The goal of this project is to generate pathway-specific therapeutic inhibitors for the study and treatment of complement-related diseases. Complement has been shown to play a role in various disorders ranging from inflammatory (e.g., periodontitis), immune, and degenerative, diseases to sepsis. Also, complement-related complications can be detrimental in biomaterial applications (e.g., hemodialysis) and transplant rejection. While the potential of inhibiting complement has long been recognized, therapeutic options are still limited, costly, do not include specific inhibitors of initiation and amplification steps, and are not readily available for research. Hence, extension and diversification of the inhibitory arsenal is desired both for therapy and as tools to dissect disease mechanisms. Starting from a panel of potent inhibitors discovered by our group or publicly disclosed, this project aims at generating a """"""""complement inhibitor toolbox"""""""" with broad use in the studies of this P01. The C3 inhibitor compstatin, which blocks initiation, amplification, and effector pathways, has shown clinical promise in many disease models, including transplantation, hemodialysis, and periodontitis, yet its pharmacokinetic (PK) profile and limited administration options render the use of this compound challenging in certain applications. We will therefore optimize the PK parameters of compstatin and evaluate its oral and subcutaneous administration in non-human primates. While inhibition of C3 has advantages, we will also develop inhibitors that specifically block the classical and alternative pathways. For the former, we will focus on a potent CIs-binding protein from leeches, which appears to bind both the catalytic and a potential exosite on CIs. By characterizing the activity of this protein and derived peptides, we will generate and optimize novel inhibitors for CIs. Based on factor H (FH) as a major host regulator of the alternative pathway, we rationally engineered a streamlined inhibitor with unique targeting properties toward diseased host cells and a potency that surpasses the parent protein FH. Terminal pathway inhibition will focus on anti- C5 antibodies and peptidomimetics available to this group, and the """"""""toolbox"""""""" will be completed by inhibitors Of the lectin pathway, the clinically used regulator C1-INH, and anaphylatoxin receptor antagonists. Finally, we explore novel strategies to direct complement inhibitors to foreign or diseased surfaces, where complement activation mainly occurs. For this purpose, we will modify compstatin and a newly discovered FHbinding peptide with anchors that allow attachment to cell membranes, self-cell surfaces, or biomaterials. All inhibitors and targeting options will be characterized for efficacy and specificity, and selected compounds will be subjected to production in Core B and evaluation in Projects 2 &3. Our integrated inhibitor development based on modular synthesis, potent lead structures and established techniques has high potential to pave the way to new clinical complement inhibitors and will be of great use for the study of complement diseases.

Public Health Relevance

The purpose of this study is to develop compounds for the selective inhibition of the complement system. We will optimize promising candidate drugs and develop novel compounds that act at distinct stages of the complement cascade, thereby contributing to preclinical research and therapeutic applications. Optimized compounds will be evaluated in disease models to arrive at potent and specific inhibitors with clinical potential.

Agency
National Institute of Health (NIH)
Institute
National Institute of Allergy and Infectious Diseases (NIAID)
Type
Research Program Projects (P01)
Project #
2P01AI068730-06
Application #
8627395
Study Section
Special Emphasis Panel (ZAI1-ESB-I (S1))
Project Start
Project End
Budget Start
2014-06-01
Budget End
2015-05-31
Support Year
6
Fiscal Year
2014
Total Cost
$473,384
Indirect Cost
$177,519
Name
University of Pennsylvania
Department
Type
DUNS #
042250712
City
Philadelphia
State
PA
Country
United States
Zip Code
19104
Blom, Anna M; Magda, Michal; Kohl, Lisa et al. (2017) Factor H-IgG Chimeric Proteins as a Therapeutic Approach against the Gram-Positive Bacterial Pathogen Streptococcus pyogenes. J Immunol 199:3828-3839
Blatt, Adam Z; Saggu, Gurpanna; Cortes, Claudio et al. (2017) Factor H C-Terminal Domains Are Critical for Regulation of Platelet/Granulocyte Aggregate Formation. Front Immunol 8:1586
Hajishengallis, G; Krauss, J L; Jotwani, R et al. (2017) Differential capacity for complement receptor-mediated immune evasion by Porphyromonas gingivalis depending on the type of innate leukocyte. Mol Oral Microbiol 32:154-165
Kovtun, Anna; Bergdolt, Stephanie; Hägele, Yvonne et al. (2017) Complement receptors C5aR1 and C5aR2 act differentially during the early immune response after bone fracture but are similarly involved in bone repair. Sci Rep 7:14061
Hajishengallis, George; Korostoff, Jonathan M (2017) Revisiting the Page & Schroeder model: the good, the bad and the unknowns in the periodontal host response 40 years later. Periodontol 2000 75:116-151
Primikyri, Alexandra; Papanastasiou, Malvina; Sarigiannis, Yiannis et al. (2017) Method development and validation for the quantitation of the complement inhibitor Cp40 in human and cynomolgus monkey plasma by UPLC-ESI-MS. J Chromatogr B Analyt Technol Biomed Life Sci 1041-1042:19-26
Harder, Markus J; Kuhn, Nadine; Schrezenmeier, Hubert et al. (2017) Incomplete inhibition by eculizumab: mechanistic evidence for residual C5 activity during strong complement activation. Blood 129:970-980
Kajikawa, Tetsuhiro; Briones, Ruel A; Resuello, Ranillo R G et al. (2017) Safety and Efficacy of the Complement Inhibitor AMY-101 in a Natural Model of Periodontitis in Non-human Primates. Mol Ther Methods Clin Dev 6:207-215
Abicht, Jan-Michael; Kourtzelis, Ioannis; Reichart, Bruno et al. (2017) Complement C3 inhibitor Cp40 attenuates xenoreactions in pig hearts perfused with human blood. Xenotransplantation 24:
Kajikawa, Tetsuhiro; Meshikhes, Fatimah; Maekawa, Tomoki et al. (2017) Milk fat globule epidermal growth factor 8 inhibits periodontitis in non-human primates and its gingival crevicular fluid levels can differentiate periodontal health from disease in humans. J Clin Periodontol 44:472-483

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