Patent Application
20200325173
Epithelial cells constitute a barrier to drug delivery. For example, the absorption of orally-administered therapeutics may be limited by the gut epithelium, and the absorption of therapeutics delivered by inhalation may be limited by the lung epithelium. Likewise, the absorption of therapeutics delivered to other epithelial sites, such as the rectal cavity, buccal cavity, vaginal cavity, nasal cavity or by topical administration to the skin may be similarly limited by an epithelial barrier. This barrier presents a challenge to the delivery of a wide range of drugs including small molecules, peptides, proteins, vaccines and nucleic acids. Various attempts have been made to mitigate the effect of the barrier to drug absorption provided by epithelia. However, many of those attempts involve the use of agents which either deliberately or as an unintended side effect damage the epithelium. Such damage may result in uncontrolled passage of materials across the epithelium, and that, in possible combination with immunological danger signals resulting from cellular damage, may result in unwanted inflammation of the epithelium. There therefore exists a need for improved technique of assisting the passage of therapeutic agents across an epithelial surface, preferably in a manner which is controlled, temporarily and results in no unacceptable cellular damage (Brayden & Maher (2000) Therapeutic Delivery 1 (1):5-9).
The challenge to drug absorption presented by the epithelium has resulted in some drugs needing to be delivered by routes other than across an epithelium, for example by sub-cutaneous injection. This brings a number of disadvantages including reduced patient acceptability, lower patient compliance and higher costs associated with using and storing liquid formulations, providing injection devices and disposing of used injection devices in a safe and responsible way.
The epithelium provides a barrier to the absorption of drugs because it comprises a layer of cells which are connected to each other by tight junctions which provide a seal against many substances but which can be transiently opened. There exists a need to be able to better control tight junction opening to assist in the delivery of therapeutics. A number of solutions to the problem of opening tight junctions have been proposed. These efforts have led to the identification of two sets of molecules: non-native, extended amino acids (NEAAs) and short-chain fatty acids (SCFAs). NEAAs have been developed primarily by the company Emisphere who have demonstrated marginal improvements in drug uptake but have yet to submit an application for the regulatory approval of a new drug. One SCFA, sodium caprate is used in an approved rectal suppository product to improve the uptake of ampicillin. It is suspected however that the mechanism of improved uptake is through local damage of the mucosal epithelium (Maher et al. (2009) Adv. Drug Deliv. Rev. 61:1427-1449).
There is particular interest in the oral delivery of insulin, glucagon like peptide 1 (GLP-1) and other related molecules for the treatment of diabetics, obesity, suppression of appetite and improvement of carbohydrate metabolism. Such compounds are especially in need of an oral delivery route because they are typically administered for months, years or more, meaning that avoiding injections would significantly increase patient acceptability and potentially lower cost, and also because in nature these gut hormones enter the blood stream of the subject via the hepatic portal vein and delivery across an intestinal barrier would more closely mimic the physiological delivery route.
The present invention is based on the discovery of compounds useful for the controlled opening of epithelial tight junctions.
According to a first aspect of the invention there is provided a peptide comprising a sequence according to Formula 1:
Wherein:
X4 is a negatively charged amino acid residue, for example pTyr, Asp or Glu;
X5 is a small hydrophobic amino acid residue, for example Val or Ala;
X6 is a positively charged amino acid residue, for example Lys or Arg;
X7 is a hydrophilic amino acid residue, for example, Tyr, Phe, Thr or Ser; and
X8 is a negatively charged amino acid residue, for example pTyr, Asp or Glu,
or comprising a sequence according to Formula 2
wherein:
X5 is any amino acid residue;
or comprising a retro-inverso form of the sequence according to Formula 1 or Formula 2 wherein all amino acid residues are in the D-configuration and the peptide sequence order is reversed.
According to a second aspect of the invention there is provided a pharmaceutical composition comprising a peptide comprising sequence according to Formula 1
wherein:
X4 is a negatively charged amino acid residue, for example pTyr, Asp or Glu;
X5 is a small hydrophobic amino acid residue, for example Val or Ala;
X6 is a positively charged amino acid residue, for example Lys or Arg;
X7 is a hydrophilic amino acid residue, for example, Tyr, Phe, Thr or Ser; and
X8 is a negatively charged amino acid residue, for example pTyr, Asp or Glu,
and/or a peptide comprising a sequence according to Formula 2
wherein:
X5 is any amino acid residue;
or wherein the sequence according to Formula 1 and/or Formula 2 is in retro-inverso configuration wherein all amino acid residues are in the D-configuration and the peptide sequence order is reversed, and a pharmaceutically acceptable carrier.
According to a third aspect of the invention there is provided a peptide according to the first aspect of the invention or a pharmaceutical composition according to the second aspect of the invention for use as a medicament.
According to a fourth aspect of the invention there is provided use of a peptide according to the first aspect of the invention or a pharmaceutical composition according to the second aspect of the invention for the manufacture of a medicament.
According to a fifth aspect of the invention there is provided a method of opening the tight junctions of an epithelial surface comprising administering an effective amount of a peptide according to the first aspect of the invention or a pharmaceutical composition according to the second aspect of the invention to the epithelium.
According to a sixth aspect of the invention there is provided a method of delivering an agent across an epithelial surface comprising administering said agent in conjunction with a peptide according to a first aspect of the invention or as part of pharmaceutical composition according to a second aspect of the invention.
Polypeptide: A polymer in which the monomers are amino acid residues which are joined together through amide bonds. When the amino acids are alpha-amino acids, either the L-optical isomer or the D-optical isomer can be used. The present invention relates to both L-isomers and D-isomers. Preferably the invention relates to D-isomers, in particular, but not exclusively, when the peptide comprises the reverse sequence to that specified in Formula 1 or 2. Such peptides are referred to as being in the “retro-inverso” form. The terms “polypeptide” or “protein” as used herein encompass any amino acid sequence and include modified sequences such as glycoproteins and sequences using naturally occurring and non-naturally occurring amino acids. The term “polypeptide” covers naturally occurring proteins, as well as those which are recombinantly or synthetically produced, and salts, solvates and derivatives of polypeptides. Peptides of the present invention are preferably amidated at their C-terminus.
Salts and solvates of peptides of the invention are preferably those wherein the counterion or associated solvent is pharmaceutically acceptable. However, salts and solvates having non-pharmaceutically acceptable counterions or associated solvents are within the scope of the present invention, for example, for use as intermediates.
Peptides relating to all aspects of the invention are preferably active in their ability to enhance paracellular transport. This may be measured in accordance with one of the methods detailed herein (especially in the Examples).
Suitable salts according to the invention include those formed with organic or inorganic acids or bases.
Pharmaceutically acceptable acid addition salts include those formed with hydrochloric, hydrobromic, sulphuric, nitric, citric, tartaric, acetic, phosphoric, lactic, pyruvic, acetic, trifluoroacetic, succinic, perchloric, fumaric, maleic, glycollic, lactic, salicylic, oxaloacetic, methanesulfonic, ethanesulfonic, p-toluenesulfonic, formic, benzoic, malonic, naphthalene-2-sulfonic, benzenesulfonic, and isethionic acids. Other acids such as oxalic, while not in themselves pharmaceutically acceptable, may be useful as intermediates in obtaining the compounds of the invention and their pharmaceutical acceptable salts. Pharmaceutically acceptable salts with bases include ammonium salts, alkali metal salts, for example potassium and sodium salts, alkaline earth metal salts, for example calcium and magnesium salts, and salts with organic bases, for example dicyclohexylamine and N-methyl-D-glucomine.
Those skilled in the art of organic chemistry will appreciate that many organic compounds can form complexes with solvents in which they are reacted or from which they are precipitated or crystallized. Such complexes are known as “solvates”. For example, a complex with water is known as a “hydrate”. The present invention provides solvates of compounds of the invention.
Peptides of the invention may be made by any suitable technique for making peptides, including but not limited to conventional methodology, for example, synthesis from individual amino acids, especially step-wise synthesis using an automatic peptide synthesizer; modification of native peptides; or recombinant manufacturing techniques.
While it is possible for the peptides of the invention to be administered alone, it is preferable for it to be present in a pharmaceutical composition. Accordingly, the invention provides a pharmaceutical composition comprising a peptide of the invention, and a pharmaceutically acceptable carrier. Pharmaceutical compositions of the invention may take the form of a pharmaceutical formulation as described below.
The pharmaceutical formulations relating to the invention include those suitable for oral, parenteral inhalation (including fine particle dusts or mists which may be generated by means of various types of metered doses, pressurized aerosols, nebulizers or insufflators), rectal and topical (including dermal, transdermal, transmucosal, buccal, sublingual, and intraocular) administration, although the most suitable route may depend upon, for example, the condition and disorder of the recipient.
The formulations may conveniently be presented in unit dosage form and may be prepared by any of the methods well known in the art of pharmacy. All methods include the step of bringing the active ingredient into association with a pharmaceutical carrier which constitutes one or more accessory ingredients. In general the formulations are prepared by uniformly and intimately bringing into association the active ingredient with liquid carriers or finely divided solid carriers or both and then, if necessary, shaping the product into the desired formulation.
Formulations of the present invention suitable for oral administration may be presented as discrete units such as capsules, cachets or tablets, each containing a predetermined amount of the active ingredient; as a powder or granules; as a solution or a suspension in an aqueous liquid or a non-aqueous liquid; or as an oil-in-water liquid emulsion or a water-in-oil liquid emulsion. The active ingredient may also be presented as a bolus, electuary or paste. Various pharmaceutically acceptable carriers and their formulation are described in standard formulation treatises, e.g., Remington's Pharmaceutical Sciences by E. W. Martin. See also Wang, Y. J. and Hanson, M. A., Journal of Parenteral Science and Technology, Technical Report No. 10, Supp. 42:2S, 1988.
A tablet may be made by compression or moulding, optionally with one or more accessory ingredients. Compressed tablets may be prepared by compressing in a suitable machine the active ingredient in a free-flowing form such as a powder or granules, optionally mixed with a binder, lubricant, inert diluent, lubricating, surface active or dispersing agent. Moulded tablets may be made by moulding in a suitable machine a mixture of the powdered compound moistened with an inert liquid diluent. The tablets may optionally be coated or scored and may be formulated so as to provide slow or controlled release of the active ingredient therein. The present compounds can, for example, be administered in a form suitable for immediate release or extended release. Immediate release or extended release can be achieved by the use of suitable pharmaceutical compositions comprising the present compounds. The compounds can be formulated, for administration orally, with delivery agents or carriers that facilitate the transport of therapeutic macromolecules and highly charged compounds across cell membranes, especially in the small intestine. Such delivery agents or carriers may in addition inhibit enzymatic degradation of peptides during passage through the gastrointestinal (GI) tract and/or the formulation may include additional agents that protect against such degradation. The present compounds can also be administered liposomally.
Exemplary compositions for oral administration include suspensions which can contain, for example, microcrystalline cellulose for imparting bulk, alginic acid or sodium alginate as a suspending agent, methylcellulose as a viscosity enhancer, and sweeteners or flavoring agents such as those known in the art; and immediate release tablets which can contain, for example, microcrystalline cellulose, dicalcium phosphate, starch, magnesium stearate and/or lactose and/or other excipients, binders, extenders, disintegrants, diluents and lubricants such as those known in the art. The peptide of the invention can also be delivered through the oral cavity by sublingual and/or buccal administration. Moulded tablets, compressed tablets or freeze-dried tablets are exemplary forms which may be used. Exemplary compositions include those formulating the present compound(s) with fast dissolving diluents such as mannitol, lactose, sucrose and/or cyclodextrins. Also included in such formulations may be high molecular weight excipients such as celluloses (avicel) or polyethylene glycols (PEG). Such formulations can also include an excipient to aid mucosal adhesion such as hydroxy propyl cellulose (HPC), hydroxy propyl methyl cellulose (HPMC), sodium carboxy methyl cellulose (SCMC), maleic anhydride copolymer (e.g., Gantrez), and agents to control release such as polyacrylic copolymer (e.g. Carbopol 934). Lubricants, glidants, flavors, coloring agents and stabilizers may also be added for ease of fabrication and use.
Excipients that can be included are, for instance, proteins, such as human serum albumin or plasma preparations. If desired, the pharmaceutical composition may also contain minor amounts of non-toxic auxiliary substances, such as wetting or emulsifying agents, preservatives, and pH buffering agents and the like, for example sodium acetate or sorbitan monolaurate.
Exemplary compositions for nasal aerosol or inhalation administration include solutions in saline, which can contain, for example, benzyl alcohol or other suitable preservatives, absorption promoters to enhance bioavailability, and/or other solubilizing or dispersing agents such as those known in the art. Conveniently in compositions for nasal aerosol or inhalation administration the compound of the invention is delivered in the form of an aerosol spray presentation from a pressurized pack or a nebulizer, with the use of a suitable propellant, e.g., dichlorodifluoro-methane, trichlorofluoromethane, dichlorotetrafluoroethane, carbon dioxide or other suitable gas. In the case of a pressurized aerosol the dosage unit can be determined by providing a valve to deliver a metered amount. Capsules and cartridges of e.g., gelatin for use in an inhaler or insufflator can be formulated to contain a powder mix of the compound and a suitable powder base, for example lactose or starch. In one specific, non-limiting example, a compound of the invention is administered as an aerosol from a metered dose valve, through an aerosol adapter also known as an actuator. Optionally, a stabilizer is also included, and/or porous particles for deep lung delivery are included (e.g., see U.S. Pat. No. 6,447,743).
Formulations for rectal administration may be presented as a retention enema or a suppository with the usual carriers such as cocoa butter, synthetic glyceride esters or polyethylene glycol. Such carriers are typically solid at ordinary temperatures, but liquefy and/or dissolve in the rectal cavity to release the drug.
Formulations for topical administration in the mouth, for example buccally or sublingually, include lozenges comprising the active ingredient in a flavoured basis such as sucrose and acacia or tragacanth, and pastilles comprising the active ingredient in a basis such as gelatin and glycerine or sucrose and acacia. Exemplary compositions for topical administration include a topical carrier such as Plastibase (mineral oil gelled with polyethylene).
Preferred unit dosage formulations are those containing an effective dose, as hereinbefore recited, or an appropriate fraction thereof, of the active ingredient.
It should be understood that in addition to the ingredients particularly mentioned above, the formulations of this invention may include other agents conventional in the art having regard to the type of formulation in question, for example those suitable for oral administration may include flavouring agents.
The peptides of the invention are also suitably administered as sustained-release systems. Suitable examples of sustained-release systems of the invention include suitable polymeric materials, for example semi-permeable polymer matrices in the form of shaped articles, e.g., films, or microcapsules; suitable hydrophobic materials, for example as an emulsion in an acceptable oil; or ion exchange resins; and sparingly soluble derivatives of the compound of the invention, for example, a sparingly soluble salt. Sustained-release systems may be administered orally; rectally; parenterally; intracistemally; intravaginally; intraperitoneally; topically, for example as a powder, ointment, gel, drop or transdermal patch; bucally; or as an oral or nasal spray.
Preparations for administration can be suitably formulated to give controlled release of compounds of the invention. For example, the pharmaceutical compositions may be in the form of particles comprising one or more of biodegradable polymers, polysaccharide jellifying and/or bioadhesive polymers, amphiphilic polymers, agents capable of modifying the interface properties of the particles of the peptides of the invention. These compositions exhibit certain biocompatibility features which allow a controlled release of the active substance. See U.S. Pat. No. 5,700,486.
A therapeutically effective amount of a peptide or pharmaceutical composition of the invention may be administered as a single pulse dose, as a bolus dose, or as pulse doses administered over time. Thus, in pulse doses, a bolus administration of a peptide or composition of the invention is provided, followed by the elapse of time period followed by a second bolus administration. In specific, non-limiting examples, pulse doses of a compound of the invention are administered during the course of a day, during the course of a week, or during the course of a month.
The present invention is based on the development of strategies to open the paracellular route between adjacent cells in an epithelium by controlling the dynamic opening and closing of tight junctions by harnessing an endogenous control mechanism. The strategies related to the provision of peptide compounds designed de novo to target specific cellular targets and to have specific action on those targets.
Recent studies have suggested that chronic inflammation events that occur at simple mucosal surfaces, such as those of the intestine and airway, are associated with increase permeability of the epithelial barriers at these locations (4, 13). The basis for this increased permeability was determined to be an increased phosphorylation status of the tight junction (TJ)-associated cytosolic protein known as myosin light chain (MLC). This mechanism was verified by the identification and in vivo testing of a nine amino acid, membrane-permeable peptide that selectively inhibited MLC phosphorylation. The knowledge of endogenous mechanism of intestinal cell regulation of MLC phosphorylation, was used to design two classes of peptides to selectively alter the actions of myosin phosphatase target subunit 1 (MYPT1) or 17 KDa L-kinase potentiated protein phosphatase-1 inhibitor (CPI-17) proteins. These two proteins function to reduce MLC phosphorylation and the present invention relates to transient inhibition of their function so as to transiently increase paracellular permeability of an epithelium. The two target proteins regulate MLC phosphorylation at different rates and by providing agents and methods selectively targeting those two different proteins, it is possible to finally control the time course of opening and reclosing of the tight junctions.
According to a first aspect of the invention there is provided a peptide comprising sequence According to Formula 1:
wherein:
X4 is a negatively charged amino acid residue, for example pTyr, Asp or Glu;
X5 is a small hydrophobic amino acid residue, for example Val or Ala;
X6 is a positively charged amino acid residue, for example Lys or Arg;
X7 is a hydrophilic amino acid residue, for example, Tyr, Phe, Thr or Ser; and
X8 is a negatively charged amino acid residue, for example pTyr, Asp or Glu. or comprising sequence according to Formula 2
wherein:
X5 is any amino acid residue;
or comprising a retro-inverso form of the sequence according to Formula 1 or Formula 2 wherein all amino acid residues are in the D-configuration and the peptide sequence order is reversed.
Formula 1 defines a sequence which targets PP1-CP1-17 interactions. Formula 2 defines a sequence which targets PP1-MYPT1 interactions. The unifying feature of both sequences is that they both act to reduce MLC phosphorylation and therefore their inhibition leads to an increased phosphorylation of MLC and opening of the tight junctions of an epithelium.
According to some embodiments of all aspects of the invention the functional feature of reducing MLC phosphorylation may be a feature of the claimed invention.
Peptides according to formula 1 inhibit PP1-CP1-17 interactions. According to some embodiments of the various aspects of the invention according to the sequence encompassed by Formula 1 wherein
X4 is pTyr, Asp or Glu;
X8 is pTyr, Asp or Glu.
According to some embodiments:
According to some embodiments:
According to some embodiments:
The sequences according to various embodiments of Formula 1, define the PP1-CP1-17 targeting motif. In order to function effectively in some embodiments of the invention, a peptide comprising a sequence according to Formula 1, also contains sequence to ensure its delivery into the cytosol of epithelial cells where it has its target. Such a sequence may be a cell penetration—promoting sequence or a sequence that promotes cell surface binding to epithelial cells followed by phagocytosis into that cell. According to certain preferred embodiments a sequence according to Formula 1 is
wherein:
X1 is up to 10 positively charged amino acid residues;
X2 is a positively charged amino acid residue;
X3 is absent or a hydrophobic amino acid residue;
X4 is a negatively charged amino acid residue;
X5 is a small hydrophobic amino acid residue;
X6 is a positively charged amino acid residue;
X7 is a hydrophobic amino acid residue;
X8 is a negatively charged amino acid residue;
X9 is a positively charge amino acid residue; and
X10 is up to 10 positively charged amino acid residues; or wherein all amino acid residues are in the D-configuration and the peptide sequence order is reversed.
According to certain embodiments of the alternative formulae given immediately above, as relating to all aspects of the present invention,
X1 is up to 10 positively charge amino acid residues;
X2 is a positively charged amino acid residue;
X4 is pTyr, Asp or Glu;
X8 is pTyr, Asp or Glu;
X9 is a positively charged amino acid residue; and
X10 is up to 10 positively charged amino acid residues; or all amino acid residues are in the D-configuration and the peptide sequence order is reversed.
According to some embodiments:
X1 is up to 10 residues of Lys or Arg;
X4 is pTyr, Asp or Glu;
X8 is pTyr, Asp or Glu;
X10 is up to 10 residues of Lys or Arg.
According to some embodiments:
According to some embodiments:
According to some embodiments:
The invention also comprises, in certain embodiments, the retro-inverso form of the sequences given above.
Peptides according to Formula 2 inhibit PP1-MYPT1 interactions. According to some embodiments of the various aspects of the invention according to the sequence encompassed by Formula 2 wherein:
X5 is a positively charged amino acid residue;
According to some embodiments:
According to some embodiments:
The invention also comprises, in certain embodiments, the retro-inverso form of the sequences given above.
The sequences according to various embodiments of Formula 2, define the PP1-MYPT1 targeting motif. In order to function effectively in some embodiments of the invention, a peptide comprising a sequence according to Formula 2 also contains sequence to ensure its delivery into the cytosol of epithelial cells where it has its target. Such a sequence may be a cell-penetration-promoting sequence or a sequence that promotes cell surface binding to epithelial cells followed by phagocytosis into that cell.
According to certain preferred embodiments, a sequence according to Formula 2 is
wherein:
X1 is up to 10 positively charged amino acid residues;
X2 is a positively charged amino acid residue;
X4 is absent or Ala or 1, 2, 3 or 4 positively charged amino acid residues;
X5 is a positively charged amino acid residue;
X9 is absent or Ala or 1, 2, 3 or 4 positively charge amino acid residues;
X10 is a positively charged amino acid residue;
X11 is a positively charged amino acid residue; and
X12 is up to 10 positively charge amino acid residues; or wherein all amino acid residues are of the D-configuration and the sequence order is reversed.
According to certain embodiments of the alternative formulae give immediately above for Formula 2a, relating to all aspects of the present invention,
X1 is up to 10 residues of Lys and/or Arg in any combination;
X4 is absent Ala, Lys or Arg;
X12 up to 10 residues of Lys and/or Arg in any combination; or all amino acid residues are of the D-configuration and the sequence order is reversed.
According to some embodiments:
X4 is absent;
X9 is absent;
According to some embodiments:
X4 is absent;
X9 is absent;
that is to say the sequence is Arg1-Lys5-Ala3-Lys5-Tyr6-Gln7-Tyr8-Arg10-Arg11-Lys12 (SEQ ID NO: 4)
The invention also comprises, in certain embodiments, the retro-inverso form of the sequences given above.
The sequences of Formula 1 and Formula 2 are derived from naturally occurring sequences. The naturally occurring sequences from which they derive have amino acid residues in the L-configuration.
Therefore, in such circumstances, according to some embodiments, the amino acids are in L-configuration.
Peptides comprising D-amino acids may be more attractive as drugs because they tend to be less susceptible to degradation in the stomach or inside cells by proteolysis. They therefore tend to be more suitable for oral administration and tend to be effective for longer periods of time.
The present invention, in its various aspects, encompasses peptides in which all amino acids are in the D-configuration and the peptide sequence order of Formula 1 and 2 (and more narrowly defined sequences falling within the scope of Formula 1 or 2 and specified above) is reversed.
For example, the invention relates to peptides having the sequence RRVEVKYDRR-NH2 (SEQ ID NO: 3) wherein the residues are preferably in L-configuration and the retro-inverso sequence NH2-rrdykvevrr (SEQ ID NO: 20) wherein the residues are in D-configuration. The lower case single letter amino acid code is shorthand for retro-inverso configuration. According to certain embodiments the retro-inverso configuration is preferred.
According to a second aspect of the invention, there is provided, a pharmaceutical composition comprising a peptide according to any of the various embodiments of the first aspect of the invention, and a pharmaceutically acceptable carrier.
According to certain embodiments, the pharmaceutical composition comprises an agent to promote penetration of the peptide into the cytosol of the target epithelial cell, for example a liposome-forming agent. The presence of such an agent is especially favoured if the peptide itself lacks a cell penetration sequence, for example if it lacks the cell-penetrating peptide sequence of Formula 1a or 2a. However, agents to assist with cell penetration may, according to some embodiments, may be present regardless of the presence or absence of such sequences in the peptide according to the first aspect of the invention. According to certain embodiments a pharmaceutical composition according to the invention may comprise a peptide according to Formula 1, or the retro-inverso analogue thereof, in combination with a peptide according to Formula 2, or the retro-inverso analogue thereof.
A pharmaceutical composition may comprise a dosage from having an enteric coating. An enteric coating is a coating applied to oral medicinal compositions such as tablets, caplet and capsules so as to control absorption so that it takes place in the small intestine. Enteric coatings are typically applied to the surface of dosage forms so that they present a stable surface in the highly acid pH of the stomach, but breakdown rapidly in the relatively more basic environment of the small intestine. Materials used for enteric coatings include fatty acids, waxes, shellac, plastics and plant fibres.
When the present invention is used in the context of delivery of a second therapeutic agent in an oral dosage across the epithelium of the small intestine, an enteric coating may be used if the therapeutic agent would otherwise be degraded in the stomach environment. Such a coating may be especially useful if the second therapeutic agent is irritating to the stomach, if it is acid unstable (for example certain azoles such as esomeprazole are acid unstable), or if the second therapeutic agent is a protein or peptide (for example insulin, GLD-1 or a derivative, or analogue thereof) which might be expected to be degraded by enzymes present in the stomach.
Accordingly, pharmaceutical compositions according to the second aspect of the invention may comprise a solid dosage form having an enteric coating and other aspects of the invention may also utilise or relate to such a coating.
According to various aspects of the invention which relate to a peptide of the invention and a second therapeutic agent, for example the pharmaceutical compositions according to the second aspect of the invention, the two components are preferably co-mixed, for example in the pharmaceutical composition so that they are presented at the epithelial surface at the same time. The peptides of the invention may be used to deliver a wide range of therapeutic agents. They may be especially relevant to the delivery of therapeutic agents which are small molecules, and also in the delivery of therapeutic agents which are peptides or proteins or nucleic acids. For example the therapeutic agent might be insulin, parathyroid hormone, calcitonin, erythropoietin, GM-SF or growth hormone, or a siRNA or gene therapy agent. The invention also relates to the delivery of therapeutic agents which are antibodies or antibody derivatives. Should it be found that whole antibody molecules are too large to be effectively delivered in accordance with the invention, smaller versions of antibody-based technologies for example scFv molecules, camel antibodies, single change antibody fragments and domains and the like may be of particular use. All of these therapeutic could be administered either singly or in combination with other therapeutic agents following tight junction opening by a peptide of the invention. For example insulin and GLP-1 could be delivered in the same dosage form as a peptide of the invention.
A pharmaceutical carrier (or “drug carrier”) is a substance present in a pharmaceutical composition to improve the delivery, formulation, dosage or effectiveness of a drug or to assist in its preservation, blending, preparation or processing.
The invention in its various aspects relates to an epithelium (“epithelial surface”). This may be an in vitro or in vivo surface. Non-limiting examples include the epithelium of the large intestine, the small intestine, the rectum, the anus, the cervix, the vagina, the respiratory tract (for example trachea, bronchioles, bronchiole or larynx), the nose, the mouth and the cornea, present both in vivo and in vitro.
Immortalized cell lines of epithelial cells, for example of the epithelial cell types described immediately above are especially contemplated.
According to a third aspect of the invention, there is provided a peptide to the first aspect of the invention or a pharmaceutical composition according to a second aspect of the invention of use as a medicament. Both the third and fourth aspects of the invention refer to a “medicament”. Said medicament may comprise a peptide of the invention or a peptide of the invention and a second therapeutic agent as described herein with reference to other aspects of the invention. This second therapeutic agent may be a peptide, small molecular entity, nucleic acid or other chemical compound. The medicament may be formulated as described herein with reference to other aspects of the invention for the treatment of a disease disorder or non-medical condition as described elsewhere herein a subject as described elsewhere herein.
According to certain embodiments the present invention, in all aspects relates to the treatment of subjects. Such subjects may be of any species which have an epithelium with tight junctions.
According to certain preferred embodiments, the present invention in all aspects relates to the treatment of mammalian subjects. Most preferably the present invention in all aspects relates to the treatment of human subjects of either sex and of any age (for example from birth to 1 yrs, birth to 5 yrs, birth to 12 yrs, birth to 60 yrs, birth to 80 yrs, 2 to 60 yrs, 5 to 80 yrs, 12 to 80 yrs or 16 or 18 yrs upwards).
According to certain embodiments, the present invention in all aspects relates to the treatment of human subjects in need of a therapeutic agent which is to be delivered across a mucosal membrane. The therapeutic agent may be one of the agents described elsewhere herein. The human subject, according to certain embodiments of all aspects of the invention may be a subject to whom has been administered the therapeutic agent mentioned above simultaneously or within a time-window of 15, 10, 5, 2 or 1 minutes either side of administration of the peptide or pharmaceutical composition of the invention.
The peptide according to the first aspect, the pharmaceutical composition according to the second aspect, or the medicament according to the third aspect may be for the treatment of a disease or disorder or other condition. According to certain embodiments, the disease or a lung disease, The delivery of poorly absorbed drugs in accordance with the invention may have the effect similar to their administration by injection. Importantly, the ability to deliver therapeutic agents to discrete epithelial locations would also result in the local delivery to the submucosal space. For these reasons, the invention may be especially suitable for treating both systemic conditions and diseases (e.g. arthritis, short-stature, etc) and also conditions and diseases that would benefit from local targeting of therapeutic agents (e.g. Crohn's disease, asthma, etc).
According to certain embodiments, the various aspects of the invention relate to non-therapeutic treatment of conditions, such as cosmetic skin condition, or the treatment of a person who is not medically obese but who wishes to lose weight (or maintain a healthy weight) for cosmetic purposes.
In respect of jurisdictions where methods of medical treatment constitute patentable subject matter the present invention provides a method of treatment of a disease in a subject comprising administering to said subject a pharmaceutical composition according to the second aspect of the invention, wherein the second therapeutic agent is for treatment of the disease and wherein the presence in the pharmaceutical composition of the peptide according to the first aspect of the invention improves the delivery of the second therapeutic agent across an epithelium of the subject. According to certain preferred embodiments of this aspect of the invention, the subject, rate of administration, features of the pharmaceutical composition, the peptide of the invention, the second therapeutic agent, or the disease to be treated are as described herein in reference to other aspects of the invention.
According to a fourth aspect of the invention there is provided a method of opening the tight junctions of an epithelial surface comprising administering an effective amount of a peptide according to the first aspect of the invention, or a pharmaceutical composition according to a second aspect of the invention to the epithelium.
This method may be an in vivo or in vitro method. In vivo methods include methods directed to the medical treatment of a subject, for example by promoting the delivery of a second therapeutic agent to the circulation of a subject by opening the paracellular administration rate of said subject's epithelium and disease to be treated may be as described herein by reference to other aspects of the invention.
Alternatively, the method of this aspect of the invention may relate to the in vivo testing in an experimental animal or human volunteer or patient of the delivery of an agent across an epithelium. For example, a second therapeutic agent as defined by reference to other aspects of the invention may be delivered across an epithelium in order to measure the efficacy of the second therapeutic agent in treating a disease or in order to assist with the subsequent measurement of pharmacokinetic (PK) parameters. In this regard the method of this aspect of the invention may relate to the measurement of a marker molecule (for example a radiolabelled marker or other imaging or contrast agent) across said epithelium.
Alternatively this aspect of the invention may relate to the in vivo opening of tight junctions of an epithelium in cell culture, for example as a cell cultured monolayer of human or animal epithelium, in order to study the properties of the epithelium or the passage of molecules (for example drug candidates) across said epithelium.
According to a sixth aspect of the invention there is provided a method of delivering an agent across an epithelial surface comprising administering said agent in conjunction with a peptide according to a first aspect of the invention or as part of a pharmaceutical composition according to a second aspect of the invention.
In various aspects of this aspect of the invention, the epithelial surface, peptide and pharmaceutical composition may be as described in reference to the various other aspects of the invention. The method may be carried out in vitro or in vivo. The agent may be a diagnostic agent, contrast agent or according to certain preferred embodiments a therapeutic agent as described herein under the heading “second therapeutic agents”.
Various aspects of the present invention are described below by reference to the following non-limiting examples and figures.
Peptides were synthesized by (Fmoc)-SPSS (ActivoSyn peptide synthesizer) using amino acids obtained from Nova Biochem, except for isoleucine, which was obtained from Sigma Aldrich. The first amino acid was coupled to Rink Amide MBHA resin (100-200 mesh; Nova Biochem) using N,N′-diisopropylcarbodiimide. Subsequent couplings were carried out on an Activo P-11 peptide synthesizer using PyBop. De-protection was carried out using 20% piperidine in dimethylformamide. Peptides were cleaved from the resin using a mixture of trifluoracetic acid (TFA), triisopropylsilane and water (95:2.5:2.5), and then precipitated in diethyl ether. Crude product was purified by HPLC, using a Phenomenex Gemini C18 column (250×10 mm, pore size 5 μm) and a gradient mobile phase of water with 0.1% TFA and acetonitrile with 0.1% TFA using a flow rate of 2.5 ml/min. High resolution time-of-flight mass spectra were obtained on a Bruker Daltonics micrOTOF mass spectrometer using electrospray ionisation (ESI) to verify peptide identity. Purified peptides were dried by lyophilization and stored at −80° C.
An immortalized human intestinal epithelial cell line (Caco-2) were maintained in DMEM/F12 medium (Gibco, Paisley, UK) supplemented with 10% FBS, 2 mM L-glutamine (Gibco) 100 U/ml penicillin and 100 μg/ml streptomycin (Gibco). Caco-2 cells were seeded at a density of 7×104/well on Transwell™ (Corning, N.Y.) polyester membrane filters (12 mm diameter, 0.4 μm pore size). Re-feeding with DMEM (Life Technologies, Paisley, UK) was carried out every second day. Caco-2 monolayers with trans-epithelial electrical resistance (TEER) >350 Ω·cm2 were considered confluent and used in transport assays; fixed paddle electrodes were used to measure TEER (World Precision Instruments, UK).
Apical to basal flux of 50 mg/ml 4 kDa dextran or 50 mg/ml 70 kDa dextran (Sigma) was performed to assess the impact of PIP peptides on paracellular permeability. Apical compartment volume was 200 μl; at set times the 600 μl basal compartment volume was collected and replaced with fresh HBSS. Apical and basal compartment fluorescence was determined using a Floustar Omega microplate reader (BMG Labtech, Ortenburg, Germany). TEER measurements were made for each well immediately after HBSS replacement. After 3 hr, the apical compartment dextran and peptide solution was removed and replaced with PBS and TEER values were recorded for a further 30 min to assess monolayer recovery.
After rinsing with ice cold PBS, Caco-2 monolayers or epithelial cells from isolated intestinal tissue were lysed in 34 of a protease inhibitor cocktail and 2004 RIPA buffer and left on ice for 10 min. Isolated intestinal tissue was similarly placed in ice cold PBS for 15 min prior to maceration in a protease inhibitor cocktail and RIPA buffer, being left on ice for 10 min. All cell and tissues lysates were centrifuged at 8000 rpm for 15 min to collect the supernatant, which was stored at −80° C. until use. For Western blots analysis, lysates were separated by SDS-PAGE (12%) run at 220V for 40 min and electro-transferred onto a PDVF membrane at 30V for 70 min using an XCell™ Blot module (Invitrogen). Membranes were blocked using 5% bovine serum albumin in TBS-T (2 M Tris, HCl, pH 7.5, 4 M NaCl and 0.1% Tween 20) for 1 hr. Membranes were washed with water, incubated with primary antibody (anti-myosin light chain (phospho S20) antibody or anti-myosin light chain 2) antibody overnight at 5° C., washed thrice with TBS-T, and then incubated with secondary horseradish peroxide (HRP)-coupled antibody for 1 hr at room temperature. After washing thrice in TBS-T, HRP activity was detected by ECL (Santa Cruz).
MTT assay: Cell viability was assessed using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT; Invitrogen, Paisley, UK) assay. Following exposure of cells to CPP complexes for 72 hours, 0.5 mg/ml MTT was added to the culture medium and incubated with the cells for a further 3 hours. Media was then removed and replaced with DMSO to lyse the cells. Absorbance was then recorded at 550 nm.
Cells were cultured on glass coverslips before the addition of CPPs, in complex with Rhodamine tagged BSA. Cells were incubated with the complexes for 2 hours then subsequently washed several times with complete medium to remove excess complexes before being fixed with 4% paraformaldehyde. Incorporation of tagged BSA into the cells was determined through confocal microscopy (Zeiss LSM 510). Levels of BSA entry were estimated through measurement of the mean fluorescence intensity of the Rhodamine tag relative to the number of cells in the field of view.
Male Wistar rats, bred in house, were 225-275 g (approximately 6-8 weeks old) when placed on study. Rats were housed in groups of 3-5 per cage in a 12/12 hr light/dark cycle. All experiments were conducted during the light phase and carried out using a non-recovery protocol that used continuous isoflurane anesthesia. A 4-5 cm midline abdominal incision was made to expose mid-jejunum to early ileum regions of the small intestine and to provide access to the portal vein for the insertion of a cannula. Solutions of insulin (human recombinant; Sigma) and PIP peptides were prepared in 0.9% saline containing 10 mM citric acid to reduce local proteolysis and mixed 1:1 before injection using a 29-gauge hypodermic needle in a volume of 200 μL/kg (or −50 μL per 250 g rat). The injection site was marked with a permanent marker. The incision was closed with surgical glue. Blood draws were taken from the portal vein as well as systemic circulation over the next two hours to monitor glucose, serum insulin and endotoxin. Control treatment groups included SC injection of insulin delivered into the intestinal lumen as well as intestinal injection of PIP peptide without insulin or insulin alone in the phosphate buffered saline (PBS) formulation used for all groups. At the end of a study, a 3-5 mm region about the marked intestine segment was isolated. This tissue was lysed for biochemical assessment of MLC phosphorylation state or fixed, sectioned, and stained with hematoxylin/eosin prior to analysis read by a licensed veterinary pathologist. Subcutaneous (SC) insulin injections (20 μl/kg) were performed in the mid-scapular region and blood glucose was measured in the same manner. All experiments were performed in accordance with the U.K. Animals (Scientific Procedures) Act of 1986, the European Communities Council Directive of 1986 (86/609/EEC), and the University of Bath's ethical review procedures.
Since the actions of cell penetrating peptides to induce cellular damage and toxicity is a possibility (Carter, 2013 #109; Kilk, 2009 #110), induction of apoptosis, as a measure of early stage cell intoxication, was assessed by examining caspase-3 enzyme activity using the APT165 commercial kit as per manufacturer's instructions (Millipore, Watford, UK). Intestinal tissues were isolated 45 min after exposure to test agents administered by direct intestinal intraluminal injection. Hygromycin (150 μg/mL) was administered as a positive control to incite apoptosis through caspase-3 activation.
After rinsing with ice cold PBS to remove PIP peptide or control treatment agents, isolated intestinal tissue was placed in ice cold PBS for 15 min prior to addition of 25 μl protease inhibitor cocktail (Fisher), 25 μl phosphatase inhibitor cocktail (Fisher) and 500 μl RIPA buffer (Sigma Aldrich). After 10 min on ice lysates were centrifuged at 8000 rpm for 15 min to collect the supernatant, which was stored at −80° C. until use. For Western blots analysis, lysates were separated by SDS-PAGE (12%) run at 220V for 40 min and electro-transferred onto a PDVF membrane at 30V for 70 min using an XCell™ Blot module (Invitrogen). Membranes were blocked using 5% bovine serum albumin in TBS-T (2 M Tris HCl, pH 7.5, 4 M NaCl and 0.1% Tween 20) for 1 h. Membranes were washed with water, incubated with primary antibody (anti-myosin light chain (phospho S19) antibody (Cell Signalling Technologies) or anti-myosin light chain 2 antibody (Abcam) overnight at 5° C., washed thrice with TBS-T, and then incubated with secondary horseradish peroxide (HRP)-coupled antibody for 1 h at room temperature. After washing thrice in TBS-T, HRP activity was detected by ECL (Santa Cruz).
Induction of apoptosis, as a measure of early stage cell intoxication, was assessed by examining caspase-3 enzyme activity using the APT165 commercial kit as per manufacturer's instructions (Millipore, Watford, UK). Intestinal tissues were isolated 45 min after exposure to test agents administered by direct intestinal intraluminal injection. Hygromycin (150 □g/mL) was administered as a positive control to incite apoptosis through caspase-3 activation.
PIP peptide-mediated uptake of Cy3-labeled insulin (Nancocs) was evaluated in vivo where exposed intestinal segments were isolated 15 min after administration for microscopic analysis. Isolated tissues were rinse briefly in ice-cold PBS and then fixed with 4% paraformaldehyde on ice prior to assessment using a Zeiss LSM 510 fluorescence microscope. DAPI (4′,6-diamidino-2-phenylindole) was used as a nuclear stain.
TEER values were calculated by subtracting blank filter reading and normalized as a percentage of the initial TEER value for that monolayer. Fluorescent dextran flux used to calculate paracellular permeability was performed as previously described. Blood glucose levels were expressed as a percentage of the baseline glucose levels for each animal. Data were compared to control values using a two-tailed, un-paired Student's T-test. A p-value of <0.05 was considered to demonstrate significant differences.
TJ structures are composed of integral membrane proteins that interact with contractile and scaffolding elements to dynamically regulate epithelial barrier properties in health and disease (Turner (2009) Nat. Rev. Immunol. 9:799-809; Xiao et al. (2011) J.Aller. Clin. Immunol. 128:549-556). Physiological and pathological stimuli alter TJ barrier properties thru multiple kinases: protein kinase C (PKC), protein kinase A, mitogen-activated protein kinases, phosphoinositide 3-kinase and Rho signalling pathways (Gonzalez-Mariscal (2008) Biochim. Biophys. Acta 1778:729-756). A central element of this kinase cross-talk involves regulating myosin light chain (MLC) phosphorylation (Woodsome et al. (2006) J. Cell Sci. 119:1769-1780);
The inventor has previously developed a 9-residue peptide (PIK) inhibitor of MLCK that closes TJ structures poised in the open position due to inflammatory events. PIK emulates a protein surface structure critical to MLCK function. Following identification of critical interfacial contacts, this peptide was modified to integrate amino acid that would allow for cell-penetrating peptide (CPP) function and increase metabolic stability. Applying these same design principles, agents and methods according to various aspects of the present invention have been developed.
MLCP is a trimeric protein phosphatase-1 (PP1) holoenzyme, consisting of a PP1 isoform, the myosin targeting subunit MYPT1-CPI-17 regulatory complex, and a 21 kDa accessory subunit. To identify potential peptide MLCP inhibitors, the inventor has focused on interactions between MYPT1 or the 17 kDa protein inhibitor CPI-17 with PP1 to directly regulate MLCP function (
Inhibition of MLCP by CPI-17 is driven by PKC-stimulated events; phosphorylation of residue T38 (pT38) in CPI-17 enhances MLCP inhibition over 1000-fold; a minimal inhibitory domain within CPI-17 was identified that includes T38 (24) and a small cadre of peptides emulating the R36VTVKYDRR44 (SEQ ID NO: 13) sequence in CPI-17 that participates in its interaction with PP1 were synthesised. Included in the initial peptide set were modifications to mimic pT38 (glutamic acid; E), and introduction of additional basic to emulate CPP sequences to enhance membrane permeability (Table 1).
Peptides were applied apically at a concentration of 5 mM to confluent monolayers of Caco-2 cells grown on semi-permeable inserts (Rubus et al. (1996) J. Pharma. Sci 85:165-169) to assess their ability to affect TJ function (Peterson & Mooseker (1992) J. Cell. Sci. 102(3):581-600). RRVEVKYDRR (peptide #6; peptide 640, SEQ ID NO: 3) reduced the trans-epithelial electrical resistance (TEER) of Caco-2 monolayers with a drop of 50% within 25 min of addition (
While CPI-17 is widely expressed in smooth muscle (Eto (2009) J. Bid. Chem. 369:149-156), this data is the first to suggest its functional role in polarized epithelial cells. While pT38 is essential for the inhibitory function of CPI-17 itself, the present findings indicate a suitable stable mimetic (e.g. E residue) can replace pT38 for our application. The N and C termini of the peptides of table 1 are provided as cell-penetrating sequences but could be dispensed of if other methods of achieving cell penetration were employed.
MLCP inhibition occurs following Rho-kinase mediated phosphorylation of MYPT1 at residues T696 and T853 (Murthy et al. (2003) Biochem. J. 374:145-155). MYPT1 binds PP1 via 3 different regions: the RVxF binding motif, the N-terminal arm and the 2nd group of ankyrin repeats of this protein. While phosphorylation of MYPT1 at both T696 and T853 appears be involved in MLCP regulation, a KVKF sequence within the 300 residue N-terminal domain of MYPT1 facilitates its association with PP1 (Peti et al. (2013) FEB S.J. 280:596-611). Structural analysis of MYPT bound to PP1 shows that E300 to E309 of PP1 is positioned between 2 ankyrin repeats of MYPT; in particular the ankyrin repeats bind with Y305 and Y307, suggesting that the C terminus of PP1 is important for regulatory subunit interaction to mediate isoform specificity. It was therefore speculated that a peptide corresponding to this area could prevent MYPT binding to PP1 and hence diminish myosin specificity of the MYPT/PP1 complex.
To test this hypothesis RKAKYQYRRK (peptide 250, SEQ ID NO: 4) was synthesized that incorporated the 301KAKYQY306 (SEQ ID NO: 19) region of the C-terminal region of PP1. Assessment of the targeted inter-facial contacts suggested one could add an R residue and the tripeptide RRK at the N- and C-termini, respectively, without interfering with function to facilitate CPP function. Since poly-cations can induce cellular damage and toxicity (Wender et al. (2005) Org. Lett. 7:4815-4818), a lack of cytotoxicity for this peptide was confirmed using the MTT assay (data not shown). Apical addition to polarized Caco-2 monolayers of 5 mM peptide 250 was compared to that of 5 mM RRVEVKYDRR (peptide #6; peptide 640, SEQ ID NO: 3) and a control peptide (
Based upon this information a lead candidate, peptide 250=NH2-krryqykakr-NH2 (SEQ ID NO: 21), which uses the retro-inverso configuration and D-amino acids, was identified.
These studies demonstrate that peptides rationally designed to block interactions of CPI-17 or MYPT1 with PP1 can produce distinct pharmacological outcomes with regard to TEER and paracellular transport, suggesting that separate regulatory mechanisms are present, involving CPI-17 and MYPT1, which allow TJs to open dynamically to varying extents and rates.
In order to adequately compare PIP peptides 250 and 640, we attempted to match the two based on response based upon TEER. This was done because of several uncertainties that make a direct dose comparison inappropriate because it is likely that the two peptides have different properties critical to their actions: accessibility to their intracellular targets (due to differing CPP capabilities), binding affinities for their respective MLCP-related targets, off-target actions, and intracellular stabilities. We determined that 20 mM peptide 250 provided a very comparable response to 10 mM peptide 640 (
We next asked if the actions of PIP peptides 640 and 250 on TEER values translated to changes in paracellular permeability (
Our focus was to examine intestinal epithelial transport prior to addressing formulation challenges related to bypassing stomach acids and pancreatic enzymes; such challenges can be solved with established pill or tablet technologies but require higher order animal models than rodents. Presently, we used a rat model where small (50 μL) volume was directly injected into the lumen of the small intestine, in particular distal jejunum to proximal ileum. We calibrated the responses achieved by oral delivery by subcutaneous (SC) injection of insulin; a dose-dependent decrease in blood glucose that reached its nadir by ˜30 min and began to recover by ˜90 min. SC injection of 3 IU/kg produced ˜50% decrease in blood glucose (
These results are intriguing as they suggest that these PIP peptides have distinct in vitro and in vivo response profiles that may be related to the durability of their response. In vitro the applied PIP peptide remains present and functional until it is physically removed. In vivo, however, the effective concentration of a PIP peptide at the luminal epithelial surface is complicated by events such as luminal flush and systemic absorption; events that might alter the amount and duration of time a PIP peptide may be in the cytoplasm of a small intestinal epithelial cell. We observed that peptide 640 appeared to induce more dynamic responses for TEER than peptide 250, which would result in more durable responses in vivo.
These in vivo results are, in general, consistent with our in vitro studies performed using the human intestinal epithelial cell line Caco-2 that suggested a dynamic alteration in paracellular permeability (
The ratio of total MLC to pMLC was assessed by semi-quantitative Western blot analysis (
We probed our hypothesis of the PIP peptide mechanism of action further by examining the fate of a fluorescent-labeled form of insulin following its ILI injection. Fluorescent (cy3-labeled) insulin was observed in the intestinal paracellular space only when co-administered with a PIP peptide without gross anatomical modification of the epithelium (
Time course studies monitoring blood glucose depression and alterations in MLC phosphorylation relevant to total MLC cell content following ILI injection of PIP peptides and 10 IU of insulin suggest an in vivo event window of approximately 30-60 min. To explore this further, we measured serum insulin concentrations in blood collected from the portal vein (
The total amount of insulin detected by ELISA in the portal and systemic (tail vein) after ILI of 10 IU/kg showed slightly different profiles following enhanced uptake by peptide 250 versus peptide 640 for the conditions tested here. Additionally, we determined time-concentration profiles for portal and systemic concentrations of insulin following SC injection (
Initial in vitro studies using Caco-2 cells suggested that peptide 250 and 640, tested at concentrations that modulated TEER and paracellular permeability, did not affect cell viability as assessed by the mitochondrial membrane polarity marker MTS. Due to the transient nature of PIP actions in vivo, we focused on cell signals that might better define early cellular changes that could correlate with decreased cell viability; activation of the caspase enzyme cascade is an early step in apoptosis events in epithelial cells. We measured the level of caspase-3 activity in rat intestinal tissue isolated 60 min after apical exposure of peptides 250 or 640 at concentrations shown to decrease blood glucose (
A number of agents have been explored to increase intestinal paracellular flux for the purposes of enhancing the oral delivery of biopharmaceuticals; quillaja saponin, dipotassium glycyrrhizinate, 18β-glycyrrhetinic, sodium caprate, taurine, and alkylmaltosides are just a few of the agents that have been described. In general, these agents are typically screened using in vitro cell systems such as Caco-2 monolayers or isolated intestinal tissues. Some of these agents, like palmitoyl carnitine, initially show promise but ultimately their benefits are correlated with lytic effects on the cell membrane and reduced cell viability. Sodium caprate, a medium chain fatty acid present in human milk, has been even been approved as an absorption-enhancing agent in a rectal ampicillin suppository. While caprate was shown to cause TJ dilations to enhance paracellular permeability in vitro, the efficacy of caprate in vivo for its actions in man are better correlated with non-specific damage to the rectal mucosa than paracellular permeability modification. At present, there are no approved agents designed to enhance paracellular transport of a biopharmaceutical following oral delivery.
Toxicity, primarily based upon an uncertainty of their mechanism of action (or actions), seems to be a central element that limits the identification of agents to safely enhance paracellular transport of a biopharmaceutical following oral delivery. With this in mind, recent studies have suggested that caprate can alter expression of the TJ component tricellulin, to increase paracellular flux through tri-cellular contracts in the epithelium. This finding may explain the in vitro benefit of caprate as it is similar to the possible increase in paracellular uptake in vitro and in vivo induced by a peptide that emulates an extracellular loop domain of the TJ protein claudin 1. Therefore, methods to selectively disorganize tri-cellular TJ contacts may provide a potential mechanism of action to safely and effectively increase paracellular permeability. We have taken one such approach to identify an agent with a defined mechanism of action that could transiently open intestinal TJs to enhance the paracellular uptake of a biopharmaceutical. Our approach is based upon findings made initially by Papenheimer that demonstrated intestinal epithelium top have an endogenous nutrient-activated mechanism to increase paracellular permeation of solutes. Subsequent studies showed that this increase in paracellular permeation was due to an increase in myosin light chain (MLC) phosphorylation.
Validation of MLC phosphorylation in controlling TJ-mediated solute permeability was initially validated using a rationally designed, stable, membrane permeable inhibitor of MLC kinase (PIK) peptide that was shown to be effective in models of chronic epithelial inflammation. Presently, our goal was to identify membrane-permeable, stable, selective inhibitors of MLC phosphatase (MLCP) that counterbalances the actions of residual MLC kinase activity (
Recent studies have validated the approach of using stable, membrane permeable peptides to disrupt an interfacial contact site and alter protein phosphatase 1 in living cells. As previously shown for MLPC modulation with a membrane-permeant peptide designed to target the RVxF-type PP1-binding motif and other cell membrane penetrating peptides, the PIP peptides examined in our studies did not show any cytotoxic actions in vitro or in vivo. This is in striking contrast to microcystins, a class of cyclic heptapeptide hepatoxins that inhibit multiple PP1 along with other Ser/Thr protein phosphatases by binding to a common site; illnesses associated with microcystin intoxication are related to non-specific actions resulting from increased phosphorylation of many proteins. Our results demonstrate the feasibility of enhancing the oral uptake of biopharmaceuticals by selectively inhibiting MLCP activity by targeting interfacial contacts between MLCP and specific regulatory proteins that do not induce cytotoxicity, possibly due to their specific actions.
Investigations over the last 20 years have demonstrated Ca2+/calmodulin to activate MLCK activity while Rho kinase and protein kinase C regulate MLCP through MYPT1 and CPI-17, respectively. PIP peptide 250 had less dynamic actions and opened TJ structures to transport larger solutes when compared to the actions of peptide 640. This data suggests that suppression of MLCP through a Rho kinase-related mechanism results in a more durable and extensive modification of TJ function than those mediated by CPI-17 (
The PIP peptides identified and tested in these studies have provided a proof of principle outcome to support several concepts regarding the regulation of MLC phosphorylation. 1) Peptides designed to disrupt protein-protein interactions between PP1 and its regulatory proteins CPI-17 and MYPT1 can transiently increase MLC phosphorylation. 2) Increased MLC phosphorylation induced by these peptides can increase the paracellular flux of macromolecules, 3) Regulation of paracellular permeability changes induced by these peptides designed to disrupt protein-protein interactions between PP1 and its regulatory proteins CPI-17 and MYPT1 is rapid and reversible. 4) Changes in MLC phosphorylation associated with these dynamic effects on paracellular barrier properties are not associated with or lead to cell toxicity. This last point is important in the consideration of next steps. While the PIP peptides 640 and 250 are effective, apparently specific, and non-toxic, the concentrations required for their function is in the mM range. This is actually not a significant issue since achieving these concentrations at local, topical applications where a biopharmaceutical is positioned simultaneously is readily achieved. Optimization of these PIP peptides to decrease the concentration required is one area of future interest. Such an effort will require multiple and iterative efforts to minimize the peptide structure while retaining target specificity and actions as well as increasing the efficiency of membrane permeability to reach the required intracellular target. These efforts may benefit from the use of stable phospho-amino acid analogues rather than the use of negatively charged amino acids to emulate these required functional elements.
Overall, our studies demonstrate that peptides rationally designed to block interactions of CPI-17 or MYPT1 with PP1 (MLCP) can produce distinct pharmacological outcomes with regard to TEER and paracellular transport. While CPI-17 is widely expressed in smooth muscle, this data is the first to suggest its functional role in polarized epithelial cells. Additionally, our results suggest that separate regulatory mechanisms may exist that allow CPI-17 and MYPT1 to open TJs dynamically to varying extents and rates. Finally, we have shown that manipulation of MLCP function using peptides designed to increase MLCP activity can be applied to the pharmaceutically relevant issue increasing the oral bioavailability of insulin.
| Number | Date | Country | Kind |
|---|---|---|---|
| 1410507.6 | Jun 2014 | GB | national |
| Number | Date | Country | |
|---|---|---|---|
| Parent | 15314424 | Nov 2016 | US |
| Child | 16842408 | US |
