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Berg T, Hegelund-Myrbäck T, Öckinger J, Zhou XH, Brännström M, Hagemann-Jensen M, Werkström V, Seidegård J, Grunewald J, Nord M, Gustavsson L. Expression of MATE1, P-gp, OCTN1 and OCTN2, in epithelial and immune cells in the lung of COPD and healthy individuals. Respir Res 2018; 19:68. [PMID: 29678179 PMCID: PMC5910606 DOI: 10.1186/s12931-018-0760-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Accepted: 03/27/2018] [Indexed: 02/03/2023] Open
Abstract
Background Several inhaled drugs are dependent on organic cation transporters to cross cell membranes. To further evaluate their potential to impact on inhaled drug disposition, the localization of MATE1, P-gp, OCTN1 and OCTN2 were investigated in human lung. Methods Transporter proteins were analysed by immunohistochemistry in lung tissue from healthy subjects and COPD patients. Transporter mRNA was analysed by qPCR in lung tissue and in bronchoalveolar lavage (BAL) cells from smokers and non-smokers. Results We demonstrate for the first time MATE1 protein expression in the lung with localization to the apical side of bronchial and bronchiolar epithelial cells. Interestingly, MATE1 was strongly expressed in alveolar macrophages as demonstrated both in lung tissue and in BAL cells, and in inflammatory cells including CD3 positive T cells. P-gp, OCTN1 and OCTN2 were also expressed in the alveolar epithelial cells and in inflammatory cells including alveolar macrophages. In BAL cells from smokers, MATE1 and P-gp mRNA expression was significantly lower compared to cells from non-smokers whereas no difference was observed between COPD patients and healthy subjects. THP-1 cells were evaluated as a model for alveolar macrophages but did not reflect the transporter expression observed in BAL cells. Conclusions We conclude that MATE1, P-gp, OCTN1 and OCTN2 are expressed in pulmonary lung epithelium, in alveolar macrophages and in other inflammatory cells. This is important to consider in the development of drugs treating pulmonary disease as the transporters may impact drug disposition in the lung and consequently affect pharmacological efficacy and toxicity. Electronic supplementary material The online version of this article (10.1186/s12931-018-0760-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Tove Berg
- Respiratory Medicine Unit, Department of Medicine Solna and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Tove Hegelund-Myrbäck
- Quantitative Clinical Pharmacology, Early Clinical Development, IMED Biotech Unit, AstraZeneca R&D, Gothenburg, Sweden.
| | - Johan Öckinger
- Respiratory Medicine Unit, Department of Medicine Solna and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Xiao-Hong Zhou
- Respiratory, Inflammation and Autoimmunity, IMED Biotech Unit, AstraZeneca R&D, Gothenburg, Sweden
| | - Marie Brännström
- Respiratory, Inflammation and Autoimmunity, IMED Biotech Unit, AstraZeneca R&D, Gothenburg, Sweden
| | - Michael Hagemann-Jensen
- Respiratory Medicine Unit, Department of Medicine Solna and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Viktoria Werkström
- Respiratory GMed, Global Medicines Development, AstraZeneca R&D, Gothenburg, Sweden
| | - Janeric Seidegård
- Respiratory, Inflammation and Autoimmunity, IMED Biotech Unit, AstraZeneca R&D, Gothenburg, Sweden
| | - Johan Grunewald
- Respiratory Medicine Unit, Department of Medicine Solna and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Magnus Nord
- Respiratory Medicine Unit, Department of Medicine Solna and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.,Global Patient Safety, Global Medicines Development, AstraZeneca R&D, Gothenburg, Sweden
| | - Lena Gustavsson
- Department of Drug Metabolism, H. Lundbeck A/S, Ottiliavej 9, 2500, Valby, Denmark
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Patel NR, Cunoosamy DM, Fagerås M, Taib Z, Asimus S, Hegelund-Myrbäck T, Lundin S, Pardali K, Kurian N, Ersdal E, Kristensson C, Korsback K, Palmér R, Brown MN, Greenaway S, Siew L, Clarke GW, Rennard SI, Make BJ, Wise RA, Jansson P. The development of AZD7624 for prevention of exacerbations in COPD: a randomized controlled trial. Int J Chron Obstruct Pulmon Dis 2018; 13:1009-1019. [PMID: 29628759 PMCID: PMC5877500 DOI: 10.2147/copd.s150576] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background p38 mitogen-activated protein kinase (MAPK) plays a central role in the regulation and activation of pro-inflammatory mediators. COPD patients have increased levels of activated p38 MAPK, which correlate with increased lung function impairment, alveolar wall inflammation, and COPD exacerbations. Objectives These studies aimed to assess the effect of p38 inhibition with AZD7624 in healthy volunteers and patients with COPD. The principal hypothesis was that decreasing lung inflammation via inhibition of p38α would reduce exacerbations and improve quality of life for COPD patients at high risk for acute exacerbations. Methods The p38 isoform most relevant to lung inflammation was assessed using an in situ proximity ligation assay in severe COPD patients and donor controls. Volunteers aged 18–55 years were randomized into the lipopolysaccharide (LPS) challenge study, which investigated the effect of a single dose of AZD7624 vs placebo on inflammatory biomarkers. The Proof of Principle study randomized patients aged 40–85 years with a diagnosis of COPD for >1 year to AZD7624 or placebo to assess the effect of p38 inhibition in decreasing the rate of exacerbations. Results The p38 isoform most relevant to lung inflammation was p38α, and AZD7624 specifically inhibited p38α and p38β isoforms in human alveolar macrophages. Thirty volunteers were randomized in the LPS challenge study. AZD7624 reduced the increase from baseline in sputum neutrophils and TNF-α by 56.6% and 85.4%, respectively (p<0.001). In the 213 patients randomized into the Proof of Principle study, there was no statistically significant difference between AZD7624 and placebo when comparing the number of days to the first moderate or severe exacerbation or early dropout. Conclusion Although p38α is upregulated in the lungs of COPD patients, AZD7624, an isoform-specific inhaled p38 MAPK inhibitor, failed to show any benefit in patients with COPD.
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Affiliation(s)
- Naimish R Patel
- Innovative Medicines and Early Development, AstraZeneca, Gothenburg, Sweden.,Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Hospital, Boston, MA
| | - Danen M Cunoosamy
- Innovative Medicines and Early Development, AstraZeneca, Gothenburg, Sweden
| | - Malin Fagerås
- Innovative Medicines and Early Development, AstraZeneca, Gothenburg, Sweden
| | - Ziad Taib
- Innovative Medicines and Early Development, AstraZeneca, Gothenburg, Sweden
| | - Sara Asimus
- Innovative Medicines and Early Development, AstraZeneca, Gothenburg, Sweden
| | | | - Sofia Lundin
- Innovative Medicines and Early Development, AstraZeneca, Gothenburg, Sweden
| | - Katerina Pardali
- Innovative Medicines and Early Development, AstraZeneca, Gothenburg, Sweden
| | - Nisha Kurian
- Innovative Medicines and Early Development, AstraZeneca, Gothenburg, Sweden
| | - Eva Ersdal
- Innovative Medicines and Early Development, AstraZeneca, Gothenburg, Sweden
| | | | - Katarina Korsback
- Innovative Medicines and Early Development, AstraZeneca, Gothenburg, Sweden
| | - Robert Palmér
- Innovative Medicines and Early Development, AstraZeneca, Gothenburg, Sweden
| | - Mary N Brown
- Innovative Medicines and Early Development, AstraZeneca, Boston, MA, USA
| | | | - Leonard Siew
- Quintiles Drug Research Unit at Guy's Hospital, London
| | - Graham W Clarke
- Quintiles Drug Research Unit at Guy's Hospital, London.,Department of Cardiothoracic Pharmacology, NHLI, Imperial College London, London, UK
| | - Stephen I Rennard
- Division of Pulmonary, Critical Care, Sleep and Allergy, University of Nebraska, Omaha, NE, USA.,Clinical Discovery Unit, Innovative Medicines and Early Development, AstraZeneca, Cambridge, UK
| | - Barry J Make
- Division of Pulmonary Sciences and Critical Care Medicine, National Jewish Health, University of Colorado, Denver, CO
| | - Robert A Wise
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Paul Jansson
- Innovative Medicines and Early Development, AstraZeneca, Gothenburg, Sweden
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Ripa L, Edman K, Dearman M, Edenro G, Hendrickx R, Ullah V, Chang HF, Lepistö M, Chapman D, Geschwindner S, Wissler L, Svanberg P, Lawitz K, Malmberg J, Nikitidis A, Olsson RI, Bird J, Llinas A, Hegelund-Myrbäck T, Berger M, Thorne P, Harrison R, Köhler C, Drmota T. Discovery of a Novel Oral Glucocorticoid Receptor Modulator (AZD9567) with Improved Side Effect Profile. J Med Chem 2018; 61:1785-1799. [PMID: 29424542 DOI: 10.1021/acs.jmedchem.7b01690] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Synthetic glucocorticoids (GC) are essential for the treatment of a broad range of inflammatory diseases. However, their use is limited by target related adverse effects on, e.g., glucose homeostasis and bone metabolism. Starting from a nonsteroidal GR ligand (4) that is a full agonist in reporter gene assays, we exploited key functional triggers within the receptor, generating a range of structurally diverse partial agonists. Of these, only a narrow subset exhibited full anti-inflammatory efficacy and a significantly reduced impact on adverse effect markers in human cell assays compared to prednisolone. This led to the discovery of AZD9567 (15) with excellent in vivo efficacy when dosed orally in a rat model of joint inflammation. Compound 15 is currently being evaluated in clinical trials comparing the efficacy and side effect markers with those of prednisolone.
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Affiliation(s)
- Lena Ripa
- Respiratory, Inflammation and Autoimmunity, IMED Biotech Unit , AstraZeneca Gothenburg , Pepparedsleden 1 , Mölndal 43183 , Sweden
| | - Karl Edman
- Discovery Sciences, IMED Biotech Unit , AstraZeneca Gothenburg , Pepparedsleden 1 , Mölndal 431 83 , Sweden
| | - Matthew Dearman
- Respiratory, Inflammation and Autoimmunity, IMED Biotech Unit , AstraZeneca Gothenburg , Pepparedsleden 1 , Mölndal 43183 , Sweden
| | - Goran Edenro
- Respiratory, Inflammation and Autoimmunity, IMED Biotech Unit , AstraZeneca Gothenburg , Pepparedsleden 1 , Mölndal 43183 , Sweden
| | - Ramon Hendrickx
- Respiratory, Inflammation and Autoimmunity, IMED Biotech Unit , AstraZeneca Gothenburg , Pepparedsleden 1 , Mölndal 43183 , Sweden
| | - Victoria Ullah
- Respiratory, Inflammation and Autoimmunity, IMED Biotech Unit , AstraZeneca Gothenburg , Pepparedsleden 1 , Mölndal 43183 , Sweden
| | - Hui-Fang Chang
- Respiratory, Inflammation and Autoimmunity, IMED Biotech Unit , AstraZeneca Gothenburg , Pepparedsleden 1 , Mölndal 43183 , Sweden
| | - Matti Lepistö
- Respiratory, Inflammation and Autoimmunity, IMED Biotech Unit , AstraZeneca Gothenburg , Pepparedsleden 1 , Mölndal 43183 , Sweden
| | - Dave Chapman
- Respiratory, Inflammation and Autoimmunity, IMED Biotech Unit , AstraZeneca Gothenburg , Pepparedsleden 1 , Mölndal 43183 , Sweden
| | - Stefan Geschwindner
- Discovery Sciences, IMED Biotech Unit , AstraZeneca Gothenburg , Pepparedsleden 1 , Mölndal 431 83 , Sweden
| | - Lisa Wissler
- Discovery Sciences, IMED Biotech Unit , AstraZeneca Gothenburg , Pepparedsleden 1 , Mölndal 431 83 , Sweden
| | - Petter Svanberg
- Respiratory, Inflammation and Autoimmunity, IMED Biotech Unit , AstraZeneca Gothenburg , Pepparedsleden 1 , Mölndal 43183 , Sweden
| | | | - Jesper Malmberg
- Respiratory, Inflammation and Autoimmunity, IMED Biotech Unit , AstraZeneca Gothenburg , Pepparedsleden 1 , Mölndal 43183 , Sweden
| | - Antonios Nikitidis
- Respiratory, Inflammation and Autoimmunity, IMED Biotech Unit , AstraZeneca Gothenburg , Pepparedsleden 1 , Mölndal 43183 , Sweden
| | - Roine I Olsson
- Respiratory, Inflammation and Autoimmunity, IMED Biotech Unit , AstraZeneca Gothenburg , Pepparedsleden 1 , Mölndal 43183 , Sweden
| | - James Bird
- Respiratory, Inflammation and Autoimmunity, IMED Biotech Unit , AstraZeneca Gothenburg , Pepparedsleden 1 , Mölndal 43183 , Sweden
| | - Antoni Llinas
- Respiratory, Inflammation and Autoimmunity, IMED Biotech Unit , AstraZeneca Gothenburg , Pepparedsleden 1 , Mölndal 43183 , Sweden
| | - Tove Hegelund-Myrbäck
- Respiratory, Inflammation and Autoimmunity, IMED Biotech Unit , AstraZeneca Gothenburg , Pepparedsleden 1 , Mölndal 43183 , Sweden
| | - Markus Berger
- Medicinal Chemistry Berlin, Drug Discovery, Pharmaceuticals , Bayer AG , Berlin 13353 , Germany
| | - Philip Thorne
- AstraZeneca R&D Charnwood , Bakewell Road , Loughborough , Leicestershire LE11 5RH , U.K
| | - Richard Harrison
- AstraZeneca R&D Charnwood , Bakewell Road , Loughborough , Leicestershire LE11 5RH , U.K
| | - Christian Köhler
- Discovery Sciences, IMED Biotech Unit , AstraZeneca Gothenburg , Pepparedsleden 1 , Mölndal 431 83 , Sweden
| | - Tomas Drmota
- Respiratory, Inflammation and Autoimmunity, IMED Biotech Unit , AstraZeneca Gothenburg , Pepparedsleden 1 , Mölndal 43183 , Sweden
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