1
|
Zheng L, Aimaiti Z, Long L, Xia C, Wang W, Zhou ZZ. Discovery of 4-Ethoxy-6-chloro-5-azaindazoles as Novel PDE4 Inhibitors for the Treatment of Alcohol Use Disorder and Alcoholic Liver Diseases. J Med Chem 2024; 67:728-753. [PMID: 38156615 DOI: 10.1021/acs.jmedchem.3c02087] [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: 01/03/2024]
Abstract
Alcohol use disorder (AUD) results in numerous disabilities and approximately 3 million deaths annually, caused mainly by alcoholic liver disease (ALD). Phosphodiesterase IV (PDE4) has emerged as an attractive molecular target for a new treatment for AUD and ALD. In this study, we describe the identification of 5-azaindazole analogues as PDE4 inhibitors against AUD and ALD. System optimization studies led to the discovery of ZL40 (IC50 = 37.4 nM) with a remarkable oral bioavailability (F = 94%), satisfactory safety, and a lower emetogenic potency than the approved PDE4 inhibitors roflumilast and apremilast. Encouragingly, ZL40 exhibited AUD therapeutic effects by decreasing alcohol intake and improving acute alcohol-induced sedation and motor impairment. Meanwhile, ZL40 displayed the potential to alleviate alcoholic liver injury and attenuate inflammation in the NIAAA mice model. These results showed that ZL40 is a promising compound for future drug development to treat alcohol-related diseases.
Collapse
Affiliation(s)
- Lei Zheng
- Innovation Program of Drug Research on Neurological and Metabolic Diseases, Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
| | - Zulihuma Aimaiti
- Innovation Program of Drug Research on Neurological and Metabolic Diseases, Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
| | - Lu Long
- Innovation Program of Drug Research on Neurological and Metabolic Diseases, Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
| | - Chuang Xia
- Innovation Program of Drug Research on Neurological and Metabolic Diseases, Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
| | - Wenya Wang
- Innovation Program of Drug Research on Neurological and Metabolic Diseases, Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
| | - Zhong-Zhen Zhou
- Innovation Program of Drug Research on Neurological and Metabolic Diseases, Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
| |
Collapse
|
2
|
Rizzi A, Amari G, Pivetti F, Delcanale M, Amadei F, Pappani A, Fornasari L, Villetti G, Marchini G, Pisano AR, Pitozzi V, Pittelli MG, Trevisani M, Salvadori M, Cenacchi V, Fioni A, Puccini P, Civelli M, Patacchini R, Baker-Glenn C, Van de Poël H, Blackaby W, Nash K, Armani E. Optimization of M 3 Antagonist-PDE4 Inhibitor (MAPI) Dual Pharmacology Molecules for the Treatment of COPD. J Med Chem 2023; 66:11476-11497. [PMID: 37561958 DOI: 10.1021/acs.jmedchem.3c01012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2023]
Abstract
Aiming at the inhaled treatment of pulmonary diseases, the optimization process of the previously reported MAPI compound 92a is herein described. The project was focused on overcoming the chemical stability issue and achieving a balanced bronchodilator/anti-inflammatory profile in rats in order to be confident in a clinical effect without having to overdose at one of the biological targets. The chemical strategy was based on fine-tuning of the substitution pattern in the muscarinic and PDE4 structural portions of the dual pharmacology compounds, also making use of the analysis of a proprietary crystal structure in the PDE4 catalytic site. Compound 10f was identified as a chemically stable, potent, and in vivo balanced MAPI lead compound, as assessed in bronchoconstriction and inflammation assays in rats after intratracheal administration. After the in-depth investigation of the pharmacological and solid-state profile, 10f proved to be safe and suitable for development.
Collapse
Affiliation(s)
- Andrea Rizzi
- Chiesi Farmaceutici S.p.A., Centro Ricerche, Largo Belloli 11/a, 43122 Parma, Italy
| | - Gabriele Amari
- Chiesi Farmaceutici S.p.A., Centro Ricerche, Largo Belloli 11/a, 43122 Parma, Italy
| | - Fausto Pivetti
- Chiesi Farmaceutici S.p.A., Centro Ricerche, Largo Belloli 11/a, 43122 Parma, Italy
| | - Maurizio Delcanale
- Chiesi Farmaceutici S.p.A., Centro Ricerche, Largo Belloli 11/a, 43122 Parma, Italy
| | - Francesco Amadei
- Chiesi Farmaceutici S.p.A., Centro Ricerche, Largo Belloli 11/a, 43122 Parma, Italy
| | - Alice Pappani
- Chiesi Farmaceutici S.p.A., Centro Ricerche, Largo Belloli 11/a, 43122 Parma, Italy
| | - Luca Fornasari
- Chiesi Farmaceutici S.p.A., Centro Ricerche, Largo Belloli 11/a, 43122 Parma, Italy
| | - Gino Villetti
- Chiesi Farmaceutici S.p.A., Centro Ricerche, Largo Belloli 11/a, 43122 Parma, Italy
| | - Gessica Marchini
- Chiesi Farmaceutici S.p.A., Centro Ricerche, Largo Belloli 11/a, 43122 Parma, Italy
| | - Anna Rita Pisano
- Chiesi Farmaceutici S.p.A., Centro Ricerche, Largo Belloli 11/a, 43122 Parma, Italy
| | - Vanessa Pitozzi
- Chiesi Farmaceutici S.p.A., Centro Ricerche, Largo Belloli 11/a, 43122 Parma, Italy
| | | | - Marcello Trevisani
- Chiesi Farmaceutici S.p.A., Centro Ricerche, Largo Belloli 11/a, 43122 Parma, Italy
| | - Michela Salvadori
- Chiesi Farmaceutici S.p.A., Centro Ricerche, Largo Belloli 11/a, 43122 Parma, Italy
| | - Valentina Cenacchi
- Chiesi Farmaceutici S.p.A., Centro Ricerche, Largo Belloli 11/a, 43122 Parma, Italy
| | - Alessandro Fioni
- Chiesi Farmaceutici S.p.A., Centro Ricerche, Largo Belloli 11/a, 43122 Parma, Italy
| | - Paola Puccini
- Chiesi Farmaceutici S.p.A., Centro Ricerche, Largo Belloli 11/a, 43122 Parma, Italy
| | - Maurizio Civelli
- Chiesi Farmaceutici S.p.A., Centro Ricerche, Largo Belloli 11/a, 43122 Parma, Italy
| | - Riccardo Patacchini
- Chiesi Farmaceutici S.p.A., Centro Ricerche, Largo Belloli 11/a, 43122 Parma, Italy
| | - Charles Baker-Glenn
- Charles River Discovery Research Services UK Ltd., Chesterford Research Park, Saffron Walden CB10 1XL, United Kingdom
| | - Hervé Van de Poël
- Charles River Discovery Research Services UK Ltd., Chesterford Research Park, Saffron Walden CB10 1XL, United Kingdom
| | - Wesley Blackaby
- Charles River Discovery Research Services UK Ltd., Chesterford Research Park, Saffron Walden CB10 1XL, United Kingdom
| | - Kevin Nash
- Charles River Discovery Research Services UK Ltd., Chesterford Research Park, Saffron Walden CB10 1XL, United Kingdom
| | - Elisabetta Armani
- Chiesi Farmaceutici S.p.A., Centro Ricerche, Largo Belloli 11/a, 43122 Parma, Italy
| |
Collapse
|
3
|
Stolfa I, Page C. Phosphodiesterase inhibitors and lung diseases. ADVANCES IN PHARMACOLOGY (SAN DIEGO, CALIF.) 2023; 98:55-81. [PMID: 37524492 DOI: 10.1016/bs.apha.2023.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/02/2023]
Abstract
Phosphodiesterase enzymes (PDE) have long been known as regulators of cAMP and cGMP, second messengers involved in various signaling pathways and expressed in a variety of cell types implicated in respiratory diseases such as airway smooth muscle and inflammatory cells making them a key target for the treatment of lung diseases as chronic obstructive pulmonary disease (COPD), asthma, cystic fibrosis, and pulmonary hypertension (PH). The first reported PDE inhibitor was the xanthine, theophylline, described as a non-specific PDE inhibitor and whilst this drug is effective, it also has a range of unwanted side effects. In an attempt to improve the therapeutic window of xanthines, a number of selective PDE inhibitors have been developed for the treatment of respiratory diseases with only the selective PDE 4 inhibitor, roflumilast, being approved for the treatment of severe COPD. However, roflumilast also has a very narrow therapeutic window due to a number of important doses limiting side effects, particularly in the gastrointestinal tract. However, there continues to be research carried out in this field to identify improved selective PDE inhibitors, both by targeting other PDE subtypes (e.g., PDE 7 found in a number of inflammatory and immune cells) and through development of selective PDE inhibitors for pulmonary administration to reduce systemic exposure and improve the side effect profile. This approach has been exemplified by the development of ensifentrine, a dual PDE 3-PDE 4 inhibitor, an inhaled drug that has recently completed two successful Phase III clinical trials in patients with COPD.
Collapse
Affiliation(s)
- Ivana Stolfa
- Sackler Institute of Pulmonary Pharmacology, Institute of Pharmaceutical Science, King's College, London, United Kingdom
| | - Clive Page
- Sackler Institute of Pulmonary Pharmacology, Institute of Pharmaceutical Science, King's College, London, United Kingdom.
| |
Collapse
|
4
|
Nguyen HO, Salvi V, Tiberio L, Facchinetti F, Govoni M, Villetti G, Civelli M, Barbazza I, Gaudenzi C, Passari M, Schioppa T, Sozio F, Del Prete A, Sozzani S, Bosisio D. The PDE4 inhibitor tanimilast shows distinct immunomodulatory properties associated with a type 2 endotype and CD141 upregulation. J Transl Med 2022; 20:203. [PMID: 35538539 PMCID: PMC9092691 DOI: 10.1186/s12967-022-03402-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 04/20/2022] [Indexed: 12/01/2022] Open
Abstract
Background Tanimilast is a novel and selective inhaled inhibitor of phosphodiesterase-4 in advanced clinical development for chronic obstructive pulmonary disease (COPD). Tanimilast is known to exert prominent anti-inflammatory activity when tested in preclinical experimental models as well as in human clinical studies. Recently, we have demonstrated that it also finely tunes, rather than suppressing, the cytokine network secreted by activated dendritic cells (DCs). This study was designed to characterize the effects of tanimilast on T-cell polarizing properties of DCs and to investigate additional functional and phenotypical features induced by tanimilast. Methods DCs at day 6 of culture were stimulated with LPS in the presence or absence of tanimilast or the control drug budesonide. After 24 h, DCs were analyzed for the expression of surface markers of maturation and activation by flow cytometry and cocultured with T cells to investigate cell proliferation and activation/polarization. The regulation of type 2-skewing mediators was investigated by real-time PCR in DCs and compared to results obtained in vivo in a randomized placebo-controlled trial on COPD patients treated with tanimilast. Results Our results show that both tanimilast and budesonide reduced the production of the immunostimulatory cytokine IFN-γ by CD4+ T cells. However, the two drugs acted at different levels since budesonide mainly blocked T cell proliferation, while tanimilast skewed T cells towards a Th2 phenotype without affecting cell proliferation. In addition, only DCs matured in the presence of tanimilast displayed increased CD86/CD80 ratio and CD141 expression, which correlated with Th2 T cell induction and dead cell uptake respectively. These cells also upregulated cAMP-dependent immunosuppressive molecules such as IDO1, TSP1, VEGF-A and Amphiregulin. Notably, the translational value of these data was confirmed by the finding that these same genes were upregulated also in sputum cells of COPD patients treated with tanimilast as add-on to inhaled glucocorticoids and bronchodilators. Conclusion Taken together, these findings demonstrate distinct immunomodulatory properties of tanimilast associated with a type 2 endotype and CD141 upregulation in DCs and provide a mechanistic rationale for the administration of tanimilast on top of inhaled corticosteroids.
Collapse
Affiliation(s)
- Hoang Oanh Nguyen
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Valentina Salvi
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Laura Tiberio
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Fabrizio Facchinetti
- Department of Experimental Pharmacology and Translational Science, Corporate Pre-Clinical R&D, Chiesi Farmaceutici S.p.A., Parma, Italy
| | - Mirco Govoni
- Global Clinical Development, Chiesi Farmaceutici S.p.A., Parma, Italy
| | - Gino Villetti
- Department of Experimental Pharmacology and Translational Science, Corporate Pre-Clinical R&D, Chiesi Farmaceutici S.p.A., Parma, Italy
| | - Maurizio Civelli
- Department of Experimental Pharmacology and Translational Science, Corporate Pre-Clinical R&D, Chiesi Farmaceutici S.p.A., Parma, Italy
| | - Ilaria Barbazza
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Carolina Gaudenzi
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Mauro Passari
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Tiziana Schioppa
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Francesca Sozio
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Annalisa Del Prete
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Silvano Sozzani
- Laboratory Affiliated to Istituto Pasteur Italia-Fondazione Cenci Bolognetti, Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy. .,IRCCS Neuromed, Pozzilli, IS, Italy.
| | - Daniela Bosisio
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy.
| |
Collapse
|
5
|
Xia C, He JP, Feng KW, Liu L, Zheng L, Wang HT, Xu JP, Zhou ZZ. Discovery of Novel 3-Amino-4-alkoxyphenylketones as PDE4 Inhibitors with Improved Oral Bioavailability and Safety against Spatial Memory Impairments. ACS Chem Neurosci 2022; 13:390-405. [PMID: 35050567 DOI: 10.1021/acschemneuro.1c00762] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
To realize PDE4 inhibitors with good developmental potentiality for the treatment of dementia, structure-based optimizations of lead compound FCPR03 resulted in novel aminophenylketones 9c and 9H with low nanomolar potency, which displayed comparable activity to rolipram, satisfactory bioavailability (F% = 36.92 and 42.96% respectively), and good blood-brain barrier (BBB) permeability switching from the cyclopropyl methoxy group to the cyclopropyl methylamine and the amide group to the corresponding ketone. Emetogenicity evaluation on a combined ketamine/xylazine anesthesia mice alternative model demonstrated that 9H displays no emetogenicity even at an oral dose of 5 mg/kg. In contrast, rolipram and roflumilast displayed emetogenicity at an oral dose of 0.5 mg/kg. In acute toxicological evaluation, 9H showed no obvious toxicological effect on mice when administered at oral doses below 625 mg/kg. Further investigations revealed that 9H improves the memory and cognitive impairment of Alzheimer's disease (AD) model mice induced by Aβ25-35.
Collapse
Affiliation(s)
- Chuang Xia
- Innovation Program of Drug Research on Neurological and Metabolic Diseases, Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
| | - Jia-Peng He
- Innovation Program of Drug Research on Neurological and Metabolic Diseases, Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
| | - Kai-Wen Feng
- Innovation Program of Drug Research on Neurological and Metabolic Diseases, Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
| | - Lu Liu
- Innovation Program of Drug Research on Neurological and Metabolic Diseases, Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
| | - Lei Zheng
- Innovation Program of Drug Research on Neurological and Metabolic Diseases, Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
| | - Hai-Tao Wang
- Innovation Program of Drug Research on Neurological and Metabolic Diseases, Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
| | - Jiang-Ping Xu
- Innovation Program of Drug Research on Neurological and Metabolic Diseases, Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
| | - Zhong-Zhen Zhou
- Innovation Program of Drug Research on Neurological and Metabolic Diseases, Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
- Pharmacy Department, Zhujiang Hospital, Southern Medical University, Guangzhou 510515, China
| |
Collapse
|
6
|
Nguyen HO, Schioppa T, Tiberio L, Facchinetti F, Villetti G, Civelli M, Del Prete A, Sozio F, Gaudenzi C, Passari M, Barbazza I, Sozzani S, Salvi V, Bosisio D. The PDE4 Inhibitor Tanimilast Blunts Proinflammatory Dendritic Cell Activation by SARS-CoV-2 ssRNAs. Front Immunol 2022; 12:797390. [PMID: 35140709 PMCID: PMC8818995 DOI: 10.3389/fimmu.2021.797390] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 12/31/2021] [Indexed: 12/20/2022] Open
Abstract
Phosphodiesterase 4 (PDE4) inhibitors are immunomodulatory drugs approved to treat diseases associated with chronic inflammatory conditions, such as COPD, psoriasis and atopic dermatitis. Tanimilast (international non-proprietary name of CHF6001) is a novel, potent and selective inhaled PDE4 inhibitor in advanced clinical development for the treatment of COPD. To begin testing its potential in limiting hyperinflammation and immune dysregulation associated to SARS-CoV-2 infection, we took advantage of an in vitro model of dendritic cell (DC) activation by SARS-CoV-2 genomic ssRNA (SCV2-RNA). In this context, Tanimilast decreased the release of pro-inflammatory cytokines (TNF-α and IL-6), chemokines (CCL3, CXCL9, and CXCL10) and of Th1-polarizing cytokines (IL-12, type I IFNs). In contrast to β-methasone, a reference steroid anti-inflammatory drug, Tanimilast did not impair the acquisition of the maturation markers CD83, CD86 and MHC-II, nor that of the lymph node homing receptor CCR7. Consistent with this, Tanimilast did not reduce the capability of SCV2-RNA-stimulated DCs to activate CD4+ T cells but skewed their polarization towards a Th2 phenotype. Both Tanimilast and β-methasone blocked the increase of MHC-I molecules in SCV2-RNA-activated DCs and restrained the proliferation and activation of cytotoxic CD8+ T cells. Our results indicate that Tanimilast can modulate the SCV2-RNA-induced pro-inflammatory and Th1-polarizing potential of DCs, crucial regulators of both the inflammatory and immune response. Given also the remarkable safety demonstrated by Tanimilast, up to now, in clinical studies, we propose this inhaled PDE4 inhibitor as a promising immunomodulatory drug in the scenario of COVID-19.
Collapse
Affiliation(s)
- Hoang Oanh Nguyen
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Tiziana Schioppa
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
- IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Laura Tiberio
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | | | - Gino Villetti
- Chiesi Farmaceutici S.p.A., Corporate Pre-Clinical R&D, Parma, Italy
| | - Maurizio Civelli
- Chiesi Farmaceutici S.p.A., Corporate Pre-Clinical R&D, Parma, Italy
| | - Annalisa Del Prete
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
- IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Francesca Sozio
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
- IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Carolina Gaudenzi
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Mauro Passari
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Ilaria Barbazza
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Silvano Sozzani
- Laboratory Affiliated to Istituto Pasteur Italia-Fondazione Cenci Bolognetti, Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
- IRCCS Neuromed, Pozzilli, Italy
| | - Valentina Salvi
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Daniela Bosisio
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
- *Correspondence: Daniela Bosisio,
| |
Collapse
|
7
|
Liu Z, Liu M, Cao Z, Qiu P, Song G. Phosphodiesterase‑4 inhibitors: a review of current developments (2013-2021). Expert Opin Ther Pat 2022; 32:261-278. [PMID: 34986723 DOI: 10.1080/13543776.2022.2026328] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Cyclic nucleotide phosphodiesterase 4 (PDE4) is responsible for the hydrolysis of cAMP, which has become an attractive therapeutic target for lung, skin, and severe neurological diseases. Here, we review the current status of development of PDE4 inhibitors since 2013 and discuss the applicability of novel medicinal-chemistry strategies for identifying more efficient and safer inhibitors. AREAS COVERED This review summarizes the clinical development of PDE4 inhibitors from 2013 to 2021, focused on their pharmacophores, the strategies to reduce the side effects of PDE4 inhibitors and the development of subfamily selective PDE4 inhibitors. EXPERT OPINION To date, great efforts have been made in the development of PDE4 inhibitors, and researchers have established a comprehensive preclinical database and collected some promising data from clinical trials. Although four small-molecule PDE4 inhibitors have been approved by FDA for the treatment of human diseases up to now, further development of other reported PDE4 inhibitors with strong potency has been hampered due to the occurrence of severe side effects. There are currently three main strategies for overcoming the dose limitation and systemic side effects, which provide new opportunities for the clinical development of new PDE4 inhibitors.
Collapse
Affiliation(s)
- Zhihao Liu
- Key Laboratory for Biobased Materials and Energy of Ministry of Education, College of Materials and Energy, South China Agricultural University, Guangzhou, China
| | - Mingjian Liu
- Key Laboratory for Biobased Materials and Energy of Ministry of Education, College of Materials and Energy, South China Agricultural University, Guangzhou, China
| | - Zhenqing Cao
- Key Laboratory for Biobased Materials and Energy of Ministry of Education, College of Materials and Energy, South China Agricultural University, Guangzhou, China
| | - Pengsen Qiu
- Key Laboratory for Biobased Materials and Energy of Ministry of Education, College of Materials and Energy, South China Agricultural University, Guangzhou, China
| | - Gaopeng Song
- Key Laboratory for Biobased Materials and Energy of Ministry of Education, College of Materials and Energy, South China Agricultural University, Guangzhou, China
| |
Collapse
|
8
|
Facchinetti F, Civelli M, Singh D, Papi A, Emirova A, Govoni M. Tanimilast, A Novel Inhaled Pde4 Inhibitor for the Treatment of Asthma and Chronic Obstructive Pulmonary Disease. Front Pharmacol 2021; 12:740803. [PMID: 34887752 PMCID: PMC8650159 DOI: 10.3389/fphar.2021.740803] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 11/01/2021] [Indexed: 12/12/2022] Open
Abstract
Chronic respiratory diseases are the third leading cause of death, behind cardiovascular diseases and cancer, affecting approximately 550 million of people all over the world. Most of the chronic respiratory diseases are attributable to asthma and chronic obstructive pulmonary disease (COPD) with this latter being the major cause of deaths. Despite differences in etiology and symptoms, a common feature of asthma and COPD is an underlying degree of airways inflammation. The nature and severity of this inflammation might differ between and within different respiratory conditions and pharmacological anti-inflammatory treatments are unlikely to be effective in all patients. A precision medicine approach is needed to selectively target patients to increase the chance of therapeutic success. Inhibitors of the phosphodiesterase 4 (PDE4) enzyme like the oral PDE4 inhibitor roflumilast have shown a potential to reduce inflammatory-mediated processes and the frequency of exacerbations in certain groups of COPD patients with a chronic bronchitis phenotype. However, roflumilast use is dampened by class related side effects as nausea, diarrhea, weight loss and abdominal pain, resulting in both substantial treatment discontinuation in clinical practice and withdrawal from clinical trials. This has prompted the search for PDE4 inhibitors to be given by inhalation to reduce the systemic exposure (and thus optimize the systemic safety) and maximize the therapeutic effect in the lung. Tanimilast (international non-proprietary name of CHF6001) is a novel highly potent and selective inhaled PDE4 inhibitor with proven anti-inflammatory properties in various inflammatory cells, including leukocytes derived from asthma and COPD patients, as well as in experimental rodent models of pulmonary inflammation. Inhaled tanimilast has reached phase III clinical development by showing promising pharmacodynamic results associated with a good tolerability and safety profile, with no evidence of PDE4 inhibitors class-related side effects. In this review we will discuss the main outcomes of preclinical and clinical studies conducted during tanimilast development, with particular emphasis on the characterization of the pharmacodynamic profile that led to the identification of target populations with increased therapeutic potential in inflammatory respiratory diseases.
Collapse
Affiliation(s)
| | | | - Dave Singh
- Medicines Evaluation Unit, Manchester University NHS Foundation Hospital Trust, Manchester, United Kingdom
| | - Alberto Papi
- Respiratory Medicine, Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - Aida Emirova
- Global Clinical Development, Chiesi, Parma, Italy
| | - Mirco Govoni
- Global Clinical Development, Chiesi, Parma, Italy
| |
Collapse
|
9
|
Singh D, Lea S, Mathioudakis AG. Inhaled Phosphodiesterase Inhibitors for the Treatment of Chronic Obstructive Pulmonary Disease. Drugs 2021; 81:1821-1830. [PMID: 34731461 DOI: 10.1007/s40265-021-01616-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2021] [Indexed: 12/12/2022]
Abstract
Phosphodiesterase (PDE) 4 inhibitors prevent the metabolism of cyclic adenosine monophosphate, thereby reducing inflammation. Inhaled PDE4 inhibitors aim to restrict systemic drug exposure to enhance the potential for clinical benefits (in the lungs) versus adverse events (systemically). The orally administered PDE4 inhibitor roflumilast reduces exacerbation rates in the subgroup of chronic obstructive pulmonary disease patients with a history of exacerbations and the presence of chronic bronchitis, but can cause PDE4 related adverse effects due to systemic exposure. CHF6001 is an inhaled PDE4 inhibitor, while inhaled ensifentrine is an inhibitor of both PDE3 and PDE4; antagonism of PDE3 facilitates smooth muscle relaxation and hence bronchodilation. These inhaled PDE inhibitors have both reported positive findings from early phase clinical trials, and have been well tolerated. Longer term trials are needed to firmly establish the clinical benefits of these drugs.
Collapse
Affiliation(s)
- Dave Singh
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester and Manchester University NHS Foundation Trust, Manchester, UK.
- Medicines Evaluation Unit, University of Manchester, Manchester University NHS Foundation Hospital Trust, The Langley Building, Southmoor Road, Manchester, M23 9QZ, UK.
| | - Simon Lea
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester and Manchester University NHS Foundation Trust, Manchester, UK
| | - Alexander G Mathioudakis
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester and Manchester University NHS Foundation Trust, Manchester, UK
| |
Collapse
|
10
|
Singh D, Bassi M, Balzano D, Lucci G, Emirova A, Anna Nandeuil M, Jellema G, Afolabi EK, Leaker B, Kornmann O, Michael Beeh K, Watz H, Govoni M. COPD patients with chronic bronchitis and higher sputum eosinophil counts show increased type-2 and PDE4 gene expression in sputum. J Cell Mol Med 2020; 25:905-918. [PMID: 33295083 PMCID: PMC7812250 DOI: 10.1111/jcmm.16146] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 11/22/2020] [Indexed: 12/18/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) patients with higher eosinophil counts are associated with increased clinical response to phosphodiesterase‐4‐inhibitors (PDE4i). However, the underlying inflammatory mechanisms associated with this increased response is not yet elucidated. This post hoc analysis focused on sputum gene expression in patients with chronic bronchitis who underwent 32‐day treatment with two doses of the inhaled PDE4i CHF6001 (tanimilast) or placebo on top of triple therapy. Biological characterization and treatment effects were assessed between patients with different sputum eosinophil levels (eosinophilhigh ≥ 3%; eosinophillow < 3%) at baseline (primary samples) or at the end of the treatment of the placebo arm (validation samples). Forty‐one genes were differentially expressed in primary samples (p‐adjusted for false discovery rate < 0.05); all up‐regulated in eosinophilhigh patients and functionally enriched for type‐2 and PDE4 inflammatory processes. Eleven out of nineteen genes having immune system biological processes annotations including IL5RA, ALOX15, IL1RL1, CLC, GATA1 and PDE4D were replicated using validation samples. The expression of a number of these inflammatory mediators was reduced by tanimilast treatment, with greater effects observed in eosinophilhigh patients. These findings suggest that type‐2 and PDE4 overexpression in COPD patients with higher sputum eosinophil counts contribute to the differential clinical response to PDE4i observed in previous clinical trials.
Collapse
Affiliation(s)
- Dave Singh
- Medicines Evaluation Unit, The University of Manchester, Manchester University NHS Foundation Hospital Trust, Manchester, UK
| | | | | | | | - Aida Emirova
- Global Clinical Development, Chiesi, Parma, Italy
| | | | | | | | | | - Oliver Kornmann
- IKF Pneumologie Frankfurt, Clinical Research Centre Respiratory Diseases, Frankfurt, Germany
| | | | - Henrik Watz
- Pulmonary Research Institute at Lung Clinic Grosshansdorf, Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), Grosshansdorf, Germany
| | - Mirco Govoni
- Global Clinical Development, Chiesi, Parma, Italy
| |
Collapse
|
11
|
Wang C, Zhou J, Wang J, Li S, Fukunaga A, Yodoi J, Tian H. Progress in the mechanism and targeted drug therapy for COPD. Signal Transduct Target Ther 2020; 5:248. [PMID: 33110061 PMCID: PMC7588592 DOI: 10.1038/s41392-020-00345-x] [Citation(s) in RCA: 102] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 09/15/2020] [Accepted: 09/21/2020] [Indexed: 02/07/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is emphysema and/or chronic bronchitis characterised by long-term breathing problems and poor airflow. The prevalence of COPD has increased over the last decade and the drugs most commonly used to treat it, such as glucocorticoids and bronchodilators, have significant therapeutic effects; however, they also cause side effects, including infection and immunosuppression. Here we reviewed the pathogenesis and progression of COPD and elaborated on the effects and mechanisms of newly developed molecular targeted COPD therapeutic drugs. Among these new drugs, we focussed on thioredoxin (Trx). Trx effectively prevents the progression of COPD by regulating redox status and protease/anti-protease balance, blocking the NF-κB and MAPK signalling pathways, suppressing the activation and migration of inflammatory cells and the production of cytokines, inhibiting the synthesis and the activation of adhesion factors and growth factors, and controlling the cAMP-PKA and PI3K/Akt signalling pathways. The mechanism by which Trx affects COPD is different from glucocorticoid-based mechanisms which regulate the inflammatory reaction in association with suppressing immune responses. In addition, Trx also improves the insensitivity of COPD to steroids by inhibiting the production and internalisation of macrophage migration inhibitory factor (MIF). Taken together, these findings suggest that Trx may be the ideal drug for treating COPD.
Collapse
Affiliation(s)
- Cuixue Wang
- Department of Basic Medicine, Medical College, Shaoxing University, Shaoxing, 312000, China
| | - Jiedong Zhou
- Department of Basic Medicine, Medical College, Shaoxing University, Shaoxing, 312000, China
| | - Jinquan Wang
- Department of Basic Medicine, Medical College, Shaoxing University, Shaoxing, 312000, China
| | - Shujing Li
- Department of Basic Medicine, Medical College, Shaoxing University, Shaoxing, 312000, China
| | - Atsushi Fukunaga
- Division of Dermatology, Department of Internal Related, Kobe University Graduate School of Medicine, Kobe, 650-0017, Japan
| | - Junji Yodoi
- Laboratory of Infection and Prevention, Department of Biological Response, Institute for Virus Research, Kyoto University, Kyoto, 606-8501, Japan
| | - Hai Tian
- Department of Basic Medicine, Medical College, Shaoxing University, Shaoxing, 312000, China.
- Jiaozhimei Biotechnology (Shaoxing) Co, Ltd, Shaoxing, 312000, China.
| |
Collapse
|
12
|
Singh D, Emirova A, Francisco C, Santoro D, Govoni M, Nandeuil MA. Efficacy and safety of CHF6001, a novel inhaled PDE4 inhibitor in COPD: the PIONEER study. Respir Res 2020; 21:246. [PMID: 32962709 PMCID: PMC7510119 DOI: 10.1186/s12931-020-01512-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 09/16/2020] [Indexed: 12/25/2022] Open
Abstract
Background This study evaluated the efficacy, safety and tolerability of the novel inhaled phosphodiesterase-4 inhibitor CHF6001 added-on to formoterol in patients with chronic obstructive pulmonary disease (COPD). Methods Randomised, double-blind, placebo- and active-controlled, parallel-group study. Eligible patients had symptomatic COPD, post-bronchodilator forced expiratory volume in 1 s (FEV1) 30–70% predicted, and history of ≥1 moderate/severe exacerbation. Patients were randomised to extrafine CHF6001 400, 800, 1200 or 1600 μg twice daily (BID), budesonide, or placebo for 24 weeks. Primary objectives: To investigate CHF6001 dose-response for pre-dose FEV1 after 12 weeks, and to identify the optimal dose. Moderate-to-severe exacerbations were a secondary endpoint. Results Of 1130 patients randomised, 91.9% completed. Changes from baseline in pre-dose FEV1 at Week 12 were small in all groups (including budesonide), with no CHF6001 dose-response, and no significant treatment–placebo differences. For moderate-to-severe exacerbations, CHF6001 rate reductions versus placebo were 13–28% (non-significant). In post-hoc analyses, CHF6001 effects were larger in patients with a chronic bronchitis phenotype (rate reductions versus placebo 24–37%; non-significant), and were further increased in patients with chronic bronchitis and eosinophil count ≥150 cells/μL (49–73%, statistically significant for CHF6001 800 and 1600 μg BID). CHF6001 was well tolerated with no safety signal (including in terms of gastrointestinal adverse events). Conclusions CHF6001 had no effect in the primary lung function analysis, although was well-tolerated with no gastrointestinal adverse event signal. Post-hoc analyses focused on exacerbation risk indicate specific patient subgroups who may receive particular benefit from CHF6001. Trial registration ClinicalTrials.gov (NCT02986321). Registered 8 Dec 2016.
Collapse
Affiliation(s)
- Dave Singh
- Medicines Evaluation Unit, The University of Manchester, Manchester University NHS Foundation Trust, Manchester, UK.
| | - Aida Emirova
- Global Clinical Development, Chiesi, Parma, Italy
| | | | | | - Mirco Govoni
- Global Clinical Development, Chiesi, Parma, Italy
| | | |
Collapse
|
13
|
Sabogal Piñeros YS, Dekker T, Smids B, Majoor CJ, Ravanetti L, Villetti G, Civelli M, Facchinetti F, Lutter R. Phosphodiesterase 4 inhibitors attenuate virus-induced activation of eosinophils from asthmatics without affecting virus binding. Pharmacol Res Perspect 2020; 8:e00557. [PMID: 32447834 PMCID: PMC7245579 DOI: 10.1002/prp2.557] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 12/02/2019] [Accepted: 12/06/2019] [Indexed: 11/11/2022] Open
Abstract
Acute respiratory virus infections, such as influenza and RSV, are predominant causes of asthma exacerbations. Eosinophils act as a double-edged sword in exacerbations in that they are activated by viral infections but also can capture and inactivate respiratory viruses. Phosphodiesterase type 4 (PDE4) is abundantly expressed by eosinophils and has been implicated in their activation. This exploratory study aims to determine whether these opposing roles of eosinophils activation of eosinophils upon interaction with virus can be modulated by selective PDE4 inhibitors and whether eosinophils from healthy, moderate and severe asthmatic subjects respond differently. Eosinophils were purified by negative selection from blood and subsequently exposed to RSV or influenza. Prior to exposure to virus, eosinophils were treated with vehicle or selective PDE4 inhibitors CHF6001 and GSK256066. After 18 hours of exposure, influenza, but not RSV, increased CD69 and CD63 expression by eosinophils from each group, which were inhibited by PDE4 inhibitors. ECP release, although not stimulated by virus, was also attenuated by PDE4 inhibitors. Eosinophils showed an increased Nox2 activity upon virus exposure, which was less pronounced in eosinophils derived from mild and severe asthmatics and was counteracted by PDE4 inhibitors. PDE4 inhibitors had no effect on binding of virus by eosinophils from each group. Our data indicate that PDE4 inhibitors can attenuate eosinophil activation, without affecting virus binding. By attenuating virus-induced responses, PDE4 inhibitors may mitigate virus-induced asthma exacerbations.
Collapse
Affiliation(s)
- Yanaika Shari Sabogal Piñeros
- Department of Experimental ImmunologyAmsterdam Infection & Immunity InstituteAmsterdamThe Netherlands
- Department of Respiratory MedicineAmsterdam University Medical CentresUniversity of AmsterdamAmsterdamThe Netherlands
| | - Tamara Dekker
- Department of Experimental ImmunologyAmsterdam Infection & Immunity InstituteAmsterdamThe Netherlands
- Department of Respiratory MedicineAmsterdam University Medical CentresUniversity of AmsterdamAmsterdamThe Netherlands
| | - Barbara Smids
- Department of Experimental ImmunologyAmsterdam Infection & Immunity InstituteAmsterdamThe Netherlands
- Department of Respiratory MedicineAmsterdam University Medical CentresUniversity of AmsterdamAmsterdamThe Netherlands
| | - Christof J. Majoor
- Department of Respiratory MedicineAmsterdam University Medical CentresUniversity of AmsterdamAmsterdamThe Netherlands
| | - Lara Ravanetti
- Department of Experimental ImmunologyAmsterdam Infection & Immunity InstituteAmsterdamThe Netherlands
- Department of Respiratory MedicineAmsterdam University Medical CentresUniversity of AmsterdamAmsterdamThe Netherlands
| | - Gino Villetti
- Corporate Pre‐Clinical R&DChiesi Farmaceutici S.p.A.ParmaItaly
| | | | | | - René Lutter
- Department of Experimental ImmunologyAmsterdam Infection & Immunity InstituteAmsterdamThe Netherlands
- Department of Respiratory MedicineAmsterdam University Medical CentresUniversity of AmsterdamAmsterdamThe Netherlands
| |
Collapse
|
14
|
The PDE4 inhibitor CHF6001 affects keratinocyte proliferation via cellular redox pathways. Arch Biochem Biophys 2020; 685:108355. [DOI: 10.1016/j.abb.2020.108355] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 03/11/2020] [Accepted: 03/31/2020] [Indexed: 11/22/2022]
|
15
|
Govoni M, Bassi M, Vezzoli S, Lucci G, Emirova A, Nandeuil MA, Petruzzelli S, Jellema GL, Afolabi EK, Colgan B, Leaker B, Kornmann O, Beeh KM, Watz H, Singh D. Sputum and blood transcriptomics characterisation of the inhaled PDE4 inhibitor CHF6001 on top of triple therapy in patients with chronic bronchitis. Respir Res 2020; 21:72. [PMID: 32197620 PMCID: PMC7085203 DOI: 10.1186/s12931-020-1329-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 02/27/2020] [Indexed: 02/06/2023] Open
Abstract
Background Although phosphodiesterase-4 (PDE4) inhibitors have been shown to reduce COPD exacerbation rate, their biological mechanism of action is not completely elucidated at the molecular level. We aimed to characterise the whole genome gene expression profile of the inhaled PDE4-inhibitor CHF6001 on top of triple therapy in sputum cells and whole blood of patients with COPD and chronic bronchitis. Methods Whole genome gene expression analysis was carried out by microarray in 54 patients before and after 32 days treatment with CHF6001 800 and 1600 μg and placebo twice daily (BID) in a randomised crossover study. Results CHF6001 had a strong effect in sputum, with 1471 and 2598 significantly differentially-expressed probe-sets relative to placebo (p-adjusted for False Discovery Rate < 0.05) with 800 and 1600 μg BID, respectively. Functional enrichment analysis showed significant modulation of key inflammatory pathways involved in cytokine activity, pathogen-associated-pattern-recognition activity, oxidative stress and vitamin D with associated inhibition of downstream inflammatory effectors. A large number of pro-inflammatory genes coding for cytokines and matrix-metalloproteinases were significantly differentially expressed for both doses; the majority (> 87%) were downregulated, including macrophage inflammatory protein-1-alpha and 1-beta, interleukin-27-beta, interleukin-12-beta, interleukin-32, tumour necrosis factor-alpha-induced-protein-8, ligand-superfamily-member-15, and matrix-metalloproteinases-7,12 and 14. The effect in blood was not significant. Conclusions Inhaled PDE4 inhibition by CHF6001 on top of triple therapy in patients with COPD and chronic bronchitis significantly modulated key inflammatory targets and pathways in the lung but not in blood. Mechanistically these findings support a targeted effect in the lung while minimising unwanted systemic class-effects. Trial registration ClinicalTrial.gov, EudraCT, 2015–005550-35. Registered 15 July 2016.
Collapse
Affiliation(s)
- Mirco Govoni
- Global Clinical Development, Personalised Medicine and Biomarkers, Chiesi, Parma, Italy.
| | - Michele Bassi
- Global Clinical Development, Personalised Medicine and Biomarkers, Chiesi, Parma, Italy
| | - Stefano Vezzoli
- Global Clinical Development, Personalised Medicine and Biomarkers, Chiesi, Parma, Italy
| | - Germano Lucci
- Global Clinical Development, Personalised Medicine and Biomarkers, Chiesi, Parma, Italy
| | - Aida Emirova
- Global Clinical Development, Personalised Medicine and Biomarkers, Chiesi, Parma, Italy
| | - Marie Anna Nandeuil
- Global Clinical Development, Personalised Medicine and Biomarkers, Chiesi, Parma, Italy
| | - Stefano Petruzzelli
- Global Clinical Development, Personalised Medicine and Biomarkers, Chiesi, Parma, Italy
| | | | | | | | | | - Oliver Kornmann
- IKF Pneumologie Frankfurt, Clinical Research Centre Respiratory Diseases, Frankfurt, Germany
| | | | - Henrik Watz
- Pulmonary Research Institute at Lung Clinic Grosshansdorf, Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), Grosshansdorf, Germany
| | - Dave Singh
- Medicines Evaluation Unit, The University of Manchester, Manchester University NHS Foundation Trust, Manchester, UK
| |
Collapse
|
16
|
Phillips JE. Inhaled Phosphodiesterase 4 (PDE4) Inhibitors for Inflammatory Respiratory Diseases. Front Pharmacol 2020; 11:259. [PMID: 32226383 PMCID: PMC7080983 DOI: 10.3389/fphar.2020.00259] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 02/24/2020] [Indexed: 01/09/2023] Open
Abstract
PDE4 inhibitors can suppress a variety of inflammatory cell functions that contribute to their anti-inflammatory actions in respiratory diseases like chronic obstructive pulmonary disease (COPD) and asthma. The systemically delivered PDE4 inhibitor roflumilast has been approved for use in a subset of patients with severe COPD with chronic bronchitis and a history of exacerbations. Use of systemically delivered PDE4 inhibitors has been limited by systemic side effects. Inhaled PDE4 inhibitors have been considered as a viable alternative to increase tolerability and determine the maximum therapeutic potential of PDE4 inhibition in respiratory diseases.
Collapse
Affiliation(s)
- Jonathan E. Phillips
- Department of Inflammation Research, Amgen Research, Thousand Oaks, CA, United States
| |
Collapse
|
17
|
Stellari FF, Sala A, Ruscitti F, Buccellati C, Allen A, Risé P, Civelli M, Villetti G. CHF6001 Inhibits NF-κB Activation and Neutrophilic Recruitment in LPS-Induced Lung Inflammation in Mice. Front Pharmacol 2019; 10:1337. [PMID: 31798449 PMCID: PMC6863066 DOI: 10.3389/fphar.2019.01337] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 10/18/2019] [Indexed: 12/15/2022] Open
Abstract
Inhibitors of phosphodiesterase 4 (PDE4) are potent anti-inflammatory agents, inhibiting the production of inflammatory mediators through the elevation of intracellular cAMP concentrations. We studied the activity of a novel PDE4 inhibitor, CHF6001, both in vitro in human cells and in vivo, using bioluminescence imaging (BLI) in mice lung inflammation. Mice transiently transfected with the luciferase gene under the control of an NF-κB responsive element (NF-κB-luc) have been used to assess the in vivo anti-inflammatory activity of CHF6001 in lipopolysaccharide (LPS)-induced lung inflammation. BLI as well as inflammatory cells and the concentrations of pro-inflammatory cytokines were monitored in bronchoalveolar lavage fluids (BALF) while testing in vitro its ability to affect the production of leukotriene B4 (LTB4), measured by LC/MS/MS, by LPS/LPS/N-formyl--methionyl--leucyl-phenylalanine (fMLP)-activated human blood. CHF6001 inhibited the production of LTB4 in LPS/fMLP-activated human blood at sub-nanomolar concentrations. LPS-induced an increase of BLI signal in NF-κB-luc mice, and CHF6001 administered by dry powder inhalation decreased in parallel luciferase signal, cell airway infiltration, and pro-inflammatory cytokine concentrations in BALF. The results obtained provide in vitro and in vivo evidence of the anti-inflammatory activity of the potent PDE4 inhibitor CHF6001, showing that with a topical administration that closely mimics inhalation in humans, it efficiently disrupts the NF-κB activation associated with LPS challenge, an effect that may be relevant for the prevention of exacerbation episodes in chronic obstructive pulmonary disease subjects.
Collapse
Affiliation(s)
- Fabio F Stellari
- Pharmacology and Toxicology Department Corporate Pre-Clinical R&D, Chiesi Farmaceutici S.p.A, Parma, Italy
| | - Angelo Sala
- Department of Pharmaceutical Sciences, School of Drug Sciences, University of Milan, Milan, Italy.,IBIM, Consiglio Nazionale delle Ricerche, Palermo, Italy
| | - Francesca Ruscitti
- Pharmacology and Toxicology Department Corporate Pre-Clinical R&D, Chiesi Farmaceutici S.p.A, Parma, Italy
| | - Carola Buccellati
- Department of Pharmaceutical Sciences, School of Drug Sciences, University of Milan, Milan, Italy
| | - Andrew Allen
- Pharmacology and Toxicology Department Corporate Pre-Clinical R&D, Chiesi Farmaceutici S.p.A, Parma, Italy
| | - Patrizia Risé
- Department of Pharmaceutical Sciences, School of Drug Sciences, University of Milan, Milan, Italy
| | - Maurizio Civelli
- Pharmacology and Toxicology Department Corporate Pre-Clinical R&D, Chiesi Farmaceutici S.p.A, Parma, Italy
| | - Gino Villetti
- Pharmacology and Toxicology Department Corporate Pre-Clinical R&D, Chiesi Farmaceutici S.p.A, Parma, Italy
| |
Collapse
|
18
|
The modulatory effects of the PDE4 inhibitors CHF6001 and roflumilast in alveolar macrophages and lung tissue from COPD patients. Cytokine 2019; 123:154739. [DOI: 10.1016/j.cyto.2019.154739] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
|
19
|
Singh D, Beeh KM, Colgan B, Kornmann O, Leaker B, Watz H, Lucci G, Geraci S, Emirova A, Govoni M, Nandeuil MA. Effect of the inhaled PDE4 inhibitor CHF6001 on biomarkers of inflammation in COPD. Respir Res 2019; 20:180. [PMID: 31399091 PMCID: PMC6688371 DOI: 10.1186/s12931-019-1142-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 07/23/2019] [Indexed: 12/03/2022] Open
Abstract
Background CHF6001 is a novel inhaled phosphodiesterase-4 inhibitor. This Phase IIa study assessed the effects of CHF6001 on markers of inflammation in induced sputum and blood in patients with chronic obstructive pulmonary disease (COPD). Methods This was a multicentre, three-period (each 32 days), three-way, placebo-controlled, double-blind, complete-block crossover study. Eligible patients had COPD, chronic bronchitis, and were receiving inhaled triple therapy for ≥2 months. Patients received CHF6001 800 or 1600 μg, or matching placebo twice daily via multi-dose dry-powder inhaler (NEXThaler). Induced sputum was collected pre-dose on Day 1, and post-dose on Days 20, 26 and 32. Blood was sampled pre-dose on Day 1, and pre- and post-dose on Day 32. Results Of 61 randomised patients, 54 (88.5%) completed the study. There were no significant differences between groups for overall sputum cell count, or absolute numbers of neutrophils, eosinophils or lymphocytes. CHF6001 800 μg significantly decreased the absolute number and percentage of macrophages vs placebo. In sputum, compared with placebo both CHF6001 doses significantly decreased leukotriene B4, C-X-C motif chemokine ligand 8, macrophage inflammatory protein 1β, matrix metalloproteinase 9, and tumour necrosis factor α (TNFα). In blood, both CHF6001 doses significantly decreased serum surfactant protein D vs placebo. CHF6001 1600 μg significantly decreased TNFα ex-vivo (after incubation with lipopolysaccharide). Conclusion The data from this study show that CHF6001 inhaled twice daily has anti-inflammatory effects in the lungs of patients with COPD already treated with triple inhaled therapy. Trial registration The study is registered on ClinicalTrials.gov (NCT03004417). Electronic supplementary material The online version of this article (10.1186/s12931-019-1142-7) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Dave Singh
- Medicines Evaluation Unit, The University of Manchester, Manchester University NHS Foundation Trust, Manchester, UK
| | | | | | - Oliver Kornmann
- IKF Pneumologie Frankfurt, Clinical Research Centre Respiratory Diseases, Frankfurt, Germany
| | | | - Henrik Watz
- Pulmonary Research Institute at Lung Clinic Grosshansdorf, Airway Research Center North, Member of the German Center for Lung Research, Grosshansdorf, Germany
| | | | | | - Aida Emirova
- Global Clinical Development, Chiesi, Parma, Italy
| | - Mirco Govoni
- Global Clinical Development, Chiesi, Parma, Italy.
| | | |
Collapse
|
20
|
Jolling K, Äbelö A, Luyckx N, Nandeuil M, Govoni M, Cella M, Lindauer A. Concentration-QT Modeling Following Inhalation of the Novel Inhaled Phosphodiesterase-4 Inhibitor CHF6001 in Healthy Volunteers Shows an Absence of QT Prolongation. CPT Pharmacometrics Syst Pharmacol 2019; 8:460-468. [PMID: 31077576 PMCID: PMC6656937 DOI: 10.1002/psp4.12405] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 03/04/2019] [Indexed: 01/08/2023] Open
Abstract
Concentration-QTcF data obtained from two phase I studies in healthy volunteers treated with a novel phosphodiesterase-4 inhibitor currently under development for the treatment of chronic obstructive pulmonary disease were analyzed by means of mixed-effects modeling. A simple linear mixed-effects model and a more complex model that included oscillatory functions were employed and compared. The slope of the concentration-QTcF relationship was not significantly greater than 0 in both approaches, and the simulations showed that the upper limit of the 90% confidence interval around the mean ΔΔQTcF is not expected to exceed 10 ms within the range of clinically relevant concentrations. An additional simulation study confirmed the robustness of the simple linear mixed-effects model for the analysis of concentration-QT data and supported the modeling of data obtained from studies with different designs (parallel and crossover).
Collapse
Affiliation(s)
- Koen Jolling
- SGSMechelenBelgium
- Present address:
qPharmetraNijmegenThe Netherlands
| | - Angela Äbelö
- SGSMechelenBelgium
- Present address:
PharmetheusUppsalaSweden
| | | | | | - Mirco Govoni
- Global Clinical DevelopmentChiesi Farmaceutici S.p.AParmaItaly
| | - Massimo Cella
- Global Clinical DevelopmentChiesi Farmaceutici S.p.AParmaItaly
| | | |
Collapse
|
21
|
WITHDRAWN: The modulatory effects of the PDE4 inhibitors CHF6001 and roflumilast in alveolar macrophages and lung tissue from COPD patients. Cytokine X 2019. [DOI: 10.1016/j.cytox.2019.100006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
|
22
|
The PDE4 inhibitor CHF6001 modulates pro-inflammatory cytokines, chemokines and Th1- and Th17-polarizing cytokines in human dendritic cells. Biochem Pharmacol 2019; 163:371-380. [PMID: 30851246 DOI: 10.1016/j.bcp.2019.03.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 03/04/2019] [Indexed: 02/07/2023]
Abstract
Phosphodiesterase 4 (PDE4) inhibitors are used to treat autoimmune and inflammatory diseases, such as psoriasis and chronic obstructive pulmonary disease (COPD). CHF6001 is a novel, potent and selective inhaled PDE4 inhibitor in development for the treatment of COPD. When tested in vitro on human dendritic cells (DCs), CHF6001 decreased the release of pro-inflammatory cytokines (TNF-α and IL-6), chemokines (CXCL8, CCL3, CXCL10 and CCL19) and of Th1- and Th17-polarizing cytokines (IL-12, IL-23 and IL-1β). In contrast to β-methasone, a reference steroid anti-inflammatory drug, CHF6001 increased the secretion of CCL22, a Th2 recruiting chemokine, and the expression of the lymph node homing receptor CCR7. Accordingly, the migration of DCs to CCR7 ligands was increased, while migration to pro-inflammatory chemokines was decreased. Of note, the action of CHF6001 was apparently mediated by a promoter-specific decrease in NF-κB p65 recruitment, independent of perturbation of LPS signalling or NF-κB nuclear translocation. Our results indicate that CHF6001 can modulate DC pro-inflammatory Th1/Th17 polarizing potential by fine tuning the transcriptional activity of the master inflammatory transcription factor NF-κB. Therefore, CHF6001 may prove useful to control Th1/Th17-polarized inflammatory diseases such as COPD.
Collapse
|
23
|
Zuo H, Cattani-Cavalieri I, Musheshe N, Nikolaev VO, Schmidt M. Phosphodiesterases as therapeutic targets for respiratory diseases. Pharmacol Ther 2019; 197:225-242. [PMID: 30759374 DOI: 10.1016/j.pharmthera.2019.02.002] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Chronic respiratory diseases, such as chronic obstructive pulmonary disease (COPD) and asthma, affect millions of people all over the world. Cyclic adenosine monophosphate (cAMP) which is one of the most important second messengers, plays a vital role in relaxing airway smooth muscles and suppressing inflammation. Given its vast role in regulating intracellular responses, cAMP provides an attractive pharmaceutical target in the treatment of chronic respiratory diseases. Phosphodiesterases (PDEs) are enzymes that hydrolyze cyclic nucleotides and help control cyclic nucleotide signals in a compartmentalized manner. Currently, the selective PDE4 inhibitor, roflumilast, is used as an add-on treatment for patients with severe COPD associated with bronchitis and a history of frequent exacerbations. In addition, other novel PDE inhibitors are in different phases of clinical trials. The current review provides an overview of the regulation of various PDEs and the potential application of selective PDE inhibitors in the treatment of COPD and asthma. The possibility to combine various PDE inhibitors as a way to increase their therapeutic effectiveness is also emphasized.
Collapse
Affiliation(s)
- Haoxiao Zuo
- Department of Molecular Pharmacology, University of Groningen, the Netherlands; Institute of Experimental Cardiovascular Research, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany.
| | - Isabella Cattani-Cavalieri
- Department of Molecular Pharmacology, University of Groningen, the Netherlands; Groningen Research Institute for Asthma and COPD, GRIAC, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands; Institute of Biomedical Sciences, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Nshunge Musheshe
- Department of Molecular Pharmacology, University of Groningen, the Netherlands
| | - Viacheslav O Nikolaev
- Institute of Experimental Cardiovascular Research, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; German Center for Cardiovascular Research (DZHK), 20246 Hamburg, Germany
| | - Martina Schmidt
- Department of Molecular Pharmacology, University of Groningen, the Netherlands; Groningen Research Institute for Asthma and COPD, GRIAC, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| |
Collapse
|
24
|
Mariotti F, Govoni M, Lucci G, Santoro D, Nandeuil MA. Safety, tolerability, and pharmacokinetics of single and repeat ascending doses of CHF6001, a novel inhaled phosphodiesterase-4 inhibitor: two randomized trials in healthy volunteers. Int J Chron Obstruct Pulmon Dis 2018; 13:3399-3410. [PMID: 30425469 PMCID: PMC6203112 DOI: 10.2147/copd.s174156] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
PURPOSE The purpose of this study was to evaluate safety, tolerability, and pharmacokinetics (PK) of CHF6001, an inhaled phosphodiesterase-4 inhibitor. MATERIALS AND METHODS Two healthy volunteer, randomized, double-blind, placebo-controlled studies were conducted. In each, Part 1 evaluated single ascending doses, with PK sampling up to 48 hours post-dose; Part 2 evaluated multiple ascending doses (Study 1, 7 days; Study 2, 14 days), with PK sampling up to 24 hours post-dose on first and last day of each period. In Study 1, treatments were administered via single-dose dry-powder inhaler (SDDPI; Aerolizer): Part 1, 20, 100, 200, 400, 800, 1,600, and 2,000 µg or placebo; Part 2, 100, 300, 600, 1,200, and 1,600 µg or placebo once daily (OD). In Study 2, treatments were administered via multi-dose dry-powder inhaler (MDDPI; NEXThaler): Part 1, 2,400, 4,000, and 4,800 µg or placebo; Part 2, 1,200, 2,000, or 2,400 µg twice daily (BID) or placebo. Modeling and simulation then compared OD and BID dosing via MDDPI. RESULTS There was a clear correlation between CHF6001 dose and plasma concentration, following single and multiple doses and using SDDPI and MDDPI. CHF6001 plasma concentration area under the curve (AUC) was dose proportional, with steady state slopes of the fitted line of 0.95 (90% CI: 0.86, 1.04) for AUC0-24 h in Study 1, and 0.85 (90% CI: 0.38, 1.32) for AUC0-12 h in Study 2. Bioavailability waŝ30% higher with MDDPI than SDDPI. The PK simulation confirmed dose proportionality; the same total daily dose OD or BID via MDDPI resulted in similar 24 hours exposure, with BID dosing providing smaller fluctuation and lower maximum concentration. CHF6001 was well tolerated with no relationship between dose and adverse events. CONCLUSION CHF6001 demonstrated a good safety profile. There was a clear dose proportionality for systemic exposure, with higher bioavailability via MDDPI, suggesting that the MDDPI provides better pulmonary drug deposition. BID dosing was associated with a better exposure profile.
Collapse
Affiliation(s)
| | - Mirco Govoni
- Global Clinical Development, Chiesi Farmaceutici SpA, Parma, Italy,
| | - Germano Lucci
- Global Clinical Development, Chiesi Farmaceutici SpA, Parma, Italy,
| | - Debora Santoro
- Global Clinical Development, Chiesi Farmaceutici SpA, Parma, Italy,
| | | |
Collapse
|
25
|
Li H, Zuo J, Tang W. Phosphodiesterase-4 Inhibitors for the Treatment of Inflammatory Diseases. Front Pharmacol 2018; 9:1048. [PMID: 30386231 PMCID: PMC6199465 DOI: 10.3389/fphar.2018.01048] [Citation(s) in RCA: 297] [Impact Index Per Article: 49.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 08/30/2018] [Indexed: 12/25/2022] Open
Abstract
Phosphodiesterase-4 (PDE4), mainly present in immune cells, epithelial cells, and brain cells, manifests as an intracellular non-receptor enzyme that modulates inflammation and epithelial integrity. Inhibition of PDE4 is predicted to have diverse effects via the elevation of the level of cyclic adenosine monophosphate (cAMP) and the subsequent regulation of a wide array of genes and proteins. It has been identified that PDE4 is a promising therapeutic target for the treatment of diverse pulmonary, dermatological, and severe neurological diseases. Over the past decades, numerous PDE4 inhibitors have been designed and synthesized, among which roflumilast, apremilast, and crisaborole were approved for the treatment of inflammatory airway diseases, psoriatic arthritis, and atopic dermatitis, respectively. It is regrettable that the dramatic efficacies of a drug are often accompanied by adverse effects, such as nausea, emesis, and gastrointestinal reactions. However, substantial advances have been made to mitigate the adverse effects and obtain better benefit-to-risk ratio. This review highlights the dialectical role of PDE4 in drug discovery and the disquisitive details of certain PDE4 inhibitors to provide an overview of the topics that still need to be addressed in the future.
Collapse
Affiliation(s)
- Heng Li
- Laboratory of Anti-inflammation, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China.,School of Pharmacy, University of Chinese Academy of Sciences, Beijing, China
| | - Jianping Zuo
- School of Pharmacy, University of Chinese Academy of Sciences, Beijing, China.,Laboratory of Immunopharmacology, State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China
| | - Wei Tang
- Laboratory of Anti-inflammation, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China.,School of Pharmacy, University of Chinese Academy of Sciences, Beijing, China.,Open Studio for Druggability Research of Marine Natural Products, Pilot National Laboratory for Marine Science and Technology, Qingdao, China
| |
Collapse
|
26
|
Anti-inflammatory effects of the phosphodiesterase type 4 inhibitor CHF6001 on bronchoalveolar lavage lymphocytes from asthma patients. Cytokine 2018; 113:68-73. [PMID: 29934047 DOI: 10.1016/j.cyto.2018.06.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 05/09/2018] [Accepted: 06/07/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND Lymphocytes play a key role in asthma pathophysiology, secreting various cytokines involved in chronic inflammation. CHF6001 is a highly potent and selective phosphodiesterase type 4 (PDE4) inhibitor designed for inhaled administration and has been shown to reduce the late asthmatic response. However, the effect of PDE4 inhibition on the different cytokines produced by lung lymphocytes from asthma patients has not been examined. METHODS This study investigated the anti-inflammatory effects of CHF6001 and the corticosteroid, 17-BMP, on T-cell receptor (TCR) stimulated Th1, Th2 and Th17 cytokine release from bronchoalveolar lavage (BAL) cells from mild (n = 12) and moderate asthma (n = 12) patients. RESULTS CHF6001 inhibited IFNγ, IL-2 and IL-17, but not IL-13, secretion from both mild and moderate asthma patient BAL cells; there was a greater effect on IFNγ and IL-2 than IL-17. The corticosteroid inhibited all four cytokines from both patient groups, but was less effective in cells from more severe patients. CHF6001 had a greater inhibitory effect on IFNγ and IL-2 than 17-BMP. CONCLUSION The PDE4 inhibitor CHF6001 had a greater effect on Th1 cytokines from TCR-stimulated BAL cells than corticosteroid. This pharmacological effect suggests the therapeutic potential for PDE4 inhibitors to be used in the subset of more severe asthma patients with increased airway levels of IFNγ.
Collapse
|
27
|
Gross N. The COPD Pipeline XXXVIII. CHRONIC OBSTRUCTIVE PULMONARY DISEASES-JOURNAL OF THE COPD FOUNDATION 2018; 5:144-147. [PMID: 30374452 DOI: 10.15326/jcopdf.5.2.2018.0136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Nicholas Gross
- St Francis Hospital and University Medical Research, LLC
| |
Collapse
|
28
|
Cenacchi V, Salvadori M, Riccardi B, Brogin G, Ghiglieri A, Messina M, Imre G, Puccini P. Role of efflux transporters in the absorption, distribution and elimination in rodents of a novel PDE4 inhibitor, CHF6001. Eur J Pharm Sci 2018; 115:100-108. [PMID: 29307855 DOI: 10.1016/j.ejps.2017.12.030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 12/18/2017] [Accepted: 12/30/2017] [Indexed: 01/16/2023]
Abstract
CHF6001 is a new and potent PDE4 inhibitor for the treatment of human lung diseases, designed for topical administration by inhalation. In preclinical assessment CHF6001 appeared safe and devoid of emetic effect, which is typical side effect of PDE4 inhibitors in humans. CHF6001 absorption, distribution and excretion were evaluated in rats by PO and IV administration of [14C]CHF6001; additionally the role of transporters was investigated by using transfected cells expressing either human transporters or MDR1 and BCRP KO mice. [14C]CHF6001 intravenously administered as bolus distributed in all the tissues (with very low levels in brain and fetus) and it was mainly eliminated in bile. Following oral administration [14C]CHF6001 about half of the dose was absorbed through the gut. In vitro, CHF6001 was a substrate of human membrane transporters MDR1 and BCRP. In wild and BCRP KO mice CHF6001 was not detectable in brain, whereas it was measurable in Mdr1a/b KO mice. Therefore, in animal species Mdr1a/b plays a significant role in CHF6001 disposition, limiting its distribution into brain and contributing to the safety profile observed in preclinical evaluation. This behavior was confirmed by the results of the first human studies, where CHF6001 was safe and with no emetic effect at all the evaluated doses.
Collapse
Affiliation(s)
- V Cenacchi
- Chiesi Farmaceutici S.p.A., Largo Belloli 11/a, 43122 Parma, Italy.
| | - M Salvadori
- Chiesi Farmaceutici S.p.A., Largo Belloli 11/a, 43122 Parma, Italy
| | - B Riccardi
- Chiesi Farmaceutici S.p.A., Largo Belloli 11/a, 43122 Parma, Italy
| | - G Brogin
- Chiesi Farmaceutici S.p.A., Largo Belloli 11/a, 43122 Parma, Italy
| | - A Ghiglieri
- Drug Disposition Laboratory, Accelera S.r.l., Nerviano, Milano, Italy
| | - M Messina
- Drug Disposition Laboratory, Accelera S.r.l., Nerviano, Milano, Italy
| | - G Imre
- Solvo Biotechnology, Budaörs, Hungary
| | - P Puccini
- Chiesi Farmaceutici S.p.A., Largo Belloli 11/a, 43122 Parma, Italy
| |
Collapse
|
29
|
Carzaniga L, Amari G, Rizzi A, Capaldi C, De Fanti R, Ghidini E, Villetti G, Carnini C, Moretto N, Facchinetti F, Caruso P, Marchini G, Battipaglia L, Patacchini R, Cenacchi V, Volta R, Amadei F, Pappani A, Capacchi S, Bagnacani V, Delcanale M, Puccini P, Catinella S, Civelli M, Armani E. Discovery and Optimization of Thiazolidinyl and Pyrrolidinyl Derivatives as Inhaled PDE4 Inhibitors for Respiratory Diseases. J Med Chem 2017; 60:10026-10046. [PMID: 29200281 DOI: 10.1021/acs.jmedchem.7b01044] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Phosphodiesterase 4 (PDE4) is a key cAMP-metabolizing enzyme involved in the pathogenesis of inflammatory disease, and its pharmacological inhibition has been shown to exert therapeutic efficacy in chronic obstructive pulmonary disease (COPD). Herein, we describe a drug discovery program aiming at the identification of novel classes of potent PDE4 inhibitors suitable for pulmonary administration. Starting from a previous series of benzoic acid esters, we explored the chemical space in the solvent-exposed region of the enzyme catalytic binding pocket. Extensive structural modifications led to the discovery of a number of heterocycloalkyl esters as potent in vitro PDE4 inhibitors. (S*,S**)-18e and (S*,S**)-22e, in particular, exhibited optimal in vitro ADME and pharmacokinetics properties and dose-dependently counteracted acute lung eosinophilia in an experimental animal model. The optimal biological profile as well as the excellent solid-state properties suggest that both compounds have the potential to be effective topical agents for treating respiratory inflammatory diseases.
Collapse
Affiliation(s)
- Laura Carzaniga
- Chemistry Research and Drug Design, ∥Pharmacology and Toxicology, ‡Pharmacokinetics Biochemistry and Metabolism, †Analytics and Early Formulations, #Project Leader Corporate Drug Development, and ⊥Corporate Pre-Clinical R&D Director, Chiesi Farmaceutici S.p.A , Nuovo Centro Ricerche, Largo Belloli 11/a, 43122 Parma, Italy
| | - Gabriele Amari
- Chemistry Research and Drug Design, ∥Pharmacology and Toxicology, ‡Pharmacokinetics Biochemistry and Metabolism, †Analytics and Early Formulations, #Project Leader Corporate Drug Development, and ⊥Corporate Pre-Clinical R&D Director, Chiesi Farmaceutici S.p.A , Nuovo Centro Ricerche, Largo Belloli 11/a, 43122 Parma, Italy
| | - Andrea Rizzi
- Chemistry Research and Drug Design, ∥Pharmacology and Toxicology, ‡Pharmacokinetics Biochemistry and Metabolism, †Analytics and Early Formulations, #Project Leader Corporate Drug Development, and ⊥Corporate Pre-Clinical R&D Director, Chiesi Farmaceutici S.p.A , Nuovo Centro Ricerche, Largo Belloli 11/a, 43122 Parma, Italy
| | - Carmelida Capaldi
- Chemistry Research and Drug Design, ∥Pharmacology and Toxicology, ‡Pharmacokinetics Biochemistry and Metabolism, †Analytics and Early Formulations, #Project Leader Corporate Drug Development, and ⊥Corporate Pre-Clinical R&D Director, Chiesi Farmaceutici S.p.A , Nuovo Centro Ricerche, Largo Belloli 11/a, 43122 Parma, Italy
| | - Renato De Fanti
- Chemistry Research and Drug Design, ∥Pharmacology and Toxicology, ‡Pharmacokinetics Biochemistry and Metabolism, †Analytics and Early Formulations, #Project Leader Corporate Drug Development, and ⊥Corporate Pre-Clinical R&D Director, Chiesi Farmaceutici S.p.A , Nuovo Centro Ricerche, Largo Belloli 11/a, 43122 Parma, Italy
| | - Eleonora Ghidini
- Chemistry Research and Drug Design, ∥Pharmacology and Toxicology, ‡Pharmacokinetics Biochemistry and Metabolism, †Analytics and Early Formulations, #Project Leader Corporate Drug Development, and ⊥Corporate Pre-Clinical R&D Director, Chiesi Farmaceutici S.p.A , Nuovo Centro Ricerche, Largo Belloli 11/a, 43122 Parma, Italy
| | - Gino Villetti
- Chemistry Research and Drug Design, ∥Pharmacology and Toxicology, ‡Pharmacokinetics Biochemistry and Metabolism, †Analytics and Early Formulations, #Project Leader Corporate Drug Development, and ⊥Corporate Pre-Clinical R&D Director, Chiesi Farmaceutici S.p.A , Nuovo Centro Ricerche, Largo Belloli 11/a, 43122 Parma, Italy
| | - Chiara Carnini
- Chemistry Research and Drug Design, ∥Pharmacology and Toxicology, ‡Pharmacokinetics Biochemistry and Metabolism, †Analytics and Early Formulations, #Project Leader Corporate Drug Development, and ⊥Corporate Pre-Clinical R&D Director, Chiesi Farmaceutici S.p.A , Nuovo Centro Ricerche, Largo Belloli 11/a, 43122 Parma, Italy
| | - Nadia Moretto
- Chemistry Research and Drug Design, ∥Pharmacology and Toxicology, ‡Pharmacokinetics Biochemistry and Metabolism, †Analytics and Early Formulations, #Project Leader Corporate Drug Development, and ⊥Corporate Pre-Clinical R&D Director, Chiesi Farmaceutici S.p.A , Nuovo Centro Ricerche, Largo Belloli 11/a, 43122 Parma, Italy
| | - Fabrizio Facchinetti
- Chemistry Research and Drug Design, ∥Pharmacology and Toxicology, ‡Pharmacokinetics Biochemistry and Metabolism, †Analytics and Early Formulations, #Project Leader Corporate Drug Development, and ⊥Corporate Pre-Clinical R&D Director, Chiesi Farmaceutici S.p.A , Nuovo Centro Ricerche, Largo Belloli 11/a, 43122 Parma, Italy
| | - Paola Caruso
- Chemistry Research and Drug Design, ∥Pharmacology and Toxicology, ‡Pharmacokinetics Biochemistry and Metabolism, †Analytics and Early Formulations, #Project Leader Corporate Drug Development, and ⊥Corporate Pre-Clinical R&D Director, Chiesi Farmaceutici S.p.A , Nuovo Centro Ricerche, Largo Belloli 11/a, 43122 Parma, Italy
| | - Gessica Marchini
- Chemistry Research and Drug Design, ∥Pharmacology and Toxicology, ‡Pharmacokinetics Biochemistry and Metabolism, †Analytics and Early Formulations, #Project Leader Corporate Drug Development, and ⊥Corporate Pre-Clinical R&D Director, Chiesi Farmaceutici S.p.A , Nuovo Centro Ricerche, Largo Belloli 11/a, 43122 Parma, Italy
| | - Loredana Battipaglia
- Chemistry Research and Drug Design, ∥Pharmacology and Toxicology, ‡Pharmacokinetics Biochemistry and Metabolism, †Analytics and Early Formulations, #Project Leader Corporate Drug Development, and ⊥Corporate Pre-Clinical R&D Director, Chiesi Farmaceutici S.p.A , Nuovo Centro Ricerche, Largo Belloli 11/a, 43122 Parma, Italy
| | - Riccardo Patacchini
- Chemistry Research and Drug Design, ∥Pharmacology and Toxicology, ‡Pharmacokinetics Biochemistry and Metabolism, †Analytics and Early Formulations, #Project Leader Corporate Drug Development, and ⊥Corporate Pre-Clinical R&D Director, Chiesi Farmaceutici S.p.A , Nuovo Centro Ricerche, Largo Belloli 11/a, 43122 Parma, Italy
| | - Valentina Cenacchi
- Chemistry Research and Drug Design, ∥Pharmacology and Toxicology, ‡Pharmacokinetics Biochemistry and Metabolism, †Analytics and Early Formulations, #Project Leader Corporate Drug Development, and ⊥Corporate Pre-Clinical R&D Director, Chiesi Farmaceutici S.p.A , Nuovo Centro Ricerche, Largo Belloli 11/a, 43122 Parma, Italy
| | - Roberta Volta
- Chemistry Research and Drug Design, ∥Pharmacology and Toxicology, ‡Pharmacokinetics Biochemistry and Metabolism, †Analytics and Early Formulations, #Project Leader Corporate Drug Development, and ⊥Corporate Pre-Clinical R&D Director, Chiesi Farmaceutici S.p.A , Nuovo Centro Ricerche, Largo Belloli 11/a, 43122 Parma, Italy
| | - Francesco Amadei
- Chemistry Research and Drug Design, ∥Pharmacology and Toxicology, ‡Pharmacokinetics Biochemistry and Metabolism, †Analytics and Early Formulations, #Project Leader Corporate Drug Development, and ⊥Corporate Pre-Clinical R&D Director, Chiesi Farmaceutici S.p.A , Nuovo Centro Ricerche, Largo Belloli 11/a, 43122 Parma, Italy
| | - Alice Pappani
- Chemistry Research and Drug Design, ∥Pharmacology and Toxicology, ‡Pharmacokinetics Biochemistry and Metabolism, †Analytics and Early Formulations, #Project Leader Corporate Drug Development, and ⊥Corporate Pre-Clinical R&D Director, Chiesi Farmaceutici S.p.A , Nuovo Centro Ricerche, Largo Belloli 11/a, 43122 Parma, Italy
| | - Silvia Capacchi
- Chemistry Research and Drug Design, ∥Pharmacology and Toxicology, ‡Pharmacokinetics Biochemistry and Metabolism, †Analytics and Early Formulations, #Project Leader Corporate Drug Development, and ⊥Corporate Pre-Clinical R&D Director, Chiesi Farmaceutici S.p.A , Nuovo Centro Ricerche, Largo Belloli 11/a, 43122 Parma, Italy
| | - Valentina Bagnacani
- Chemistry Research and Drug Design, ∥Pharmacology and Toxicology, ‡Pharmacokinetics Biochemistry and Metabolism, †Analytics and Early Formulations, #Project Leader Corporate Drug Development, and ⊥Corporate Pre-Clinical R&D Director, Chiesi Farmaceutici S.p.A , Nuovo Centro Ricerche, Largo Belloli 11/a, 43122 Parma, Italy
| | - Maurizio Delcanale
- Chemistry Research and Drug Design, ∥Pharmacology and Toxicology, ‡Pharmacokinetics Biochemistry and Metabolism, †Analytics and Early Formulations, #Project Leader Corporate Drug Development, and ⊥Corporate Pre-Clinical R&D Director, Chiesi Farmaceutici S.p.A , Nuovo Centro Ricerche, Largo Belloli 11/a, 43122 Parma, Italy
| | - Paola Puccini
- Chemistry Research and Drug Design, ∥Pharmacology and Toxicology, ‡Pharmacokinetics Biochemistry and Metabolism, †Analytics and Early Formulations, #Project Leader Corporate Drug Development, and ⊥Corporate Pre-Clinical R&D Director, Chiesi Farmaceutici S.p.A , Nuovo Centro Ricerche, Largo Belloli 11/a, 43122 Parma, Italy
| | - Silvia Catinella
- Chemistry Research and Drug Design, ∥Pharmacology and Toxicology, ‡Pharmacokinetics Biochemistry and Metabolism, †Analytics and Early Formulations, #Project Leader Corporate Drug Development, and ⊥Corporate Pre-Clinical R&D Director, Chiesi Farmaceutici S.p.A , Nuovo Centro Ricerche, Largo Belloli 11/a, 43122 Parma, Italy
| | - Maurizio Civelli
- Chemistry Research and Drug Design, ∥Pharmacology and Toxicology, ‡Pharmacokinetics Biochemistry and Metabolism, †Analytics and Early Formulations, #Project Leader Corporate Drug Development, and ⊥Corporate Pre-Clinical R&D Director, Chiesi Farmaceutici S.p.A , Nuovo Centro Ricerche, Largo Belloli 11/a, 43122 Parma, Italy
| | - Elisabetta Armani
- Chemistry Research and Drug Design, ∥Pharmacology and Toxicology, ‡Pharmacokinetics Biochemistry and Metabolism, †Analytics and Early Formulations, #Project Leader Corporate Drug Development, and ⊥Corporate Pre-Clinical R&D Director, Chiesi Farmaceutici S.p.A , Nuovo Centro Ricerche, Largo Belloli 11/a, 43122 Parma, Italy
| |
Collapse
|
30
|
Lakshmi SP, Reddy AT, Reddy RC. Emerging pharmaceutical therapies for COPD. Int J Chron Obstruct Pulmon Dis 2017; 12:2141-2156. [PMID: 28790817 PMCID: PMC5531723 DOI: 10.2147/copd.s121416] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
COPD, for which cigarette smoking is the major risk factor, remains a worldwide burden. Current therapies provide only limited short-term benefit and fail to halt progression. A variety of potential therapeutic targets are currently being investigated, including COPD-related proinflammatory mediators and signaling pathways. Other investigational compounds target specific aspects or complications of COPD such as mucus hypersecretion and pulmonary hypertension. Although many candidate therapies have shown no significant effects, other emerging therapies have improved lung function, pulmonary hypertension, glucocorticoid sensitivity, and/or the frequency of exacerbations. Among these are compounds that inhibit the CXCR2 receptor, mitogen-activated protein kinase/Src kinase, myristoylated alanine-rich C kinase substrate, selectins, and the endothelin receptor. Activation of certain transcription factors may also be relevant, as a large retrospective cohort study of COPD patients with diabetes found that the peroxisome proliferator-activated receptor γ (PPARγ) agonists rosiglitazone and pioglitazone were associated with reduced COPD exacerbation rate. Notably, several therapies have shown efficacy only in identifiable subgroups of COPD patients, suggesting that subgroup identification may become more important in future treatment strategies. This review summarizes the status of emerging therapeutic pharmaceuticals for COPD and highlights those that appear most promising.
Collapse
Affiliation(s)
- Sowmya P Lakshmi
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh School of Medicine.,Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, USA
| | - Aravind T Reddy
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh School of Medicine.,Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, USA
| | - Raju C Reddy
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh School of Medicine.,Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, USA
| |
Collapse
|
31
|
Zhou ZZ, Cheng YF, Zou ZQ, Ge BC, Yu H, Huang C, Wang HT, Yang XM, Xu JP. Discovery of N-Alkyl Catecholamides as Selective Phosphodiesterase-4 Inhibitors with Anti-neuroinflammation Potential Exhibiting Antidepressant-like Effects at Non-emetic Doses. ACS Chem Neurosci 2017; 8:135-146. [PMID: 27690383 DOI: 10.1021/acschemneuro.6b00271] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Depression involving neuroinflammation is one of the most common disabling and life-threatening psychiatric disorders. Phosphodiesterase 4 (PDE4) inhibitors produce potent antidepressant-like and cognition-enhancing effects. However, their clinical utility is limited by their major side effect of emesis. To obtain more selective PDE4 inhibitors with antidepressant and anti-neuroinflammation potential and less emesis, we designed and synthesized a series of N-alkyl catecholamides by modifying the 4-methoxybenzyl group of our hit compound, FCPE07, with an alkyl side chain. Among these compounds, 10 compounds displayed submicromolar IC50 values in the mid- to low-nanomolar range. Moreover, 4-difluoromethoxybenzamides 10g and 10j, bearing isopropyl groups, exhibited the highest PDE4 inhibitory activities, with IC50 values in the low-nanomolar range and with higher selectivities for PDE4 (approximately 5000-fold and 2100-fold over other PDEs, respectively). Furthermore, compound 10j displayed anti-neuroinflammation potential, promising antidepressant-like effects, and a zero incidence rate of emesis at 0.8 mg/kg within 180 min.
Collapse
Affiliation(s)
- Zhong-Zhen Zhou
- Department of Neuropharmacology and Novel
Drug Discovery, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
| | - Yu-Fang Cheng
- Department of Neuropharmacology and Novel
Drug Discovery, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
| | - Zheng-Qiang Zou
- Department of Neuropharmacology and Novel
Drug Discovery, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
| | - Bing-Chen Ge
- Department of Neuropharmacology and Novel
Drug Discovery, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
| | - Hui Yu
- Department of Neuropharmacology and Novel
Drug Discovery, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
| | - Cang Huang
- Department of Neuropharmacology and Novel
Drug Discovery, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
| | - Hai-Tao Wang
- Department of Neuropharmacology and Novel
Drug Discovery, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
| | - Xue-Mei Yang
- Hygiene
Detection Center, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Jiang-Ping Xu
- Department of Neuropharmacology and Novel
Drug Discovery, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
| |
Collapse
|
32
|
Nunes IKDC, de Souza ET, Cardozo SVS, Carvalho VDF, Romeiro NC, Silva PMRE, Martins MA, Barreiro EJ, Lima LM. Synthesis, Pharmacological Profile and Docking Studies of New Sulfonamides Designed as Phosphodiesterase-4 Inhibitors. PLoS One 2016; 11:e0162895. [PMID: 27695125 PMCID: PMC5047629 DOI: 10.1371/journal.pone.0162895] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 08/30/2016] [Indexed: 11/21/2022] Open
Abstract
Prior investigations showed that increased levels of cyclic AMP down-regulate lung inflammatory changes, stimulating the interest in phosphodiesterase (PDE)4 as therapeutic target. Here, we described the synthesis, pharmacological profile and docking properties of a novel sulfonamide series (5 and 6a-k) designed as PDE4 inhibitors. Compounds were screened for their selectivity against the four isoforms of human PDE4 using an IMAP fluorescence polarized protocol. The effect on allergen- or LPS-induced lung inflammation and airway hyper-reactivity (AHR) was studied in A/J mice, while the xylazine/ketamine-induced anesthesia test was employed as a behavioral correlate of emesis in rodents. As compared to rolipram, the most promising screened compound, 6a (LASSBio-448) presented a better inhibitory index concerning PDE4D/PDE4A or PDE4D/PDE4B. Accordingly, docking analyses of the putative interactions of LASSBio-448 revealed similar poses in the active site of PDE4A and PDE4C, but slight unlike orientations in PDE4B and PDE4D. LASSBio-448 (100 mg/kg, oral), 1 h before provocation, inhibited allergen-induced eosinophil accumulation in BAL fluid and lung tissue samples. Under an interventional approach, LASSBio-448 reversed ongoing lung eosinophilic infiltration, mucus exacerbation, peribronchiolar fibrosis and AHR by allergen provocation, in a mechanism clearly associated with blockade of pro-inflammatory mediators such as IL-4, IL-5, IL-13 and eotaxin-2. LASSBio-448 (2.5 and 10 mg/kg) also prevented inflammation and AHR induced by LPS. Finally, the sulfonamide derivative was shown to be less pro-emetic than rolipram and cilomilast in the assay employed. These findings suggest that LASSBio-448 is a new PDE4 inhibitor with marked potential to prevent and reverse pivotal pathological features of diseases characterized by lung inflammation, such as asthma.
Collapse
Affiliation(s)
- Isabelle Karine da Costa Nunes
- Instituto Nacional de Ciência e Tecnologia de Fármacos e Medicamentos (INCT-INOFAR). Laboratório de Avaliação e Síntese de Substâncias Bioativas (LASSBio®), Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
- Programa de Pós-graduação em Farmacologia e Química Medicinal, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Everton Tenório de Souza
- Programa de Pós-graduação em Farmacologia e Química Medicinal, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
- Laborat×rio de Inflamação, Instituto Oswaldo Cruz-Fiocruz, Rio de Janeiro, Brasil
| | - Suzana Vanessa S. Cardozo
- Programa de Pós-graduação em Farmacologia e Química Medicinal, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
- Laborat×rio de Inflamação, Instituto Oswaldo Cruz-Fiocruz, Rio de Janeiro, Brasil
| | - Vinicius de Frias Carvalho
- Instituto Nacional de Ciência e Tecnologia de Fármacos e Medicamentos (INCT-INOFAR). Laboratório de Avaliação e Síntese de Substâncias Bioativas (LASSBio®), Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
- Laborat×rio de Inflamação, Instituto Oswaldo Cruz-Fiocruz, Rio de Janeiro, Brasil
| | - Nelilma Correia Romeiro
- Instituto Nacional de Ciência e Tecnologia de Fármacos e Medicamentos (INCT-INOFAR). Laboratório de Avaliação e Síntese de Substâncias Bioativas (LASSBio®), Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Patrícia Machado Rodrigues e Silva
- Instituto Nacional de Ciência e Tecnologia de Fármacos e Medicamentos (INCT-INOFAR). Laboratório de Avaliação e Síntese de Substâncias Bioativas (LASSBio®), Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
- Programa de Pós-graduação em Farmacologia e Química Medicinal, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
- Laborat×rio de Inflamação, Instituto Oswaldo Cruz-Fiocruz, Rio de Janeiro, Brasil
| | - Marco Aurélio Martins
- Instituto Nacional de Ciência e Tecnologia de Fármacos e Medicamentos (INCT-INOFAR). Laboratório de Avaliação e Síntese de Substâncias Bioativas (LASSBio®), Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
- Programa de Pós-graduação em Farmacologia e Química Medicinal, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
- Laborat×rio de Inflamação, Instituto Oswaldo Cruz-Fiocruz, Rio de Janeiro, Brasil
- * E-mail: (LML); (MAM)
| | - Eliezer J. Barreiro
- Instituto Nacional de Ciência e Tecnologia de Fármacos e Medicamentos (INCT-INOFAR). Laboratório de Avaliação e Síntese de Substâncias Bioativas (LASSBio®), Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
- Programa de Pós-graduação em Farmacologia e Química Medicinal, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Lídia Moreira Lima
- Instituto Nacional de Ciência e Tecnologia de Fármacos e Medicamentos (INCT-INOFAR). Laboratório de Avaliação e Síntese de Substâncias Bioativas (LASSBio®), Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
- Programa de Pós-graduação em Farmacologia e Química Medicinal, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
- * E-mail: (LML); (MAM)
| |
Collapse
|
33
|
Abstract
PURPOSE OF REVIEW The Th2 pathway starts with the binding of IL-4 to the IL-4 receptor followed by the phosphorylation of signal transducer and activator of transcription 6 and the activation of GATA3. The most important question relates to the sources of IL-4 and IL-4 related inflammation. Which cells other than Th2 cells are responsible for airway inflammation in asthma? RECENT FINDINGS Accumulating data indicate that basophils contribute to endothelium-related IL-4-dependent inflammation. There is also a dendritic cell-related alternative for the induction of Th2 cells via Notch signalling. GATA3 deoxyribozyme improves asthma that is not clearly related to T-cells. The innate immune response in allergy is linked to mast cells, basophils, and the innate lymphoid cell type 2 (ILC2). ILC2s respond to IL-25, IL-33, thymic stromal lymphopoietin, and leukotrienes by producing IL-4, IL-5, and IL-13. In addition to all this inflammatory-cell-driven asthma, increasing evidence has emerged relating to smooth muscle cell activation, the endothelial and epithelial barrier functions, and improvements in the barrier function. The elevation of intracellular cyclic adenosine monophosphate because of the use of phosphodiesterase inhibitors adds to the prevention of epithelial-endothelial leakage, supports airway smooth muscle relaxation, and is immunosuppressive. CONCLUSION AND SUMMARY IL-4 is the predominant Th2 cell cytokine. Many more cells, including eosinophils, basophils, mast cells, and ILC2, contribute to the production of IL-4 in the airways. Epithelial cells and endothelial cells lose barrier function in the context of allergic airway inflammation, and this could be at least partially remedied by increasing the intracellular cyclic adenosine monophosphate levels through phosphodiesterase inhibition.
Collapse
|
34
|
Evaluation of the Effects of CHF6001, an Inhaled PDE4 Inhibitor, on Cardiac Repolarization and Cardiac Arrhythmias in Healthy Volunteers. J Cardiovasc Pharmacol 2016; 68:41-8. [PMID: 26945156 DOI: 10.1097/fjc.0000000000000384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) is a multicomponent condition characterized by airway inflammation and associated to comorbidities, including cardiovascular diseases. Among anti-inflammatory agents in development for COPD, the phosphodiesterase inhibitors administrated by inhalation have the potential for increased efficacy and reduced systemic side effects. CHF6001 is an inhaled PDE4 inhibitor with proven anti-inflammatory properties in animal models. This randomized, double-blind, placebo-controlled study was aimed to demonstrate its cardiovascular safety and tolerability in healthy male volunteers with normal electrocardiogram and cardiac parameters. Single and multiple ascending doses (7 days of administration) of CHF6001 were administered. Three electrocardiograms were recorded at several pharmacokinetic time points and at each time points, postdose heart rate, QRS and PR intervals, and presence of arrhythmia were evaluated. In single ascending dose, QTcF intervals did not increase more than 30 milliseconds from the baseline, all heart rate was between 45 and 100 bpm, and no statistically significant differences were observed in PR and QRS intervals. In multiple ascending dose, cardiac parameters did not differ significantly from baseline. In the pharmacokinetic/pharmacodynamic analysis, no medically or clinically significant changes were found. Further studies are ongoing to demonstrate that CHF6001 is safe and well tolerated in COPD patients as well.
Collapse
|
35
|
Edwards MR, Facchinetti F, Civelli M, Villetti G, Johnston SL. Anti-inflammatory effects of the novel inhaled phosphodiesterase type 4 inhibitor CHF6001 on virus-inducible cytokines. Pharmacol Res Perspect 2016; 4:e00202. [PMID: 26977295 PMCID: PMC4777265 DOI: 10.1002/prp2.202] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 10/30/2015] [Accepted: 11/03/2015] [Indexed: 12/31/2022] Open
Abstract
Respiratory virus infections precipitate asthma and chronic obstructive pulmonary disease (COPD) exacerbations, with most exacerbations due to rhinovirus infection. Both asthma and COPD exacerbations are not well controlled by steroid therapies, and there is a much research interest in finding improved therapies or combinations of therapies for controlling exacerbations. CHF6001 is a new, inhaled highly potent and selective phosphodiesterase type 4 (PDE4) inhibitor. Using in vitro human bronchial epithelial cells (BEAS‐2B), we investigated the potential anti‐inflammatory effects of CHF6001 on rhinovirus (RV1B)‐induced cytokines. Cytokine mRNA was measured by real‐time PCR, while protein release was measured by ELISA. CHF6001 was used in a 7‐point dose–response curve (1000–0.001 nmol/L) as a 1.5‐h pretreatment prior to infection in comparison with roflumilast. Both roflumilast and CHF6001 reduced RV1B‐induced IL‐8, IL‐29, IP‐10, and RANTES mRNA and protein in a concentration‐dependent manner. Generally, CHF6001 was 13‐ to 16‐fold more potent (subnanomolar EC50 values) than roflumilast at reducing IL‐8, IL‐29, IP‐10, and RANTES mRNA and protein release, but had similar efficacies. In combination with the steroid fluticasone propionate (1 nmol/L), CHF6001 had additive effects, significantly reducing RV‐induced cytokines when compared with steroid or CHF6001 alone. Combined low‐dose steroid and low‐dose CHF6001 had a similar efficacy as high‐dose steroid or CHF6001 alone, indicating the combination had steroid and PDE4 inhibitor sparing effects. Overall results indicate that PDE4 inhibitors have anti‐inflammatory activity against virus‐induced inflammatory mediators and that CHF6001 is more potent than roflumilast.
Collapse
Affiliation(s)
- Michael R Edwards
- Airway Disease Infection Section National Heart Lung Institute Imperial College London London United Kingdom; MRC and Asthma UK Centre for Allergic Mechanisms of Asthma London United Kingdom
| | | | - Maurizio Civelli
- Corporate Pre-clinical R&D Chiesi Farmaceutici S.p.A. Parma Italy
| | - Gino Villetti
- Corporate Pre-clinical R&D Chiesi Farmaceutici S.p.A. Parma Italy
| | - Sebastian L Johnston
- Airway Disease Infection Section National Heart Lung Institute Imperial College London London United Kingdom; MRC and Asthma UK Centre for Allergic Mechanisms of Asthma London United Kingdom
| |
Collapse
|
36
|
Mulhall AM, Droege CA, Ernst NE, Panos RJ, Zafar MA. Phosphodiesterase 4 inhibitors for the treatment of chronic obstructive pulmonary disease: a review of current and developing drugs. Expert Opin Investig Drugs 2015; 24:1597-611. [PMID: 26419847 DOI: 10.1517/13543784.2015.1094054] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Phosphodiesterase (PDE) inhibitors modulate lung inflammation and cause bronchodilation by increasing intracellular cyclic adenosine 3', 5'-monophosphate in airway smooth muscle and inflammatory cells. Roflumilast is the only approved PDE-4 inhibitor (PDE4I) for use in chronic obstructive pulmonary disease (COPD). Its beneficial clinical effects occur preferentially in patients with chronic bronchitis and frequent COPD exacerbations. Use of roflumilast as adjunctive or alternate therapy to other COPD medications reduces exacerbations and modestly improves lung function. AREAS COVERED This article reviews the current role of PDE4I in COPD treatment emphasizing roflumilast's clinical efficacy and adverse effects. This article also reviews developing PDE4Is in early clinical trials and in preclinical studies. EXPERT OPINION After decades of research in drug development, PDE4Is are a welcomed addition to the COPD therapeutic armamentarium. In its current clinical role, the salubrious clinical effects of PDE4I in reducing exacerbations and stabilizing the frequent exacerbator phenotype have to be cautiously balanced with numerous adverse effects. Developing drugs may provide similar or better clinical benefits while minimizing adverse effects by changing the mode of drug delivery to inhaled formulations, combining dual PDE isoenzyme inhibitors (PDE1/4I and PDE3/4I) and by forming hybrid molecules with other bronchodilators (muscarinic receptor antagonist/PDE4I and β2-agonist/PDE4I).
Collapse
Affiliation(s)
- Aaron M Mulhall
- a 1 University of Cincinnati Medical Center, Division of Pulmonary and Critical Care Medicine , Cincinnati, USA .,b 2 Division of Pulmonary and Critical Care Medicine, Veterans Affairs Medical Center , Cincinnati, USA
| | - Christopher A Droege
- c 3 University of Cincinnati Medical Center, Department of Pharmacy Services , Cincinnati, USA
| | - Neil E Ernst
- c 3 University of Cincinnati Medical Center, Department of Pharmacy Services , Cincinnati, USA
| | - Ralph J Panos
- a 1 University of Cincinnati Medical Center, Division of Pulmonary and Critical Care Medicine , Cincinnati, USA .,b 2 Division of Pulmonary and Critical Care Medicine, Veterans Affairs Medical Center , Cincinnati, USA
| | - Muhammad A Zafar
- a 1 University of Cincinnati Medical Center, Division of Pulmonary and Critical Care Medicine , Cincinnati, USA .,b 2 Division of Pulmonary and Critical Care Medicine, Veterans Affairs Medical Center , Cincinnati, USA
| |
Collapse
|
37
|
Cenacchi V, Battaglia R, Cinato F, Riccardi B, Spinabelli D, Brogin G, Puccini P, Pezzetta D. In vitro and in vivo metabolism of CHF 6001, a selective phosphodiesterase (PDE4) inhibitor. Xenobiotica 2015; 45:693-710. [PMID: 25733029 DOI: 10.3109/00498254.2015.1014945] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
1. The metabolism of CHF 6001, a novel PDE4 inhibitor, was determined in vitro in mouse, rat, dog, monkey and human microsomes and hepatocytes and in vivo in plasma, urine, feces and bile of rats after intravenous and intratracheal administration. 2. The behavior of CHF 6001 in microsomes and hepatocytes changed across species. CYP3A4/5 isoenzymes were identified to be the primary enzymes responsible for the metabolism of CHF 6001 in human liver microsomes. 3. In the rat, CHF 6001 was found extensively metabolized in urine, feces and bile, but not in plasma, where CHF 6001 was the main compound present. The metabolite profiles were different in the four biological matrices from both qualitative and quantitative point of view. 4. CHF 6001 was metabolized through hydrolysis with the formation of the alcohol CHF 5956, loss of a chlorine atom, loss of the N-oxide, hydroxylation, loss of the cyclopropylmethyl group in the alcohol moiety, conjugation with glucuronic acid, glutathione and cysteine-glycine. 5. The major metabolite present in the bile was isolated and characterized by nuclear magnetic resonance analysis. It derived from CHF 6001 through contraction of the pyridine-N-oxide ring to N-hydroxy pyrrole and conjugation with glucuronic acid.
Collapse
|
38
|
Moretto N, Caruso P, Bosco R, Marchini G, Pastore F, Armani E, Amari G, Rizzi A, Ghidini E, De Fanti R, Capaldi C, Carzaniga L, Hirsch E, Buccellati C, Sala A, Carnini C, Patacchini R, Delcanale M, Civelli M, Villetti G, Facchinetti F. CHF6001 I: a novel highly potent and selective phosphodiesterase 4 inhibitor with robust anti-inflammatory activity and suitable for topical pulmonary administration. J Pharmacol Exp Ther 2015; 352:559-67. [PMID: 25576075 DOI: 10.1124/jpet.114.220541] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
This study examined the pharmacologic characterization of CHF6001 [(S)-3,5-dichloro-4-(2-(3-(cyclopropylmethoxy)-4-(difluoromethoxy)phenyl)-2-(3-(cyclopropylmethoxy)-4-(methylsulfonamido)benzoyloxy)ethyl)pyridine 1-oxide], a novel phosphodiesterase (PDE)4 inhibitor designed for treating pulmonary inflammatory diseases via inhaled administration. CHF6001 was 7- and 923-fold more potent than roflumilast and cilomilast, respectively, in inhibiting PDE4 enzymatic activity (IC50 = 0.026 ± 0.006 nM). CHF6001 inhibited PDE4 isoforms A-D with equal potency, showed an elevated ratio of high-affinity rolipram binding site versus low-affinity rolipram binding site (i.e., >40) and displayed >20,000-fold selectivity versus PDE4 compared with a panel of PDEs. CHF6001 effectively inhibited (subnanomolar IC50 values) the release of tumor necrosis factor-α from human peripheral blood mononuclear cells, human acute monocytic leukemia cell line macrophages (THP-1), and rodent macrophages (RAW264.7 and NR8383). Moreover, CHF6001 potently inhibited the activation of oxidative burst in neutrophils and eosinophils, neutrophil chemotaxis, and the release of interferon-γ from CD4(+) T cells. In all these functional assays, CHF6001 was more potent than previously described PDE4 inhibitors, including roflumilast, UK-500,001 [2-(3,4-difluorophenoxy)-5-fluoro-N-((1S,4S)-4-(2-hydroxy-5-methylbenzamido)cyclohexyl)nicotinamide], and cilomilast, and it was comparable to GSK256066 [6-((3-(dimethylcarbamoyl)phenyl)sulfonyl)-4-((3-methoxyphenyl)amino)-8-methylquinoline-3-carboxamide]. When administered intratracheally to rats as a micronized dry powder, CHF6001 inhibited liposaccharide-induced pulmonary neutrophilia (ED50 = 0.205 μmol/kg) and leukocyte infiltration (ED50 = 0.188 μmol/kg) with an efficacy comparable to a high dose of budesonide (1 μmol/kg i.p.). In sum, CHF6001 has the potential to be an effective topical treatment of conditions associated with pulmonary inflammation, including asthma and chronic obstructive pulmonary disease.
Collapse
Affiliation(s)
- Nadia Moretto
- Corporate Pre-Clinical R & D, Chiesi Farmaceutici S.p.A., Parma, Italy (N.M., P.C., R.B., G.M., F.P., E.A., G.A., A.R., E.G., R.D.F., Ca.C., L.C., Ch.C., R.P. M.D., M.C., G.V., F.F.); Molecular Biotechnology Center, University of Turin, Turin, Italy (E.H.); and Dipartimento di Scienze Farmacologiche e Biomolecolari, Milan, Italy (C.B., A.S.)
| | - Paola Caruso
- Corporate Pre-Clinical R & D, Chiesi Farmaceutici S.p.A., Parma, Italy (N.M., P.C., R.B., G.M., F.P., E.A., G.A., A.R., E.G., R.D.F., Ca.C., L.C., Ch.C., R.P. M.D., M.C., G.V., F.F.); Molecular Biotechnology Center, University of Turin, Turin, Italy (E.H.); and Dipartimento di Scienze Farmacologiche e Biomolecolari, Milan, Italy (C.B., A.S.)
| | - Raffaella Bosco
- Corporate Pre-Clinical R & D, Chiesi Farmaceutici S.p.A., Parma, Italy (N.M., P.C., R.B., G.M., F.P., E.A., G.A., A.R., E.G., R.D.F., Ca.C., L.C., Ch.C., R.P. M.D., M.C., G.V., F.F.); Molecular Biotechnology Center, University of Turin, Turin, Italy (E.H.); and Dipartimento di Scienze Farmacologiche e Biomolecolari, Milan, Italy (C.B., A.S.)
| | - Gessica Marchini
- Corporate Pre-Clinical R & D, Chiesi Farmaceutici S.p.A., Parma, Italy (N.M., P.C., R.B., G.M., F.P., E.A., G.A., A.R., E.G., R.D.F., Ca.C., L.C., Ch.C., R.P. M.D., M.C., G.V., F.F.); Molecular Biotechnology Center, University of Turin, Turin, Italy (E.H.); and Dipartimento di Scienze Farmacologiche e Biomolecolari, Milan, Italy (C.B., A.S.)
| | - Fiorella Pastore
- Corporate Pre-Clinical R & D, Chiesi Farmaceutici S.p.A., Parma, Italy (N.M., P.C., R.B., G.M., F.P., E.A., G.A., A.R., E.G., R.D.F., Ca.C., L.C., Ch.C., R.P. M.D., M.C., G.V., F.F.); Molecular Biotechnology Center, University of Turin, Turin, Italy (E.H.); and Dipartimento di Scienze Farmacologiche e Biomolecolari, Milan, Italy (C.B., A.S.)
| | - Elisabetta Armani
- Corporate Pre-Clinical R & D, Chiesi Farmaceutici S.p.A., Parma, Italy (N.M., P.C., R.B., G.M., F.P., E.A., G.A., A.R., E.G., R.D.F., Ca.C., L.C., Ch.C., R.P. M.D., M.C., G.V., F.F.); Molecular Biotechnology Center, University of Turin, Turin, Italy (E.H.); and Dipartimento di Scienze Farmacologiche e Biomolecolari, Milan, Italy (C.B., A.S.)
| | - Gabriele Amari
- Corporate Pre-Clinical R & D, Chiesi Farmaceutici S.p.A., Parma, Italy (N.M., P.C., R.B., G.M., F.P., E.A., G.A., A.R., E.G., R.D.F., Ca.C., L.C., Ch.C., R.P. M.D., M.C., G.V., F.F.); Molecular Biotechnology Center, University of Turin, Turin, Italy (E.H.); and Dipartimento di Scienze Farmacologiche e Biomolecolari, Milan, Italy (C.B., A.S.)
| | - Andrea Rizzi
- Corporate Pre-Clinical R & D, Chiesi Farmaceutici S.p.A., Parma, Italy (N.M., P.C., R.B., G.M., F.P., E.A., G.A., A.R., E.G., R.D.F., Ca.C., L.C., Ch.C., R.P. M.D., M.C., G.V., F.F.); Molecular Biotechnology Center, University of Turin, Turin, Italy (E.H.); and Dipartimento di Scienze Farmacologiche e Biomolecolari, Milan, Italy (C.B., A.S.)
| | - Eleonora Ghidini
- Corporate Pre-Clinical R & D, Chiesi Farmaceutici S.p.A., Parma, Italy (N.M., P.C., R.B., G.M., F.P., E.A., G.A., A.R., E.G., R.D.F., Ca.C., L.C., Ch.C., R.P. M.D., M.C., G.V., F.F.); Molecular Biotechnology Center, University of Turin, Turin, Italy (E.H.); and Dipartimento di Scienze Farmacologiche e Biomolecolari, Milan, Italy (C.B., A.S.)
| | - Renato De Fanti
- Corporate Pre-Clinical R & D, Chiesi Farmaceutici S.p.A., Parma, Italy (N.M., P.C., R.B., G.M., F.P., E.A., G.A., A.R., E.G., R.D.F., Ca.C., L.C., Ch.C., R.P. M.D., M.C., G.V., F.F.); Molecular Biotechnology Center, University of Turin, Turin, Italy (E.H.); and Dipartimento di Scienze Farmacologiche e Biomolecolari, Milan, Italy (C.B., A.S.)
| | - Carmelida Capaldi
- Corporate Pre-Clinical R & D, Chiesi Farmaceutici S.p.A., Parma, Italy (N.M., P.C., R.B., G.M., F.P., E.A., G.A., A.R., E.G., R.D.F., Ca.C., L.C., Ch.C., R.P. M.D., M.C., G.V., F.F.); Molecular Biotechnology Center, University of Turin, Turin, Italy (E.H.); and Dipartimento di Scienze Farmacologiche e Biomolecolari, Milan, Italy (C.B., A.S.)
| | - Laura Carzaniga
- Corporate Pre-Clinical R & D, Chiesi Farmaceutici S.p.A., Parma, Italy (N.M., P.C., R.B., G.M., F.P., E.A., G.A., A.R., E.G., R.D.F., Ca.C., L.C., Ch.C., R.P. M.D., M.C., G.V., F.F.); Molecular Biotechnology Center, University of Turin, Turin, Italy (E.H.); and Dipartimento di Scienze Farmacologiche e Biomolecolari, Milan, Italy (C.B., A.S.)
| | - Emilio Hirsch
- Corporate Pre-Clinical R & D, Chiesi Farmaceutici S.p.A., Parma, Italy (N.M., P.C., R.B., G.M., F.P., E.A., G.A., A.R., E.G., R.D.F., Ca.C., L.C., Ch.C., R.P. M.D., M.C., G.V., F.F.); Molecular Biotechnology Center, University of Turin, Turin, Italy (E.H.); and Dipartimento di Scienze Farmacologiche e Biomolecolari, Milan, Italy (C.B., A.S.)
| | - Carola Buccellati
- Corporate Pre-Clinical R & D, Chiesi Farmaceutici S.p.A., Parma, Italy (N.M., P.C., R.B., G.M., F.P., E.A., G.A., A.R., E.G., R.D.F., Ca.C., L.C., Ch.C., R.P. M.D., M.C., G.V., F.F.); Molecular Biotechnology Center, University of Turin, Turin, Italy (E.H.); and Dipartimento di Scienze Farmacologiche e Biomolecolari, Milan, Italy (C.B., A.S.)
| | - Angelo Sala
- Corporate Pre-Clinical R & D, Chiesi Farmaceutici S.p.A., Parma, Italy (N.M., P.C., R.B., G.M., F.P., E.A., G.A., A.R., E.G., R.D.F., Ca.C., L.C., Ch.C., R.P. M.D., M.C., G.V., F.F.); Molecular Biotechnology Center, University of Turin, Turin, Italy (E.H.); and Dipartimento di Scienze Farmacologiche e Biomolecolari, Milan, Italy (C.B., A.S.)
| | - Chiara Carnini
- Corporate Pre-Clinical R & D, Chiesi Farmaceutici S.p.A., Parma, Italy (N.M., P.C., R.B., G.M., F.P., E.A., G.A., A.R., E.G., R.D.F., Ca.C., L.C., Ch.C., R.P. M.D., M.C., G.V., F.F.); Molecular Biotechnology Center, University of Turin, Turin, Italy (E.H.); and Dipartimento di Scienze Farmacologiche e Biomolecolari, Milan, Italy (C.B., A.S.)
| | - Riccardo Patacchini
- Corporate Pre-Clinical R & D, Chiesi Farmaceutici S.p.A., Parma, Italy (N.M., P.C., R.B., G.M., F.P., E.A., G.A., A.R., E.G., R.D.F., Ca.C., L.C., Ch.C., R.P. M.D., M.C., G.V., F.F.); Molecular Biotechnology Center, University of Turin, Turin, Italy (E.H.); and Dipartimento di Scienze Farmacologiche e Biomolecolari, Milan, Italy (C.B., A.S.)
| | - Maurizio Delcanale
- Corporate Pre-Clinical R & D, Chiesi Farmaceutici S.p.A., Parma, Italy (N.M., P.C., R.B., G.M., F.P., E.A., G.A., A.R., E.G., R.D.F., Ca.C., L.C., Ch.C., R.P. M.D., M.C., G.V., F.F.); Molecular Biotechnology Center, University of Turin, Turin, Italy (E.H.); and Dipartimento di Scienze Farmacologiche e Biomolecolari, Milan, Italy (C.B., A.S.)
| | - Maurizio Civelli
- Corporate Pre-Clinical R & D, Chiesi Farmaceutici S.p.A., Parma, Italy (N.M., P.C., R.B., G.M., F.P., E.A., G.A., A.R., E.G., R.D.F., Ca.C., L.C., Ch.C., R.P. M.D., M.C., G.V., F.F.); Molecular Biotechnology Center, University of Turin, Turin, Italy (E.H.); and Dipartimento di Scienze Farmacologiche e Biomolecolari, Milan, Italy (C.B., A.S.)
| | - Gino Villetti
- Corporate Pre-Clinical R & D, Chiesi Farmaceutici S.p.A., Parma, Italy (N.M., P.C., R.B., G.M., F.P., E.A., G.A., A.R., E.G., R.D.F., Ca.C., L.C., Ch.C., R.P. M.D., M.C., G.V., F.F.); Molecular Biotechnology Center, University of Turin, Turin, Italy (E.H.); and Dipartimento di Scienze Farmacologiche e Biomolecolari, Milan, Italy (C.B., A.S.)
| | - Fabrizio Facchinetti
- Corporate Pre-Clinical R & D, Chiesi Farmaceutici S.p.A., Parma, Italy (N.M., P.C., R.B., G.M., F.P., E.A., G.A., A.R., E.G., R.D.F., Ca.C., L.C., Ch.C., R.P. M.D., M.C., G.V., F.F.); Molecular Biotechnology Center, University of Turin, Turin, Italy (E.H.); and Dipartimento di Scienze Farmacologiche e Biomolecolari, Milan, Italy (C.B., A.S.)
| |
Collapse
|