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γ-分泌酶调节剂NGP 555在安全剂量下可使人类脑脊液中淀粉样蛋白生物标志物的比例发生有益变化。

NGP 555, a γ-secretase modulator, shows a beneficial shift in the ratio of amyloid biomarkers in human cerebrospinal fluid at safe doses.

作者信息

Kounnas Maria Z, Durakoglugil Murat S, Herz Joachim, Comer William T

机构信息

Department of Pathology, University of California, San Diego, La Jolla, CA.

Department of Molecular Genetics, Center for Translational Neurodegeneration Research, University of Texas Southwestern Medical Center, Dallas, TX.

出版信息

Alzheimers Dement (N Y). 2019 Nov 25;5:458-467. doi: 10.1016/j.trci.2019.06.006. eCollection 2019.

Abstract

INTRODUCTION

Currently, there is no cure for Alzheimer's disease (AD), and it is widely accepted that AD is a complex disease with multiple approaches necessary to prevent and treat the disease.

METHODS

Using amyloid biomarkers in human cerebrospinal fluid, pharmacokinetic, safety, and metabolism studies, we investigate the properties of NGP 555, γ-secretase modulator, for the first time in human clinical trials.

RESULTS

Our preclinical and clinical studies combined show beneficial effects with NGP 555 on synaptic response and amyloid cerebrospinal fluid biomarkers while avoiding negative side effects. Importantly, pharmacokinetic and pharmacodynamic parameters combined with safety outcomes indicate that NGP 555 penetrates the blood-brain barrier and increases the ratio of amyloid-β peptide Aβ and Aβ compared with that of Aβ, establishing a proof of target engagement in humans in a 14 day, once-daily oral dosing trial.

DISCUSSION

In humans, NGP 555 has demonstrated a beneficial shift in the production of Aβ and Aβ versus Aβ biomarker levels in the cerebrospinal fluid while maintaining an adequate safety profile. The overall clinical goal is to achieve an optimal balance of efficacy for altering amyloid-β peptide (Aβ) biomarkers while maintaining a safe profile so that NGP 555 can be given early in AD to prevent production of Aβ and accumulation of amyloid plaques, in an effort to prevent aggregation of tau and destruction of neurons and synapses resulting in cognitive decline.

摘要

引言

目前,阿尔茨海默病(AD)尚无治愈方法,人们普遍认为AD是一种复杂疾病,需要多种方法来预防和治疗。

方法

利用人类脑脊液中的淀粉样蛋白生物标志物、药代动力学、安全性和代谢研究,我们首次在人体临床试验中研究了γ-分泌酶调节剂NGP 555的特性。

结果

我们的临床前和临床研究综合显示,NGP 555对突触反应和淀粉样脑脊液生物标志物具有有益作用,同时避免了负面副作用。重要的是,药代动力学和药效学参数与安全性结果表明,与Aβ相比,NGP 555能够穿透血脑屏障并增加淀粉样β肽Aβ42和Aβ40的比例,在一项为期14天、每日一次口服给药的试验中证实了其在人体中的靶点作用。

讨论

在人体中,NGP 555已证明在脑脊液中Aβ42和Aβ40与Aβ43生物标志物水平的产生方面有有益的变化,同时保持了足够的安全性。总体临床目标是在改变淀粉样β肽(Aβ)生物标志物的疗效方面实现最佳平衡,同时保持安全,以便在AD早期给予NGP 555以防止Aβ的产生和淀粉样斑块的积累,从而努力防止tau蛋白聚集以及神经元和突触的破坏导致认知能力下降。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e89d/6944734/c8d90ce21d7f/gr1.jpg

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