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Mortier C, Gracey E, Coudenys J, Manuello T, Decruy T, Maelegheer M, Stappers F, Gilis E, Gaublomme D, Van Hoorebeke L, Van Welden S, Ambler C, Hegen M, Symanowicz P, Steyn S, Berstein G, Elewaut D, Venken K. RORγt inhibition ameliorates IL-23 driven experimental psoriatic arthritis by predominantly modulating γδ-T cells. Rheumatology (Oxford) 2023; 62:3169-3178. [PMID: 36661300 DOI: 10.1093/rheumatology/kead022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/19/2022] [Accepted: 01/04/2023] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE Divergent therapeutic outcomes on different disease domains have been noted with IL-23 and IL-17A-blockade in PsA. Therefore, elucidating the role of RORγt, the master regulator of type 17 immune responses, is of potential therapeutic interest. To this end, RORγt inhibition was assessed in combined skin, joint and gut inflammation in vivo, using a PsA model. METHODS We tested the efficacy of a RORγt antagonist in B10.RIII mice challenged with systemic overexpression of IL-23 by hydrodynamic injection of IL-23 enhanced episomal vector (IL-23 EEV). Clinical outcomes were evaluated by histopathology. Bone density and surface erosions were examined using micro-computed tomography. Cytokine production was measured in serum and by intracellular flow cytometry. Gene expression in PsA-related tissues was analysed by qPCR. RESULTS RORγt-blockade significantly ameliorated psoriasis, peripheral arthritis and colitis development in IL-23 EEV mice (improvement of clinical scores and weight loss respectively by 91.8%, 58.2% and 7.0%, P < 0.001), in line with profound suppression of an enhanced type IL-17 immune signature in PsA-affected tissues. Moreover, inflammation-induced bone loss and bone erosions were reduced (P < 0.05 in calcaneus, P < 0.01 in tibia). Sustained IL-23 overexpression resulted in only mild signs of sacroiliitis. Gamma-delta (γδ)-T cells, the dominant source of T cell-derived IL-17A and IL-22, were expanded during IL-23 overexpression, and together with Th17 cells, clearly countered by RORγt inhibition (P < 0.001). CONCLUSION RORγt-blockade shows therapeutic efficacy in a preclinical PsA model with protection towards extra-musculoskeletal manifestations, reflected by a clear attenuation of type 17 cytokine responses by γδ-T cells and Th17 cells.
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Affiliation(s)
- Céline Mortier
- Department of Rheumatology, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Unit for Molecular Immunology and Inflammation, VIB-UGent Center for Inflammation Research, Ghent, Belgium
| | - Eric Gracey
- Department of Rheumatology, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Unit for Molecular Immunology and Inflammation, VIB-UGent Center for Inflammation Research, Ghent, Belgium
| | - Julie Coudenys
- Department of Rheumatology, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Unit for Molecular Immunology and Inflammation, VIB-UGent Center for Inflammation Research, Ghent, Belgium
| | - Teddy Manuello
- Department of Rheumatology, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Unit for Molecular Immunology and Inflammation, VIB-UGent Center for Inflammation Research, Ghent, Belgium
| | - Tine Decruy
- Department of Rheumatology, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Unit for Molecular Immunology and Inflammation, VIB-UGent Center for Inflammation Research, Ghent, Belgium
| | - Margaux Maelegheer
- Department of Rheumatology, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Unit for Molecular Immunology and Inflammation, VIB-UGent Center for Inflammation Research, Ghent, Belgium
| | - Flore Stappers
- Department of Rheumatology, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Unit for Molecular Immunology and Inflammation, VIB-UGent Center for Inflammation Research, Ghent, Belgium
| | - Elisabeth Gilis
- Department of Rheumatology, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Unit for Molecular Immunology and Inflammation, VIB-UGent Center for Inflammation Research, Ghent, Belgium
| | - Djoere Gaublomme
- Department of Rheumatology, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Unit for Molecular Immunology and Inflammation, VIB-UGent Center for Inflammation Research, Ghent, Belgium
| | - Luc Van Hoorebeke
- UGCT, Department of Physics and Astronomy, Ghent University, Ghent, Belgium
| | - Sophie Van Welden
- IBD Research Unit, Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium
- Intestinal Barrier Signaling in Disease and Therapy, VIB-UGent Center for Inflammation Research, Ghent, Belgium
| | | | - Martin Hegen
- Inflammation and Immunology Research Unit, Pfizer Inc, Cambridge, MA, USA
| | - Peter Symanowicz
- Inflammation and Immunology Research Unit, Pfizer Inc, Cambridge, MA, USA
| | - Stefan Steyn
- Pharmacokinetics, Dynamics and Metabolism, Pfizer Inc, Cambridge, MA, USA
| | - Gabriel Berstein
- Inflammation and Immunology Research Unit, Pfizer Inc, Cambridge, MA, USA
| | - Dirk Elewaut
- Department of Rheumatology, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Unit for Molecular Immunology and Inflammation, VIB-UGent Center for Inflammation Research, Ghent, Belgium
| | - Koen Venken
- Department of Rheumatology, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Unit for Molecular Immunology and Inflammation, VIB-UGent Center for Inflammation Research, Ghent, Belgium
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Gerstenberger BS, Ambler C, Arnold EP, Banker ME, Brown MF, Clark JD, Dermenci A, Dowty ME, Fensome A, Fish S, Hayward MM, Hegen M, Hollingshead BD, Knafels JD, Lin DW, Lin TH, Owen DR, Saiah E, Sharma R, Vajdos FF, Xing L, Yang X, Yang X, Wright SW. Discovery of Tyrosine Kinase 2 (TYK2) Inhibitor (PF-06826647) for the Treatment of Autoimmune Diseases. J Med Chem 2020; 63:13561-13577. [PMID: 32787094 DOI: 10.1021/acs.jmedchem.0c00948] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Tyrosine kinase 2 (TYK2) is a member of the JAK kinase family that regulates signal transduction downstream of receptors for the IL-23/IL-12 pathways and type I interferon family, where it pairs with JAK2 or JAK1, respectively. On the basis of human genetic and emerging clinical data, a selective TYK2 inhibitor provides an opportunity to treat autoimmune diseases delivering a potentially differentiated clinical profile compared to currently approved JAK inhibitors. The discovery of an ATP-competitive pyrazolopyrazinyl series of TYK2 inhibitors was accomplished through computational and structurally enabled design starting from a known kinase hinge binding motif. With understanding of PK/PD relationships, a target profile balancing TYK2 potency and selectivity over off-target JAK2 was established. Lead optimization involved modulating potency, selectivity, and ADME properties which led to the identification of the clinical candidate PF-06826647 (22).
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Affiliation(s)
| | | | - Eric P Arnold
- Pfizer Inc., Groton, Connecticut 06340, United States
| | | | | | - James D Clark
- Pfizer Inc., Cambridge, Massachusetts 02139, United States
| | | | - Martin E Dowty
- Pfizer Inc., Cambridge, Massachusetts 02139, United States
| | - Andrew Fensome
- Pfizer Inc., Cambridge, Massachusetts 02139, United States
| | - Susan Fish
- Pfizer Inc., Cambridge, Massachusetts 02139, United States
| | | | - Martin Hegen
- Pfizer Inc., Cambridge, Massachusetts 02139, United States
| | | | | | - David W Lin
- Pfizer Inc., Groton, Connecticut 06340, United States
| | - Tsung H Lin
- Pfizer Inc., Cambridge, Massachusetts 02139, United States
| | - Dafydd R Owen
- Pfizer Inc., Cambridge, Massachusetts 02139, United States
| | - Eddine Saiah
- Pfizer Inc., Cambridge, Massachusetts 02139, United States
| | - Raman Sharma
- Pfizer Inc., Groton, Connecticut 06340, United States
| | | | - Li Xing
- Pfizer Inc., Cambridge, Massachusetts 02139, United States
| | - Xiaojing Yang
- Pfizer Inc., Groton, Connecticut 06340, United States
| | - Xin Yang
- Pfizer Inc., Groton, Connecticut 06340, United States
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Casimiro-Garcia A, Piotrowski DW, Ambler C, Arhancet GB, Banker ME, Banks T, Boustany-Kari CM, Cai C, Chen X, Eudy R, Hepworth D, Hulford CA, Jennings SM, Loria PM, Meyers MJ, Petersen DN, Raheja NK, Sammons M, She L, Song K, Vrieze D, Wei L. Identification of (R)-6-(1-(4-Cyano-3-methylphenyl)-5-cyclopentyl-4,5-dihydro-1H-pyrazol-3-yl)-2-methoxynicotinic Acid, a Highly Potent and Selective Nonsteroidal Mineralocorticoid Receptor Antagonist. J Med Chem 2014; 57:4273-88. [DOI: 10.1021/jm500206r] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Agustin Casimiro-Garcia
- Pfizer Worldwide Research and Development, 200 CambridgePark Drive, Cambridge, Massachusetts 02140, United States
| | - David W. Piotrowski
- Pfizer Worldwide Research and Development, Eastern Point Road, Groton, Connecticut 06340, United States
| | - Catherine Ambler
- Pfizer Worldwide Research and Development, Eastern Point Road, Groton, Connecticut 06340, United States
| | - Graciela B. Arhancet
- Pfizer Worldwide Medicinal Chemistry, 700 Chesterfield Parkway West, Chesterfield, Missouri 63017, United States
| | - Mary Ellen Banker
- Pfizer Worldwide Research and Development, Eastern Point Road, Groton, Connecticut 06340, United States
| | - Tereece Banks
- Pfizer Worldwide Research and Development, Eastern Point Road, Groton, Connecticut 06340, United States
| | - Carine M. Boustany-Kari
- Pfizer Worldwide Research and Development, Eastern Point Road, Groton, Connecticut 06340, United States
| | - Cuiman Cai
- Pfizer Worldwide Research and Development, Eastern Point Road, Groton, Connecticut 06340, United States
| | - Xiangyang Chen
- Pfizer Worldwide Medicinal Chemistry, 700 Chesterfield Parkway West, Chesterfield, Missouri 63017, United States
| | - Rena Eudy
- Pfizer Worldwide Research and Development, Eastern Point Road, Groton, Connecticut 06340, United States
| | - David Hepworth
- Pfizer Worldwide Research and Development, 200 CambridgePark Drive, Cambridge, Massachusetts 02140, United States
| | - Catherine A. Hulford
- Pfizer Worldwide Research and Development, Eastern Point Road, Groton, Connecticut 06340, United States
| | - Sandra M. Jennings
- Pfizer Worldwide Research and Development, Eastern Point Road, Groton, Connecticut 06340, United States
| | - Paula M. Loria
- Pfizer Worldwide Research and Development, Eastern Point Road, Groton, Connecticut 06340, United States
| | - Marvin J. Meyers
- Pfizer Worldwide Medicinal Chemistry, 700 Chesterfield Parkway West, Chesterfield, Missouri 63017, United States
| | - Donna N. Petersen
- Pfizer Worldwide Research and Development, Eastern Point Road, Groton, Connecticut 06340, United States
| | - Neil K. Raheja
- Pfizer Worldwide Research and Development, Eastern Point Road, Groton, Connecticut 06340, United States
| | - Matthew Sammons
- Pfizer Worldwide Research and Development, 610 Main Street, Cambridge, Massachusetts 02139, United States
| | - Li She
- Pfizer Worldwide Research and Development, Eastern Point Road, Groton, Connecticut 06340, United States
| | - Kun Song
- Pfizer Worldwide Research and Development, 610 Main Street, Cambridge, Massachusetts 02139, United States
| | - Derek Vrieze
- Pfizer Worldwide Research and Development, Eastern Point Road, Groton, Connecticut 06340, United States
| | - Liuqing Wei
- Pfizer Worldwide Research and Development, Eastern Point Road, Groton, Connecticut 06340, United States
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Abstract
OBJECTIVE In healthy, nonobese, adolescent males and females to: (1) Determine the relationship between fitness and energy intake; (2) assess the effect of five-weeks endurance training on energy intake and food choice and (3) compare food record assessments of energy intake with doubly-labeled water (DLW) measurement of total energy expenditure (TEE). DESIGN (1) Cross sectional analysis of fitness and food intake and (2) Prospective, randomized, controlled interventional study of endurance-type exercise training in 44 females and 44 males (age range, 15-17 y). MEASUREMENTS Pre and end interventional three day food records were successfully collected from 32 females (15 controls, 17 trained) and 39 males (19 controls, 20 trained). Fitness was assessed from cycle ergometry as peak oxygen uptake normalized both to thigh muscle mass and body weight. Thigh muscle mass was measured by magnetic resonance imaging. TEE using the DLW technique was measured in 12 females (6 controls, 6 trained) and 20 males (10 controls, 10 trained) during weeks 4-5 of the exercise training program (simultaneously with the second assessment of food records). Food record data were analyzed using the Minnesota Nutrition Data System. RESULTS Fitness was correlated with self reported total caloric intake in males but not females. In females, there was a significant increase in fat intake (19.8+/-9%, P < 0.05) and a significant decrease in carbohydrate intake (-9.8+/-4%) in the trained subjects. No changes were observed in the control subjects. Energy expenditure (2072+/-52 kcal/d) was significantly greater than the estimated energy intake (1520+/-112 kcal/d, P < 0.007) during the intervention in the trained, but not control, subjects. However, there was no weight change in either control or trained subjects. In males, no changes were observed in food choice in either control or trained subjects. Similar to the females, energy expenditure (2425+/-22 kcal/d) was significantly greater than the estimated energy intake (2168+/-117 kcal/d, P < 0.05) during the intervention in the trained, but not control, subjects. No weight changes were observed in either group. CONCLUSIONS Fitness is associated with increased self-reported energy intake in males but not females, while exercise training led to alterations in food selection (greater fat and reduced carbohydrate) only in females. These observations could reflect specific gender differences, or, alternatively, the generally lower levels of fitness in the females. The apparent negative energy balance without evidence for weight loss in both the trained males and females suggests a systematic under reporting of food intake during exercise programs in adolescents, and indicates the possibility that errors in self reported food intake might be greater during transitions from one level of energy expenditure to another.
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Affiliation(s)
- C Ambler
- Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA 90509, USA
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Chlebowski RT, Beall G, Grosvenor M, Lillington L, Weintraub N, Ambler C, Richards EW, Abbruzzese BC, McCamish MA, Cope FO. Long-term effects of early nutritional support with new enterotropic peptide-based formula vs. standard enteral formula in HIV-infected patients: randomized prospective trial. Nutrition 1993; 9:507-12. [PMID: 8111140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Despite association with adverse clinical outcome, human immunodeficiency virus (HIV)-associated malnutrition has been relatively refractory to conventional nutrition management. Consequently, a prospective randomized trial was conducted to evaluate a new peptide-based enteral formula (NEF) in contrast to a standard enteral formula (SEF) in patients with HIV infection. Eighty early-stage largely asymptomatic patients were randomized into a dietary regimen supplemented with either a ready-to-feed NEF (18.7% protein, 65.5% carbohydrate, 15.8% fat; 1.28 kcal/ml) or SEF (14% protein, 55% carbohydrate, 31% fat; 1.06 kcal/ml). Patients received 2-3 8-oz cans of the NEF or SEF supplement per day for 6 mo. Parameters evaluated at 0 (baseline), 3, and 6 mo included adherence, weight change, anthropometric measurements, serum biochemical indices, gastrointestinal symptoms, physical performance, and intercurrent health events (including hospitalizations). For the 56 evaluable patients, those supplemented with NEF maintained their body weight significantly (p = 0.04) better, had significantly (p = 0.03) more stable triceps skin-fold measurements, and had significantly (p = 0.04) lower blood urea nitrogen than patients consuming the SEF supplement. Consumption of the NEF supplement was also associated with significantly reduced hospitalizations during the 3- to 6-mo evaluation period (p = 0.02). The NEF supplement was well tolerated and did not result in untoward clinical effects. These data suggest that supplemental use of an NEF provides superior nutritional management compared with an SEF for patients with early-stage HIV infection.
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