Danish Headache Center, Department of Neurology, University of Copenhagen, Denmark.
Danish Knowledge Center on Headache Disorders, Rigshospitalet-Glostrup, Denmark.
Pharmacol Res Perspect. 2021 Apr;9(2):e00741. doi: 10.1002/prp2.741.
The kynurenine pathway (KP) is the main path for tryptophan metabolism, and it represents a multitude of potential sites for drug discovery in neuroscience, including pain, stroke, and epilepsy. L-kynurenine (LKYN), the first active metabolite in the pathway, emerges to be a prodrug targeting glutamate receptors. The safety, tolerability, pharmacokinetics, and pharmacodynamics of LKYN in humans have not been previously investigated. In an open-label, single ascending dose study, six participants received an intravenous infusion of 50, 100, and 150 µg/kg LKYN and new six participants received an intravenous infusion of 0.3, 0.5, 1, and 5 mg/kg LKYN. To compare the pharmacological effects between species, we investigated in vivo the vascular effects of LKYN in rats. In humans, LKYN was safe and well-tolerated at all dose levels examined. After infusion, LKYN plasma concentration increased significantly over time 3.23 ± 1.12 µg/mL (after 50 µg/kg), 4.04 ± 1.1 µg/mL (after 100 µg/kg), and 5.25 ± 1.01 µg/mL (after 150 µg/kg) (p ≤ 0.001). We observed no vascular changes after infusion compared with baseline. In rats, LKYN had no effect on HR and MAP and caused no dilation of dural and pial arteries. This first-in-human study of LKYN showed that LKYN was safe and well-tolerated after intravenous infusion up to 5 mg/kg over 20 minutes. The lack of change in LKYN metabolites in plasma suggests a relatively slow metabolism of LKYN and no or little feed-back effect of LKYN on its synthesis. The therapeutic potential of LKYN in stroke and epilepsy should be explored in future studies in humans.
犬尿氨酸途径(KP)是色氨酸代谢的主要途径,它代表了神经科学中许多潜在的药物发现靶点,包括疼痛、中风和癫痫。KP 中的第一个活性代谢产物 L-犬尿氨酸(LKYN),作为一种靶向谷氨酸受体的前药出现。LKYN 在人体内的安全性、耐受性、药代动力学和药效学尚未被研究过。在一项开放标签、单剂量递增研究中,六名参与者接受了静脉输注 50、100 和 150μg/kg LKYN,另外六名参与者接受了静脉输注 0.3、0.5、1 和 5mg/kg LKYN。为了比较种间的药理作用,我们在大鼠体内研究了 LKYN 的血管作用。在人体内,所有检查剂量水平的 LKYN 均安全且耐受良好。输注后,LKYN 血浆浓度随时间显著增加,分别为 3.23±1.12μg/mL(50μg/kg 后)、4.04±1.1μg/mL(100μg/kg 后)和 5.25±1.01μg/mL(150μg/kg 后)(p≤0.001)。与基线相比,输注后我们没有观察到血管变化。在大鼠中,LKYN 对 HR 和 MAP 没有影响,也没有引起硬脑膜和软脑膜动脉扩张。这是 LKYN 在人体内的首次研究,表明 LKYN 在 20 分钟内静脉输注高达 5mg/kg 是安全且耐受良好的。血浆中 LKYN 代谢物无变化表明 LKYN 的代谢相对较慢,并且 LKYN 对其合成没有或几乎没有反馈作用。在未来的人类研究中,应该探索 LKYN 在中风和癫痫中的治疗潜力。