Targeted pharmacological depletion of serum amyloid P component for treatment of human amyloidosis

Nature. 2002 May 16;417(6886):254-9. doi: 10.1038/417254a.

Abstract

The normal plasma protein serum amyloid P component (SAP) binds to fibrils in all types of amyloid deposits, and contributes to the pathogenesis of amyloidosis. In order to intervene in this process we have developed a drug, R-1-[6-[R-2-carboxy-pyrrolidin-1-yl]-6-oxo-hexanoyl]pyrrolidine-2-carboxylic acid, that is a competitive inhibitor of SAP binding to amyloid fibrils. This palindromic compound also crosslinks and dimerizes SAP molecules, leading to their very rapid clearance by the liver, and thus produces a marked depletion of circulating human SAP. This mechanism of drug action potently removes SAP from human amyloid deposits in the tissues and may provide a new therapeutic approach to both systemic amyloidosis and diseases associated with local amyloid, including Alzheimer's disease and type 2 diabetes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Amyloidosis / blood
  • Amyloidosis / drug therapy*
  • Amyloidosis / metabolism*
  • Animals
  • Calcium / metabolism
  • Carboxylic Acids / chemistry
  • Carboxylic Acids / metabolism
  • Carboxylic Acids / pharmacology
  • Carboxylic Acids / therapeutic use
  • Cross-Linking Reagents / chemistry
  • Cross-Linking Reagents / metabolism
  • Cross-Linking Reagents / pharmacology
  • Cross-Linking Reagents / therapeutic use
  • Crystallography, X-Ray
  • Dimerization
  • Humans
  • Inhibitory Concentration 50
  • Liver / metabolism
  • Mice
  • Models, Molecular
  • Protein Binding
  • Protein Structure, Quaternary / drug effects
  • Pyrrolidines / chemistry
  • Pyrrolidines / metabolism
  • Pyrrolidines / pharmacology
  • Pyrrolidines / therapeutic use
  • Serum Amyloid P-Component / antagonists & inhibitors
  • Serum Amyloid P-Component / chemistry
  • Serum Amyloid P-Component / metabolism*

Substances

  • Carboxylic Acids
  • Cross-Linking Reagents
  • Pyrrolidines
  • R-1-(6-(R-2-carboxypyrrolidin-1-yl)-6-oxohexanoyl)pyrrolidine-2-carboxylic acid
  • Serum Amyloid P-Component
  • Calcium