The overall objective of this Translational Research Proposal is to synthesize, characterize, and advance an optimized galanin-based analog to IND filing so that a human proof-of-concept clinical trial with a novel first-in-class therapeutic can be conducted in patients with refractory epilepsy. Most of the available antiepileptic drugs (AEDs) exert their activity by modulating voltage- and/or receptor-gated ion channels. Despite treatment with currently available AEDs, approximately 25-40% of patients with refractory partial epilepsy continue to experience uncontrolled seizures, so clearly there is a need for a novel approach. The endogenous neuropeptide galanin and its associated receptors play an important role in the control of seizures and is therefore an attractive therapeutic target. However, developing neuropeptides as therapeutics has been challenging due to their intrinsic lack of metabolic stability and inability to cross the blood-brain-barrier. We have applied a novel technology platform to develop a galanin analog, NAX 5055, that is metabolically stable, maintains low nanomolar affinity for galanin receptors and following systemic administration is effective in an animal seizure model that displays resistance to the majority of first-line AEDs.
The Aims outlined in this proposal are designed to optimize the NAX 5055 backbone and to advance one compound to an IND filing as follows: 1) identify one to six optimized galanin receptor 2-preferring analogs that display potent anticonvulsant activity and wide behavioral, cognitive and metabolic safety margins;2) select at least one IND candidate based on the most favorable pharmacological and ADME profiles;3) develop a formulation that maintains efficacy in animal models following systemic administration and is suitable for further preclinical and clinical development;4) and 5) perform all necessary IND-enabling preclinical studies. Successful completion of Aims 1 - 5 will allow the development of a clinical plan and submission of an IND application with the FDA to begin clinical trials of a new, first-in-class neurotherapy for refractory epilepsy.

Public Health Relevance

Epilepsy affects over 50 million persons world-wide and approximately 25-40% of refractory partial epilepsy patients have uncontrolled seizures despite treatment with antiepileptic drugs. Galanin is an endogenous peptide in the brain that plays an important role in controlling seizures. The goal of this proposal is to apply our proprietary technology to develop a novel galanin-based therapy for treating this debilitating disorder.

National Institute of Health (NIH)
National Institute of Neurological Disorders and Stroke (NINDS)
Research Project--Cooperative Agreements (U01)
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National Institute of Neurological Disorders and Stroke Initial Review Group (NSD)
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Stewart, Randall R
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University of Utah
Schools of Pharmacy
Salt Lake City
United States
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Metcalf, Cameron S; Smith, Misty D; Klein, Brian D et al. (2017) Preclinical Analgesic and Safety Evaluation of the GalR2-preferring Analog, NAX 810-2. Neurochem Res 42:1983-1994
Metcalf, Cameron S; Klein, Brian D; McDougle, Daniel R et al. (2017) Preclinical evaluation of intravenous NAX 810-2, a novel GalR2-preferring analog, for anticonvulsant efficacy and pharmacokinetics. Epilepsia 58:239-246
Walls, Anne B; Flynn, Sean P; West, Peter J et al. (2016) The anticonvulsant action of the galanin receptor agonist NAX-5055 involves modulation of both excitatory- and inhibitory neurotransmission. Epilepsy Res 121:55-63
Flynn, Sean P; White, H Steve (2015) Regulation of glucose and insulin release following acute and repeated treatment with the synthetic galanin analog NAX-5055. Neuropeptides 50:35-42
Jequier Gygax, Marine; Klein, Brian D; White, H Steve et al. (2014) Efficacy and tolerability of the galanin analog NAX 5055 in the multiple-hit rat model of symptomatic infantile spasms. Epilepsy Res 108:98-108
Robertson, Charles R; Pruess, Timothy H; Grussendorf, Erin et al. (2012) Generating orally active galanin analogues with analgesic activities. ChemMedChem 7:903-9