Newly discovered drug-like compound may revolutionize treatment of autoimmune diseases

University of Colorado Boulder researchers have discovered a potent, drug-like compound that could someday revolutionize treatment of rheumatoid arthritis and other autoimmune diseases by inhibiting a protein instrumental in prompting the body to start attacking its own tissue.

"We have discovered a key to lock this protein in a resting state," said Hang Hubert Yin, a biochemistry professor in the BioFrontiers Institute and lead author of a paper, published today in Nature Chemical Biology, describing the discovery. "This could be paradigm shifting."

More than 23.5 million Americans suffer from autoimmune diseases like rheumatoid arthritis, scleroderma and lupus, in which an overzealous immune response leads to pain, inflammation, skin disorders and other chronic health problems.

Three of the top five selling drugs in the United States aim to ease their symptoms. But no cure exists, and treatments are expensive and come with side effects.

"Given the prevalence of these diseases, there is a big push for alternatives," Yin said.

For years, scientists have suspected that a protein called Toll-like receptor 8 (TLR8) plays a key role in the innate immune response. When it senses the presence of a virus or bacteria, it goes through a series of steps to transform from its passive to active state, triggering a cascade of inflammatory signals to fight off the foreign invader. But, as Yin explained, "it can be a double-edged sword" leading to disease when that response is excessive.

Because TLR8 has a unique molecular structure and is hidden inside the endosome -- an infinitesimal bubble inside the cell -- rather than on the cell's surface, it has proven an extremely difficult target for drug development.

"This is a long-sought-after target with very little success," Yin said.

But his study shows a drug-like molecule called CU-CPT8m binds to and inhibits TLR8 and exerts "potent anti-inflammatory effects" on the tissue of patients with arthritis, osteoarthritis and Still's disease, a rare autoimmune illness.

For the study, Yin and his co-authors used high-throughput screening to look through more than 14,000 small molecule compounds to determine whether they had the right chemical structure to bind to TLR8. They identified four that shared a similar structure.

Using that structure as a model, they chemically synthesized hundreds of novel compounds in an effort to find one that perfectly bound to and inhibited TLR8.

Previous efforts to target the protein have focused on shutting it down when it is in its active state. But the compound Yin discovered prevents it from activating while still in its passive state.

"Before, people were trying to close the open door to shut it down. We found the key to lock the door from the inside so it never opens," Yin said.

Much more research is necessary, but that could lead to treatments that strike at the root cause of autoimmune diseases, rather than just treating symptoms.

With help from CU's Technology Transfer Office, Yin has already filed a patent application and hopes to move on to animal studies and clinical trials within the next two years.

In the meantime, the new compound can serve as a first-of-its kind tool to understand exactly what TLR8 and the other nine toll-like receptors do in the body.

"Our study provides the first small molecule tool to shut this protein down so we can understand its pathogenesis," Yin said.

Ref : https://www.colorado.edu/today/2017/11/20/arthritis-autoimmune-disease-discovery-could-lead-new-treatments

Newly discovered drug-like compound may revolutionize treatment of autoimmune diseases

Multiple sclerosis drug can beat obstinate bacteria

In continuation of my update on glatiramer

Encountering bacteria with innocent names such as Pseudomonas aeruginosa and Enterobacteriaceae can lead to hospitalization and - in a worst-case scenario - can also be life-threatening. The bacteria, which cause infections such as pneumonia, frequently develop multi-resistance towards classic antibiotics.

Researchers from Aarhus University have discovered that a drug known as glatiramer acetate, which is normally used for treating the disease multiple sclerosis, has a hitherto unknown effect on obstinate bacteria.

Laboratory experiments have shown that the drug kills half of the Pseudomonas bacteria in specimens from patients with cystic fibrosis who are often exposed to the bacteria in the lungs.

The research results have recently been published in the scientific journal Scientific Reports.

The discovery is good news at a time where multi-resistant bacteria are a growing problem.

"We see great perspectives in the discovery because our data shows that the drug is effective against infections that occur because of what are known as Gram-negative bacteria. These bacteria form the basis of diseases such as pneumonia, cystitis and septic shock. Due to growing resistance, we are experiencing a decline in the number of effective treatments against them, and some of the medicaments which we otherwise know to be effective must be given in such high doses to be effective that they become toxic for the patients," explains Professor with special responsibilities (MSO) Thomas Vorup-Jensen from the Department of Biomedicine at Aarhus University.

According to a British survey commissioned by the British government, in 2050 resistant bacteria will all-in-all kill more people around the world than cancer. Neither the pharmaceutical industry or researchers have so far succeeded in developing new types of antibiotics that can beat the bacteria following classic strategies for the development of new medicines.

Multiple sclerosis drug can beat obstinate bacteria

Methotrexate drug holiday improves flu vaccine efficacy in rheumatoid arthritis patients

In continuation of my update on methotrexate

People with RA who stop taking methotrexate treatment for just two weeks after they have a seasonal flu shot can improve the vaccine's efficacy without increasing RA disease activity, according to new research findings presented this week at the 2017 ACR/ARHP Annual Meeting in San Diego.

Rheumatoid arthritis (RA) is a chronic disease that causes   pain,  stiffness,  welling, and limitation in the motion and function of multiple joints. Though joints are the principal body parts affected by RA, inflammation can develop in other organs as well. An estimated 1.3million Americans have RA, and the disease typically affects women twice as often as men.

Methotrexate, a widely used immunosuppressant, can lower vaccine efficacy in people with RA. So researchers in Seoul, Republic of Korea, set out to investigate whether patients with RA could improve their response to influenza vaccinations by temporarily pausing methotrexate use for two weeks after their flu shot.

"RA patients are more susceptible to infections, including seasonal flu, due to their underlying abnormal immune function and the treatment-associated immune suppression," said Jin Kyun Park, MD, Assistant Professor of Medicine at Seoul National University Hospital, and a lead author of the study. "RA patients taking methotrexate are at even higher risk of infection and infection-related complications, so it's important that they be vaccinated against preventable infectious diseases. However, the immune suppression decreases vaccine response.

To overcome this shortcoming, our group has been working on a novel immunization protocol for RA patients to optimize vaccine response,  including increasing immunogenicity of flu vaccines."

In this prospective, multicenter, randomized, parallel-group trial conducted from October 2016 to January 2017, 316 RA patients who were taking a stable methotrexate dose were randomly assigned to two groups: 156 continued their regular methotrexate and 160 discontinued their dose for two weeks after receiving their flu shot. All participants were vaccinated with a seasonal, quadrivalent influenza vaccine containing H1N1, H3N2, B-Yamagata and B-Victoria.

Methotrexate drug holiday improves flu vaccine efficacy in rheumatoid arthritis patients

FDA Approves Juluca, First Two-Drug Regimen for HIV Patients

In continuation of my updates on dolutegravir and rilpivirine,

The FDA has approved the first complete treatment regimen containing only two drugs to treat certain adults with human immunodeficiency virus type 1 (HIV-1) instead of the three or more drugs included in standard HIV treatment.

Juluca (dolutegravir/rilpivirine, ViiV Healthcare) is a fixed-dose tablet approved to treat adults with HIV-1 infections whose virus is currently suppressed (HIV-1 RNA less than 50 copies per mL) on a stable regimen for at least six months, with no history of treatment failure and no known substitutions associated with resistance to the individual components of the new combination. Dolutegravir 50 mg (ViiV Healthcare) is an integrase strand transfer inhibitor, and rilpivirine 25 mg (Janssen Therapeutics) is a non-nucleoside reverse transcriptase inhibitor.

 rilpivirine     Dolutegravir

 “Limiting the number of drugs in any HIV treatment regimen can help reduce toxicity for patients,” said Debra Birnkrant, MD, director of the Division of Antiviral Products in the FDA’s Center for Drug Evaluation and Research.

HIV weakens a person’s immune system by destroying important cells that fight disease and infection. According to the Centers for Disease Control and Prevention, an estimated 1.1 million people in the United States are living with HIV, and the disease remains a significant cause of death for certain populations.

This FDA approval is based primarily on data from two pivotal phase 3 clinical trials, SWORD-12 and SWORD-2,2 which showed the two-drug regimen achieved non-inferior viral suppression (HIV-1 RNA less than 50 copies per mL) at 48 weeks compared with patients’ three- or four-drug current antiretroviral regimen (CAR) in both pooled and individual analyses of the SWORD-1 and SWORD-2 studies (dolutegravir/rilpivirine 486/513 [95%], CAR 485/511 [95%]; adjusted difference, –0.2%; 95% confidence interval, –3.0% to  2.5%, pooled analysis). Virological suppression rates were similar between treatment arms. Drug related adverse events and adverse events leading to withdrawal occurred in low frequencies in both arms of the study, but more frequently in the investigational arm.

The most common side effects in patients taking Juluca were diarrhea and headache. Serious side effects include skin rash and allergic reactions, liver problems, and depression or mood changes. Juluca should not be given with other anti-HIV drugs and may have drug interactions with other commonly used medications.

Ref : https://www.viivhealthcare.com/media/press-releases/2017/november/viiv-healthcare-announces-us-fda-approval-for-juluca.aspx

FDA Approves Juluca, First Two-Drug Regimen for HIV Patients

New findings on tolvaptan as autosomal dominant polycystic kidney disease treatment

 In continuation of my update on tolvaptan

A phase 3 trial studying the effects of tolvaptan has found that the drug slowed the rate of decline in kidney function in patients with the most common form of polycystic kidney disease, a condition with no cure. The results are published today in the New England Journal of Medicine.

Autosomal dominant polycystic kidney disease is an inheritedcondition that affects 1 in every 500 to 1,000 individuals in the U.S.This disease is found in all races and sexes.

Autosomal dominant polycystic kidney disease, which is the fourth most common cause of end-stage kidney disease, requires dialysis orkidney transplant.

The disease causes a slow but relentless growth of cysts that damage the kidneys. In addition to negatively affecting quality of life, thecondition also causes hypertension and painful complications. The cysts, which can damage kidneys with their size, can develop in other organs,especially the liver.

Approximately half of individuals with autosomal dominant polycystic kidney disease eventually will require dialysis or kidney transplant by age 60. The results of the trial demonstrated tolvaptan's ability to intervene in a way that slows kidney function decline in this population.

"This is the first treatment that targets a mechanism that directlycontributes to the development and growth of the kidney cysts inautosomal dominant polycystic kidney disease," says Vicente Torres, M.D., Ph.D., director of Mayo Clinic's Translational Polycystic Kidney Disease Center. "This in effect means it may delay the need for a kidney transplant or dialysis in patients with this disease."

Omega-3 and Omega-6 fatty acid intake may affect lupus outcomes

 

In continuation of my update on omega fatty acids

Higher intake of omega-3 fatty acids was associated with better sleep quality and a decrease in depressive symptoms in lupus patients, among other patient-reported outcomes, according to new research findings presented this week at the 2017 ACR/ARHP Annual Meeting in San Diego. 

Lupus is a chronic (long-term) inflammatory autoimmune disease in which an unknown trigger causes the body's immune system to attack its own healthy tissues. The most common type of lupus is systemic lupus erythematosus (SLE), a complex, multiple symptom disease that can cause inflammation, pain and damage to various parts of the body. While anyone can develop lupus, it occurs 9-10 times more often in women than in men, and is 2-3 times more common among women of color.

Omega fatty acids have an effect on inflammation in the body, with omega-3 fatty acids generally acting as an anti-inflammatory and omega-6 fatty acids acting as a pro-inflammatory. Western diets are often much higher in omega-6fatty acids, and they are suspected to contribute to chronic diseases.

While small studies show an association between omega-3 supplementation and reduced disease activity in lupus patients. Researchers at the University of Michigan in Ann Arbor examined their impact on patient-reported outcomes, or PROs. They performed a population-based, cross-sectional study to look for a possibleassociation between dietary intake of omega-3 and omega-6 fatty acidsand PROs in lupus patients. Data from the Michigan Lupus Epidemiology & Surveillance (MILES) program was used.

"Western diets are thought to contribute to an increase in people with chronic conditions including autoimmune diseases. Many small studies found that omega-3 supplementation was associated with an improvement in disease activity in SLE patients, but no studies have looked at omega-3 exposure through diet or its impact on PROs," said Prae Charoenwoodhipong, MS, a graduate student in the Department of
Nutrition Science at the University of Michigan School of Public Health in Ann Arbor. "Also, very few studies have looked at the impact of omega-6, an inflammatory fatty acid that is very common in U.S. diets. According to rheumatologists I've worked with, patients with SLE are always asking about what they might be able to do with supplements or their diet to help improve their health."

Omega-3 and Omega-6 fatty acid intake may affect lupus outcomes

Onalespib could be an effective treatment for glioblastoma, preclinical studies show

The targeted therapy onalespib has shown effectiveness in preclinical studies of glioblastoma by researchers at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute.

Onalespib is designed to inhibit a molecule called HSP90. The molecule helps newly made protein molecules fold into their final functional form. A large number of receptor and DNA-damage-response proteins require HSP90 to achieve their functional conformation. In cancer cells, HSP90 can be expressed up to 10 times higher than in normal cells.

This study showed that onalespib blocked HSP90 activity and thereby reduced the expression of cell-survival proteins such as AKT and endothelial growth factor receptor in several glioma cell lines and in glioma stem cells obtained from patient tumors. This, in turn, reduced the survival, proliferation, invasion and migration of the cells.

In animal models of glioblastoma (GBM), the agent crossed the blood-brain barrier, and showed effectiveness as a single agent, and then greater effectiveness in combination with temozolomide, improving survival in both cases.

The findings are published in the journal Clinical Cancer Research.

"Our studies show that onalespib can efficiently breach the blood-brain barrier and reach tumor cells better than other HSP90 inhibitors," says principal investigator Vinay Puduvalli, MD, professor and director of the Division of Neuro-Oncology at Ohio State and a clinician-researcher at the OSUCCC – James.

"By inhibiting HSP90, onalespib disrupts several key signaling pathways that drive the proliferation, metastasis and survival of glioblastoma cells. These findings suggest that this agent, in combination with chemotherapeutic temozolomide, could be an exciting new therapy for GBM. Based on the results of this study, we have generated a clinical trial that will determine whether onalespib in combination with standard therapy is safe and effective in patients with newly diagnosed glioblastoma," he says.

Glioblastoma is the most common and deadly form of brain cancer. More than 12,000 new cases are expected to be diagnosed in 2017, with overall survival averaging 16-18 months. The disease remains incurable, largely because GBM is difficult to remove surgically, because the blood-brain barrier prevents most chemotherapy from reaching these tumors and because these tumors tend to be radiation resistant.

The study's key findings include:

• Onalespib levels were higher in brain tissue compared with plasma after intravenous administration in a mouse model, showing that the agent can cross the blood-brain barrier.
• Tumor cells derived from patients and implanted into a mouse model showed that onalespib plus temozolomide significantly survival compared with mice treated with a neutral agent or either agent alone.

 Ref : https://medicalxpress.com/journals/clinical-cancer-research/

Onalespib could be an effective treatment for glioblastoma, preclinical studies show

Drug 'melts away' fat inside arteries

 

 A new drug being trialled for treating breast cancer and diabetes has been shown to 'melt away' the fat inside arteries that can cause heart attacks and  strokes. Researchers fromthe University of Aberdeen, using pre-clinical mouse models, showedthat just a single dose of the drug (Trodusquemine) completely reversedthe effects of a disease that causes a host of heart problems.

Atherosclerosis is the build-up of fatty material inside the arteries. Over time this fatty material can grow bigger until your arteries become so narrow that not enough blood can pass through.

Atherosclerosis is the condition that causes most heart attacks and strokes. In pre-clinical tests, mice with set-in atherosclerosis, mimicking what happens in humans, had less fatty plaques in their arteries whether they had regular doses over time or just a single dose of Trodusquemine.

The drug works by stopping an enzyme called PTP1B, which is normally increased in people with obesity or diabetes and conditions involving prolonged inflammation such as sepsis, inflamed diabetic foot ulcers and allergic lung inflammation. The researchers found that it also stimulated the action of another protein (AMPK), which effectively mimics exercise and reduces chronic inflammation.

It has already been shown to be effective with diabetes and breast cancer patients but this is the first time the drug has been shown to have benefits for long-term cardiovascular disease.

The £236,000 study was funded by the British Heart Foundation. Professor Mirela Delibegovic and Dr Dawn Thompson from the University of Aberdeen's Institute of Medical Sciences who led the study said:

"All humans have some level of atherosclerosis. As you age you start to

develop these fatty streaks inside your arteries. It is a big problem

for people who are overweight or have underlying cardiovascular

conditions."

"Trodusquemine has already been trialled for treatment of diabetes and breast cancer but this is the first time it has been used in models of atherosclerosis. 

"These have only been tested at pre-clinical level, in mice, so far but the results were quite impressive and showed that just a single dose of this drug seemed to completely reverse the effects of arthrosclerosis.

"The next step is to test the ability of this drug to improve outcomes in human patients with developed atherosclerosis and cardiovascular disease".

Professor Jeremy Pearson, Associate Medical Director at the British Heart Foundation, said: "Trodusquemine is in early clinical trials for the treatment of diabetes. This study shows it can also limit the build-up of fatty atherosclerotic plaques in mice. If we see the same effect in patients, the drug may prove even more useful than currently hoped for.

 Ref : https://pubchem.ncbi.nlm.nih.gov/compound/Trodusquemine#section=2D-Structure

https://www.abdn.ac.uk/news/11280/







Drug 'melts away' fat inside arteries

AZD6738 found to slow some types of children's tumor growth in mouse models

Prior research has shown that cancer in children is very seldom the same as  cancer in adults—in many cases, tumors that grow in children differ markedly from tumors that grow in adults which means they require completely different types of treatment. Unfortunately, treatments for childhood tumors has progressed at a much slower pace than for adults. Just four of them, for example, have been approved for use in the U.S. over the last 25 years. One of the main ways to treat adult tumors is to apply chemicals that serve to actively reduce tumor size, an approach that has not worked well with children. To get around that problem, the researchers with this new effort have been studying a chemical that has shown an ability to stop tumor growth by preventing tumor cells from repairing their DNA.

The researchers began by noting that prior research had shown that many types of childhood tumors rely on a DNA pathway called nonhomologous end joining (NHEJ) to survive. That led them to search for a chemical that would disrupt the pathway, preventing the cell from repairing its own DNA. Such tumors, the researchers noted, appear to depend on NHEJ to help them overcome problems with handling the excess amounts of an enzyme called PGBD5 they produce.

After finding that applying the chemical AZD6738 to tumor cells directly prevented them from growing, the team then began testing it in mouse models (mice with human tumor cells implanted in them). They report that doing so caused two types of tumors to stop growing but did not work against two others. While promising, the researchers acknowledge that the chemical is not likely to represent a means for destroying tumors in human patients even if it were to pass clinical trials. It stops growth but does not decrease tumor size. But that would of course still be a far better outcome for treating patients who have no other options. 

AZD6738 found to slow some types of children's tumor growth in mouse models

Caffeine consumption may help kidney disease patients live longer

In continuation of my update on caffeine..

Caffeine consumption may prolong the lives in patients with chronic kidney disease (CKD), according to a study that will be presented at ASN Kidney Week 2017 October 31-November 5 at the Ernest N. Morial Convention Center in New Orleans, LA.  

Coffee consumption has been linked to a longer life in the general population. To see if this holds true for individuals with CKD, Miguel Bigotte Vieira, MD (Centro Hospitalar Lisboa Norte, in Portugal), and his colleagues examined the association of caffeine consumption with mortality among 2328 patients with CKD in a prospective US cohort, using the continuous National Health and Nutrition Examination Survey(NHANES) 1999-2010.

The team found a dose-dependent inverse association between caffeine and all-cause mortality. Compared with those in the lowest quartile of caffeine consumption, those in the second, third, and highest quartiles had 12%, 22%, and 24% lower risks of dying.

"Our study showed a dose-dependent protective effect of caffeine consumption on mortality among patients with CKD. This association was independent of potential confounders including age, gender, race, annual family income, education level, estimated GFR, albumin/creatinine ratio, hypertension, smoking status, dyslipidemia, body mass index, previous cardiovascular events and diet: consumption of alcohol, carbohydrates, polyunsaturated fatty acids, and fibers," said Dr. Bigotte Vieira. 

"These results suggest that advising patients with CKD to drink more caffeine may reduce their mortality. This would represent a simple, clinically beneficial, and inexpensive option, though this benefit should ideally be confirmed in a randomized clinical trial." Dr. Bigotte Vieira stressed that this observational study cannot prove thatcaffeine reduces the risk of death in patients with CKD, but onlysuggests the possibility of such a protective effect.

Caffeine consumption may help kidney disease patients live longer