Subcutaneous therapy for portal hypertension: PHIN-214, a partial vasopressin receptor 1A agonist - 04/02/24
, Yao Yao a, Rebecca E. Guerra a, Han Jiang a, Akiko Nishimoto-Ashfield a, Alexander V. Lyubimov b, Joshua F. Alfaro a, Kali A. Striker a, Nikolay Buynov a, Philipp Schwabl c, Elijah M. Bolotin a, ⁎ 
Abstract |
Cirrhosis is a liver disease that leads to increased intrahepatic resistance, portal hypertension (PH), and splanchnic hyperemia resulting in ascites, variceal bleeding, and hepatorenal syndrome. Terlipressin, a prodrug that converts to a short half-life vasopressin receptor 1 A (V1a) full agonist [8-Lys]-Vasopressin (LVP), is an intravenous treatment for PH complications, but hyponatremia and ischemic side effects require close monitoring. We developed PHIN-214 which converts into PHIN-156, a more biologically stable V1a partial agonist. PHIN-214 enables once-daily subcutaneous administration without causing ischemia or tissue necrosis and has a 10-fold higher therapeutic index than terlipressin in healthy rats. As V1a partial agonists, PHIN-214 and PHIN-156 exhibited maximum activities of 28 % and 42 % of Arginine vasopressin (AVP), respectively. The potency of PHIN-156 and LVP relative to AVP is comparable for V1a (5.20 and 1.65 nM, respectively) and V1b (102 and 115 nM, respectively) receptors. However, the EC50 of PHIN-156 to the V2 receptor was 26-fold higher than that of LVP, indicating reduced potential for dilutional hyponatremia via V2 agonism compared to terlipressin/LVP. No significant off-target binding to 87 toxicologically relevant receptors were observed when evaluated in vitro at 10 µM concentration. In bile duct ligated rats with PH, subcutaneous PHIN-214 reduced portal pressure by 13.4 % ± 3.4 in 4 h. These collective findings suggest that PHIN-214 could be a novel pharmacological treatment for patients with PH, potentially administered outside of hospital settings, providing a safe and convenient alternative for managing PH and its complications.
El texto completo de este artículo está disponible en PDF.Highlights |
• | PHIN-214 is a prodrug of a long acting partial V1a agonist (PHIN-156). |
• | PHIN-214 is a SC drug with 10-fold higher therapeutic index than terlipressin. |
• | PHIN-214 was effective in portal hypertensive bile duct ligated rat model. |
• | PHIN-156 and Lys-Vasopressin (LVP) have comparable affinity to V1a receptor. |
• | PHIN-156 has 26-fold lower affinity to V2 receptor than LVP. |
Abbreviations : PH, HVPG, WHVG, HRS, V1a, LVP, AVP, IV, MPVP, BDL, IACUC, SPPS, PK, SD, SC, EC50, V1b, V2, TI, NOAEL, NOEL, LOAEL, AEL, HED, NO, MAP
Keywords : Portal hypertension, Cirrhosis, Hepatorenal syndrome, Ascites, Vasopressor, V1a agonist
Esquema
| ☆ | Trial Registration Number: ClinicalTrials.gov Identifier: NCT05490888. |
Vol 171
Artículo 116068- février 2024 Regresar al númeroBienvenido a EM-consulte, la referencia de los profesionales de la salud.
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