Smith Rosamund C, O'Bryan Linda M, Mitchell Pamela J, Leung Donmienne, Ghanem Mahmoud, Wilson Jonathan M, Hanson Jeff C, Sossick Sandra, Cooper Jane, Huang Lihua, Merchant Kalpana M, Lu Jirong, O'Neill Michael J
Eli Lilly & Co., Biotechnology Discovery Research, Lilly Corporate Center, Indianapolis, IN 46285, USA.
Eli Lilly & Co., Biotechnology Discovery Research, Lilly Corporate Center, Indianapolis, IN 46285, USA. Electronic address: o'
Exp Neurol. 2015 May;267:165-76. doi: 10.1016/j.expneurol.2015.03.002. Epub 2015 Mar 12.
Several lines of evidence indicate that Glial cell line-derived neurotrophic factor (GDNF) is a trophic factor for dopaminergic neurons. Direct parenchymal administration of GDNF is robustly neuroprotective and neurorestorative in multiple neurotoxin-based animal models (rat and non-human primate (NHP)) of Parkinson's Disease (PD), suggesting its potential as a therapeutic agent. Although small, open-label clinical trials of intra-putamenal administration of bacteria-derived, full length, wild type GDNF (GDNFwt) were efficacious in improving standardized behavioral scores, a double-blinded, randomized controlled trial failed to do so. We hypothesize that the lack of clinical efficacy of GDNFwt in the larger randomized trial was due to poor bio-distribution in the putamen and/or poor chemical stability while in the delivery device for prolonged time periods at 37°C. The development of neutralizing antibodies in some patients may also have been a contributing factor. GDNFv is an engineered form of GDNFwt, expressed and purified from mammalian cells, designed to overcome these limitations, including removal of the N-terminal heparin-binding domain to improve its diffusivity in brain parenchyma by reducing its binding to extracellular matrix (ECM), and key amino acid substitutions to improve chemical stability. Intra-striatal administration of a single injection of GDNFv in the rat produced significantly greater brain distribution than GDNFwt, consistent with reduced binding to ECM. Using liquid chromatography/mass spectrometry (LS/MS) methods GDNFv was shown to have improved chemical stability compared to GDNFwt when stored at 37°C for 4weeks. In addition, GDNFv resulted in lower predicted clinical immunogenicity compared to GDNFwt, as demonstrated by reduced CD4+ T cell proliferation and reduced IL-2-induced secretion in peripheral blood mononucleated cells collected from volunteers representing the world's major histocompatibility complex (MHC) haplotypes. GDNFv was demonstrated to be pharmacologically equivalent to GDNFwt in the key parameters in vitro of GFRα1 receptor binding, c-Ret phosphorylation, neurite outgrowth, and in vivo in its ability to increase dopamine turnover (DA). GDNFv protected dopamine nerve terminals and neurons in a 6-hydroxy-dopamine (6-OHDA) rat model. In summary, we empirically demonstrate the superior properties of GDNFv compared to GDNFwt through enhanced bio-distribution and chemical stability concurrently with decreased predicted clinical immunogenicity while maintaining pharmacological and neurotrophic activity. These data indicate that GDNFv is an improved version of GDNF suitable for clinical assessment as a targeted regenerative therapy for PD.
多条证据表明,胶质细胞源性神经营养因子(GDNF)是多巴胺能神经元的一种营养因子。在帕金森病(PD)的多种基于神经毒素的动物模型(大鼠和非人类灵长类动物(NHP))中,直接脑实质内给予GDNF具有强大的神经保护和神经修复作用,表明其作为治疗药物的潜力。尽管对壳核内给予细菌衍生的全长野生型GDNF(GDNFwt)进行的小型开放标签临床试验在改善标准化行为评分方面有效,但一项双盲、随机对照试验却未能达到此效果。我们推测,在更大规模的随机试验中GDNFwt缺乏临床疗效是由于其在壳核中的生物分布不佳和/或在37°C的给药装置中长时间保存时化学稳定性较差。一些患者中中和抗体的产生也可能是一个促成因素。GDNFv是GDNFwt的一种工程形式,从哺乳动物细胞中表达和纯化,旨在克服这些限制,包括去除N端肝素结合结构域以通过减少其与细胞外基质(ECM)的结合来改善其在脑实质中的扩散,以及进行关键氨基酸替换以提高化学稳定性。在大鼠中单次脑内注射GDNFv产生的脑内分布明显比GDNFwt更广,这与减少了与ECM的结合一致。使用液相色谱/质谱(LS/MS)方法显示,与GDNFwt相比,GDNFv在37°C下储存4周时化学稳定性有所提高。此外,与GDNFwt相比,GDNFv导致预测的临床免疫原性更低,这在代表世界主要组织相容性复合体(MHC)单倍型的志愿者采集的外周血单核细胞中,通过减少CD4 + T细胞增殖和减少IL - 2诱导的分泌得到证明。在GFRα1受体结合、c - Ret磷酸化、神经突生长等体外关键参数以及增加多巴胺周转率(DA)的体内能力方面,GDNFv被证明在药理学上与GDNFwt等效。GDNFv在6 - 羟基多巴胺(6 - OHDA)大鼠模型中保护了多巴胺神经末梢和神经元。总之,我们通过增强生物分布和化学稳定性,同时降低预测的临床免疫原性,同时保持药理学和神经营养活性,凭经验证明了GDNFv相对于GDNFwt具有更优越的特性。这些数据表明,GDNFv是GDNF的一种改进版本,适合作为PD的靶向再生疗法进行临床评估。