WORKING LUNCHEONE FUTURE THERAPIES. Nature 474, S6, 2010 The Hep C Drug Pipeline.
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Transcript of WORKING LUNCHEONE FUTURE THERAPIES. Nature 474, S6, 2010 The Hep C Drug Pipeline.
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WORKING LUNCHEONE
FUTURE THERAPIES
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Na
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The Hep C Drug Pipeline
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Brass et al. PNAS 2008
Structure of Membrane-Associated NS3/4A
• chymotrypsin-like enzyme
• activation by NS4A
• cleaves viral and cellular proteins
Polyprotein processing
innate responses (TLR3, RIG-I)
proteasedomain
helicasedomain
NS4A proteasecofactor
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Boceprevir
Structures of NS3-Specific Drugs
Telaprevir
‚linear‘
TMC435 MK5172
‚macrocyclic‘
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1 (+) RNA > 1.000 polyproteins
RV
LDTranslation Assembly
Mode-of-Action of NS3-specific DAAs
Blockage of polyprotein cleavage
block of new formation of replication vesicles
no effect on established replication vesicels
Restoration of innate immune response?
RIG-I (MAVS)
TLR3 (TRIF)
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EC50 > 4-fold
Resistance against PIs:2nd Generation
Halfon & Locarnini, J. Hepatol. 2011
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Form of a right hand ‘closed’ active site
Thumb Palm Fingers
The NS5B RNA-Dependent RNA Polymerase
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Nucleosidic and Non-nucleosidicNS5B-Specific Drugs
Non-nucleosidic Inhibitors
Benzimidazole derivative Thiophene derivative Thiadiazine derivative
2'-C-methyl cytidine
Nucleosidic Inhibitors
PSI-7977 INX-189
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1 (+) RNA > 1.000 polyproteins
RV
LDTranslation Assembly
Mode-of-Action of NS5B-Specific Inhibitors
Block of RNA synthesis
direct effect also on established replication complexes
direct inhibition of NS5B (non-nucs)
block of elongation (nucs)
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• R7128: 10x and 15x IC50 eliminated HCV replicons within ~3 weeks
no resistance detected
• HCV-796: 10x and 15x IC50 did not eliminate the replicon
C316Y and S365S/A
• Telaprevir: 10x and 15x IC50 did not eliminate the replicon
A156T/S and T54T/A
Telaprevir1X IC50 10X IC50 15X IC50
HCV-796
1X IC50 10X IC50 15X IC50
NS5B Nuc NS5B Non-Nuc NS3/4A PI
R7128 Active Moiety (PSI-6130)
Higher Genetic Barrier of Nucsas compared to Non-Nucs and PIs
Untreated 1X IC50 10X IC50 15X IC50
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Na
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A-831:4-NH2-quinazolines (Arrow/AZ)BMS -790052
R
R
Resistance mutations in NS5A domain I:L31V, Y93H (gt 1b)M28T, Q30H/R, L31M/V, Y93C (gt 1a)
Resistance mutations inNS5A domain I, II and III:L199F, T200P, E212D, P299L, I302T,V362A, S370P, V388D, S390GNS4B: S258TNS5B: S76A
target NS5A
PI4K-IIIαSchmitz & Tan, Rec Pat Antiinfect Drug Discov, 2008; Delang et al., Viruses 2010
2 classes of antivirals reported as „NS5A inhibitors“R. DeFrancesco et al., 18th international Symposium on Hepatitis C virus and related viruses, Seattle, 2011
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Structure of NS5A
D1
D2
D3
membrane
(polyU)
Basicgroove
F. Penin F. Penin
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Targett-Adams et al., JVi 2011
X
X
NS5A inhibitors are dominant negative
(1 inhibitor per 100 – 1.000 NS5A molecules)
block of 5A oligomerization?
block PI4K-IIIα activation?
block NS5A hyperphosphorylation?
Mode-of-action of NS5A inhibitors
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IRBM/Merck
Genelabs Bristol Myers Squibb
A92VY93HR157W
L28VL31VP58LY93H
M28T (1a); L28V (1b)Q30H/RL31V/F/MY93H/C/W
Gao et al. Nature 465, 96-100 (2010)
HCV RNA
Schmitz Recent Pat Antiinfect Drug Discov. 2008
Resistance against NS5A inhibitorsin replicon studies
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• CyPs are chaperones with peptidyl-prolyl isomerase activity
• Abundant cytosolic protein (0.1% of total cellular proteins)
• Ubiquitously expressed in eukaryotic cells
• Multiple functions, depending on target protein
• Discovered as specific ligand for immunosuppressive drug cyclosporin A
Cyclophilins
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Structure of CsA and CsA-Derivativesa
da
pte
d f
rom
Ga
llay,
Clin
Liv
Dis
20
09
Inhibition of HCV replication by CsA
Watashi et al., Hepatology 2003
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Structure of Cyclophilin Inhibitorsa
da
pte
d f
rom
Ga
llay,
Clin
Liv
Dis
20
09
Sanglifehrin 0.3nM 0.02µM?
Alisporivir
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Mode-of-Action of Cyp Inhibitors?
5B
5A
3
HCV replication
5B
5A
3
HCV replication
CypA
CypA
CypA
CypA
CsA CypA
CsA
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Na
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Virus
IFN-
dsRNAvRNA
IFN-
TLR3
TRIF
RIG-I
MAVS
IFN-
adapted from Haller et al., Virology, 2005
ISGISRE
IFNAR
JAK / Stat
ISGF-3
dsRNA
antiviral genes(~ 400)
The Interferon System
• IFN-α and IFN-λ share the same signalling pathways
• Very similar set of ISGs induced
But: Receptor distribution very different
IFN-α receptor on most cells
IFN-λ receptor primarily on hepatocytes & airway epithelia
faster and prolonged ISG induction
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SOC-based treatment of HCV infection:correlation with IL28B polymorphism
*Ge et al., Nature 2009; Suppiah et al., Nat Gen 2009; Tanaka et al., Nat Gen 2009Thomas et al., Nature 2009;
High positive correlation with therapy outcome
High correlation with outcome of acute therapy
A special role of IFN-lambda to combat HCV?
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ISGs impairing HCV replication
Schoggins et al., Nature 2011; Han et al., 2002; Gale et al., 1997; Helbig et al., 2005; Taylor et al., 2005
RIG-IMDA-5IRF-1IRF-2IRF-7MAP3K14
OASLRNaseLPKR RNA translationIFI44L GTPaseNT5C3 nucleoside dephosph.?Viperin LDs? membrane curv?ADAR RNA editingDDIT4 ?
signal transduction
RNA degradationMultiple Attack Strategies Against HCV