavio Corral
- UNIR Health Sciences School & Medical Center, Madrid, Spain
| |
Collapse
|