Cell-Penetrating Pepducin Therapy Targeting PAR1 in Subjects With Coronary Artery Disease

Pepducins are membrane-tethered, cell-penetrating lipopeptides that target the cytoplasmic surface of their cognate receptor. Here, we report the first human use of a protease-activated receptor-1-based pepducin, which is intended as an antiplatelet agent to prevent ischemic complications of percuta...

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Vydané v:Arteriosclerosis, thrombosis, and vascular biology Ročník 36; číslo 1; s. 189
Hlavní autori: Gurbel, Paul A, Bliden, Kevin P, Turner, Susan E, Tantry, Udaya S, Gesheff, Martin G, Barr, Travis P, Covic, Lidija, Kuliopulos, Athan
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: United States 01.01.2016
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ISSN:1524-4636, 1524-4636
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Abstract Pepducins are membrane-tethered, cell-penetrating lipopeptides that target the cytoplasmic surface of their cognate receptor. Here, we report the first human use of a protease-activated receptor-1-based pepducin, which is intended as an antiplatelet agent to prevent ischemic complications of percutaneous coronary interventions. PZ-128 was administered by 1 to 2 hours continuous intravenous infusion (0.01-2 mg/kg) to 31 subjects with coronary artery disease or multiple coronary artery disease risk factors. Safety, antiplatelet efficacy, and pharmacokinetics were assessed at baseline and 0.5, 1, 2, 6, 24 hours, and 7 to 10 days postdosing. The inhibitory effects of PZ-128 on platelet aggregation stimulated by the protease-activated receptor-1 agonist SFLLRN (8 μmol/L) at 30 minutes to 6 hours were dose dependent with 20% to 40% inhibition at 0.3 mg/kg, 40% to 60% at 0.5 mg/kg, and ≥ 80% to 100% at 1 to 2 mg/kg. The subgroup receiving aspirin in the 0.5 and 1-mg/kg dose cohorts had 65% to 100% inhibition of final aggregation to SFLLRN at 30 minutes to 2 hours and 95% to 100% inhibition by 6 hours. The inhibitory effects of 0.5 mg/kg PZ-128 were reversible with 50% recovery of aggregation to SFLLRN by 24 hours. There were no significant effects of PZ-128 on aggregation induced by AYPGKF, ADP, or collagen, indicating that the observed effects were specific to protease-activated receptor-1. The plasma half-life was 1.3 to 1.8 hours, and PZ-128 was nondetectable in urine. There were no effects on bleeding, coagulation, clinical chemistry, or ECG parameters. PZ-128 is a promising antiplatelet agent that provides rapid, specific, dose dependent, and reversible inhibition of platelet protease-activated receptor-1 through a novel intracellular mechanism. URL: http://www.clinicaltrials.gov. Unique identifier: NCT01806077.
AbstractList Pepducins are membrane-tethered, cell-penetrating lipopeptides that target the cytoplasmic surface of their cognate receptor. Here, we report the first human use of a protease-activated receptor-1-based pepducin, which is intended as an antiplatelet agent to prevent ischemic complications of percutaneous coronary interventions.OBJECTIVEPepducins are membrane-tethered, cell-penetrating lipopeptides that target the cytoplasmic surface of their cognate receptor. Here, we report the first human use of a protease-activated receptor-1-based pepducin, which is intended as an antiplatelet agent to prevent ischemic complications of percutaneous coronary interventions.PZ-128 was administered by 1 to 2 hours continuous intravenous infusion (0.01-2 mg/kg) to 31 subjects with coronary artery disease or multiple coronary artery disease risk factors. Safety, antiplatelet efficacy, and pharmacokinetics were assessed at baseline and 0.5, 1, 2, 6, 24 hours, and 7 to 10 days postdosing. The inhibitory effects of PZ-128 on platelet aggregation stimulated by the protease-activated receptor-1 agonist SFLLRN (8 μmol/L) at 30 minutes to 6 hours were dose dependent with 20% to 40% inhibition at 0.3 mg/kg, 40% to 60% at 0.5 mg/kg, and ≥ 80% to 100% at 1 to 2 mg/kg. The subgroup receiving aspirin in the 0.5 and 1-mg/kg dose cohorts had 65% to 100% inhibition of final aggregation to SFLLRN at 30 minutes to 2 hours and 95% to 100% inhibition by 6 hours. The inhibitory effects of 0.5 mg/kg PZ-128 were reversible with 50% recovery of aggregation to SFLLRN by 24 hours. There were no significant effects of PZ-128 on aggregation induced by AYPGKF, ADP, or collagen, indicating that the observed effects were specific to protease-activated receptor-1. The plasma half-life was 1.3 to 1.8 hours, and PZ-128 was nondetectable in urine. There were no effects on bleeding, coagulation, clinical chemistry, or ECG parameters.APPROACH AND RESULTSPZ-128 was administered by 1 to 2 hours continuous intravenous infusion (0.01-2 mg/kg) to 31 subjects with coronary artery disease or multiple coronary artery disease risk factors. Safety, antiplatelet efficacy, and pharmacokinetics were assessed at baseline and 0.5, 1, 2, 6, 24 hours, and 7 to 10 days postdosing. The inhibitory effects of PZ-128 on platelet aggregation stimulated by the protease-activated receptor-1 agonist SFLLRN (8 μmol/L) at 30 minutes to 6 hours were dose dependent with 20% to 40% inhibition at 0.3 mg/kg, 40% to 60% at 0.5 mg/kg, and ≥ 80% to 100% at 1 to 2 mg/kg. The subgroup receiving aspirin in the 0.5 and 1-mg/kg dose cohorts had 65% to 100% inhibition of final aggregation to SFLLRN at 30 minutes to 2 hours and 95% to 100% inhibition by 6 hours. The inhibitory effects of 0.5 mg/kg PZ-128 were reversible with 50% recovery of aggregation to SFLLRN by 24 hours. There were no significant effects of PZ-128 on aggregation induced by AYPGKF, ADP, or collagen, indicating that the observed effects were specific to protease-activated receptor-1. The plasma half-life was 1.3 to 1.8 hours, and PZ-128 was nondetectable in urine. There were no effects on bleeding, coagulation, clinical chemistry, or ECG parameters.PZ-128 is a promising antiplatelet agent that provides rapid, specific, dose dependent, and reversible inhibition of platelet protease-activated receptor-1 through a novel intracellular mechanism.CONCLUSIONSPZ-128 is a promising antiplatelet agent that provides rapid, specific, dose dependent, and reversible inhibition of platelet protease-activated receptor-1 through a novel intracellular mechanism.URL: http://www.clinicaltrials.gov. Unique identifier: NCT01806077.CLINICAL TRIAL REGISTRATIONURL: http://www.clinicaltrials.gov. Unique identifier: NCT01806077.
Pepducins are membrane-tethered, cell-penetrating lipopeptides that target the cytoplasmic surface of their cognate receptor. Here, we report the first human use of a protease-activated receptor-1-based pepducin, which is intended as an antiplatelet agent to prevent ischemic complications of percutaneous coronary interventions. PZ-128 was administered by 1 to 2 hours continuous intravenous infusion (0.01-2 mg/kg) to 31 subjects with coronary artery disease or multiple coronary artery disease risk factors. Safety, antiplatelet efficacy, and pharmacokinetics were assessed at baseline and 0.5, 1, 2, 6, 24 hours, and 7 to 10 days postdosing. The inhibitory effects of PZ-128 on platelet aggregation stimulated by the protease-activated receptor-1 agonist SFLLRN (8 μmol/L) at 30 minutes to 6 hours were dose dependent with 20% to 40% inhibition at 0.3 mg/kg, 40% to 60% at 0.5 mg/kg, and ≥ 80% to 100% at 1 to 2 mg/kg. The subgroup receiving aspirin in the 0.5 and 1-mg/kg dose cohorts had 65% to 100% inhibition of final aggregation to SFLLRN at 30 minutes to 2 hours and 95% to 100% inhibition by 6 hours. The inhibitory effects of 0.5 mg/kg PZ-128 were reversible with 50% recovery of aggregation to SFLLRN by 24 hours. There were no significant effects of PZ-128 on aggregation induced by AYPGKF, ADP, or collagen, indicating that the observed effects were specific to protease-activated receptor-1. The plasma half-life was 1.3 to 1.8 hours, and PZ-128 was nondetectable in urine. There were no effects on bleeding, coagulation, clinical chemistry, or ECG parameters. PZ-128 is a promising antiplatelet agent that provides rapid, specific, dose dependent, and reversible inhibition of platelet protease-activated receptor-1 through a novel intracellular mechanism. URL: http://www.clinicaltrials.gov. Unique identifier: NCT01806077.
Author Kuliopulos, Athan
Gurbel, Paul A
Barr, Travis P
Turner, Susan E
Gesheff, Martin G
Covic, Lidija
Bliden, Kevin P
Tantry, Udaya S
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  givenname: Paul A
  surname: Gurbel
  fullname: Gurbel, Paul A
  organization: From the Sinai Center for Thrombosis Research, Sinai Hospital of Baltimore, MD (P.A.G., K.P.B., U.S.T., M.G.G.); and the Center for Hemostasis and Thrombosis Research, MORI, Tufts Medical Center, Boston, MA (S.E.T., T.P.B., L.C., A.K.)
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  givenname: Kevin P
  surname: Bliden
  fullname: Bliden, Kevin P
  organization: From the Sinai Center for Thrombosis Research, Sinai Hospital of Baltimore, MD (P.A.G., K.P.B., U.S.T., M.G.G.); and the Center for Hemostasis and Thrombosis Research, MORI, Tufts Medical Center, Boston, MA (S.E.T., T.P.B., L.C., A.K.)
– sequence: 3
  givenname: Susan E
  surname: Turner
  fullname: Turner, Susan E
  organization: From the Sinai Center for Thrombosis Research, Sinai Hospital of Baltimore, MD (P.A.G., K.P.B., U.S.T., M.G.G.); and the Center for Hemostasis and Thrombosis Research, MORI, Tufts Medical Center, Boston, MA (S.E.T., T.P.B., L.C., A.K.)
– sequence: 4
  givenname: Udaya S
  surname: Tantry
  fullname: Tantry, Udaya S
  organization: From the Sinai Center for Thrombosis Research, Sinai Hospital of Baltimore, MD (P.A.G., K.P.B., U.S.T., M.G.G.); and the Center for Hemostasis and Thrombosis Research, MORI, Tufts Medical Center, Boston, MA (S.E.T., T.P.B., L.C., A.K.)
– sequence: 5
  givenname: Martin G
  surname: Gesheff
  fullname: Gesheff, Martin G
  organization: From the Sinai Center for Thrombosis Research, Sinai Hospital of Baltimore, MD (P.A.G., K.P.B., U.S.T., M.G.G.); and the Center for Hemostasis and Thrombosis Research, MORI, Tufts Medical Center, Boston, MA (S.E.T., T.P.B., L.C., A.K.)
– sequence: 6
  givenname: Travis P
  surname: Barr
  fullname: Barr, Travis P
  organization: From the Sinai Center for Thrombosis Research, Sinai Hospital of Baltimore, MD (P.A.G., K.P.B., U.S.T., M.G.G.); and the Center for Hemostasis and Thrombosis Research, MORI, Tufts Medical Center, Boston, MA (S.E.T., T.P.B., L.C., A.K.)
– sequence: 7
  givenname: Lidija
  surname: Covic
  fullname: Covic, Lidija
  organization: From the Sinai Center for Thrombosis Research, Sinai Hospital of Baltimore, MD (P.A.G., K.P.B., U.S.T., M.G.G.); and the Center for Hemostasis and Thrombosis Research, MORI, Tufts Medical Center, Boston, MA (S.E.T., T.P.B., L.C., A.K.)
– sequence: 8
  givenname: Athan
  surname: Kuliopulos
  fullname: Kuliopulos, Athan
  email: athan.kuliopulos@tufts.edu
  organization: From the Sinai Center for Thrombosis Research, Sinai Hospital of Baltimore, MD (P.A.G., K.P.B., U.S.T., M.G.G.); and the Center for Hemostasis and Thrombosis Research, MORI, Tufts Medical Center, Boston, MA (S.E.T., T.P.B., L.C., A.K.). athan.kuliopulos@tufts.edu
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Snippet Pepducins are membrane-tethered, cell-penetrating lipopeptides that target the cytoplasmic surface of their cognate receptor. Here, we report the first human...
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StartPage 189
SubjectTerms Adult
Aged
Blood Platelets - drug effects
Blood Platelets - metabolism
Cell-Penetrating Peptides - administration & dosage
Cell-Penetrating Peptides - adverse effects
Cell-Penetrating Peptides - pharmacokinetics
Coronary Artery Disease - blood
Coronary Artery Disease - diagnosis
Coronary Artery Disease - therapy
Dose-Response Relationship, Drug
Female
Half-Life
Humans
Infusions, Intravenous
Lipopeptides - administration & dosage
Lipopeptides - adverse effects
Lipopeptides - pharmacokinetics
Male
Middle Aged
Percutaneous Coronary Intervention - adverse effects
Platelet Aggregation - drug effects
Platelet Aggregation Inhibitors - administration & dosage
Platelet Aggregation Inhibitors - adverse effects
Platelet Aggregation Inhibitors - pharmacokinetics
Platelet Function Tests
Receptor, PAR-1 - antagonists & inhibitors
Receptor, PAR-1 - metabolism
Treatment Outcome
Title Cell-Penetrating Pepducin Therapy Targeting PAR1 in Subjects With Coronary Artery Disease
URI https://www.ncbi.nlm.nih.gov/pubmed/26681756
https://www.proquest.com/docview/1751996641
Volume 36
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