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Herodes M, Anderson LJ, Shober S, Schur EA, Graf SA, Ammer N, Salas R, Marcelli M, Garcia JM. Pilot clinical trial of macimorelin to assess safety and efficacy in patients with cancer cachexia. J Cachexia Sarcopenia Muscle 2023; 14:835-846. [PMID: 36860137 PMCID: PMC10067502 DOI: 10.1002/jcsm.13191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 01/05/2023] [Accepted: 01/22/2023] [Indexed: 03/03/2023] Open
Abstract
BACKGROUND Cancer cachexia is associated with reduced body weight, appetite and quality of life (QOL) with no approved treatments. Growth hormone secretagogues like macimorelin have potential to mitigate these effects. METHODS This pilot study assessed the safety and efficacy of macimorelin for 1 week. Efficacy was defined a priori as 1-week change in body weight (≥0.8 kg), plasma insulin-like growth factor (IGF)-1 (≥50 ng/mL) or QOL (≥15%). Secondary outcomes included food intake, appetite, functional performance, energy expenditure and safety laboratory parameters. Patients with cancer cachexia were randomized to 0.5 or 1.0 mg/kg macimorelin or placebo; outcomes were assessed non-parametrically. RESULTS Participants receiving at least one of either macimorelin dose were combined (N = 10; 100% male; median age = 65.50 ± 2.12) and compared with placebo (N = 5; 80% male; median age = 68.00 ± 6.19). Efficacy criteria achieved: body weight (macimorelin N = 2; placebo N = 0; P = 0.92); IGF-1 (macimorelin N = 0; placebo N = 0); QOL by Anderson Symptom Assessment Scale (macimorelin N = 4; placebo N = 1; P = 1.00) or Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F; macimorelin N = 3; placebo N = 0; P = 0.50). No related serious or non-serious adverse events were reported. In macimorelin recipients, change in FACIT-F was directly associated with change in body weight (r = 0.92, P = 0.001), IGF-1 (r = 0.80, P = 0.01), and caloric intake (r = 0.83, P = 0.005), and inversely associated with change in energy expenditure (r = -0.67, P = 0.05). CONCLUSIONS Daily oral macimorelin for 1 week was safe and numerically improved body weight and QOL in patients with cancer cachexia compared with placebo. Longer term administration should be evaluated for mitigation of cancer-induced reductions in body weight, appetite and QOL in larger studies.
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Affiliation(s)
- Megan Herodes
- Division of Gerontology and Geriatric Medicine, School of MedicineUniversity of WashingtonSeattleWAUSA
- Geriatric Research, Education and Clinical CenterVeterans Affairs Puget Sound Health Care SystemSeattleWAUSA
| | - Lindsey J. Anderson
- Division of Gerontology and Geriatric Medicine, School of MedicineUniversity of WashingtonSeattleWAUSA
- Geriatric Research, Education and Clinical CenterVeterans Affairs Puget Sound Health Care SystemSeattleWAUSA
| | - Samuel Shober
- Division of Gerontology and Geriatric Medicine, School of MedicineUniversity of WashingtonSeattleWAUSA
- Geriatric Research, Education and Clinical CenterVeterans Affairs Puget Sound Health Care SystemSeattleWAUSA
| | - Ellen A. Schur
- Division of General Internal Medicine, Department of MedicineUniversity of WashingtonSeattleWAUSA
| | - Solomon A. Graf
- Hospital and Specialty MedicineVeterans Affairs Puget Sound Health Care SystemSeattleWAUSA
- Division of Medical Oncology, Department of MedicineUniversity of WashingtonSeattleWAUSA
- Clinical Research DivisionFred Hutchinson Cancer CenterSeattleWAUSA
| | - Nicola Ammer
- Department of Clinical DevelopmentAeterna Zentaris GmbHFrankfurtGermany
| | - Ramiro Salas
- Departments of Psychiatry and NeuroscienceBaylor College of MedicineHoustonTXUSA
- The Menninger ClinicHoustonTXUSA
- Center for Translational Research on Inflammatory DiseasesMichael E. DeBakey Veterans Affairs Medical CenterHoustonTXUSA
| | - Marco Marcelli
- Medical Care Line, Michael E. DeBakey Veterans Affairs Medical Center; Department of Medicine, Endocrinology, Diabetes and MetabolismBaylor College of MedicineHoustonTXUSA
| | - Jose M. Garcia
- Division of Gerontology and Geriatric Medicine, School of MedicineUniversity of WashingtonSeattleWAUSA
- Geriatric Research, Education and Clinical CenterVeterans Affairs Puget Sound Health Care SystemSeattleWAUSA
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Gu J, Wu Q, Zhang Q, You Q, Wang L. A decade of approved first-in-class small molecule orphan drugs: Achievements, challenges and perspectives. Eur J Med Chem 2022; 243:114742. [PMID: 36155354 DOI: 10.1016/j.ejmech.2022.114742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/01/2022] [Accepted: 09/01/2022] [Indexed: 12/01/2022]
Abstract
In the past decade (2011-2020), there was a growing interest in the discovery and development of orphan drugs for the treatment of rare diseases. However, rare diseases only account for a population of 0.65‰-1‰ which usually occur with previously unknown biological mechanisms and lack of specific therapeutics, thus to increase the demands for the first-in-class (FIC) drugs with new biological targets or mechanisms. Considering the achievements in the past 10 years, a total of 410 drugs were approved by U.S. Food and Drug Administration (FDA), which contained 151 FIC drugs and 184 orphan drugs, contributing to make up significant numbers of the approvals. Notably, more than 50% of FIC drugs are developed as orphan drugs and some of them have already been milestones in drug development. In this review, we aim to discuss the FIC small molecules for the development of orphan drugs case by case and highlight the R&D strategy with novel targets and scientific breakthroughs.
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Affiliation(s)
- Jinying Gu
- State Key Laboratory of Natural Medicines and Jiangsu Key Laboratory of Drug Design and Optimization, China Pharmaceutical University, Nanjing, 210009, China; Department of Medicinal Chemistry, School of Pharmacy, China Pharmaceutical University, Nanjing, 210009, China
| | - Qiuyu Wu
- State Key Laboratory of Natural Medicines and Jiangsu Key Laboratory of Drug Design and Optimization, China Pharmaceutical University, Nanjing, 210009, China; Department of Medicinal Chemistry, School of Pharmacy, China Pharmaceutical University, Nanjing, 210009, China
| | - Qiuyue Zhang
- State Key Laboratory of Natural Medicines and Jiangsu Key Laboratory of Drug Design and Optimization, China Pharmaceutical University, Nanjing, 210009, China; Department of Medicinal Chemistry, School of Pharmacy, China Pharmaceutical University, Nanjing, 210009, China
| | - Qidong You
- State Key Laboratory of Natural Medicines and Jiangsu Key Laboratory of Drug Design and Optimization, China Pharmaceutical University, Nanjing, 210009, China; Department of Medicinal Chemistry, School of Pharmacy, China Pharmaceutical University, Nanjing, 210009, China.
| | - Lei Wang
- State Key Laboratory of Natural Medicines and Jiangsu Key Laboratory of Drug Design and Optimization, China Pharmaceutical University, Nanjing, 210009, China; Department of Medicinal Chemistry, School of Pharmacy, China Pharmaceutical University, Nanjing, 210009, China.
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Bukhari SNA. An insight into the multifunctional role of ghrelin and structure activity relationship studies of ghrelin receptor ligands with clinical trials. Eur J Med Chem 2022; 235:114308. [PMID: 35344905 DOI: 10.1016/j.ejmech.2022.114308] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 02/06/2022] [Accepted: 03/18/2022] [Indexed: 11/30/2022]
Abstract
Ghrelin is a multifunctional gastrointestinal acylated peptide, primarily synthesized in the stomach and regulates the secretion of growth hormone and energy homeostasis. It plays a central role in modulating the diverse biological, physiological and pathological functions in vertebrates. The synthesis of ghrelin receptor ligands after the finding of growth hormone secretagogue developed from Met-enkephalin led to reveal the endogenous ligand ghrelin and the receptors. Subsequently, many peptides, small molecules and peptidomimetics focusing on the ghrelin receptor, GHS-R1a, were derived. In this review, the key features of ghrelin's structure, forms, its bio-physiological functions, pathological roles and therapeutic potential have been highlighted. A few peptidomimetics and pseudo peptide synthetic perspectives have also been discussed to make ghrelin receptor ligands, clinical trials and their success.
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Affiliation(s)
- Syed Nasir Abbas Bukhari
- Department of Pharmaceutical Chemistry, College of Pharmacy, Jouf University, Sakaka, Aljouf, 2014, Saudi Arabia.
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Urwyler SA, Lustenberger S, Drummond JR, Soares BS, Vogt DR, Ammer N, Yuen KCJ, Ribeiro-Oliveira A, Christ-Crain M. Effects of oral macimorelin on copeptin and anterior pituitary hormones in healthy volunteers. Pituitary 2021; 24:555-563. [PMID: 33615399 PMCID: PMC8270818 DOI: 10.1007/s11102-021-01132-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/08/2021] [Indexed: 11/12/2022]
Abstract
PURPOSE The test with the highest diagnostic accuracy for diabetes insipidus is copeptin measurement after hypertonic saline infusion. However, the procedure is cumbersome and unpleasant due to rapid sodium increase. An oral stimulation test would be highly desirable. Macimorelin, an oral ghrelin agonist, is a newly approved diagnostic test for growth hormone (GH) deficiency, but its effects on copeptin/vasopressin are unknown and the effects on other pituitary hormones only scarcely investigated. METHODS In this prospective, interventional, proof-of-concept study Copeptin and anterior pituitary hormones were measured in 28 healthy volunteers on two test days at baseline, 30, 45, 60, 90 and 120 min after a single dose of macimorelin (first visit: 0.5 mg/kg, second visit: 0.75 mg/kg). RESULTS Baseline copeptin levels were 5.26 pmol/L [1.57, 6.81] and did not change after macimorelin intake (0.5 mg/kg: maximal median change 0.40 [- 0.49, 0.65] pmol/L, p = 0.442; 0.75 mg/kg: - 0.13 [- 0.45, 0.17] pmol/L, p = 0.442. Median GH levels increased from 3.67 mU/L with a maximal median change of 94.66 [IQR 56.5; 110.96] mU/L, p < 0.001. No effect was seen on cortisol, ACTH, LH and FSH levels. Prolactin (max. median change 100 [2.5; 146.5] mU/L, p = 0.004) and free thyroxine (fT4) (0.5 [0.2; 0.8] pmol/L, p < 0.001) increased, whereas TSH decreased (- 0.18 [- 0.22, - 0.09] mU/L, p < 0.001). CONCLUSION We confirm an increase of GH upon macimorelin in healthy volunteers. However, macimorelin did not stimulate copeptin and therefore does not provide an oral test alternative for the diagnosis of diabetes insipidus. Additionally, a stimulatory effect was seen for prolactin and fT4, but not for ACTH and gonadotropic hormones. REGISTRATION The trial was registered on ClinicalTrials.gov (NCT03844217) on February 18, 2019.
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Affiliation(s)
- Sandrine A Urwyler
- Department of Endocrinology, Diabetology and Metabolism, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland.
- Department of Clinical Research, University Basel, Basel, Switzerland.
| | - Sven Lustenberger
- Department of Endocrinology, Diabetology and Metabolism, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
- Department of Clinical Research, University Basel, Basel, Switzerland
| | - Juliana R Drummond
- Faculdade de Medicina da UFMG, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Beatriz Santana Soares
- Faculdade de Medicina da UFMG, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Deborah R Vogt
- Department of Clinical Research, Clinical Trial Unit, University Hospital Basel, University of Basel, Basel, Switzerland
| | | | - Kevin C J Yuen
- Department of Neuroendocrinology, Barrow Neurological Institute, University of Arizona College of Medicine and Creighton School of Medicine, Phoenix, AZ, USA
| | | | - Mirjam Christ-Crain
- Department of Endocrinology, Diabetology and Metabolism, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
- Department of Clinical Research, University Basel, Basel, Switzerland
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Lissy M, Demmel V, Sachse R, Ammer N, Kelepouris N, Ostrow V. Thorough QT/QTc Study Evaluating the Effect of Macimorelin on Cardiac Safety Parameters in Healthy Participants. Clin Pharmacol Drug Dev 2021; 10:494-501. [PMID: 32961034 PMCID: PMC8246819 DOI: 10.1002/cpdd.872] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 09/02/2020] [Indexed: 11/21/2022]
Abstract
Macimorelin is an orally active growth hormone secretagogue indicated for the diagnosis of adult growth hormone deficiency. The primary objective of this study was to evaluate the effect of macimorelin on the baseline and placebo-corrected mean QT interval using Fridericia's formula (ΔΔQTcF). Secondary objectives were to determine QTcF for moxifloxacin; evaluate the effects of macimorelin on other cardiac intervals (PR, QRS, RR), heart rate, and electrocardiogram morphology parameters; characterize pharmacokinetics; and assess safety of macimorelin. The phase 1 thorough QT/QTc study, designed according to the International Council for Harmonisation E14 guideline, was a randomized, placebo-controlled, double-blind, 3-way complete crossover study comparing the effect of macimorelin 2.0 mg/kg with placebo and moxifloxacin 400 mg (positive control). Data were collected over a 3-month span from male (n=36) and female participants (n=24) aged 18 to 55 years with body mass index between 18.5 and 30.0 kg/m2 . Fifty-six participants received all 3 treatments. The ΔΔQTcF for macimorelin showed a prolongation with a maximum mean value of 9.61 milliseconds (2-sided 90% confidence interval, 7.81 milliseconds and 11.41 milliseconds) at 4 hours after dosing. The 2-sided 90% confidence interval of this value also exceeded the 10 millisecond threshold at 3 hours after dosing. Assay sensitivity was confirmed with moxifloxacin. Other electrocardiogram parameters evaluated were not influenced by macimorelin. Macimorelin did not raise other safety concerns and was well tolerated. In summary, a single supratherapeutic dose of macimorelin prolonged cardiac repolarization according to the regulatory guideline.
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Klaus B, Sachse R, Ammer N, Kelepouris N, Ostrow V. Safety, tolerability, pharmacokinetics, and pharmacodynamics of macimorelin in healthy adults: Results of a single-dose, randomized controlled study. Growth Horm IGF Res 2020; 52:101321. [PMID: 32325373 DOI: 10.1016/j.ghir.2020.101321] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 04/13/2020] [Accepted: 04/14/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Macimorelin is an orally active ghrelin receptor agonist indicated for the diagnosis of adult growth hormone (GH) deficiency in the United States. This phase 1 study evaluated the safety, tolerability, pharmacokinetics, and pharmacodynamics of single ascending doses of macimorelin (including a supratherapeutic dose to be used in a thorough QT trial) in healthy adults. DESIGN Participants were randomized to receive macimorelin 0.5, 1.0, or 2.0 mg/kg or placebo in 1 of 3 sequential ascending-dose cohorts. Blood samples for pharmacokinetic and pharmacodynamic assays were collected pre-dose and at specified time points over a 24-h period. Pharmacokinetic parameters assessed included area under the concentration-time curve (AUC), maximum concentration (Cmax) of macimorelin in plasma, time to Cmax (tmax), and terminal elimination half-life (t1/2). Pharmacodynamic assessments evaluated levels of GH, adrenocorticotropic hormone, thyroid-stimulating hormone, cortisol, and prolactin. Safety was assessed based on treatment-emergent adverse events (TEAEs), vital signs, 12‑lead electrocardiograms, and laboratory parameters. RESULTS A total of 28 healthy adults were enrolled and completed the study. Macimorelin AUC and Cmax showed less than dose-proportional increases following administration of 0.5 and 1.0 mg/kg. Mean t1/2 was 3.51 h for macimorelin 0.5 and 1.0 mg/kg and 8.29 h for macimorelin 2.0 mg/kg; median tmax occurred at 0.5 to 0.75 h. GH levels increased after dosing, with a tmax of 0.75 h to 1.0 h. Mean GH Cmax was similar with the macimorelin 0.5- and 1.0-mg/kg doses (31.9 and 37.8 ng/mL, respectively) and was ~50% lower with macimorelin 2.0 mg/kg (18.4 ng/mL). Transient increases were observed in adrenocorticotropic hormone, cortisol, and prolactin, which were not dose related. A total of 19 TEAEs were reported in 35.7% (10/28) of participants; all TEAEs were mild or moderate and resolved. A total of 12 drug-related TEAEs were reported in 8 participants. Headache was the most common drug-related TEAE. All doses of macimorelin prolonged mean QTcF by 10 to 11 ms. There were no clinically meaningful changes in vital signs or laboratory parameters. CONCLUSIONS Single-dose administration of macimorelin 0.5 to 2.0 mg/kg was well tolerated. Macimorelin exposure was less than dose-proportional over the dose range studied. Administration of macimorelin stimulated GH production, with the greatest increases observed in the macimorelin 0.5- and 1.0-mg/kg groups.
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Affiliation(s)
| | | | | | | | - Vlady Ostrow
- Novo Nordisk Inc., Plainsboro, New Jersey, United States
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7
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Abstract
Growth hormone deficiency (GHD) is a severe pathology that greatly affects the quality of life, and increases morbidity and mortality of patients owing to the augmentation of cardiovascular events. Treatment of GHD is challenging, mainly because there is no specific characteristic sign or symptom that can be used to make a clear diagnosis. There is need for an unequivocal diagnosis of GHD to avoid unnecessary treatment with GH, because the available provocative tests (GH stimulation tests) are not specific and sensitive enough, and are contraindicated in some patients. Ghrelin is an endogenous peptide that stimulates GH secretion by interacting with a G-protein-coupled receptor named ghrelin receptor (GH secretagogue receptor 1a, GHS-R1a). Given this, a GH stimulation test using ghrelin or its analogues appears to be attractive. In this paper, a modified tripeptide first named JMV-1843 in the laboratory is briefly presented. It is potent and selective in stimulating the release of GH and is orally active. It has been recently commercialised for the diagnosis of adult GH deficiency under the tradename Macrilen. The test using this compound appears to be reliable, well tolerated, and simple.
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8
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Garcia JM, Biller BMK, Korbonits M, Popovic V, Luger A, Strasburger CJ, Chanson P, Medic-Stojanoska M, Schopohl J, Zakrzewska A, Pekic S, Bolanowski M, Swerdloff R, Wang C, Blevins T, Marcelli M, Ammer N, Sachse R, Yuen KCJ. Macimorelin as a Diagnostic Test for Adult GH Deficiency. J Clin Endocrinol Metab 2018; 103:3083-3093. [PMID: 29860473 DOI: 10.1210/jc.2018-00665] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 05/25/2018] [Indexed: 11/19/2022]
Abstract
PURPOSE The diagnosis of adult GH deficiency (AGHD) is challenging and often requires confirmation with a GH stimulation test (GHST). The insulin tolerance test (ITT) is considered the reference standard GHST but is labor intensive, can cause severe hypoglycemia, and is contraindicated for certain patients. Macimorelin, an orally active GH secretagogue, could be used to diagnose AGHD by measuring stimulated GH levels after an oral dose. MATERIALS AND METHODS The present multicenter, open-label, randomized, two-way crossover trial was designed to validate the efficacy and safety of single-dose oral macimorelin for AGHD diagnosis compared with the ITT. Subjects with high (n = 38), intermediate (n = 37), and low (n = 39) likelihood for AGHD and healthy, matched controls (n = 25) were included in the efficacy analysis. RESULTS After the first test, 99% of macimorelin tests and 82% of ITTs were evaluable. Using GH cutoff levels of 2.8 ng/mL for macimorelin and 5.1 ng/mL for ITTs, the negative agreement was 95.38% (95% CI, 87% to 99%), the positive agreement was 74.32% (95% CI, 63% to 84%), sensitivity was 87%, and specificity was 96%. On retesting, the reproducibility was 97% for macimorelin (n = 33). In post hoc analyses, a GH cutoff of 5.1 ng/mL for both tests resulted in 94% (95% CI, 85% to 98%) negative agreement, 82% (95% CI, 72% to 90%) positive agreement, 92% sensitivity, and 96% specificity. No serious adverse events were reported for macimorelin. CONCLUSIONS Oral macimorelin is a simple, well-tolerated, reproducible, and safe diagnostic test for AGHD with accuracy comparable to that of the ITT. A GH cutoff of 5.1 ng/mL for the macimorelin test provides an excellent balance between sensitivity and specificity.
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Affiliation(s)
- Jose M Garcia
- Geriatric Research Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, University of Washington and SIBCR, Seattle, Washington
| | | | - Márta Korbonits
- Barts and the London School of Medicine, Queen Mary University of London, London, United Kingdom
| | - Vera Popovic
- University of Belgrade Faculty of Medicine, Belgrade, Serbia
| | - Anton Luger
- Vienna General Hospital - Medical University Campus, Vienna, Austria
| | | | - Philippe Chanson
- Service d'Endocrinologie et des Maladies de la Reproduction, Centre de Référence des Maladies Rares de l'Hypophyse, Assistance Publique-Hôpitaux de Paris, Hôpital de Bicêtre, Le Kremlin Bicêtre, France
- Unité Mixte de Recherche S-1185, Faculté de Médecine Paris Sud, Université Paris Sud, Le Kremlin-Bicêtre, France
| | | | - Jochen Schopohl
- Medizinische Klinik IV, Ludwig Maximilian University of Munich, Munich, Germany
| | | | - Sandra Pekic
- University of Belgrade Faculty of Medicine, Belgrade, Serbia
- Clinic for Endocrinology, University Clinical Center, Belgrade, Serbia
| | - Marek Bolanowski
- WroMedica, Wrocław, Poland
- Medical University Wroclaw, Wrocław, Poland
| | - Ronald Swerdloff
- Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center, Torrance, California
| | - Christina Wang
- Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center, Torrance, California
| | | | - Marco Marcelli
- Baylor College of Medicine and Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas
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Al Musaimi O, Al Shaer D, de la Torre BG, Albericio F. 2017 FDA Peptide Harvest. Pharmaceuticals (Basel) 2018; 11:ph11020042. [PMID: 29735913 PMCID: PMC6027222 DOI: 10.3390/ph11020042] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 04/30/2018] [Accepted: 05/03/2018] [Indexed: 12/11/2022] Open
Abstract
2017 was an excellent year in terms of new drugs (chemical entities and biologics) approved by the FDA, with a total of 46. In turn, one of the highlights was the number of peptides (six) included in this list. Here, the six peptides are analyzed in terms of chemical structure, synthetic strategy used for their production, source, therapeutic use, and mode of action.
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Affiliation(s)
- Othman Al Musaimi
- College of Health Sciences, University of KwaZulu-Natal, Durban 4000, South Africa.
- School of Chemistry, University of KwaZulu-Natal, Durban 4001, South Africa.
| | - Danah Al Shaer
- College of Health Sciences, University of KwaZulu-Natal, Durban 4000, South Africa.
- School of Chemistry, University of KwaZulu-Natal, Durban 4001, South Africa.
| | - Beatriz G de la Torre
- KRISP, College of Health Sciences, University of KwaZulu-Natal, Durban 4001, South Africa.
| | - Fernando Albericio
- School of Chemistry, University of KwaZulu-Natal, Durban 4001, South Africa.
- CIBER-BBN, Networking Centre on Bioengineering, Biomaterials and Nanomedicine, University of Barcelona, 08028 Barcelona, Spain.
- Department of Organic Chemistry, University of Barcelona, 08028 Barcelona, Spain.
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From Belly to Brain: Targeting the Ghrelin Receptor in Appetite and Food Intake Regulation. Int J Mol Sci 2017; 18:ijms18020273. [PMID: 28134808 PMCID: PMC5343809 DOI: 10.3390/ijms18020273] [Citation(s) in RCA: 92] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 01/19/2017] [Indexed: 12/20/2022] Open
Abstract
Ghrelin is the only known peripherally-derived orexigenic hormone, increasing appetite and subsequent food intake. The ghrelinergic system has therefore received considerable attention as a therapeutic target to reduce appetite in obesity as well as to stimulate food intake in conditions of anorexia, malnutrition and cachexia. As the therapeutic potential of targeting this hormone becomes clearer, it is apparent that its pleiotropic actions span both the central nervous system and peripheral organs. Despite a wealth of research, a therapeutic compound specifically targeting the ghrelin system for appetite modulation remains elusive although some promising effects on metabolic function are emerging. This is due to many factors, ranging from the complexity of the ghrelin receptor (Growth Hormone Secretagogue Receptor, GHSR-1a) internalisation and heterodimerization, to biased ligand interactions and compensatory neuroendocrine outputs. Not least is the ubiquitous expression of the GHSR-1a, which makes it impossible to modulate centrally-mediated appetite regulation without encroaching on the various peripheral functions attributable to ghrelin. It is becoming clear that ghrelin’s central signalling is critical for its effects on appetite, body weight regulation and incentive salience of food. Improving the ability of ghrelin ligands to penetrate the blood brain barrier would enhance central delivery to GHSR-1a expressing brain regions, particularly within the mesolimbic reward circuitry.
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Coppens J, Aourz N, Walrave L, Fehrentz JA, Martinez J, De Bundel D, Portelli J, Smolders I. Anticonvulsant effect of a ghrelin receptor agonist in 6Hz corneally kindled mice. Epilepsia 2016; 57:e195-9. [DOI: 10.1111/epi.13463] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Jessica Coppens
- Center for Neurosciences; VUB Free University Brussels; Brussels Belgium
| | - Najat Aourz
- Center for Neurosciences; VUB Free University Brussels; Brussels Belgium
| | - Laura Walrave
- Center for Neurosciences; VUB Free University Brussels; Brussels Belgium
| | - Jean-Alain Fehrentz
- IBMM Institute of Biomolecules Max Mousseron; University of Montpellier; Montpellier France
| | - Jean Martinez
- IBMM Institute of Biomolecules Max Mousseron; University of Montpellier; Montpellier France
| | - Dimitri De Bundel
- Center for Neurosciences; VUB Free University Brussels; Brussels Belgium
| | - Jeanelle Portelli
- Center for Neurosciences; VUB Free University Brussels; Brussels Belgium
- Department of Neurology; UZ Gent; Ghent Belgium
| | - Ilse Smolders
- Center for Neurosciences; VUB Free University Brussels; Brussels Belgium
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12
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Maingot M, Blayo AL, Denoyelle S, M'Kadmi C, Damian M, Mary S, Gagne D, Sanchez P, Aicher B, Schmidt P, Müller G, Teifel M, Günther E, Marie J, Banères JL, Martinez J, Fehrentz JA. New ligands of the ghrelin receptor based on the 1,2,4-triazole scaffold by introduction of a second chiral center. Bioorg Med Chem Lett 2016; 26:2408-2412. [PMID: 27072910 DOI: 10.1016/j.bmcl.2016.04.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 04/01/2016] [Accepted: 04/03/2016] [Indexed: 12/25/2022]
Abstract
Introducing a second chiral center on our previously described 1,2,4-triazole, allowed us to increase diversity and elongate the 'C-terminal part' of the molecule. Therefore, we were able to explore mimics of the substance P analogs described as inverse agonists. Some compounds presented affinities in the nanomolar range and potent biological activities, while one exhibited a partial inverse agonist behavior similar to a Substance P analog.
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Affiliation(s)
- Mathieu Maingot
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247, CNRS, ENSCM, Université de Montpellier, BP 14491, Faculté de Pharmacie, bât. E, 3(ème) étage, 15 avenue Charles Flahault, 34093 Montpellier Cedex 5, France
| | - Anne-Laure Blayo
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247, CNRS, ENSCM, Université de Montpellier, BP 14491, Faculté de Pharmacie, bât. E, 3(ème) étage, 15 avenue Charles Flahault, 34093 Montpellier Cedex 5, France
| | - Séverine Denoyelle
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247, CNRS, ENSCM, Université de Montpellier, BP 14491, Faculté de Pharmacie, bât. E, 3(ème) étage, 15 avenue Charles Flahault, 34093 Montpellier Cedex 5, France
| | - Céline M'Kadmi
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247, CNRS, ENSCM, Université de Montpellier, BP 14491, Faculté de Pharmacie, bât. E, 3(ème) étage, 15 avenue Charles Flahault, 34093 Montpellier Cedex 5, France
| | - Marjorie Damian
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247, CNRS, ENSCM, Université de Montpellier, BP 14491, Faculté de Pharmacie, bât. E, 3(ème) étage, 15 avenue Charles Flahault, 34093 Montpellier Cedex 5, France
| | - Sophie Mary
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247, CNRS, ENSCM, Université de Montpellier, BP 14491, Faculté de Pharmacie, bât. E, 3(ème) étage, 15 avenue Charles Flahault, 34093 Montpellier Cedex 5, France
| | - Didier Gagne
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247, CNRS, ENSCM, Université de Montpellier, BP 14491, Faculté de Pharmacie, bât. E, 3(ème) étage, 15 avenue Charles Flahault, 34093 Montpellier Cedex 5, France
| | - Pierre Sanchez
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247, CNRS, ENSCM, Université de Montpellier, BP 14491, Faculté de Pharmacie, bât. E, 3(ème) étage, 15 avenue Charles Flahault, 34093 Montpellier Cedex 5, France
| | - Babette Aicher
- Æterna Zentaris GmbH, Weismuellerstrasse 50, 60314 Frankfurt am Main, Germany
| | - Peter Schmidt
- Æterna Zentaris GmbH, Weismuellerstrasse 50, 60314 Frankfurt am Main, Germany
| | - Gilbert Müller
- Æterna Zentaris GmbH, Weismuellerstrasse 50, 60314 Frankfurt am Main, Germany
| | - Michael Teifel
- Æterna Zentaris GmbH, Weismuellerstrasse 50, 60314 Frankfurt am Main, Germany
| | - Eckhard Günther
- Æterna Zentaris GmbH, Weismuellerstrasse 50, 60314 Frankfurt am Main, Germany
| | - Jacky Marie
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247, CNRS, ENSCM, Université de Montpellier, BP 14491, Faculté de Pharmacie, bât. E, 3(ème) étage, 15 avenue Charles Flahault, 34093 Montpellier Cedex 5, France
| | - Jean-Louis Banères
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247, CNRS, ENSCM, Université de Montpellier, BP 14491, Faculté de Pharmacie, bât. E, 3(ème) étage, 15 avenue Charles Flahault, 34093 Montpellier Cedex 5, France
| | - Jean Martinez
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247, CNRS, ENSCM, Université de Montpellier, BP 14491, Faculté de Pharmacie, bât. E, 3(ème) étage, 15 avenue Charles Flahault, 34093 Montpellier Cedex 5, France
| | - Jean-Alain Fehrentz
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247, CNRS, ENSCM, Université de Montpellier, BP 14491, Faculté de Pharmacie, bât. E, 3(ème) étage, 15 avenue Charles Flahault, 34093 Montpellier Cedex 5, France.
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Lucchi C, Vinet J, Meletti S, Biagini G. Ischemic-hypoxic mechanisms leading to hippocampal dysfunction as a consequence of status epilepticus. Epilepsy Behav 2015; 49:47-54. [PMID: 25934585 DOI: 10.1016/j.yebeh.2015.04.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 04/01/2015] [Accepted: 04/02/2015] [Indexed: 10/23/2022]
Abstract
Status epilepticus (SE) is one of the recognized primary precipitating events that can lead to temporal lobe epilepsy (TLE) associated with hippocampal sclerosis. This type of epilepsy is characterized by poor response to drug treatment, often requiring surgical intervention to remove the mesial temporal regions involved in the seizure onset. However, even neurosurgery may not be completely successful. Thus, the prevention of hippocampal damage and epileptogenesis is currently evaluated as a possible alternative therapeutic approach to prevent the development of pharmacoresistant TLE. Lines of evidence suggest that ischemic-hypoxic lesions might occur in different brain regions, including the hippocampus, during SE. Especially in the hippocampal CA3 region, an ischemic-like lesion develops in the stratum lacunosum-moleculare and is mainly characterized by a loss of astrocytes and neuronal processes and increased immunostaining of pimonidazole which probes areas exposed to hypoxia. Interestingly, these mechanisms can contribute to neuronal cell loss and may be counteracted by drugs that can afford vascular protection, as in the case of ligands of the ghrelin receptor. Notably, some of the ghrelin receptor ligands possess a double edge effect, since they are anticonvulsant and vascular-protective, thus, potentially representing new tools to counteract the consequences of SE. This article is part of a Special Issue entitled "Status Epilepticus".
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Affiliation(s)
- Chiara Lucchi
- Department of Biomedical, Metabolic and Neural Sciences, Laboratory of Experimental Epileptology, University of Modena and Reggio Emilia, Modena, Italy
| | - Jonathan Vinet
- Department of Biomedical, Metabolic and Neural Sciences, Laboratory of Experimental Epileptology, University of Modena and Reggio Emilia, Modena, Italy
| | - Stefano Meletti
- Department of Biomedical, Metabolic and Neural Sciences, Neurology Unit, University of Modena and Reggio Emilia, Modena, Italy
| | - Giuseppe Biagini
- Department of Biomedical, Metabolic and Neural Sciences, Laboratory of Experimental Epileptology, University of Modena and Reggio Emilia, Modena, Italy; Department of Neurosciences, NOCSAE Hospital, AUSL Modena, Modena, Italy.
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Dingemans AMC, de Vos-Geelen J, Langen R, Schols AMW. Phase II drugs that are currently in development for the treatment of cachexia. Expert Opin Investig Drugs 2014; 23:1655-69. [DOI: 10.1517/13543784.2014.942729] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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15
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Clinical development of ghrelin axis-derived molecules for cancer cachexia treatment. Curr Opin Support Palliat Care 2014; 7:368-75. [PMID: 24145681 DOI: 10.1097/spc.0000000000000012] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
PURPOSE OF REVIEW Cachexia is a devastating complication of cancer for which there is no approved treatment. Here we review the clinical development of ghrelin and ghrelin mimetics (also known as growth hormone secretagogues or GHS) for cancer cachexia treatment. RECENT FINDINGS Ghrelin, a novel hormone known to increase appetite, lean and fat mass, and growth hormone secretion, is being developed as a therapeutic option for cancer anorexia-cachexia syndrome (CACS). Recent animal studies suggest that it may also decrease inflammation and that some of its effects may be independent of its only known receptor, the GHS receptor-1a.Clinical studies recently have shown that administration of ghrelin or GHS improves appetite and quality of life as assessed by questionnaires. Weight gain, increased food intake and better tolerance to chemotherapy have also been reported. This treatment appears to be safe and well tolerated. SUMMARY Ghrelin and GHS have the potential to effectively prevent or reverse CACS. Preliminary studies show improvements in weight stabilization and appetite with short-term usage. Further studies are required to fully characterize the role of ghrelin and GHS for the treatment of CACS and to establish the safety of this approach.
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16
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Acylated and unacylated ghrelin protect MC3T3-E1 cells against tert-butyl hydroperoxide-induced oxidative injury: pharmacological characterization of ghrelin receptor and possible epigenetic involvement. Amino Acids 2014; 46:1715-25. [PMID: 24705647 DOI: 10.1007/s00726-014-1734-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Accepted: 03/21/2014] [Indexed: 01/02/2023]
Abstract
Increasing evidence suggests a role for oxidative stress in age-related decrease in osteoblast number and function leading to the development of osteoporosis. This study was undertaken to investigate whether ghrelin, previously reported to stimulate osteoblast proliferation, counteracts tert-butyl hydroperoxide (t-BHP)-induced oxidative damage in MC3T3-E1 osteoblastic cells as well as to characterize the ghrelin receptor (GHS-R) involved in such activity. Pretreatment with ghrelin (10(-7)-10(-11)M) significantly increased viability and reduced apoptosis of MC3T3-E1 cells cultured with t-BHP (250 μM) for three hours at the low concentration of 10(-9)M as shown by MTT assay and Hoechst-33258 staining. Furthermore, ghrelin prevented t-BHP-induced osteoblastic dysfunction and changes in the cytoskeleton organization evidenced by the staining of the actin fibers with Phalloidin-FITC by reducing reactive oxygen species generation. The GHS-R type 1a agonist, EP1572 (10(-7)-10(-11)M), had no effect against t-BHP-induced cytotoxicity and pretreatment with the selective GHS-R1a antagonist, D-Lys(3)-GHRP-6 (10(-7)M), failed to remove ghrelin (10(-9) M)-protective effects against oxidative injury, indicating that GHS-R1a is not involved in such ghrelin activity. Accordingly, unacylated ghrelin (DAG), not binding GHS-R1a, displays the same protective actions of ghrelin against t-BHP-induced cytotoxicity. Preliminary observations indicate that ghrelin increased the trimethylation of lys4 on histones H3, a known epigenetic mark activator, which may regulate the expression of some genes limiting oxidative damage. In conclusion, our data demonstrate that ghrelin and DAG promote survival of MC3T3-E1 cell exposed to t-BHP-induced oxidative damage. Such effect is independent of GHS-R1a and is likely mediated by a common ghrelin/DAG binding site.
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Curia G, Lucchi C, Vinet J, Gualtieri F, Marinelli C, Torsello A, Costantino L, Biagini G. Pathophysiogenesis of mesial temporal lobe epilepsy: is prevention of damage antiepileptogenic? Curr Med Chem 2014; 21:663-88. [PMID: 24251566 PMCID: PMC4101766 DOI: 10.2174/0929867320666131119152201] [Citation(s) in RCA: 152] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Revised: 07/04/2013] [Accepted: 08/29/2013] [Indexed: 12/26/2022]
Abstract
Temporal lobe epilepsy (TLE) is frequently associated with hippocampal sclerosis, possibly caused by a primary brain injury that occurred a long time before the appearance of neurological symptoms. This type of epilepsy is characterized by refractoriness to drug treatment, so to require surgical resection of mesial temporal regions involved in seizure onset. Even this last therapeutic approach may fail in giving relief to patients. Although prevention of hippocampal damage and epileptogenesis after a primary event could be a key innovative approach to TLE, the lack of clear data on the pathophysiological mechanisms leading to TLE does not allow any rational therapy. Here we address the current knowledge on mechanisms supposed to be involved in epileptogenesis, as well as on the possible innovative treatments that may lead to a preventive approach. Besides loss of principal neurons and of specific interneurons, network rearrangement caused by axonal sprouting and neurogenesis are well known phenomena that are integrated by changes in receptor and channel functioning and modifications in other cellular components. In particular, a growing body of evidence from the study of animal models suggests that disruption of vascular and astrocytic components of the blood-brain barrier takes place in injured brain regions such as the hippocampus and piriform cortex. These events may be counteracted by drugs able to prevent damage to the vascular component, as in the case of the growth hormone secretagogue ghrelin and its analogues. A thoroughly investigation on these new pharmacological tools may lead to design effective preventive therapies.
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Affiliation(s)
| | | | | | | | | | | | | | - G Biagini
- Dipartimento di Scienze Biomediche, Metaboliche e Neuroscienze, Laboratorio di Epilettologia Sperimentale, Universita di Modena e Reggio Emilia, Via Campi, 287, 41125 Modena, Italy.
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18
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Liantonio A, Gramegna G, Carbonara G, Sblendorio VT, Pierno S, Fraysse B, Giannuzzi V, Rizzi L, Torsello A, Camerino DC. Growth hormone secretagogues exert differential effects on skeletal muscle calcium homeostasis in male rats depending on the peptidyl/nonpeptidyl structure. Endocrinology 2013; 154:3764-75. [PMID: 23836033 DOI: 10.1210/en.2013-1334] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The orexigenic and anabolic effects induced by ghrelin and the synthetic GH secretagogues (GHSs) are thought to positively contribute to therapeutic approaches and the adjunct treatment of a number of diseases associated with muscle wasting such as cachexia and sarcopenia. However, many questions about the potential utility and safety of GHSs in both therapy and skeletal muscle function remain unanswered. By using fura-2 cytofluorimetric technique, we determined the acute effects of ghrelin, as well as of peptidyl and nonpeptidyl synthetic GHSs on calcium homeostasis, a critical biomarker of muscle function, in isolated tendon-to-tendon male rat skeletal muscle fibers. The synthetic nonpeptidyl GHSs, but not peptidyl ghrelin and hexarelin, were able to significantly increase resting cytosolic calcium [Ca²⁺]i. The nonpeptidyl GHS-induced [Ca²⁺]i increase was independent of GHS-receptor 1a but was antagonized by both thapsigargin/caffeine and cyclosporine A, indicating the involvement of the sarcoplasmic reticulum and mitochondria. Evaluation of the effects of a pseudopeptidyl GHS and a nonpeptidyl antagonist of the GHS-receptor 1a together with a drug-modeling study suggest the conclusion that the lipophilic nonpeptidyl structure of the tested compounds is the key chemical feature crucial for the GHS-induced calcium alterations in the skeletal muscle. Thus, synthetic GHSs can have different effects on skeletal muscle fibers depending on their molecular structures. The calcium homeostasis dysregulation specifically induced by the nonpeptidyl GHSs used in this study could potentially counteract the beneficial effects associated with these drugs in the treatment of muscle wasting of cachexia- or other age-related disorders.
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MESH Headings
- Animals
- Appetite Stimulants/adverse effects
- Appetite Stimulants/pharmacology
- Calcium Signaling/drug effects
- Cell Line
- Cell Membrane Permeability/drug effects
- Cell Survival/drug effects
- Cytosol/drug effects
- Cytosol/metabolism
- Ghrelin/analogs & derivatives
- Ghrelin/metabolism
- Growth Hormone/metabolism
- Male
- Mitochondria, Muscle/drug effects
- Mitochondria, Muscle/metabolism
- Muscle Fibers, Skeletal/drug effects
- Muscle Fibers, Skeletal/metabolism
- Muscle, Skeletal/drug effects
- Muscle, Skeletal/metabolism
- Oligopeptides/adverse effects
- Oligopeptides/pharmacology
- Piperidines/adverse effects
- Piperidines/pharmacology
- Pituitary Gland, Anterior/drug effects
- Pituitary Gland, Anterior/metabolism
- Rats
- Rats, Wistar
- Receptors, Ghrelin/agonists
- Receptors, Ghrelin/antagonists & inhibitors
- Receptors, Ghrelin/metabolism
- Sarcolemma/drug effects
- Sarcolemma/metabolism
- Sarcoplasmic Reticulum/drug effects
- Sarcoplasmic Reticulum/metabolism
- Spiro Compounds/adverse effects
- Spiro Compounds/pharmacology
- Structure-Activity Relationship
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Affiliation(s)
- Antonella Liantonio
- Section of Pharmacology, Department of Pharmacy-Drug Sciences, University of Bari, Via Orabona, 4, Campus, I-70125 Bari, Italy.
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Lucchi C, Curia G, Vinet J, Gualtieri F, Bresciani E, Locatelli V, Torsello A, Biagini G. Protective but not anticonvulsant effects of ghrelin and JMV-1843 in the pilocarpine model of Status epilepticus. PLoS One 2013; 8:e72716. [PMID: 24015271 PMCID: PMC3755992 DOI: 10.1371/journal.pone.0072716] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Accepted: 07/15/2013] [Indexed: 12/25/2022] Open
Abstract
In models of status epilepticus ghrelin displays neuroprotective effects mediated by the growth hormone secretagogue-receptor 1a (GHS-R1a). This activity may be explained by anticonvulsant properties that, however, are controversial. We further investigated neuroprotection and the effects on seizures by comparing ghrelin with a more effective GHS-R1a agonist, JMV-1843. Rats were treated either with ghrelin, JMV-1843 or saline 10 min before pilocarpine, which was used to induce status epilepticus. Status epilepticus, developed in all rats, was attenuated by diazepam. No differences were observed among the various groups in the characteristics of pilocarpine-induced seizures. In saline group the area of lesion, characterized by lack of glial fibrillary acidic protein immunoreactivity, was of 0.45±0.07 mm2 in the hippocampal stratum lacunosum-moleculare, and was accompanied by upregulation of laminin immunostaining, and by increased endothelin-1 expression. Both ghrelin (P<0.05) and JMV-1843 (P<0.01) were able to reduce the area of loss in glial fibrillary acidic protein immunostaining. In addition, JMV-1843 counteracted (P<0.05) the changes in laminin and endothelin-1 expression, both increased in ghrelin-treated rats. JMV-1843 was able to ameliorate neuronal survival in the hilus of dentate gyrus and medial entorhinal cortex layer III (P<0.05 vs saline and ghrelin groups). These results demonstrate diverse protective effects of growth hormone secretagogues in rats exposed to status epilepticus.
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Affiliation(s)
- Chiara Lucchi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Giulia Curia
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Jonathan Vinet
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Fabio Gualtieri
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Elena Bresciani
- Department of Health Sciences, University of Milano-Bicocca, Monza, Italy
| | - Vittorio Locatelli
- Department of Health Sciences, University of Milano-Bicocca, Monza, Italy
| | - Antonio Torsello
- Department of Health Sciences, University of Milano-Bicocca, Monza, Italy
| | - Giuseppe Biagini
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Department of Neurosciences, NOCSAE Hospital, Modena, Italy
- * E-mail:
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20
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HOLUBOVÁ M, ŠPOLCOVÁ A, DEMIANOVÁ Z, SÝKORA D, FEHRENTZ JA, MARTINEZ J, ŠTOFKOVÁ A, JURČOVIČOVÁ J, DRÁPALOVÁ J, LACINOVÁ Z, HALUZÍK M, ŽELEZNÁ B, MALETÍNSKÁ L. Ghrelin Agonist JMV 1843 Increases Food Intake, Body Weight and Expression of Orexigenic Neuropeptides in Mice. Physiol Res 2013; 62:435-44. [DOI: 10.33549/physiolres.932488] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Ghrelin and agonists of its receptor GHS-R1a are potential substances for the treatment of cachexia. In the present study, we investigated the acute and long term effects of the GHS R1a agonist JMV 1843 (H Aib-DTrp-D-gTrp-CHO) on food intake, body weight and metabolic parameters in lean C57BL/6 male mice. Additionally, we examined stability of JMV 1843 in mouse blood serum. A single subcutaneous injection of JMV 1843 (0.01-10 mg/kg) increased food intake in fed mice in a dose-dependent manner, up to 5-times relative to the saline-treated group (ED50=1.94 mg/kg at 250 min). JMV 1843 was stable in mouse serum in vitro for 24 h, but was mostly eliminated from mouse blood after 2 h in vivo. Ten days of treatment with JMV 1843 (subcutaneous administration, 10 or 20 mg/kg/day) significantly increased food intake, body weight and mRNA expression of the orexigenic neuropeptide Y and agouti-related peptide in the medial basal hypothalamus and decreased the expression of uncoupling protein 1 in brown adipose tissue. Our data suggest that JMV 1843 could have possible future uses in the treatment of cachexia.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - L. MALETÍNSKÁ
- Institute of Organic Chemistry and Biochemistry, Academy of Sciences of the Czech Republic, Prague, Czech Republic
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21
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Garcia JM, Swerdloff R, Wang C, Kyle M, Kipnes M, Biller BMK, Cook D, Yuen KCJ, Bonert V, Dobs A, Molitch ME, Merriam GR. Macimorelin (AEZS-130)-stimulated growth hormone (GH) test: validation of a novel oral stimulation test for the diagnosis of adult GH deficiency. J Clin Endocrinol Metab 2013; 98:2422-9. [PMID: 23559086 PMCID: PMC4207947 DOI: 10.1210/jc.2013-1157] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
CONTEXT In the absence of panhypopituitarism and low serum IGF-I levels, the diagnosis of adult GH deficiency (AGHD) requires confirmation with a GH stimulation test. Macimorelin is a novel, orally active ghrelin mimetic that stimulates GH secretion. OBJECTIVE The objective of the study was to determine the diagnostic efficacy and safety of macimorelin in AGHD. DESIGN This was a multicenter open-label study comparing the diagnostic accuracy of oral macimorelin with that of arginine+GHRH in AGHD patients and healthy, matched controls. After 43 AGHD patients and 10 controls were tested, the GHRH analog Geref Diagnostic [GHRH(1-29)NH2] became unavailable in the United States. The study was completed by testing 10 additional AGHD patients and 38 controls with macimorelin alone. MAIN OUTCOME MEASURE Peak GH area under the receiver operating characteristic curve after macimorelin was measured. RESULTS Fifty AGHD subjects and 48 controls were evaluated. Peak GH levels in AGHD patients and controls after macimorelin were 2.36 ± 5.69 and 17.71 ± 19.11 ng/mL, respectively (P < .0001). With macimorelin, the receiver operating characteristic analysis yielded an optimal GH cut point of 2.7 ng/mL, with 82% sensitivity, 92% specificity, and 13% misclassification rate. For subjects receiving both tests, macimorelin showed discrimination comparable with arginine+GHRH (area under the receiver operating characteristic curve 0.99 vs 0.94, respectively, P = .29). Obesity (body mass index > 30 kg/m(2)) was present in 58% of subjects, and peak GH levels were inversely associated with body mass index in controls (r = -0.37, P = .01). Using the separate cut points of 6.8 ng/mL for nonobese and 2.7 for obese subjects reduced the misclassification rate to 11%. Only 1 drug-related serious adverse event, an asymptomatic QT interval prolongation on the electrocardiogram, was reported. CONCLUSION Oral macimorelin is safe, convenient, and effective in diagnosing AGHD with accuracy comparable with the arginine+GHRH test.
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Affiliation(s)
- J M Garcia
- Division of Endocrinology, Diabetes, and Metabolism, Michael E. DeBakey Veterans Affairs Medical Center, Baylor College of Medicine, 2002 Holcombe Boulevard, Building 109, Room 210, Houston, Texas 77030, USA.
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22
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Pharmacological characterization of the ghrelin receptor mediating its inhibitory action on inflammatory pain in rats. Amino Acids 2012; 43:1751-9. [PMID: 22407485 PMCID: PMC3448055 DOI: 10.1007/s00726-012-1260-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2011] [Accepted: 02/25/2012] [Indexed: 01/23/2023]
Abstract
Recent research suggests a role for ghrelin in the modulation of inflammatory disorders. However, the type of ghrelin receptor (GHS-R) involved in both the anti-inflammatory and anti-hyperalgesic actions of ghrelin remains to be characterized. In this study, we examined whether the inhibitory effect of ghrelin in the development of hyperalgesia and edema induced by intraplantar carrageenan administration depends on an interaction with GHS-R1a. Both central (1 nmol/rat, i.c.v.) and peripheral (40 nmol/kg, i.p.) administration of the selective GHS-R1a agonist EP1572 had no effect on carrageenan-induced hyperalgesia measured by Randall-Selitto test and paw edema. Furthermore, pre-treatment with the selective GHS-R1a antagonist, D-lys(3)-GHRP-6 (3 nmol/rat, i.c.v.) failed to prevent the anti-hyperalgesic and anti-inflammatory effects exerted by central ghrelin administration (1 nmol/rat), thus indicating that the type 1a GHS-R is not involved in these peptide activities. Accordingly, both central (1 and 2 nmol/rat, i.c.v.) and peripheral (40 and 80 nmol/kg, i.p.) administration of desacyl-ghrelin (DAG), which did not bind GHS-R1a, induced a significant reduction of the hyperalgesic and edematous activities of carrageenan. In conclusion, we have shown for the first time that DAG shares with ghrelin an inhibitory role in the development of hyperalgesia, as well as the paw edema induced by carrageenan and that a ghrelin receptor different from type 1a is involved in the anti-inflammatory activities of the peptide.
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23
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Osterstock G, Escobar P, Mitutsova V, Gouty-Colomer LA, Fontanaud P, Molino F, Fehrentz JA, Carmignac D, Martinez J, Guerineau NC, Robinson ICAF, Mollard P, Méry PF. Ghrelin stimulation of growth hormone-releasing hormone neurons is direct in the arcuate nucleus. PLoS One 2010; 5:e9159. [PMID: 20161791 PMCID: PMC2820089 DOI: 10.1371/journal.pone.0009159] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2009] [Accepted: 01/08/2010] [Indexed: 11/26/2022] Open
Abstract
Background Ghrelin targets the arcuate nucleus, from where growth hormone releasing hormone (GHRH) neurones trigger GH secretion. This hypothalamic nucleus also contains neuropeptide Y (NPY) neurons which play a master role in the effect of ghrelin on feeding. Interestingly, connections between NPY and GHRH neurons have been reported, leading to the hypothesis that the GH axis and the feeding circuits might be co-regulated by ghrelin. Principal Findings Here, we show that ghrelin stimulates the firing rate of identified GHRH neurons, in transgenic GHRH-GFP mice. This stimulation is prevented by growth hormone secretagogue receptor-1 antagonism as well as by U-73122, a phospholipase C inhibitor and by calcium channels blockers. The effect of ghrelin does not require synaptic transmission, as it is not antagonized by γ-aminobutyric acid, glutamate and NPY receptor antagonists. In addition, this hypothalamic effect of ghrelin is independent of somatostatin, the inhibitor of the GH axis, since it is also found in somatostatin knockout mice. Indeed, ghrelin does not modify synaptic currents of GHRH neurons. However, ghrelin exerts a strong and direct depolarizing effect on GHRH neurons, which supports their increased firing rate. Conclusion Thus, GHRH neurons are a specific target for ghrelin within the brain, and not activated secondary to altered activity in feeding circuits. These results support the view that ghrelin related therapeutic approaches could be directed separately towards GH deficiency or feeding disorders.
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Affiliation(s)
- Guillaume Osterstock
- Inserm U-661, Montpellier, France
- CNRS UMR 5203, Institut de Génomique Fonctionnelle, Montpellier, France
- Université Montpellier 1, 2, Montpellier, France
| | - Pauline Escobar
- Inserm U-661, Montpellier, France
- CNRS UMR 5203, Institut de Génomique Fonctionnelle, Montpellier, France
- Université Montpellier 1, 2, Montpellier, France
| | - Violeta Mitutsova
- Inserm U-661, Montpellier, France
- CNRS UMR 5203, Institut de Génomique Fonctionnelle, Montpellier, France
- Université Montpellier 1, 2, Montpellier, France
| | - Laurie-Anne Gouty-Colomer
- Inserm U-661, Montpellier, France
- CNRS UMR 5203, Institut de Génomique Fonctionnelle, Montpellier, France
- Université Montpellier 1, 2, Montpellier, France
| | - Pierre Fontanaud
- Inserm U-661, Montpellier, France
- CNRS UMR 5203, Institut de Génomique Fonctionnelle, Montpellier, France
- Université Montpellier 1, 2, Montpellier, France
| | - François Molino
- Inserm U-661, Montpellier, France
- CNRS UMR 5203, Institut de Génomique Fonctionnelle, Montpellier, France
- Université Montpellier 1, 2, Montpellier, France
| | - Jean-Alain Fehrentz
- Université Montpellier 1, 2, Montpellier, France
- CNRS UMR 5247, Institut des Biomolécules Max Mousseron, Montpellier, France
| | - Danielle Carmignac
- Division of Molecular Neuroendocrinology, MRC National Institute for Medical Research, The Ridgeway, Mill Hill, London, United Kingdom
| | - Jean Martinez
- Université Montpellier 1, 2, Montpellier, France
- CNRS UMR 5247, Institut des Biomolécules Max Mousseron, Montpellier, France
| | - Nathalie C. Guerineau
- Inserm U-661, Montpellier, France
- CNRS UMR 5203, Institut de Génomique Fonctionnelle, Montpellier, France
- Université Montpellier 1, 2, Montpellier, France
| | - Iain C. A. F. Robinson
- Division of Molecular Neuroendocrinology, MRC National Institute for Medical Research, The Ridgeway, Mill Hill, London, United Kingdom
| | - Patrice Mollard
- Inserm U-661, Montpellier, France
- CNRS UMR 5203, Institut de Génomique Fonctionnelle, Montpellier, France
- Université Montpellier 1, 2, Montpellier, France
| | - Pierre-François Méry
- Inserm U-661, Montpellier, France
- CNRS UMR 5203, Institut de Génomique Fonctionnelle, Montpellier, France
- Université Montpellier 1, 2, Montpellier, France
- * E-mail:
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Nehmé R, Perrin C, Guerlavais V, Fehrentz JA, Cottet H, Martinez J, Fabre H. Use of coated capillaries for the electrophoretic separation of stereoisomers of a growth hormone secretagogue. Electrophoresis 2009; 30:3772-9. [DOI: 10.1002/elps.200900093] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Abstract
Background: Ghrelin is a peptide produced predominantly in the stomach and intestines, and is a natural growth hormone (GH) secretagogue-receptor ligand. It is able to stimulate GH release, but it also exhibits an important role in conditions related to processes regulating nutrition, body composition and growth, and heart, liver, thyroid or kidney dysfunction. Drug discovery efforts initially focused on ghrelin-receptor agonists, known as GH secretagogues, to be used as anabolic agents, but none of them reached the market. Discussion: The latest developments in this field are constituted by the discovery of new nonpeptidic compounds endowed with interesting properties: oxindole agonists are able to exert an increase in the fat-free mass, while ghrelin was reported to increase the fat mass gain, and triazole- and 2,4-diaminopyrimidine-based antagonists were shown to be able to reduce food intake, without inhibition of GH secretion stimulated by an agonist to the ghrelin receptor. Other antagonist compounds (quinazolinones) were discovered as antiobesity/antidiabetic agents. Moreover, inverse agonists have been discovered that are able to reduce weight gain. Conclusions: Taking into account the great number of pathological conditions related to ghrelin, and the discovery of several compounds able to modulate the ghrelin receptor, its importance in the field of medicinal chemistry research is set to increase significantly.
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Moulin A, Demange L, Ryan J, Mousseaux D, Sanchez P, Bergé G, Gagne D, Perrissoud D, Locatelli V, Torsello A, Galleyrand JC, Fehrentz JA, Martinez J. New Trisubstituted 1,2,4-Triazole Derivatives as Potent Ghrelin Receptor Antagonists. 3. Synthesis and Pharmacological in Vitro and in Vivo Evaluations. J Med Chem 2008; 51:689-93. [DOI: 10.1021/jm701292s] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Aline Moulin
- Institut des Biomolécules Max Mousseron, UMR 5247, CNRS, Universités Montpellier 1, Montpellier 2, BP 14491, 15 Avenue Charles Flahault, 34093 Montpellier Cedex 5, France, Zentaris GmbH, Weismuellerstrasse 50, 60314 Frankfurt am Main, Germany, and Department of Experimental Medicine, School of Medicine, University of Milano-Bicocca, Via Cadore 48, 20052 Monza (MI), Italy
| | - Luc Demange
- Institut des Biomolécules Max Mousseron, UMR 5247, CNRS, Universités Montpellier 1, Montpellier 2, BP 14491, 15 Avenue Charles Flahault, 34093 Montpellier Cedex 5, France, Zentaris GmbH, Weismuellerstrasse 50, 60314 Frankfurt am Main, Germany, and Department of Experimental Medicine, School of Medicine, University of Milano-Bicocca, Via Cadore 48, 20052 Monza (MI), Italy
| | - Joanne Ryan
- Institut des Biomolécules Max Mousseron, UMR 5247, CNRS, Universités Montpellier 1, Montpellier 2, BP 14491, 15 Avenue Charles Flahault, 34093 Montpellier Cedex 5, France, Zentaris GmbH, Weismuellerstrasse 50, 60314 Frankfurt am Main, Germany, and Department of Experimental Medicine, School of Medicine, University of Milano-Bicocca, Via Cadore 48, 20052 Monza (MI), Italy
| | - Delphine Mousseaux
- Institut des Biomolécules Max Mousseron, UMR 5247, CNRS, Universités Montpellier 1, Montpellier 2, BP 14491, 15 Avenue Charles Flahault, 34093 Montpellier Cedex 5, France, Zentaris GmbH, Weismuellerstrasse 50, 60314 Frankfurt am Main, Germany, and Department of Experimental Medicine, School of Medicine, University of Milano-Bicocca, Via Cadore 48, 20052 Monza (MI), Italy
| | - Pierre Sanchez
- Institut des Biomolécules Max Mousseron, UMR 5247, CNRS, Universités Montpellier 1, Montpellier 2, BP 14491, 15 Avenue Charles Flahault, 34093 Montpellier Cedex 5, France, Zentaris GmbH, Weismuellerstrasse 50, 60314 Frankfurt am Main, Germany, and Department of Experimental Medicine, School of Medicine, University of Milano-Bicocca, Via Cadore 48, 20052 Monza (MI), Italy
| | - Gilbert Bergé
- Institut des Biomolécules Max Mousseron, UMR 5247, CNRS, Universités Montpellier 1, Montpellier 2, BP 14491, 15 Avenue Charles Flahault, 34093 Montpellier Cedex 5, France, Zentaris GmbH, Weismuellerstrasse 50, 60314 Frankfurt am Main, Germany, and Department of Experimental Medicine, School of Medicine, University of Milano-Bicocca, Via Cadore 48, 20052 Monza (MI), Italy
| | - Didier Gagne
- Institut des Biomolécules Max Mousseron, UMR 5247, CNRS, Universités Montpellier 1, Montpellier 2, BP 14491, 15 Avenue Charles Flahault, 34093 Montpellier Cedex 5, France, Zentaris GmbH, Weismuellerstrasse 50, 60314 Frankfurt am Main, Germany, and Department of Experimental Medicine, School of Medicine, University of Milano-Bicocca, Via Cadore 48, 20052 Monza (MI), Italy
| | - Daniel Perrissoud
- Institut des Biomolécules Max Mousseron, UMR 5247, CNRS, Universités Montpellier 1, Montpellier 2, BP 14491, 15 Avenue Charles Flahault, 34093 Montpellier Cedex 5, France, Zentaris GmbH, Weismuellerstrasse 50, 60314 Frankfurt am Main, Germany, and Department of Experimental Medicine, School of Medicine, University of Milano-Bicocca, Via Cadore 48, 20052 Monza (MI), Italy
| | - Vittorio Locatelli
- Institut des Biomolécules Max Mousseron, UMR 5247, CNRS, Universités Montpellier 1, Montpellier 2, BP 14491, 15 Avenue Charles Flahault, 34093 Montpellier Cedex 5, France, Zentaris GmbH, Weismuellerstrasse 50, 60314 Frankfurt am Main, Germany, and Department of Experimental Medicine, School of Medicine, University of Milano-Bicocca, Via Cadore 48, 20052 Monza (MI), Italy
| | - Antonio Torsello
- Institut des Biomolécules Max Mousseron, UMR 5247, CNRS, Universités Montpellier 1, Montpellier 2, BP 14491, 15 Avenue Charles Flahault, 34093 Montpellier Cedex 5, France, Zentaris GmbH, Weismuellerstrasse 50, 60314 Frankfurt am Main, Germany, and Department of Experimental Medicine, School of Medicine, University of Milano-Bicocca, Via Cadore 48, 20052 Monza (MI), Italy
| | - Jean-Claude Galleyrand
- Institut des Biomolécules Max Mousseron, UMR 5247, CNRS, Universités Montpellier 1, Montpellier 2, BP 14491, 15 Avenue Charles Flahault, 34093 Montpellier Cedex 5, France, Zentaris GmbH, Weismuellerstrasse 50, 60314 Frankfurt am Main, Germany, and Department of Experimental Medicine, School of Medicine, University of Milano-Bicocca, Via Cadore 48, 20052 Monza (MI), Italy
| | - Jean-Alain Fehrentz
- Institut des Biomolécules Max Mousseron, UMR 5247, CNRS, Universités Montpellier 1, Montpellier 2, BP 14491, 15 Avenue Charles Flahault, 34093 Montpellier Cedex 5, France, Zentaris GmbH, Weismuellerstrasse 50, 60314 Frankfurt am Main, Germany, and Department of Experimental Medicine, School of Medicine, University of Milano-Bicocca, Via Cadore 48, 20052 Monza (MI), Italy
| | - Jean Martinez
- Institut des Biomolécules Max Mousseron, UMR 5247, CNRS, Universités Montpellier 1, Montpellier 2, BP 14491, 15 Avenue Charles Flahault, 34093 Montpellier Cedex 5, France, Zentaris GmbH, Weismuellerstrasse 50, 60314 Frankfurt am Main, Germany, and Department of Experimental Medicine, School of Medicine, University of Milano-Bicocca, Via Cadore 48, 20052 Monza (MI), Italy
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Abstract
The 28-amino acid peptide ghrelin is a neuroendocrine hormone synthesized primarily in the stomach. It stimulates growth hormone secretion and appetite, thus promoting food intake and body-weight gain. The pharmacological properties of this peptide are mediated by the growth hormone secretagogue receptor type 1a (GHS-R1a). Given its wide spectrum of biological activities, it is evident that the discovery of ghrelin and its receptor has opened up many perspectives in the fields of neuroendocrine and metabolic research and has had an influence on such fields of internal medicine as gastroenterology, oncology, and cardiology. It is therefore increasingly likely that synthetic, peptidyl, and nonpeptidyl GHS-R1a ligands, acting as agonists, partial agonists, antagonists, or inverse agonists, could have both clinical and therapeutic potential. This review summarizes the various types of GHS-R1a ligands that have been described in the literature and discusses the recent progress made in this research area.
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Affiliation(s)
- Aline Moulin
- Institut des Biomolécules Max Mousseron, Faculté de Pharmacie, 15 avenue Charles Flahault, BP 1441, 34093 Montpellier Cedex, France
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Piccoli F, Degen L, MacLean C, Peter S, Baselgia L, Larsen F, Beglinger C, Drewe J. Pharmacokinetics and pharmacodynamic effects of an oral ghrelin agonist in healthy subjects. J Clin Endocrinol Metab 2007; 92:1814-20. [PMID: 17284637 DOI: 10.1210/jc.2006-2160] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
CONTEXT An oral formulation of EP01572, a peptidomimetic growth hormone secretagogue, was studied. An oral delivery system would be preferable in many of the possible therapeutic indications of ghrelin agonists such as EP01572. OBJECTIVES Our objective was to establish the pharmacological profile and the GH-releasing activity of increasing oral doses of EP01572 in healthy volunteers. In addition, the pharmacokinetics and pharmacological effects of EP01572 were investigated after intraduodenal (ID) administration. SETTING This study was a single-center escalating dose study with oral and ID applications. SUBJECTS AND METHODS In the first part, EP01572 was given orally to 36 male subjects; the treatment consisted of one oral dose of either EP01572 or placebo (0.005, 0.05, and 0.5 mg/kg body weight). Six subjects received two additional oral doses of EP01572: 0.125 and 0.25 mg/kg body weight. In the second part, the following treatments were performed in a randomized order: 1) administration of a bolus of saline (placebo) to the small intestine; 2) ID administration of a bolus of EP01572 at 0.2 mg/kg body weight; 3) ID perfusion of a bolus of EP01572 at 0.35 mg/kg body weight; and 4) ID perfusion of a bolus of EP01572 at 0.5 mg/kg body weight. RESULTS The oral and ID administration of EP01572 induced a rapid and dose-dependent increase in plasma drug concentrations and a potent GH release in healthy male volunteers. CONCLUSIONS This study showed that EP01572 was active with regard to stimulation of GH release in humans after oral and ID administration.
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Affiliation(s)
- Franziska Piccoli
- Clinical Research Center, Department of Research, Division of Gastroenterology, University Hospital, CH-4031 Basel, Switzerland
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Demange L, Boeglin D, Moulin A, Mousseaux D, Ryan J, Bergé G, Gagne D, Heitz A, Perrissoud D, Locatelli V, Torsello A, Galleyrand JC, Fehrentz JA, Martinez J. Synthesis and Pharmacological in Vitro and in Vivo Evaluations of Novel Triazole Derivatives as Ligands of the Ghrelin Receptor. 1. J Med Chem 2007; 50:1939-57. [PMID: 17375904 DOI: 10.1021/jm070024h] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A new series of growth hormone secretagogue (GHS) analogues based on the 1,2,4-triazole structure were synthesized and evaluated for their in vitro binding and their ability to stimulate intracellular calcium release to the cloned hGHS-1a ghrelin receptor expressed in LLC PK-1 cells. We have synthesized potent ligands of this receptor, some of them behaving as agonists, partial agonists, or antagonists. Some compounds among the most potent, i.e., agonist 29c (JMV2873), partial agonists including 21b (JMV2810), antagonists 19b (JMV2866) and 19c (JMV2844), were evaluated for their in vivo activity on food intake, after sc injection in rodents. Some compounds were found to stimulate food intake like hexarelin; some others were identified as potent hexarelin antagonists in this assay. Among the tested compounds, 21b was identified as an in vitro ghrelin receptor partial agonist, as well as a potent in vivo antagonist of hexarelin-stimulated food intake in rodents. Compound 21b was without effect on GH release from rat. However, in this series of compounds, it was not possible to find a clear correlation between in vitro and in vivo results.
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Affiliation(s)
- Luc Demange
- Institut des Biomolécules Max Mousseron, UMR 5247, CNRS-Universités Montpellier I et II, BP. 14491, Faculté de Pharmacie, 15 avenue Charles Flahault, 34093 Montpellier Cedex 5, France
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Muccioli G, Baragli A, Granata R, Papotti M, Ghigo E. Heterogeneity of ghrelin/growth hormone secretagogue receptors. Toward the understanding of the molecular identity of novel ghrelin/GHS receptors. Neuroendocrinology 2007; 86:147-64. [PMID: 17622734 DOI: 10.1159/000105141] [Citation(s) in RCA: 82] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2007] [Accepted: 05/21/2007] [Indexed: 12/23/2022]
Abstract
Ghrelin is a gastric polypeptide displaying strong GH-releasing activity by activation of the type 1a GH secretagogue receptor (GHS-R1a) located in the hypothalamus-pituitary axis. GHS-R1a is a G-protein-coupled receptor that, upon the binding of ghrelin or synthetic peptidyl and non-peptidyl ghrelin-mimetic agents known as GHS, preferentially couples to G(q), ultimately leading to increased intracellular calcium content. Beside the potent GH-releasing action, ghrelin and GHS influence food intake, gut motility, sleep, memory and behavior, glucose and lipid metabolism, cardiovascular performances, cell proliferation, immunological responses and reproduction. A growing body of evidence suggests that the cloned GHS-R1a alone cannot be the responsible for all these effects. The cloned GHS-R1b splice variant is apparently non-ghrelin/GHS-responsive, despite demonstration of expression in neoplastic tissues responsive to ghrelin not expressing GHS-R1a; GHS-R1a homologues sensitive to ghrelin are capable of interaction with GHS-R1b, forming heterodimeric species. Furthermore, GHS-R1a-deficient mice do not show evident abnormalities in growth and diet-induced obesity, suggesting the involvement of another receptor. Additional evidence of the existence of another receptor is that ghrelin and GHS do not always share the same biological activities and activate a variety of intracellular signalling systems besides G(q). The biological actions on the heart, adipose tissue, pancreas, cancer cells and brain shared by ghrelin and the non-acylated form of ghrelin (des-octanoyl ghrelin), which does not bind GHS-R1a, represent the best evidence for the existence of a still unknown, functionally active binding site for this family of molecules. Finally, located in the heart and blood vessels is the scavenger receptor CD36, involved in the endocytosis of the pro-atherogenic oxidized low-density lipoproteins, which is a pharmacologically and structurally distinct receptor for peptidyl GHS and not for ghrelin. This review highlights the most recently discovered features of GHS-R1a and the emerging evidence for a novel group of receptors that are not of the GHS1a type; these appear involved in the transduction of the multiple levels of information provided by GHS and ghrelin.
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Affiliation(s)
- Giampiero Muccioli
- Division of Pharmacology, Department of Anatomy, Pharmacology and Forensic Medicine, University of Turin, Turin, Italy
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Sibilia V, Muccioli G, Deghenghi R, Pagani F, De Luca V, Rapetti D, Locatelli V, Netti C. Evidence for a role of the GHS-R1a receptors in ghrelin inhibition of gastric acid secretion in the rat. J Neuroendocrinol 2006; 18:122-8. [PMID: 16420281 DOI: 10.1111/j.1365-2826.2005.01391.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Ghrelin, the endogenous ligand of the GH secretagogue receptor (GHS-R) has been previously shown to inhibit gastric acid secretion in pylorus-ligated rats. Two isoforms of GHS-R have been identified: GHS-R(1a) and GHS-R(1b). The present study aimed: (i) to characterise the type of GHS-R involved in the central gastric inhibitory activity of ghrelin by using des-octanoyl ghrelin, and synthetic GHS-R(1a) agonist (EP1572) and antagonist (D-Lys(3)-GHRP-6) and (ii) to investigate the relationship between ghrelin and cortistatin (CST) in the control of gastric acid secretion by using the natural neuropeptide CST-14 and the synthetic octapeptide CST-8. The specific interactions of all the compounds with GHS-R(1a) were determined by comparing their ability to displace labelled ghrelin or somatostatin from its receptors on rat hypothalamic membranes or on rat cardiomyocyte, respectively. Intracerebroventricular administration of 0.01 and 1 nmol/rat des-octanoyl ghrelin did not affect gastric acid secretion in pylorus-ligated rats, whereas EP1572 either i.c.v. (0.01-1 nmol/rat) or i.p. (10 and 20 nmol/kg) inhibited acid gastric secretion. Preteatment with D-Lys(3)GHRP-6 (3 nmol/rat, i.c.v.) was able to remove the inhibitory action of ghrelin (0.01 nmol/rat, i.c.v.) on gastric acid volume and acid output, thus indicating that the type 1a GHS-R likely mediates the gastric inhibitory action of ghrelin. This is supported by binding data showing that D-Lys(3)GHRP-6, but not des-octanoyl ghrelin, binds to hypothalamic GHS-R. CST-14 (1 nmol/rat, i.c.v.) did not affect either basal or ghrelin inhibition of gastric acid secretion. CST-8 (1 nmol/rat, i.c.v.) was able to counteract the gastric ghrelin response. The observation that CST-14 binds both GHR-S and somatostatin receptors, whereas CST-8 specifically displaces only ghrelin binding, indicates that CST-8 behaves as a GHS-R(1a) antagonist.
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Affiliation(s)
- V Sibilia
- Department of Pharmacology, Chemotherapy and Medical Toxicology, University of Milano, Milano, Milan, Italy.
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van der Lely AJ, Tschöp M, Heiman ML, Ghigo E. Biological, physiological, pathophysiological, and pharmacological aspects of ghrelin. Endocr Rev 2004; 25:426-57. [PMID: 15180951 DOI: 10.1210/er.2002-0029] [Citation(s) in RCA: 802] [Impact Index Per Article: 40.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Ghrelin is a peptide predominantly produced by the stomach. Ghrelin displays strong GH-releasing activity. This activity is mediated by the activation of the so-called GH secretagogue receptor type 1a. This receptor had been shown to be specific for a family of synthetic, peptidyl and nonpeptidyl GH secretagogues. Apart from a potent GH-releasing action, ghrelin has other activities including stimulation of lactotroph and corticotroph function, influence on the pituitary gonadal axis, stimulation of appetite, control of energy balance, influence on sleep and behavior, control of gastric motility and acid secretion, and influence on pancreatic exocrine and endocrine function as well as on glucose metabolism. Cardiovascular actions and modulation of proliferation of neoplastic cells, as well as of the immune system, are other actions of ghrelin. Therefore, we consider ghrelin a gastrointestinal peptide contributing to the regulation of diverse functions of the gut-brain axis. So, there is indeed a possibility that ghrelin analogs, acting as either agonists or antagonists, might have clinical impact.
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Affiliation(s)
- Aart J van der Lely
- Department of Internal Medicine, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands.
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Guerlavais V, Boeglin D, Mousseaux D, Oiry C, Heitz A, Deghenghi R, Locatelli V, Torsello A, Ghé C, Catapano F, Muccioli G, Galleyrand JC, Fehrentz JA, Martinez J. New active series of growth hormone secretagogues. J Med Chem 2003; 46:1191-203. [PMID: 12646029 DOI: 10.1021/jm020985q] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
New growth hormone secretagogue (GHS) analogues were synthesized and evaluated for growth hormone releasing activity. This series derived from EP-51389 is based on a gem-diamino structure. Compounds that exhibited higher in vivo GH-releasing potency than hexarelin in rat (subcutaneous administration) were then tested per os in beagle dogs and for their binding affinity to human pituitary GHS receptors and to hGHS-R 1a. Compound 7 (JMV 1843, H-Aib-(d)-Trp-(d)-gTrp-formyl) showed high potency in these tests and was selected for clinical studies.(1)
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Affiliation(s)
- Vincent Guerlavais
- Laboratoire des Aminoacides, Peptides et Protéines (LAPP), UMR 5810, Université Montpellier I et II, B.P. 14491, Faculté de Pharmacie, 15 Avenue Charles Flahaut, 34093 Montpellier Cédex 5, France
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Boscaro M, Mancini T. GH secretagogues and hypothalamo-pituitary-adrenal axis. J Endocrinol Invest 2003; 26:190-1. [PMID: 12809166 DOI: 10.1007/bf03345155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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