LONG-ACTING NATRIURETIC PEPTIDES AND USES THEREOF

Information

  • Patent Application
  • 20240174727
  • Publication Number
    20240174727
  • Date Filed
    October 19, 2023
    a year ago
  • Date Published
    May 30, 2024
    6 months ago
Abstract
The present invention relates to Atrial Natriuretic Peptide (ANP) polypeptides and methods of treatment with ANP polypeptides.
Description
REFERENCE TO SEQUENCE LISTING SUBMITTED ELECTRONICALLY

The disclosure is being filed along with a Sequence Listing in ST.26 XML format. The Sequence Listing is provided as a file titled “30262_US_seqlisting.xml” created 3 Oct. 2023 and is 410.8 KB in size. The Sequence Listing information in the ST.26 XML format is incorporated herein by reference in its entirety.


FIELD OF THE INVENTION

This disclosure relates generally to biology and medicine, and more particularly it relates to peptides that are natriuretic peptide analogs, especially long-acting atrial natriuretic peptide (ANP) polypeptides, that bind to natriuretic peptide receptors, such as the NPR-A, thereby functioning as NPR-A agonists and exhibit improved stability. The disclosure further relates to compositions including the same and their use in treating cardiovascular conditions, diseases or disorders.


BACKGROUND

There is an unmet medical need for new and improved treatments for Heart Failure (HF). Currently available therapies are intended to slow down disease progression and improve symptoms, and rely on hemodynamic changes to reduce the workload of the failing heart. These therapies include agents intended to: (a) reduce heart rate, such as beta blockers and Hyperpolarization-activated cyclic nucleotide-gated (HCN) channel blockers such as ivabradine; (b) reduce blood pressure, such as angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARB), mineralocorticoid receptor antagonists (MRA), and ARB and Neprilysin (NEP) inhibitor combination (sacubitril/valsartan (ENTRESTO®)); and/or (c) treat or prevent volume overload, such as diuretics and MRA. These treatments, however, do not directly treat the heart, and have practical limitations, such as requiring dose titration and monitoring for hypotension. In addition, even with these existing treatment options available, all HF patients, even those who are mildly symptomatic are at high risk of dying. See, e.g., Ahmed A, A propensity matched study of New York Heart Association class and natural history end points in heart failure, AM. J. CARDIOL. 2007; 99(4):549-553. Thus, new and improved HF treatments are needed.


Natriuretic peptides (NPs) are a class of endogenous hormones which confer cardiovascular protection through regulation of body fluid homeostasis. They include four structurally related peptide hormones: Atrial Natriuretic Peptide (ANP), Brain Natriuretic Peptide (BNP), C-type Natriuretic Peptide (CNP) and Dendroaspis Natriuretic Peptide (DNP). Three subtypes of natriuretic peptide receptors (NPR) have been described and include NPR-A, NPR-B and NPR-C.


Wild-type human ANP is a 28 amino acid peptide having a 17 amino acid loop formed by an intramolecular disulfide linkage between two cysteine residues present at positions 7 and 23. It is a cardiac hormone that is part of the body's natural defense against hypoxia and pathological cardiac wall stress. ANP is released in response to myocardial wall stress and elicits natriuretic, diuretic, and vasodilatory effects. ANP acts through the NPR-A to activate the pGC-cGMP pathway and increase intracellular cGMP levels. NPR-A agonists have direct anti-hypertrophic and anti-fibrotic effects in the heart, improve lung function, and can have beneficial effects on glucose metabolism and energy metabolism. ANP treatment can translate into improvements in cardiac filling pressures, promote beneficial cardiac remodeling and improve diastolic function, and exert cardioprotective effects in the heart, vasculature, lungs and kidneys.


However, wild-type ANP has a rapid blood circulation clearance, which may be attributed to its binding to natriuretic peptide receptor C (NPR-C) with subsequent internalization and lysosomal proteolysis, proteolytic cleavage by endopeptidases and renal secretion. Human ANP has an in vivo half-life of only several minutes. Urodilatin, a naturally occurring amino terminal extended form of ANP is more resistant to enzymatic degradation, yet also has an in vivo half-life of only about 6 min. Polypeptides with such short half-life require administration by continuous intravenous infusion, typically in a hospital or other medical care facility, which often results in inconvenience for individuals receiving the polypeptide and in short-term efficacy, typically in a hospital or other medical care facility. Short-term intravenous infusion of recombinant ANP (carperitide) has been approved in Japan and demonstrated some acute benefits. However, short-term infusions for about 48 h showed no long-term outcome benefits.


Several peptide half-life extension technologies exist, for example, peptide conjugation to a fatty acid moiety, to recombinant human serum albumin (rHSA) or bovine serum albumin (BSA), to a pharmaceutically acceptable polymer, such as polymeric sequence of amino acids (XTEN), to unsulfated heparin-like carbohydrate polymer (HEP) or hydroxyl ethyl starch (HES), to a llama heavy-chain antibody fragments (VHH), pegylation, and Fc conjugation, (see e.g. Sleep, D. Epert Opin Drug Del (2015) 12, 793-812; Podust V N et. al. J Control. Release, 2015; ePUB; Hey, T. et. al. in: R. Kontermann (Ed.), Therapeutic Proteins: Strategies to Modulate their Plasma Half-Lives, Wiley-VCH Verlag Gmbh & Co. KGaA, Weinheim, Germany, 2012, pp 117-140; DeAngelis, P L, Drug Dev Delivery (2013) January, Dec. 31, 2012.


Efforts have been made to prepare ANP analogs and derivatives that mimic the biological activity of native ANP and/or have improved stability. For example, EP465097; U.S. Pat. Nos. 4,607,023; 5,212,286; 5,434,133; 6,525,022; 8,058,242; 9,193,777; 10,947,289; 11,312,758; WO 1988/03537; WO 1998/45329; WO 2004/011498; and WO 2018/175534 describe various ANP analogs and derivatives with greater stability. U.S. Pat. No. 5,204,328 describes ANP analogs containing N-alkylated amino acids to protect the peptide from enzymatic degradation. U.S. Pat. No. 6,525,022 describe ANP analogs that have equal binding affinity for NPR-A but decreased affinity for NPR-C. WO 1998/45329 describes ANP derivatives in which a lipophilic substituent is linked to the peptide. WO 2004/011498 describes ANP derivatives comprising a reactive entity coupled to the peptide that renders the peptide capable of forming a peptide-blood component conjugate. U.S. Pat. No. 9,193,777 describes ANP analogs that contain a 12 amino acid C-terminus extension based upon a familial ANP gene frameshift mutation. U.S. Pat. No. 10,947,289 describes glyco-modified ANP derivatives in which a sugar substance is linked to the peptide. WO 2008/154226 describes ANP fusion proteins linked to an antibody Fc fragment.


Nevertheless, a need remains for alternative treatment options. There is a need for therapies that improve long-term outcomes, including increased survival and reduced hospitalization rates. There is also a need for therapies that improve cardiac function, with the potential to modify or reverse the disease. There is also a need for therapies which improve quality of life (QoL) in patients with advanced disease. There is also a need for therapeutic agents available for use with sufficiently extended duration of action to allow for dosing as infrequently as once a day, thrice-weekly, twice-weekly or once a week. The present invention seeks to meet one or more of these critical unmet needs.


SUMMARY OF INVENTION

Provided herein are ANP polypeptides that bind to and agonize NPR-A and have natriuretic, diuretic and vasorelaxant activity. Moreover, the ANP polypeptides described herein have extended duration of action at NPR-A allowing for dosing as infrequently as once-a-day, thrice-weekly, twice-weekly or once-a-week. The ANP polypeptides described herein also exhibit desirable developability profiles making them suitable for use in therapeutic applications. In this manner, the ANP polypeptides described herein can be useful in chronic treatment to lower blood pressure, reduce pathological wall stress and improve adverse cardiac remodeling, as well as have beneficial effects on lung congestion.


Thus, the present disclosure also provides methods of using ANP polypeptides to treat or prevent cardiovascular disease (CVD) and related conditions, including in particular Heart Failure (HF). Preferred ANP polypeptides and methods of the present invention reduce the risk of CV-related death or HF-related hospitalization, reduce the risk of myocardial infarction (MI) or stroke, reduce the probability of a need for left ventricular assist device (LVAD) or cardiac transplant, improve cardiac function and structure, and/or improve the symptoms and physical limitations associated with HF, leading to improvements in QoL.


In one embodiment, provided herein is a polypeptide of Formula I comprising:











(SEQ ID NO: 3)



X1X2X3RSSCFX9X10X11IX13RIGX17X18SGLGCPSX26RX28X29,






wherein:

    • X1 is absent, S or E,
    • X2 is absent, L, K, 4-Pal, H or E,
    • X3 is absent, R, β-Ala, P, K, E or G,
    • X9 is G, 4-Pal or H,
    • X10 is G, K, R or Dap,
    • X11 is R, K, G or Dap,
    • X13 is D or G,
    • X17 is A, H, Dap, K, R or Om,
    • X18 is Q, Y or 4-Pal,
    • X26 is F or L,
    • X28 is Y, H or 4-Pal, and
    • X29 is either absent or selected from











GGP,







(SEQ ID NO: 4)



SGAPPPE,







(SEQ ID NO: 5)



KITAKEDE,







(SEQ ID NO: 6)



GPSSGAPPPE,







(SEQ ID NO: 7)



GPSSGAPPPS,







(SEQ ID NO: 8)



GGSSGAPPPS,







(SEQ ID NO: 9)



GGPSSGAPPPS,







(SEQ ID NO: 10)



KGPSSGAPPPS,







(SEQ ID NO: 11)



GGKSSGAPPPS,







(SEQ ID NO: 12)



GGPPS-Aib-KPPPK,







(SEQ ID NO: 13)



GSPSSGAPPPS,







(SEQ ID NO: 14)



RITAREDKQGYA,







(SEQ ID NO: 15)



RITAREDKQGEA,







(SEQ ID NO: 16)



GSPSSGAPPPS-PEG24-G,







(SEQ ID NO: 17)



SGSPSSGAPPPSG,







(SEQ ID NO: 18)



GGESSGEPPPSEE,







(SEQ ID NO: 19)



GSGSPSSGAPPPSG,



and







(SEQ ID NO: 20)



SGSPSSGAPPPSEEEG








    • and the C-terminal amino acid is optionally amidated,

    • or a pharmaceutically acceptable salt thereof.





In some embodiments, the polypeptide contains a disulfide linkage between the cysteines present at positions 7 and 23 (C7 and C23). In some embodiments, the polypeptide contains a thioacetal linkage between the cysteines present at positions 7 and 23 (C7 and C23).


In another embodiment, a polypeptide of Formula I, or a pharmaceutically acceptable salt thereof, is conjugated to a fatty acid. For instance, in some embodiments, the polypeptide of Formula I, or a pharmaceutically acceptable salt thereof, further comprises a fatty acid conjugated to the amino acid present at the N terminus of the polypeptide and comprises a basic structure from an amino-terminus (N-terminus) to a carboxy-terminus (C-terminus) of Formula II:











(SEQ ID NO: 21)



fatty acid-Z1-Z2-Z3-X1X2X3RSSCFX9X10X11IDRI







GX17X18SGLGCX24SX26RX28X29,








    • wherein the fatty acid is a C16-C26 fatty acid and is conjugated to the amino acid present at the N terminus of the polypeptide through a structure Z1-Z2-Z3, wherein

    • Z1 comprises an amino acid selected from γGlu, E and β-Ala,

    • Z2 is either absent or comprises a four to ten amino acid sequence comprising amino acids independently selected from E, K, G, P, A and S, and

    • Z3 is either absent or comprises a polyethylene glycol (PEG) or a (2-[2-(2-amino-ethoxy)-ethoxy]-acetyl) moiety.





In some embodiments, Z1 is an amino acid selected from γGu, E and β-Ala.


In some embodiments, Z2 is selected from APPSG, (EK)bG, (EP)bG, K(EK)cG, and (EK)cE, wherein b is 2, 3 or 4 and c is 1, 2, 3 or 4. For example, in some embodiments, Z2 is EKEKEKG (SEQ ID NO:22), EPEPEPG (SEQ ID NO:23), APPSG (SEQ ID NO:24), KEKEKG (SEQ ID NO:25) or EKEKEKE (SEQ ID NO:26).


In some embodiments, Z3 is selected from (polyethylene glycol)m wherein m is a whole number selected from 10 to 30 and ((2-[2-(2-amino-ethoxy)-ethoxy]-acetyl))n wherein n is selected from 2 to 10. For example, in some embodiments, Z3 is (polyethylene glycol)12 or (polyethylene glycol)24 or ((2-[2-(2-amino-ethoxy)-ethoxy]-acetyl))4 or (2-[2-(2-amino-ethoxy)-ethoxy]-acetyl))6 or (2-[2-(2-amino-ethoxy)-ethoxy]-acetyl))8.


In another embodiment, a pharmaceutical composition is provided that includes a polypeptide, or a pharmaceutically acceptable salt thereof, as described herein and a pharmaceutically acceptable carrier, diluent or excipient.


In another embodiment, provided herein is a method for using a polypeptide or a pharmaceutically acceptable salt thereof described herein to treat or prevent a cardiovascular disease (CVD) and related conditions. Such methods can include at least a step of administering to an individual in need thereof an effective amount of a polypeptide described herein, or a pharmaceutically acceptable salt thereof. In some instances, the CVD is heart failure (HF), in particular it is Heart Failure with preserved Ejection Factor (HfpEF).


In another embodiment, a polypeptide, or a pharmaceutically acceptable salt thereof, as described herein is provided for use in therapy.


In another embodiment, a polypeptide, or a pharmaceutically acceptable salt thereof, as described herein is provided for use in treating or preventing a CVD. In some instances, the CVD is HF, in particular it is HfpEF.


In another embodiment, a polypeptide, or a pharmaceutically acceptable salt thereof, as described herein is provided for use in manufacturing a medicament for treating or preventing a CVD. In some instances, the CVD is HF, in particular it is HfpEF.







DETAILED DESCRIPTION

Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of skill in the art to which the disclosure pertains. Although any methods and materials similar to or equivalent to those described herein can be used in the practice or testing of the ANP polypeptides, pharmaceutical compositions, and methods, the preferred methods and materials are described herein.


Moreover, reference to an element by the indefinite article “a” or “an” does not exclude the possibility that more than one element is present, unless the context clearly requires that there be one and only one element. The indefinite article “a” or “an” thus usually means “at least one.”


As used herein, “about” means within a statistically meaningful range of a value or values such as, for example, a stated concentration, length, molecular weight, pH, sequence identity, time frame, temperature or volume. Such a value or range can be within an order of magnitude typically within 20%, more typically within 10%, and even more typically within 5% of a given value or range. The allowable variation encompassed by “about” will depend upon the particular system under study, and can be readily appreciated by one of skill in the art.


As used herein, and in reference to one or more of the ANP receptors, “activity,” “activate,” “activating” and the like means a capacity of a compound, such as ANP polypeptides described herein, to bind to and induce a response at the receptor(s), as measured using assays known in the art, such as the in vitro assays described below.


As used herein, “ANP polypeptide” means an ANP analog having structural similarities with, but some differences from, naturally occurring ANP, especially rat ANP (SEQ ID NO:1) or human ANP (SEQ ID NO:2). The ANP polypeptides described herein include amino acid sequences resulting in the polypeptides having affinity for and activity at the NPR-A receptor. The term “ANP polypeptide” also includes acylated or otherwise derivatized ANP analog.


As used herein, “conservative substitution” means a variant of a reference peptide or polypeptide that is identical to the reference molecule, except for having one or more conservative amino acid substitutions in its amino acid sequence. In general, a conservatively modified variant includes an amino acid sequence that is at least about 70%, 75%, 80%, 85%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98% or 99% identical to a reference amino acid sequence. More specifically, a conservative substitution refers to substitution of an amino acid with an amino acid having similar characteristics (e.g., charge, side-chain size, hydrophobicity/hydrophilicity, backbone conformation and rigidity, etc.) and having minimal impact on the biological activity of the resulting substituted peptide or polypeptide. Conservative substitutions of functionally similar amino acids are well known in the art and thus need not be exhaustively described herein.


As used herein, a “C16-C26 fatty acid” means a carboxylic acid having between 16 and 26 carbon atoms. The C16-C26 fatty acid suitable for use herein can be a linear fatty acid or a branched fatty acid. The linear C16-C26 fatty acid suitable for use herein can be a saturated monoacid or a saturated diacid. As used herein, “saturated” means the fatty acid contains no carbon-carbon double or triple bonds.


As used herein, “effective amount” means an amount, concentration or dose of one or more ANP polypeptides described herein, or a pharmaceutically acceptable salt thereof which, upon single or multiple dose administration to an individual in need thereof, provides a desired effect in such an individual under diagnosis or treatment. An effective amount is also one in which any toxic or detrimental effects of the polypeptide are outweighed by the therapeutically beneficial effects. An effective amount can be determined by one of skill in the art through the use of known techniques and by observing results obtained under analogous circumstances. In determining the effective amount for an individual, a number of factors are considered including, but not limited to, the species of mammal; its size, age and general health; the specific disease or disorder involved; the degree of or involvement of or the severity of the disease or disorder; the response of the individual patient; the particular ANP polypeptide administered; the mode of administration; the bioavailability characteristics of the preparation administered; the dose regimen selected; the use of concomitant medication; and other relevant circumstances.


As used herein, “extended duration of action” means that binding affinity and activity for an ANP polypeptide continues for a period of time greater than native human ANP polypeptide, allowing for dosing at least as infrequently as once daily, thrice-weekly, twice-weekly, once-weekly, or less than once weekly such as biweekly (once in two weeks) or even monthly. The time action profile of the ANP polypeptide may be measured using known pharmacokinetic test methods such as those utilized in the examples below.


As used herein, “half-life” or “t½” means a time it takes for one-half of a quantity of a compound, such as native ANP or an ANP polypeptide herein, to be removed from a fluid or other physiological space such as serum or plasma of an individual by biological processes. Alternatively, t½ also can mean a time it takes for a quantity of such a compound to lose one-half of its pharmacological, physiological or radiological activity.


As used herein, “half-maximal effective concentration” or “EC50” means a concentration of polypeptide that results in 50% activation/stimulation of an assay endpoint, such as a dose-response curve (e.g., cGMP signaling pathway).


As used herein, “in combination with” means administering at least one of the ANP polypeptides herein either simultaneously, sequentially or in a single combined formulation with one or more additional therapeutic agents.


As used herein, “individual in need thereof” means a mammal, such as a human, with a condition, disease, disorder or symptom requiring treatment or therapy, including for example, those listed herein.


As used herein, “long-acting” means that binding affinity and activity of an ANP polypeptide herein continues for a period of time greater than native, human ANP (SEQ ID NO:2), allowing for dosing at least as infrequently as once daily or even thrice-weekly, twice-weekly, or once-weekly. The time action profile of the ANP polypeptides may be measured using known pharmacokinetic test methods such as those described in the Examples below.


As used herein, the term “pharmaceutically acceptable salt” refers to derivatives of the polypeptides herein, where a polypeptide herein is modified by making acid or base salts thereof. Pharmaceutically acceptable salts, and processes for preparing the same, are well known in the art (see, e.g., Remington: The Science and Practice of Pharmacy, L. V. Allen, Ed., 22nd Edition, Pharmaceutical Press, 2012). By way of example, pharmaceutically acceptable salts include, but are not limited to, mineral or organic acid salts of basic residues such as amines, or alkali or organic salts of acidic residues such as carboxylic acids. Pharmaceutically acceptable salts include the conventional non-toxic salts or the quaternary ammonium salts of a polypeptide herein formed, for example, from non-toxic inorganic or organic acids. Such conventional nontoxic salts include those derived from inorganic acids such as hydrochloric, hydrobromic, sulfuric, sulfamic, phosphoric, nitric and the like; and the salts prepared from organic acids such as acetic, propionic, succinic, glycolic, stearic, lactic, malic, tartaric, citric, ascorbic, pamoic, maleic, hydroxymaleic, phenylacetic, glutamic, benzoic, salicylic, sulfanilic, 2-acetoxybenzoic, fumaric, toluenesulfonic, methanesulfonic, ethane disulfonic, oxalic, isethionic, and the like. Pharmaceutically acceptable salts are those forms of a polypeptide herein, suitable for use in contact with the tissues of human beings and animals without excessive toxicity, irritation, allergic response, or other problem or complication, commensurate with a reasonable benefit/risk ratio. Pharmaceutically acceptable salt forms of a polypeptide herein can be synthesized to contain a basic or acidic moiety by conventional chemical methods. Generally, such salts are, for example, prepared by reacting the free acid or base forms of the polypeptide with a stoichiometric amount of the appropriate base or acid in water or in an organic solvent, or in a mixture of the two; generally, nonaqueous media like ether, ethyl acetate, ethanol, isopropanol, or acetonitrile are preferred (see, e.g., Stahl et al., “Handbook of Pharmaceutical Salts: Properties, Selection and Use” (Wiley-VCH 2nd ed. 2011)).


The term, “pharmaceutical composition,” as used herein, refers to a composition having an effective amount of one or more peptides herein in combination with other chemical components, such as binders, carriers, diluents, lubricants, pharmaceutical flow agents, and/or other excipients, especially a pharmaceutically acceptable carrier.


As used herein, “polypeptide” or “peptide” means a polymer of amino acid residues comprising two (2) or more amino acids and/or amino acid derivatives which, in general, are linked via peptide bonds. The term applies to polymers comprising naturally occurring amino acids and polymers comprising one or more non-naturally occurring amino acids. Embodiments may include modifications or amino acid derivatives, including post-translational modifications such as, phosphorylation, hydroxylation, sulfonation, palmitoylation, glycosylation and disulfide formation.


As used herein, “treat,” “treating,” “to treat” and the like mean managing and caring for an individual having a condition, disease, disorder or symptom for which an ANP polypeptide administration is indicated for the purpose of attenuating, restraining, slowing, stopping or reversing the progression or severity of the condition, disease, disorder or symptom. Treating includes administering an ANP polypeptide herein or composition containing an ANP polypeptide herein to the individual to prevent the onset of symptoms or complications, alleviating the symptoms or complications, or eliminating the condition, disease, disorder or symptom. Treating includes administering an ANP polypeptide or composition containing an ANP polypeptide herein to the individual to result in such as, for example, increased angiogenesis, increased vascular compliance, increased glomerular filtration rate, decreased blood pressure, decreased (or prevented) inflammation and/or reduced (or prevented) fibrosis in the heart, kidney, liver or lung).


In one embodiment, provided herein is a polypeptide of Formula I:











(SEQ ID NO: 3)



X1X2X3RSSCFX9X10X11IX13RIGX17X18SGLGCPSX26RX28X29,






wherein:

    • X1 is absent, S or E,
    • X2 is absent, L, K, 4-Pal, H or E,
    • X3 is absent, R, β-Ala, P, K, E or G,
    • X9 is G, 4-Pal or H,
    • X10 is G, K, R or Dap,
    • X11 is R, K, G or Dap,
    • X13 is D or G,
    • X17 is A, H, Dap, K, R or Om,
    • X18 is Q, Y or 4-Pal,
    • X26 is F or L,
    • X28 is Y, H or 4-Pal, and
    • X29 is either absent or selected from











GGP,







(SEQ ID NO: 4)



SGAPPPE,







(SEQ ID NO: 5)



KITAKEDE,







(SEQ ID NO: 6)



GPSSGAPPPE,







(SEQ ID NO: 7)



GPSSGAPPPS,







(SEQ ID NO: 8)



GGSSGAPPPS,







(SEQ ID NO: 9)



GGPSSGAPPPS,







(SEQ ID NO: 10)



KGPSSGAPPPS,







(SEQ ID NO: 11)



GGKSSGAPPPS,







(SEQ ID NO: 12)



GGPPS-Aib-KPPPK,







(SEQ ID NO: 13)



GSPSSGAPPPS,







(SEQ ID NO: 14)



RITAREDKQGYA,







(SEQ ID NO: 15)



RITAREDKQGEA,







(SEQ ID NO: 16)



GSPSSGAPPPS-PEG24-G,







(SEQ ID NO: 17)



SGSPSSGAPPPSG,







(SEQ ID NO: 18)



GGESSGEPPPSEE,







(SEQ ID NO: 19)



GSGSPSSGAPPPSG,



and







(SEQ ID NO: 20)



SGSPSSGAPPPSEEEG








    • and the C-terminal amino acid is optionally amidated,

    • or a pharmaceutically acceptable salt thereof.





The structural features described herein result in the polypeptides having sufficient activity at NPR-A, and also result in the polypeptides having many other beneficial attributes relevant to their developability as therapeutic treatments, including for improving solubility of the analogs in aqueous solutions, improving chemical and physical formulation stability, extending the pharmacokinetic profile, and minimizing potential for immunogenicity.


In some embodiments, X1 is selected from S and E. In some embodiments, X2 is selected from K and 4-Pal. In some embodiments, X3 is selected from R, β-Ala, P and K. In some embodiments, X9 is G, 4-Pal or H. In some embodiments, X10 is selected from G, K, R and Dap. In some embodiments, X11 is selected from R and K. In some embodiments, X13 is selected from D and G. In some embodiments, X17 is H, K, R, Dap or Om. In some embodiments, X18 is selected from Q and Y. In some embodiments, X28 is F or L. In some embodiments, X28 is H or 4-Pal. In some embodiments, X29 is absent or selected from











(SEQ ID NO: 9)



GGPSSGAPPPS,







(SEQ ID NO: 11)



GGKSSGAPPPS



and







(SEQ ID NO: 13)



GSPSSGAPPPS






In some embodiments, X1 is selected from S and E; X2 is selected from K and 4-Pal; X3 is selected from R, β-Ala, P and K; X9 is G, 4-Pal or H; X10 is selected from G, K, R and Dap; X11 is selected from R and K; X13 is selected from D and G; X17 is H, K, R, Dap or Om; X18 is selected from Q and Y; X26 is F or L; X28 is H or 4-Pal; and X29 is absent or selected from GGPSSGAPPPS (SEQ ID NO:9), GGKSSGAPPPS (SEQ ID NO:11) and GSPSSGAPPPS (SEQ ID NO:13).


In some embodiments, X1 is selected from S and E. In some embodiments, X2 is selected from K and 4-Pal. In some embodiments, X3 is selected from R, β-Ala and K. In some embodiments, X9 is G. In some embodiments, X10 is selected from G and K. In some embodiments, X11 is selected from R and K. In some embodiments, X13 is selected from D and G. In some embodiments, X17 is H. In some embodiments, X18 is selected from Q and Y. In some embodiments, X26 is F. In some embodiments, X28 is H. In some embodiments, X29 is absent or selected from GGPSSGAPPPS (SEQ ID NO:9), GGKSSGAPPPS (SEQ ID NO:11) and GSPSSGAPPPS (SEQ ID NO:13).


In some embodiments, X1 is selected from S and E, X2 is selected from K and 4-Pal, X3 is selected from R, β-Ala and K, X9 is G, X10 is selected from G and K, X11 is selected from R and K, X13 is selected from D and G, X17 is H, X18 is selected from Q and Y, X26 is F, X28 is H, and X29 is absent or selected from GGPSSGAPPPS (SEQ ID NO:9), GGKSSGAPPPS (SEQ ID NO:11) and GSPSSGAPPPS (SEQ ID NO:13).


In some embodiments, the polypeptide contains a disulfide linkage between the cysteines present at positions 7 and 23 (C7 and C23) of SEQ ID NO:3. In some embodiments, the polypeptide contains a thioacetal linkage between the cysteines present at positions 7 and 23 (C7 and C23).


In some embodiments, a polypeptide described herein is conjugated to a fatty acid.


In another embodiment, a polypeptide of Formula I, or a pharmaceutically acceptable salt thereof, is conjugated to a fatty acid. For instance, in some embodiments, it further comprises a fatty acid conjugated to the amino acid present at the N terminus of the polypeptide, and comprises a basic structure from an amino-terminus (N-terminus) to a carboxy-terminus (C-terminus) of Formula II:











(SEQ ID NO: 21)



fatty acid-Z1-Z2-Z3-X1X2X3RSSCFX9X10







X11IDRIGX17X18SGLGCX24SX26RX28X29,








    • wherein the fatty acid is a C16-C26 fatty acid and is conjugated to the amino acid present at the N terminus of the polypeptide through a structure Z1-Z2-Z3,

    • wherein Z1 comprises an amino acid selected from γGlu, E and β-Ala,

    • Z2 is either absent or comprises a four to ten amino acid sequence comprising amino acids independently selected from E, K, G, P, A and S, and

    • Z3 is either absent or comprises a polyethylene glycol or a (2-[2-(2-amino-ethoxy)-ethoxy]-acetyl) moiety.





The polypeptides of Formula II described herein include a fatty acid moiety conjugated, for example by way of a linker comprising a structure of Z1 or Z1-Z2 or Z1-Z3 or Z1-Z2-Z3, to the amino acid present at the N terminus of SEQ ID NO:3. Such a conjugation is sometimes referred to as acylation. In embodiments, where X1 is absent, the fatty acid, for example by way of a linker comprising a structure of Z1 or Z1-Z2 or Z1-Z3 or Z1-Z2-Z3, is conjugated to the amino acid present at position X2 of SEQ ID NO:3. In embodiments, where both X1 and X2 are absent, the fatty acid is conjugated to the amino acid present at position X3 of SEQ ID NO:3 (for example by way of a linker comprising a structure of Z1 or Z1-Z2 or Z1-Z3 or Z1-Z2-Z3). In embodiments, where both X1, X2 and X3 are absent, the fatty acid is conjugated to the amino acid present at position X4 of SEQ ID NO:3 (for example by way of a linker comprising a structure of Z1 or Z1-Z2 or Z1-Z3 or Z1-Z2-Z3). The fatty acid, and in certain embodiments the linker, act as albumin binders, and provide a potential to generate long-acting polypeptides.


The polypeptides described herein utilize a C16-C26 fatty acid that can be chemically conjugated to the functional group of an amino acid either by a direct bond or by a linker. The length and composition of the fatty acid impacts half-life of the polypeptides, their potency in in vivo animal models, and their solubility and stability. Conjugation to a C16-C26 fatty acid results in ANP polypeptides that exhibit desirable half-life, desirable potency in in vivo animal models, and desirable solubility and stability characteristics.


In some embodiments, the fatty acid is a C16-C22 saturated fatty monoacid or diacid. Examples of saturated C16-C22 fatty acids for use herein include, but are not limited to, palmitic acid (hexadecanoic acid) (C16 monoacid), hexadecanedioic acid (C16 diacid), margaric acid (heptadecanoic acid) (C17 monoacid), heptadecanedioic acid (C17 diacid), stearic acid (C18 monoacid), octadecanedioic acid (C18 diacid), nonadecylic acid (nonadecanoic acid)(C19 monoacid), nonadecanedioic acid (C19 diacid), arachadic acid (eicosanoic acid)(C20 monoacid), eicosanedioic acid (C20 diacid), heneicosylic acid (heneicosanoic acid)(C21 monoacid), heneicosanedioic acid (C21 diacid), behenic acid (docosanoic acid)(C22 monoacid), docosanedioic acid (C22 diacid), including branched and substituted derivatives thereof.


In certain instances, the C16-C22 fatty acid can be a saturated C16 monoacid, a saturated C16 diacid, a saturated C18 monoacid, a saturated C18 diacid, a saturated C20 monoacid, a saturated C20 diacid, and branched and substituted derivatives thereof.


In some embodiments, the linker can have a structure of Z1-Z2-Z3, wherein Z1 comprises an amino acid selected from γGlu, E and β-Ala; Z2 is either absent or comprises a four to ten amino acid sequence comprising amino acids independently selected from E, K, G, P, A and S; and Z3 is either absent or comprises a polyethylene glycol or a (2-[2-(2-amino-ethoxy)-ethoxy]-acetyl) moiety as shown below.




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Accordingly, in some embodiments, the fatty acid is attached to Z1, and Z1 is attached to the peptide of Formula I either directly or via Z2 or via Z3 or via Z2-Z3.


In some instances, Z1 is an amino acid selected from γGlu, E and β-Ala, or a dipeptide such as γGlu-γGlu or E-γGlu, or a tripeptide such as γGlu-γGlu-γGlu. In some embodiments, Z1 is γGlu or β-Ala. In some embodiments, Z1 is γGlu.


In some embodiments, the fatty acid is attached to Z1, Z1 is attached to Z2 and Z2 is attached to a peptide of Formula I either directly or via Z3. In some embodiments, Z2 is selected from APPSG, (EK)bG, (EP)bG, K(EK)cG, and (EK)cE, wherein b is 2, 3 or 4 and c is 1, 2, 3 or 4. For example, Z2 may be (EK)3G i.e. EKEKEKG, (EP)3G i.e. EPEPEPG, K(EK)2G i.e. KEKEKG or (EK)3E i.e. EKEKEKE. In some embodiments, Z2 is EKEKEKG.


In some embodiments, the fatty acid is attached to Z1, Z1 is attached to Z2, Z2 is attached to Z3, and Z3 is attached to a peptide of Formula I. In some embodiments, Z3 is selected from (polyethylene glycol)m wherein m is a whole number selected from 10 to 30 and ((2-[2-(2-amino-ethoxy)-ethoxy]-acetyl))n wherein n is selected from 2 to 10. For example, in some embodiments, Z3 is (polyethylene glycol)12 or (polyethylene glycol)24 or ((2-[2-(2-amino-ethoxy)-ethoxy]-acetyl))4 or -(2-[2-(2-amino-ethoxy)-ethoxy]-acetyl))6 or (2-[2-(2-amino-ethoxy)-ethoxy]-acetyl))8.


In some embodiments, the fatty acid is a branched C25 triacid having the following structure (also referred to herein as Bifurcated Fatty Acid or “BFA”):




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The BFA exists in two enantiomeric forms.




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It was surprisingly discovered that a purified enantiomer (EN2) of the BFA provides tighter binding to albumin as compared to the other enantiomer (EN1) or the racemic mixture, and results in a more desirable PK profile in rats. The isolation of purified EN2 (Preparation 8B) from the racemic mixture (Preparation 8) is described below. It was further discovered that for conserving the stability of the enantiomerically pure BFA during the coupling step to the peptide, it is essential to attach it to a Z1, wherein the Z1 comprises β-Ala or γGlu or E.




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Thus, in one aspect, the present invention includes a purified enantiomer EN2 of the BFA, attached to β-Ala or to γGlu or to E. Accordingly in one embodiment, included herein is a structure in which a purified enantiomer EN2 of the BFA is attached to β-Ala. In another embodiment, included herein is a structure in which a purified enantiomer EN2 of the BFA is attached to γGlu. In another embodiment, included herein is a structure in which a purified enantiomer EN2 of the BFA is attached to E.


In some embodiments, the polypeptides of Formula II comprise a purified enantiomer EN2 of the BFA attached to β-Ala. In some embodiments, the polypeptides of Formula II comprise a purified enantiomer EN2 of the BFA attached to γGlu. In some embodiments, the polypeptides of Formula II comprise a purified enantiomer EN2 of the BFA attached to E, E-γGlu, γGlu-γGlu or γGlu-γGlu-γGlu. In some embodiments, Z2 is selected from EKEKEKG, KEKEKG and EKEKEKE. In some embodiments, Z3 is selected from (polyethylene glycol)12 and (polyethylene glycol)24.


The amino acid sequences of ANP polypeptides described herein incorporate naturally occurring amino acids, typically depicted herein using standard one letter codes (e.g., L=leucine), as well as certain other unnatural amino acids, such as 3-(4-Pyridyl)-L-alanine (4Pal), L-Omithine (Orn), L-2,3-diaminopropionic acid (Dap) and β-Ala. The structures of the non-natural amino acids appear below:




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As noted above, the ANP polypeptides described herein have structural similarities to, but many structural differences, from any of the native human natriuretic peptides. For example, when compared to native human ANP (SEQ ID NO:2), the ANP polypeptides described herein include modifications at one or more of positions 1, 2, 3, 9, 10, 11, 12, 13, 17, 18, 24, 26, 28 and 29. In some instances, ANP polypeptides described herein include modifications at each of the positions 1, 2, 3, 9, 10, 11, 12, 13, 17, 18, 24, 26, 28 and 29. In addition, in some embodiments, the ANP polypeptides contain a thioacetal (S-CH2-S) linkage between cysteines present at positions 7 and 23.


In some embodiments, the ANP polypeptides described herein include the following amino acid modifications: S or E at position 1; K or 4-Pal at position 2; R, β-Ala, P or K at position 3; G, 4-Pal or H at position 9; G, K, R or Dap at position 10; R or K at position 11; D or G at position 13; H, K, R, Dap or Om at position 17; Q or Y at position 18; F or L at position 26; H or 4-Pal at position 28; and attachments at positions 29-39 with an amino acid sequence selected from GGPSSGAPPPS (SEQ ID NO:9), GGKSSGAPPPS (SEQ ID NO:11) and GSPSSGAPPPS (SEQ ID NO:13); and conjugation to the amino acid at position 1 with a C16 to C22 fatty acid, optionally through the use of a linker comprising the structure Z1-Z2-Z3.


In certain instances, the ANP polypeptides described herein include the following amino acid modifications: S or E at position 1; K or 4-Pal at position 2; R, β-Ala or K at position 3; G at position 9; G or K at position 10; R or K at position 11; I at position 12; D or G at position 13; H at position 17; Q or Y at position 18; P at position 24; F at position 26; H at position 28; and attachments at positions 29-39 with an amino acid sequence selected from GGPSSGAPPPS (SEQ ID NO:9), GGKSSGAPPPS (SEQ ID NO:11) and GSPSSGAPPPS (SEQ ID NO:13); and conjugation to the amino acid at position 1 with a C16 to C22 fatty acid, optionally through the use of a linker comprising the structure Z1-Z2-Z3.


In some embodiments, the ANP polypeptides described herein comprise a sequence selected from any one of SEQ ID NO:28 to 167. In some embodiments, the ANP polypeptides described herein comprise a sequence selected from the group consisting of any one of SEQ ID NO:28 to 167.


In some embodiments, the ANP polypeptides described herein comprise a sequence selected from any one of SEQ ID NO:168 to 172. In some embodiments, the ANP polypeptides described herein comprise a sequence selected from the group consisting of any one of SEQ ID NO:168 to 172.


In some embodiments, the ANP polypeptides described herein comprise a sequence selected from SEQ ID NO:28, 45, 50, 51, 78, 83, 84, 97, 98, 144, 158 and 159. In some embodiments, the ANP polypeptides described herein comprise a sequence selected from the group consisting of SEQ ID NO:28, 45, 50, 51, 78, 83, 84, 97, 98, 144, 158 and 159. For instance, in one embodiment, the ANP polypeptide described herein comprises SEQ ID NO:28. In another embodiment, the ANP polypeptide described herein comprises SEQ ID NO:45. In another embodiment, the ANP polypeptide described herein comprises SEQ ID NO:50. In another embodiment, the ANP polypeptide described herein comprises SEQ ID NO:51. In another embodiment, the ANP polypeptide described herein comprises SEQ ID NO:78. In another embodiment, the ANP polypeptide described herein comprises SEQ ID NO:83. In another embodiment, the ANP polypeptide described herein comprises SEQ ID NO:84. In another embodiment, the ANP polypeptide described herein comprises SEQ ID NO:97. In another embodiment, the ANP polypeptide described herein comprises SEQ ID NO:98. In another embodiment, the ANP polypeptide described herein comprises SEQ ID NO:144. In another embodiment, the ANP polypeptide described herein comprises SEQ ID NO:158. In another embodiment, the ANP polypeptide described herein comprises SEQ ID NO:159.


In certain instances, the ANP polypeptides described herein are amidated. In some embodiments, the ANP polypeptide is an agonist of NPR-A. In addition to the changes described herein, the ANP polypeptides described herein may include one or more additional amino acid modifications, provided, however, that the polypeptides remain capable of binding to and activating NPR-A receptor.


The affinity of the ANP polypeptides described herein for the NPR-A receptor may be measured using techniques known in the art for measuring receptor binding levels, including, for example, those described in the examples below, and is commonly expressed as an inhibitory constant (Ki) value. The activity of the ANP polypeptides described herein at the NPR-A receptor also may be measured using techniques known in the art, including, for example, the in vitro activity assays described below, and is commonly expressed as an EC50 value, which is the concentration of polypeptide causing half-maximal stimulation in a dose response curve.


In further embodiments, provided herein are pharmaceutically acceptable salt forms of the ANP polypeptides. For instance, pharmaceutically acceptable salts for use herein include, but are not limited to, sodium, trifluoroacetate, hydrochloride and/or acetate salts.


In further embodiments, provided herein are pharmaceutical compositions comprising a ANP polypeptide or a pharmaceutically acceptable salt thereof, and at least one of a pharmaceutically acceptable carrier, diluent or excipient.


The ANP polypeptides described herein may be used for treating a variety of conditions, disorders, diseases or symptoms. In particular, methods are provided for treating a cardiovascular condition, disorder or disease or in an individual, where such methods include at least a step of administering to an individual in need of such treatment an effective amount of an ANP polypeptide described herein, or a pharmaceutically acceptable salt thereof, or a pharmaceutical composition comprising them. Exemplary cardiovascular conditions, diseases and disorders include, but are not limited to, acute heart failure, chronic heart failure, Heart Failure with preserved Ejection Factor (HFpEF), Heart Failure with reduced Ejection Factor (HFrEF), atherosclerosis, coronary artery disease, diabetes, stroke, hypercholesterolemia, hypertension, ischemia, vasoconstriction and ventricular hypertrophy, other heart related disorders or conditions such as stroke, hypertension, congestive heart failure, diabetic heart disease, cardio myopathy, diastolic dysfunction vasoconstriction and ventricular hypertrophy. In some embodiments, the heart disease is a condition that is or is related to cardiac senescence and/or diastolic dysfunction due to aging. In some embodiments, the ANP polypeptides described herein are used for treating HFpEF.


Another use of the ANP polypeptides herein is for treating pulmonary conditions, diseases and/or disorders. Exemplary pulmonary conditions, diseases and disorders include, but are not limited to, pulmonary hypertension and chronic obstructive pulmonary disease (COPD).


Another use of the ANP polypeptides herein is for treating renal conditions, diseases and/or disorders. Exemplary renal conditions, diseases and disorders include, but are not limited to, chronic kidney disease and diabetes nephropathy.


Such methods can include selecting an individual having a cardiovascular condition, disease or disorder or who is predisposed to the same. Alternatively, the methods can include selecting an individual having a pulmonary condition, disease or disorder or who is predisposed to the same. Alternatively, the methods can include selecting an individual having a renal condition, disease or disorder or who is predisposed to the same. In certain instances, the methods can include selecting an individual who is diabetic, hypertensive with kidney function impairment and/or obese.


Accordingly, in some embodiments, provided herein is a method for treating a CVD comprising administering to a patient in need thereof, an effective amount of an ANP polypeptide described herein or a pharmaceutically acceptable salt thereof. In some embodiments, the CVD is heart failure. In an embodiment, the CVD is HFpEF.


In some embodiments, provided herein is an ANP polypeptide or a pharmaceutically acceptable salt thereof, for use in therapy.


In some embodiments, provided herein is a use of an ANP polypeptide or a pharmaceutically acceptable salt thereof, in treating a CVD. In some embodiments, the CVD is heart failure. In an embodiment, it is HFpEF.


In some embodiments, provided herein is a use of an ANP polypeptide or a pharmaceutically acceptable salt thereof, in the manufacture of a medicament for treating a CVD. In some embodiments, the CVD is heart failure. In an embodiment, it is HFpEF.


Treatment of heart failure or HFpEF according to the present invention may be reflected in one or more of a variety of measures relevant to heart failure, including, for example: reductions in left ventricular end-diastolic pressure (LVEDP), reductions in the risk of CV death and/or heart failure hospitalization, reductions in the risk of total mortality, reductions in the risk of myocardial infarction (MI), reductions in the risk of stroke, reductions in the risk of need for left ventricular assist device (LVAD) implantation and/or cardiac transplant, improvement in symptoms and physical limitations of heart failure and/or improvement in quality of life (QoL). Certain benefits of treatment according to embodiments of the present invention may be achieved after treatment for at least 1 month. Certain benefits of treatment according to embodiments of the present invention may be achieved after treatment for at least 6 months. Certain benefits of treatment according to embodiments of the present invention may be achieved after treatment for at least 1 year.


In certain embodiments, administration of ANP polypeptides according to the present invention results in significant reductions in LVEDP after 1 year of treatment. In certain embodiments, administration of ANP polypeptides according to the present invention results in a significant reduction in global longitudinal strain (GLS). In certain embodiments, administration of ANP polypeptides according to the present invention results in at least a 3.5% reduction in GLS. In certain embodiments, administration of ANP polypeptides of the present invention results in at least a 15% reduction in risk of CV death and/or HF hospitalization. In certain embodiments, administration of ANP polypeptides of the present invention results in a significant reduction in the risk of one or more of total mortality, MI, stroke, LVAD implantation or cardiac transplant. In certain embodiments, administration of ANP polypeptides of the present invention results in a significant improvement in symptoms and physical limitations of heart failure and/or QoL.


In addition, as noted above, administration of ANP polypeptides according to certain embodiments of the disclosure is capable of providing improvements in heart failure-related measures, such as those described above, without increasing safety risks. Thus, in some embodiments, administration of ANP polypeptides according to the present invention results in no increases in safety risks such as increased hypotension; worsened renal function; electrolyte imbalances; liver dysfunction; incidence of tumors or persistent hypospermia.


The term “therapeutically effective amount” refers to the amount or dose of ANP polypeptide which provides the desired effect in the patient. In the case of ANP polypeptides with extended pharmacokinetic profiles, such a dose may be the amount given upon single or multiple dose administration. Determining an effective amount can be readily accomplished by persons of skill in the art through the use of known techniques and by observing results obtained under analogous circumstances.


With regard to a route of administration, the ANP polypeptides or pharmaceutical composition including the same can be administered in accord with known methods such as, for example, orally; by injection (i.e., intra-arterially, intravenously, intraperitoneally, intracerebrally, intracerebroventricularly, intramuscularly, intraocularly, intraportally or intralesionally), by sustained release systems, or by implantation devices. Administration of ANP polypeptides according to the present invention is typically parenteral, e.g., intravenous (IV), subcutaneous (SC or SQ) or intraperitoneal (IP). Thus, in certain embodiments of the present invention, ANP polypeptides are administered intravenously. In other embodiments of the present invention. ANP polypeptides are administered intraperitoneally. In other embodiments, ANP polypeptides are administered subcutaneously. In certain instances, the ANP polypeptides or pharmaceutical composition including the same can be administered SQ by bolus injection or continuously.


The present invention also encompasses novel intermediates and processes useful for the production of ANP polypeptides of the present invention. The intermediates and ANP polypeptides of the present invention may be prepared by a variety of procedures known in the art, including processes using chemical synthesis such as those described in the Examples below or biological expression.


With respect to chemical synthesis, one can use standard manual or automated solid-phase synthesis procedures. For example, automated peptide synthesizers are commercially available from, for example, CEM (Charlotte, North Carolina), CSBio (Menlo Park, California) and Gyros Protein Technologies Inc. (Tucson, AZ). Reagents for solid-phase synthesis are readily available from commercial sources. Solid-phase synthesizers can be used according to the manufacturer's instructions for blocking interfering groups, protecting amino acids during reaction, coupling, deprotecting and capping of unreacted amino acids.


With respect to biological expression, one can use standard recombinant techniques to construct a polynucleotide having a nucleic acid sequence that encodes an amino acid sequence for all or part of an ANP polypeptide, incorporate that polynucleotide into recombinant expression vectors, and introduce the vectors into host cells, such as bacteria, yeast and mammalian cells, to produce the ANP polypeptide. See, e.g., Green & Sambrook, “Molecular Cloning: A Laboratory Manual” (Cold Spring Harbor Laboratory Press, 4th ed. 2012). The polypeptides may readily be produced in mammalian cells such as CHO, NSO, HEK293, BHK, or COS cells; in bacterial cells such as E. coli. Bacillus subtilis, or Pseudomonas fluorescens; in insect cells, or in fungal or yeast cells, which are cultured using techniques known in the art. The vectors containing the polynucleotide sequences of interest can be transferred into the host cell by well-known methods, which vary depending on the type of cellular host. Various methods of protein purification may be employed and such methods are known in the art.


As noted above, all HF patients, even those who are mildly symptomatic are at high risk of dying. Thus, when used herein, references to a “patient in need” of a treatment for heart failure (HF) may refer to a broad range of individuals having HF, including those with a broad range disease severity as described below. The New York Heart Association (NYHA) has provided a classification scheme for the degree or severity of HF, as summarized below.













NYHA



Class
Symptoms







I
No limitation of physical activity. Ordinary physical activity does not cause



undue fatigue, palpitation, dyspnea (shortness of breath).


II
Slight limitation of physical activity. Comfortable at rest. Ordinary physical



activity results in fatigue, palpitation, dyspnea (shortness of breath).


III
Marked limitation of physical activity. Comfortable at rest. Less than ordinary



activity causes fatigue, palpitation, or dyspnea.


IV
Unable to carry on any physical activity without discomfort. Symptoms of



heart failure at rest. If any physical activity is undertaken, discomfort



increases.









In certain embodiments, the patient in need is in heart failure NYHA Class II-IV. In certain embodiments, the patient in need is in heart failure NYHA Class II. In certain embodiments, the patient in need is in heart failure NYHA Class III. In certain embodiments, the patient in need is in heart failure NYHA Class IV. In certain embodiments, the patient in need is in heart failure NYHA Class II-III.


As noted above, existing therapeutic treatment options for heart failure, including current standard of care, improve symptoms and slow down disease progression through hemodynamic mechanisms—e.g., reducing blood pressure, heart rate and/or plasma volume—to reduce the workload of the failing heart. The ANP polypeptides of the present invention, by contrast, achieve their effects through a different mechanism of action, namely, selective NPR-A binding and the activity resulting therefrom to provide biomarker (cGMP. NT-proBNP), hemodynamic (LVEDP), structural (LA Volume), and symptomatic (lung congestion, dyspnea) improvements, thus improving outcomes and QoL for HFpEF patients. Due to these different mechanisms of action, ANP polypeptides of the present invention can be administered on top of existing SoC without titration or monitoring. Thus, in certain embodiments, ANP polypeptides of the present invention may be administered in combination with one or more additional treatments for heart failure. In certain embodiments, the one or more additional treatments for heart failure are selected from administration of therapeutic agents such as anticoagulants, beta blockers, ACE inhibitors, ARBs, ARNIs, MRAs, diuretics, digitalis, digoxin, hydralazine/isosorbide dinitrate, ivabradine, ARB and NEP inhibitor combination (sacubitril/valsartan (ENTRESTO®)), statins and/or anti-glycemic agents, as well as other therapeutic agents to control comorbidities, including, but not limited to, high cholesterol, high blood pressure, atrial fibrillation and diabetes. In certain embodiments, ANP polypeptides of the present invention may be administered in combination with SGLT2 inhibitors or sGC activators.


The additional therapeutic agent can be administered simultaneously, separately or sequentially with the ANP polypeptide or pharmaceutical composition including the same. Moreover, the additional therapeutic agent can be administered with a frequency same as the ANP polypeptide or pharmaceutical composition including the same (i.e., every other day, twice a week, or weekly). Alternatively, the additional therapeutic agent can be administered with a frequency distinct from the ANP polypeptide or pharmaceutical composition including the same. In other instances, the additional therapeutic agent can be administered SQ. In other instances, the additional therapeutic agent can be administered IV. In still other instances, the additional therapeutic agent can be administered orally.


It is further contemplated that the methods may be combined with diet and exercise and/or may be combined with additional therapeutic agents other than those discussed above.


The ANP polypeptides herein can be formulated as pharmaceutical compositions, which can be administered by parenteral routes (e.g., intravenous, intraperitoneal, intramuscular, subcutaneous or transdermal). Such pharmaceutical compositions and techniques for preparing the same are well known in the art. See, e.g., Remington, “The Science and Practice of Pharmacy” (D. B. Troy ed., 21st Ed., Lippincott, Williams & Wilkins, 2006). In particular instances, the ANP polypeptides are administered SQ or IV. Alternatively, however, the ANP polypeptides can be formulated in forms for other pharmaceutically acceptable routes such as, for example, tablets or other solids for oral administration; time release capsules, and any other form currently used, including creams, lotions, inhalants and the like.


As noted above, and to improve their in vivo compatibility and effectiveness, the ANP polypeptides herein may be reacted with any number of inorganic and organic acids/bases to form pharmaceutically acceptable acid/base addition salts. Pharmaceutically acceptable salts and common techniques for preparing them are well known in the art (see, e.g., Stahl et al., “Handbook of Pharmaceutical Salts: Properties, Selection and Use” (2nd Revised Ed. Wiley-VCH, 2011)). Pharmaceutically acceptable salts for use herein include sodium, trifluoroacetate, hydrochloride and acetate salts.


The ANP polypeptides herein may be administered by a physician or self-administered using an injection. It is understood the gauge size and amount of injection volume can be readily determined by one of skill in the art. However, the amount of injection volume can be ≤about 2 mL or even ≤about 1 mL, and the needle gauge can be ≥about 27 G or even ≥about 29 G.


The ANP polypeptides herein can also be provided as part of a kit. In some instances, the kit includes a device for administering at least one ANP polypeptide (and optionally at least one additional therapeutic agent) to an individual. In certain instances, the kit includes a syringe and needle for administering the at least one ANP polypeptide (and optionally at least one additional therapeutic agent). In particular instances, the ANP polypeptide (and optionally at least one additional therapeutic agent) is pre-formulated in aqueous solution within the syringe.


The invention is further illustrated by the following examples, which are not to be construed as limiting.


EXAMPLES
Preparations

Abbreviations: acetonitrile (ACN); aqueous (aq); octadecylsilane (C18); dichloromethane (DCM); N,N-dimethylformamide (DMF); dimethylsulfoxide (DMSO); ethyl acetate (EtOAc); hexafluorophosphate azabenzotriazole tetramethyl uranium (HATU); high performance liquid chromatography (HPLC); isopropanol (IPA); liquid chromatography mass spectrometry (LCMS); methanol (MeOH); minute(s) (min); mass spectrometry (MS); methyl tert-butyl ether (MTBE); mass-to-charge ratio (m/z); polyethylene glycol (PEG); reverse-phase high performance liquid chromatography (RP-HPLC); reverse-phase liquid chromatography mass spectrometry (RP-LCMS); room temperature (rt); saturated (satd); strong cation exchange (SCX); tris(2-carboxyethyl)phosphine (TCEP); trifluoroacetic acid (TFA); tetrahydrofuran (THF); tris(hydroxymethyl)aminomethane (Tris).


Preparation 1
Tert-butyl 11-bromoundecanoate



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Under a nitrogen atmosphere, a pressure vessel was charged with di-tert-butyl dicarbonate (8.65 g, 39.2 mmol) and a mixture of 11-bromoundecanoic acid (8.00 g, 30.2 mmol), dichloromagnesium hexahydrate (613 mg, 3.01 mmol) in tert-butanol (60 mmol). The vessel was sealed, and then heated to 40° C. for 24 hours. The solution was diluted with dichloromethane (100 mL) and washed with saturated ammonium chloride (3×50 mL). The organic phase was then dried over sodium sulfate, concentrated in vacuo to dryness, and purified by flash column chromatography (120 g silica column, gradient from 100% Hexane to 100% EtOAc in Hexane over 20 minutes). The desired product was isolated as a colorless oil (6.05 g); mz=265, 267 (M-tBu).


Preparation 2
O1-benzyl O3-tert-butyl 2-undecylpropanedioate



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Under a nitrogen atmosphere, sodium hydride was added in mineral oil (60 mass %, 400 mg, 10.0 mmol) in small portions to an ice-cold solution of O1-benzyl O3-tert-butyl propanedioate (2.50 g, 9.99 mmol) in N,N-dimethylformamide (15 mL). After stirring for 1 hour, 1-bromoundecane (2.35 g, 9.99 mmol) was added in 2 mL of DMF and mixed at room temperature for 15 hours. The mixture was diluted with 60 mL of ether, and washed the organic layer with 1% aqueous citric acid (50 mL), brine and water. The organic layer was dried over sodium sulfate and the volatiles removed in vacuo and purified by flash column chromatography (80 g silica column, gradient from 100% Hexane to 40% EtOAc over 25 minutes). The desired product was isolated as an oil (3.50 g); mz=403 (M-1).


Preparation 3
O11-benzyl O1,O11-ditert-butyl docosane-1,11,11-tricarboxylate



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Under a nitrogen atmosphere, was added sodium hydride in mineral oil (60 mass %, 960 mg, 24.0 mmol) in small portions of an ice-cold mixture of O1-benzyl O3-tert-butyl 2-undecylpropanedioate (8.50 g, 20.0 mmol) in N,N-dimethylformamide (40 mL). Stirred at room temperature for 40 minutes. Added tert-butyl 11-bromoundecanoate (7.50 g, 22.2 mmol) in 10 mL of DMF. Allowed to mix at room temperature for 20 hours. Diluted the mixture with 150 mL of ether and washed the organic phase with 1% aqueous citric acid (50 mL), brine and water. Dried the organic layer over sodium sulfate and removed the volatiles in vacuo. Purified by flash column chromatography (220 g silica column, gradient from 100% Hexane to 100% DCM over 15 minutes, kept for another 10 minutes). The desired product was isolated as an oil (13.00 g); mz=533 (M-2×tBU).


Preparation 4
13-tert-butoxy-2-tert-butoxycarbonyl-13-oxo-2-undecyl-tridecanoic Acid



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Charged a 2250 mL Parr shaker with 10% Pd/C (1.25 g), and purged with nitrogen. Added tetrahydrofran (125 mL) and then a solution of O11-benzyl O1,O11-ditert-butyl docosane-1,11,11-tricarboxylate (13.00 g, 19.15 mmol) in 125 mL of tetrahydrofuran. Sealed the bottle, purged with nitrogen, and pressurized with hydrogen gas at 10 psi. Shaken at room temperature for 2 hours. Depressurized the system with nitrogen gas, then filtered through Celite. Removed the solvent from the mixture under reduced pressure to isolate the racemic product as a white solid (11.0 g); mz=443 (M-2×t-Butyl).


Preparation 5
Benzyl 11-bromoundecanoate



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Dissolved 11-bromoundecanoic acid (10.00 g, 37.71 mmol), benzylalcohol (4.5 g, 42 mmol) and 4-dimethylaminopyridine (0.4 g, 3 mmol) in dichloromethane (150 mL). To the solution, added dicyclohexylcarbodiimide (9.40 g, 45.6 mmol, 100 mass %) in one portion. Stirred at room temperature for 8 hours. Removed the white solids by filtration and washed the solid with dichloromethane (3×10 mL). Removed the organic components under reduced pressure. Purified by flash column chromatography (220 g silica column, gradient from 100% Hexane to 100% dichloromethane over 20 minutes, continued for another 5 minutes). Combined the product containing fractions to isolate product as an oil (11.60 g); 1H NMR (400 MHz, CDCl3): 7.39-7.36 (m, 5H), 5.14 (s, 2H), 3.43 (t, J=6.9 Hz, 2H), 2.38 (t, J=7.6 Hz, 2H), 1.91-1.84 (m, 2H), 1.67 (quintet, J=7.3 Hz, 2H), 1.43 (dd, J=7.0, 14.4 Hz, 2H), 1.30 (s, 10H).


Preparation 6
O1-benzyl O3-tert-butyl 2-undecylpropanedioate



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Under a nitrogen atmosphere, added sodium hydride in mineral oil (60 mass %, 400 mg, 10.0 mmol) in small portions to an ice-cold solution of O1-benzyl O3-tert-butyl propanedioate (2.50 g, 9.99 mmol) in N,N-dimethylformamide (15 mL), After stirring for 1 hour, added 1-bromoundecane (2.35 g, 9.99 mmol) in 2 mL of DMF. Mixed at room temperature for 15 hours. Diluted the mixture with 60 mL of ether and washed the organic layer with 1% aqueous citric acid (50 mL), brine and water. Dried the organic layer over sodium sulfate and removed the volatiles in vacuo. Purified by flash column chromatography (80 g silica column, gradient from 100% Hexane to 40% EtOAc over 25 minutes). The desired product was isolated as an oil (3.50 g); mz=403 (M-1).


Preparation 7
O1,O11-dibenzyl O11-tert-butyl docosane-1,11,11-tricarboxylate



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Under a nitrogen atmosphere, added sodium hydride in mineral oil (60 mass %, 700 mg, 17.5 mmol) in small portions to an ice-cold solution of O1-benzyl O3-tert-butyl 2-undecylpropanedioate (6.2 g, 14.6 mmol) in N,N-dimethylformamide (30 mL). After 40 minutes, added benzyl 11-bromoundecanoate (6.00 g, 16.0 mmol) in 8 mL of DMF. Mixed at room temperature for 15 hours. Diluted the mixture with 150 mL of ether. Washed the mixture with citric acid (1%, in water, 50 mL), brine & water. Dried the organic layer over sodium sulfate and removed the volatiles in vacuo. Purified by flash column chromatography (220 g silica column, gradient from 100% Hexane to 100% DCM over 20 minutes, kept for another 10 minutes). The desired product was isolated as an oil (8.00 g); mz=624 (M-tBu), 702 (M+Na).


Preparation 8
13-Benzyloxy-2-benzyloxycarbonyl-13-oxo-2-undecyl-tridecanoic Acid



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Treated O1,O11-dibenzyl O11-tert-butyl docosane-1,11,11-tricarboxylate (11.0 g, 15.4 mmol) with trifluoroacetic acid (40 mL) at room temperature for 3 hours. Removed the volatiles to a residue and purified by flash column chromatography (120 g silica column, gradient from 100% hexane to 100% EtOAc in Hexane over 20 minutes). The desired product was isolated as an oil (9.5 g); mz=623 (M+1); 1H NMR (400 MHz, CDCl3): 8.77-8.75 (m, 1H), 7.39-7.38 (m, 10H), 5.26 (s, 2H), 5.14 (s, 2H), 2.38 (t, J=7.5 Hz, 2H), 2.02-1.84 (m, 4H), 1.66 (quintet, J=7.4 Hz, 2H), 1.31-0.89 (m, 37H).


Chiral Separation of Racemic Compound 13(benzyloxy)-2-((benzyloxy)carbonyl)-13-oxo-2-undecyltridecanoic Acid (Preparation 8) into Enantiomer 1 (Preparation 8A, EN1) and Enantiomer 2 (Preparation 8B, EN2)



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Preparative Method:





    • Column Used: Chiralpak AD-H, 21×150 mm

    • Mobile Phase: 20% EtOH: 80% CO2

    • Flow Rate: 80 mL/min

    • BPR Set Point: 100 bar

    • BPR Temperature: 20° C.

    • Column Temperature: 40° C.

    • Detection: 225 nm





Analytical Conditions:

Chiralpak AD-H, 4.6×150 mm, 25% EtOH/CO2, 5 mL/min, 225 nm


From 1300 mg of racemic compound, using the conditions for preparative method, enantiomer 1 (EN1; 564 mg, 99% ee, retention time=2.64 min) and enantiomer 2 (EN2; 511.2 mg, 98% ee, retention time=3.21 min) were isolated.


Preparation 9
Beta-Ala Linker
O1,O11-dibenzyl O11-(2,5-dioxopyrrolidin-1-yl) docosane-1,11,11-tricarboxylate



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Added N-hydroxysuccinimide (0.500 g, 4.25 mmol) to 13-benzyloxy-2-benzyloxycarbonyl-13-oxo-2-undecyl-tridecanoic acid (2.45 g, 3.54 mmol) in dichloromethane (20 mL) and THF (5 mL). Stirred for five minutes, then added N,N′-dicyclohexylcarbodiimide (0.880 g, 4.22 mmol) in one portion. Stirred for 7 hours under nitrogen atmosphere at room temperature. Stored the reaction mixture in −20° C. fridge for two days. Removed the solid by filtration, and washed the solid with DCM (3×5 mL). Removed the solvent from the filtrate and purified by flash column chromatography (80 g silica column, gradient from 100% hexane to 50% EtOAc in hexane over 20 minutes, then increased to 100% EtOAc over 5 minutes). The desired product was isolated as an oil (2.10 g); 1H NMR (400 MHz, CDCl3): 7.43-7.34 (m, 10H), 5.25 (s, 2H), 5.14 (s, 2H), 4.15 (q, J=7.2 Hz, 1H), 2.84 (d, J=3.1 Hz, 4H), 2.37 (t, J=7.6 Hz, 2H), 2.02-1.97 (m, 4H), 1.69-1.59 (m, 3H), 1.34-1.25 (m, 38H), 0.90 (t, J=6.8 Hz, 3H).


Preparation 10
3-[(13-Benzyloxy-2-benzyloxycarbonyl-13-oxo-2-undecyl-tridecanoyl)amino]propanoic Acid



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Added a suspension of beta-Alanine (250 mg, 2.80605 mmol) in 1 mL of DMF to a room temperature solution of O1,O11-dibenzyl O11-(2,5-dioxopyrrolidin-1-yl) docosane-1,11,11-tricarboxylate (1.50 g, 2.08 mmol) in tetrahydrofuran (20 mL), and followed by addition of triethylamine (0.80 mL, 5.7 mmol). Added water (3 mL), acetonitrile (6 mL, 100 mass %) and 4 mL DMF to solubilize the precipitate that forms. Mixed at room temperature for 15 hours. Diluted the mixture with chloroform/iso-propanol (3/1, 100 mL), and washed with 10% aqueous citric acid, water and brine (50 mL). Dried the organic over sodium sulfate, and concentrated in vacuo to dryness. Purified by flash column chromatography (80 g silica column, UV 254 nm, gradient from 100% hexane to 100% EtOAc over 15 minutes, kept for another 5 minutes). The desired product was isolated, 1.00 g, 66% yield) as an oil; mz=694 (M+).


Preparation 11
NHS Ester of Beta-Alanine BFA
Dibenzyl 2-[[3-(2,5-dioxopyrrolidin-1-yl)oxy-3-oxo-propyl]carbamoyl]-2-undecyl-tridecanedioate



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Added N-hydroxysuccinimide (193 mg, 1.64 mmol) to a solution of 3-[(13-benzyloxy-2-benzyloxycarbonyl-13-oxo-2-undecyl-tridecanoyl)amino]propanoic acid (1.00 g, 1.37 mmol) in dichloromethane (15 mL) and THF (2 mL). After 5 minutes, added N,N′-dicyclohexylcarbodiimide (342 mg, 1.64 mmol) in one portion. Stirred at room temperature for 15 hours. Removed the solid by filtration and washed the solid with DCM (3×5 mL). Concentrated under vacuo to dryness and purified by flash column chromatography (80 g silica column, gradient from 100% Hexane to 100% EtOAc in none over 20 minutes). The desired product was isolated as an oil (1.00 g); mz=793 (M+2); 1H NMR (400 MHz, CDCl3): 8.27 (t, J=6.0 Hz, 1H), 7.38-7.35 (m, 10H), 5.19 (s, 2H), 5.13 (s, 2H), 3.68 (q, J=6.2 Hz, 2H), 2.89-2.84 (m, 6H), 2.36 (t, J=7.6 Hz, 2H), 2.02-1.94 (m, 2H), 1.82-1.75 (m, 2H), 1.65 (quintet, J=7.4 Hz, 2H), 1.32-1.00 (m, 34H).


Preparation 12
Deprotection of Benzyl on Beta-Alanine-BFA
2-[[3-(2,5-Dioxopyrrolidin-1-yl)oxy-3-oxo-propyl]carbamoyl]-2-undecyl-tridecanedioic Acid



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Charged a 100 mL Parr shaker with 10% Pd/C (0.193 g), and purged with nitrogen. Added tetrahydrofuran (20 mL) and then a solution of dibenzyl 2-[[3-(2,5-dioxopyrrolidin-1-yl)oxy-3-oxo-propyl]carbamoyl]-2-undecyl-tridecanedioate (1.93 g, 2.68 mmol) in 20 mL of tetrahydrofuran. Sealed the bottle, purged with nitrogen, and pressurized with hydrogen gas at 10 psi. Shaken at room temperature for 2 hours. Depressurized the system with nitrogen gas, then filter through Celite. Removed the solvent from the mixture under reduced pressure to isolate the product as a solid (670 mg); mz=611 (M+).


Preparation 13
Alternative Chemistry for Amide Formation on Quaternary Acid
Beta-Ala EN2
3-[[Ire-(2R)-13-benzyloxy-2-benzyloxycarbonyl-13-oxo-2-undecyl-tridecanoyl]amino]propanoic Acid
Activated Ester
O1,O11-dibenzyl O11-(triazolo[4,5-b]pyridin-3-yl) rel-(11S)-docosane-1,11,11-tricarboxylate



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Under a nitrogen atmosphere, added [dimethylamino(triazolo[4,5-b]pyridin-3-yloxy)methylene]-dimethyl-ammonium; hexafluorophosphate (2.40 g, 6.12 mmol) to a solution of rel-(EN2)-13-benzyloxy-2-benzyloxycarbonyl-13-oxo-2-undecyl-tridecanoic acid (2.50 g, 4.01 mmol) in THF (10 mL, 100 mass %) and DMF (10 mL). Mixed at room temperature for 3 minutes, then cooled on an ice-bath prior to adding N,N-diisopropylethylamine (1.50 mL, 8.60 mmol). Stirred at room temperature for 3 hours. Diluted with DCM (60 mL), and washed with aqueous saturated solution of ammonium chloride (2×30 mL). Separated the organic layer, and dried over sodium sulfate. Purified the crude by normal phase flash chromatography (80 g silica gold column, 100% Hexane for 3 minutes, then gradient to 60% EtOAc in Hexane over 17 minutes, then switched to 100% EtOAc and keep for another 5 minutes). Isolated activated ester product and use directly onto next step.


Coupling:

Mixed beta-Alanine (1.10 g, 12.3 mmol) and N,N-diisopropylethylamine (1.40 mL, 8.03 mmol) in 10 mL of acetonitrile and 9 mL of water. Dissolved the above activated ester in acetonitrile (10 mL) and then added into the beta alanine solution dropwise via syringe over 2 minutes. Stirred at room temperature for 1 hour. Diluted the reaction mixture with DCM (100 mL), and washed with saturated aqueous ammonium chloride (2×30 mL). Separated the organic layer, and dried over sodium sulfate. Concentrated under reduced pressure to a residue that was used as is in the next step (2.60 g).


Preparation 14
EN2-Beta-Ala-BFA by Activation/Deprotection



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Activation by NHS Ester
Dibenzyl rei-(2R)-2-[[3-(2,5-dioxopyrrolidin-1-yl)oxy-3-oxo-propyl]carbamoyl]-2-undecyl-tridecanedioate

Added N-hydroxysuccinimide (240 mg, 2.04 mmol) to a mixture of 3-[[rel-(2R)-13-benzyloxy-2-benzyloxycarbonyl-13-oxo-2-undecyl-tridecanoyl]amino]propanoic acid (1.06 g, 1.53 mmol) in THF (5 mL) and dichloromethane (5 mL) at room temperature. Stirred for 3 minutes, then added N,N′-dicyclohexylcarbodiimide (420 mg, 2.01 mmol) in one portion followed by 1 mg of DMAP. Mixed at room temperature for 3 hours, and then stored in fridge for 12 hours. Removed the solid by filtration, and washed the solid with DCM (3×5 mL). Concentrated under reduced pressure, and purified by flash column chromatography (40 g silica/gold column, 100% Hexane for 5 minutes, gradient to 100% EtOAc over next 15 minutes). Purified a second time by flash chromatography (40 g column, 100% hexane 3 minutes, gradient to 100% MTBE over next 17 minutes). The desired product was isolated as a thick oil (1.0 g).


Deprotection

Charged a 100 mL Parr shaker with 10% Pd/C (0.152 mg), and purged with nitrogen. Added tetrahydrofuran (10 mL) and then a solution of dibenzyl rel-(2R)-2-[[3-(2,5-dioxopyrrolidin-1-yl)oxy-3-oxo-propyl]carbamoyl]-2-undecyl-tridecanedioate (1.0 g, 1.20 mmol) in 10 mL of tetrahydrofuran. Sealed the bottle, purged with nitrogen, and pressurized with hydrogen gas at 10 psi. Shaken at room temperature for 2 hours. Depressurized the system with nitrogen gas, then filtered through Celite. Removed the solvent from the mixture under reduced pressure to isolate the product as a solid (750 mg); mz=611 (M+).


Preparation 15
Gamma-Glu-EN2-Synthesis



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HBTU Ester
O11-(benzotriazol-1-yl) O1,O11-dibenzyl rel-(11R)-docosane-1,11,11-tricarboxylate

Under a nitrogen atmosphere, mixed EN2-(2S)-13-benzyloxy-2-benzyloxycarbonyl-13-oxo-2-undecyl-tridecanoic acid (1.40 g, 2.25 mmol) and added [dimethylamino(triazolo[4,5-b]pyridin-3-yloxy)methylene]-dimethyl-ammonium; hexafluorophosphate (1.43 g, 3.65 mmol) in DMF (5 mL) and THF (5 mL). Cooled down to 10° C. on an ice-water bath, and then added N,N-diisopropylethylamine (0.85 mL, 4.9 mmol). Stirred at room temperature for 3 hours. Diluted the mixture with DCM (60 mL), and washed with saturated ammonium chloride (2×30 mL). Separated the organic layer, dried over sodium sulfate and concentrated in vacuo to dryness. Purified by normal phase flash chromatography (80 g silica gold column, 100% hexane for 3 minutes, then gradient to 60% EtOAc in hexane over 17 minutes, then switched to 100% EtOAc & kept for another 5 minutes). The desired product was isolated as an oil (1.15 g); 1H NMR (400 MHz, CDCl3): 8.68 (dd, J=1.3, 4.5 Hz, 1H), 8.40 (dd, J=1.4, 8.4 Hz, 1H), 7.52-7.50 (m, 2H), 7.43-7.36 (m, 10H), 5.38 (s, 2H), 5.14 (s, 2H), 2.38 (t, J=7.5 Hz, 2H), 2.18 (t, J=7.8 Hz, 4H), 1.68 (quintet, J=7.2 Hz, 2H), 1.36-1.30 (m, 35H), 0.91 (t, J=6.8 Hz, 3H).


Preparation 16
Gamma-Glu Coupling onto EN2-Activated Ester
(4S)-4-[[(2S*)-13-benzyloxy-2-benzyloxycarbonyl-13-oxo-2-undecyl-tridecanoyl]amino]-5-tert-butoxy-5-oxo-pentanoic Acid



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Added N,N-diisopropylethylamine (0.55 mL, 3.2 mmol) to a solution of (4S)-4-amino-5-tert-butoxy-5-oxo-pentanoic acid (650 mg, 3.13 mmol) dissolved in acetonitrile (4 mL) and water (4 mL). Then added O11-(benzotriazol-1-yl) O1,O11-dibenzyl rel-(11R)-docosane-1,11,11-tricarboxylate (1.15 g, 1.55 mmol) in acetonitrile (3 mL). Stirred at room temperature for 12 hours. Diluted with 50 mL of DCM, and washed with 50 mL of aqueous ammonium chloride (2×). Separated the organic phase and dried over sodium sulfate. Concentrated in vacuo to dryness. Purified by normal phase flash chromatography (40 g silica gold column, 100% Hexane for 5 minutes, then gradient to 100% EtOAc in hexane over 15 minutes, kept for another 5 minutes). The desired product was isolated as an oil (900 mg); mz=806 (M-2); 1H NMR (400 MHz, CDCl3): 8.57 (d, J=7.5 Hz, 1H), 7.37-7.35 (m, 10H), 5.21 (s, 2H), 5.13 (s, 2H), 4.56 (td, J=7.7, 5.2 Hz, 1H), 4.14 (q, J=7.2 Hz, 1H), 2.44-2.35 (m, 4H), 2.27-2.20 (m, 1H), 2.02-1.93 (m, 3H), 1.85-1.77 (m, 2H), 1.65 (quintet, J=7.3 Hz, 2H), 1.32-1.18 (m, 34H), 0.90 (t, J=6.9 Hz, 3H).


Preparation 17
Two Step Procedure for Gamma-Glu-EN2-BFA
(2S*)-2-[[(1S)-1-tert-butoxycarbonyl-4-(2,5-dioxopyrrolidin-1-yl)oxy-4-oxo-butyl]carbamoyl]-2-undecyl-tridecanedioic Acid



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First step: Activated ester
Dibenzyl (2S*)-2-[[(1S)-1-tert-butoxycarbonyl-4-(2,5-dioxopyrrolidin-1-yl)oxy-4-oxo-butyl]carbamoyl]-2-undecyl-tridecanedioate

Under a nitrogen atmosphere, added N-hydroxysuccinimide (170 mg, 1.44 mmol) to a solution of (4S)-4-[[(2S*)-13-benzyloxy-2-benzyloxycarbonyl-13-oxo-2-undecyl-tridecanoyl]amino]-5-tert-butoxy-5-oxo-pentanoic acid (900 mg, 1.11 mmol,) in tetrahydrofuran (3 mL) and dichloromethane (6 mL). Mixed at room temperature for 3 minutes, then added N,N′-dicyclohexylcarbodiimide (300 mg, 1.43 mmol) as a solid and 1 mg of DMAP. Stirred at room temperature for 3 hours. Removed the white precipitate by filtration, and washed with DCM (3×5 mL). Concentrated in vacuo to dryness to provide crude activated ester. Purified by flash column chromatography (40 g silica column, 100% hexane for 5 minutes, gradient to 100% EtOAc over 15 minutes, kept for another 5 minutes). The activated ester was isolated (850 mg); mz=905 (M+).


Second Step: Hydrogenation

Charged a 250 mL Parr shaker with 10% Pd/C (0.150 mg), and purged with nitrogen. Added tetrahydrofuran (10 mL) and then a solution of dibenzyl (2S*)-2-[[(1S)-1-tert-butoxycarbonyl-4-(2,5-dioxopyrrolidin-1-yl)oxy-4-oxo-butyl]carbamoyl]-2-undecyl-tridecanedioate (0.800 g, 0.883 mmol) in 15 mL of tetrahydrofuran. Sealed the bottle, purged with nitrogen, and pressurized with hydrogen gas at 20 psi. Shaken at room temperature for 2 hours. Depressurized the system with Nitrogen gas, then filtered through Celite. Removed the solvent from the mixture under reduced pressure to isolate the product as a solid (770 mg); mz=725 (M+1).


Preparation of Example Polypeptides
Example 1

Example 1 is a polypeptide represented by the following description (SEQ ID NO:45). HOOC—(CH2)18—CO-(γGlu)-EKEKEKGS-4Pal-RRSS[CFGGRIDRIGHQSGLGC]PSFRHGGPSSGAPPPS-NH2


(Disulfide Linkage)

Below is a depiction of the structure of Example 1 using the standard single letter code for L-Amino Acids except for the γ-Glutamic and 4-Pal residues, where the structures of the residues have been expanded.




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The primary peptide sequence of Example 1 was synthesized using standard 9-Fluorenyl-methyloxycarbonyl (Fmoc) tert-Butyl (t-Bu) solid phase peptide chemistry protocols on a Symphony-X, 24-channel multiplex peptide synthesizer (Gyros Protein Technologies, Inc.), at a 0.1 mmol scale.


The solid support used consists of low loading 4-(2′,4′-Dimethoxyphenyl-Fmoc-aminomethyl)-phenoxyacetamido-norleucyl-4-Methylbenzhydrylamine resin (Fmoc-Rink-MBHA Low Loading Resin, EMD Millipore), (100-200 mesh) with a 1% DVB cross-linked polystyrene core and a substitution range of 0.3-0.4 meq/g. Standard sidechain protecting groups were used for all Fmoc-L-Amino Acids used. The non-standard amino acids used in the synthesis of Example 1 were N-α-Fmoc-L-Glutamic Acid α-tButyl Ester (Fmoc-Glu-OtBu. Ark Pharm, Inc) and N-Fmoc-3-(4-Pyridyl)-L-Alanine (Fmoc-4Pal-OH, Combi-Blocks Inc.). Fmoc deprotection prior to each coupling step was accomplished by treatment with 20% piperidine (PIP: Sigma Aldrich) in dimethylformamide (DMF; Fisher Chemicals), 2×7 minutes with nitrogen mixing, followed by 8×DMF washing cycles. All amino acid couplings were performed for 1 hour using the Fmoc Amino Acid (0.3 M in DMF), N, N, N′,N′-Tetramethyl-O-(1H-benzotriazol-1-yl)uronium hexafluorophosphate (HBTU, Ambeed Inc.; 0.9 M in DMF) and N,N-Diisopropylethylamine (DIPEA, Sigma Aldrich; 1.2 M in DMF), at a 9-fold molar excess of AA/HBTU and a 12-fold molar excess of DIPEA over the theoretical resin loading level. After the primary sequence of the peptide was synthesized, the final Fmoc-deprotection, and the DMF washes were completed, attachment of the fatty acid (FA) moiety was accomplished by manual addition of 3-fold excess of 20-tert-butoxy-20-oxo-icosanoic acid (OtBu-C20-OH) solution which was pre-activated (2 min) with O-(7-Azabenzotriazol-1-yl)-N,N,N′,N′-tetramethyluronium hexafluorophosphate (HATU; Alfa Aesar) and DIPEA (1:1:3; FA:HATU:DIPEA) in 3 mL DMF. The solution was added via transfer pipet directly to the Symphony-X reaction vessel containing the peptidyl-resin. The reaction time for the FA coupling was 3 hours, after which point the resin was washed 3× with DMF and a Kaiser test was performed to ensure coupling completion. The FA coupling process is repeated as necessary if a positive Kaiser test in noted. After the FA acylation was completed, the peptidyl resin was transferred, as a DCM slurry, to disposable fritted plastic syringe fitted with Teflon stopcock and further washes with DCM were done, finally the resin was thoroughly dried in vacuo. The dry resin was then treated with 10 mL of cleavage cocktail consisting of trifluoroacetic acid (TFA), water, 3,6-dioxa-1,8-octanedithiol (DODT), triisopropylsilane (TIPS), (TFA:Water:DODT:TIPS; 92.5:2.5:2.5:2.5 v/v) for 2 h at RT. After the 2 hr incubation, the resin was filtered off, washed twice with 2 mL of neat TFA, and the combined filtrates/washes were collected in a 50 ml conical disposable tube, the solution was then treated with 35 mL of cold diethyl ether (−20° C.) to precipitate the crude peptide. The peptide/ether suspension was then centrifuged at 4000 rpm for 2 min to form a solid pellet, the supernatant was decanted, and the solid pellet was triturated with fresh ether and the process was repeated two additional times, finally drying the peptide pellet in vacuo.


Disulfide Linkage Formation

The crude peptide was solubilized, in a suitable glass vessel, with 25% aqueous acetic acid to relatively low concentration (0.2-0.5 mg/ml crude peptide). The solution was then placed on magnetic stirrer with the requisite spin vane, mixed vigorously and titrated with a few drops of saturated Iodine in methanol solution until a faint yellow endpoint was achieved. After reaching the endpoint, the reaction was incubated at RT for 15 min, at which point the excess Iodine was quenched by the addition of a few drops of 0.1 M aqueous ascorbic acid.


HPLC Purification

The crude oxidation solution was loaded directly onto a preparative HPLC system (Waters 2545 Binary Systems) equipped with a column heater and using a Luna Phenyl-Hexyl RP-HPLC column (Phenomenex Inc.; 5 μm, 100 Å; 250×21.2 mm). The running buffers used were A: 0.1% TFA/H2O and B: 0.1% TFA/Acetonitrile (ACN). The initial loading was done at 20% B, with 5 min isocratic wash after loading, then set to 25% B for equilibration. The sample was eluted using a linear 25-45% B gradient over 60 min, at a flow of 15 mL/min, with column heating set at 60° C. Fractions that were determined to contain the desired product (analysis by LC-MS) were pooled, frozen and lyophilized to give an amorphous solid product, as the TFA salt of Example 1. The purity assessed by RP-HPLC was found to be >95%, with the observed molecular weight of 5293.4 Dalton; matching the theoretical calculated molecular weight of 5293.9 Dalton.


Example 2

Example 2 is a polypeptide represented by the following description (SEQ ID NO:60) HOOC—(CH2)18—CO-(γGlu)-EKEKEKGS-4Pal-RRSS[CFGGRIDRIGHQSGLGC]PSFRHGGPSSGAPPPS-NH2


(Thioacetal Linkage)

Below is a depiction of the structure of Example 2 using the standard single letter code for L-Amino Acids except for the γ-Glutamic and 4Pal residues, and Cysteine residues where the structures of the residues have been expanded.




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The primary peptide sequence of Example 2 is the same as Example 1. The disulfide linkage in Example 1 was replaced by a thioacetal linkage in Example 2. The synthesis of the acylated polypeptide of Example 2, formation of the disulfide linkage and purification were carried out as in Example 1.


Thioacetal Linkage Formation of Example 2

After the purification of the disulfide bridged polypeptide form (same as Example 1), the pertinent pooled fractions containing the peptide were not lyophilized, but diluted with water and ACN instead to achieve about a 50/50 mixture of water/ACN (˜400 mL total volume) with a low concentration of peptide (˜0.2 mg/ml). The solution was then adjusted to pH 8 with triethylamine (TEA) ˜10 equivalents, and the peptide's disulfide bridge was reduced with the addition of 2-4 equivalents of Tris(2-carboxyethyl) phosphine hydrochloride (TCEP-HCl) reducing agent. After the disulfide bridge reduction, the thioacetal linkage was formed by the addition of 7-10 equivalents of diiodomethane (CH2I2). The thioacetal formation reaction was carried out by incubating the solution for 18 h at RT with magnetic stirring. Progress of the reaction was monitored using analytical LC-MS and by observing the change in mass of +12 Daltons from the starting reduced peptide molecular weight.


HPLC Purification

The crude thioacetal reaction solution was diluted to 1000 ml with water and then loaded, via injection pump, directly onto a preparative HPLC system (Shimadzu LC-8A Binary Systems) using a Luna Phenyl-Hexyl RP-HPLC column (Phenomenex Inc.; 5 μm, 100 Å; 250×21.2 mm). The running buffers used were A: 0.1% TFA/H2O and B: 0.1% TFA/ACN). The initial loading was done at 20% B, with 5 min isocratic wash after loading, then set to 25% B for equilibration. The sample was eluted using a linear 25-45% B gradient over 60 min, at a flow of 25 mL/min, with column heating set at 50° C. Fractions that were determined to contain the desired product (analysis by LC-MS) were pooled, frozen and lyophilized to give a white amorphous solid product, as the TFA salt of Example 2. The purity assessed by RP-HPLC 1 was found to be >95%, with the observed molecular weight of 5308.6 Dalton; matching the theoretical calculated molecular weight of 5307.9 Dalton.


Example 3

Example 3 is a polypeptide represented by the following description (SEQ ID NO:107) HOOC—(CH2)18—CO-(γGlu)-EKEKEKG-PEG24-EK-βAla-RSS[CFGKRIDRIGHQSGLGC]PSFRHGGKSSGAPPPS-NH2


(Thioacetal Linkage)

Below is a depiction of the structure of Example 3 using the standard single letter code for L-Amino Acids except for the γ-Glutamic, Glycine at position 8, βAlanine, and Cysteine residues where the structures of the residues have been expanded.




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The primary peptide sequence of Example 3 was synthesized in a substantially similar manner as Examples 1 and 2 with a non-natural β-Alanine (βAla) residue which was incorporated using Fmoc-βAla-OH (ChemImpex International Inc.). An exception to the synthetic method was the coupling of Fmoc-N-amido-Peg24-OH which required a pause in the automated synthesis protocol. The PEG24 residue coupling was accomplished by the manual addition of 1.5-fold excess of Fmoc-N-amido-PEG24-OH (BroadPharm) solution which was pre-activated (2 min) with diisopropylcarbodiimide (DIC) and ethyl-cyano(hydroxyamino)acetate (Oxyma) (1:1.2:1; PEG24:DIC:Oxyma) in 3 mL DMF. The solution was added via transfer pipet directly to the Symphony-X reaction vessel containing the peptidyl-resin. The reaction time for the PEG24 coupling was 18 hours, after which point the resin was washed 3× with DMF and a Kaiser test was performed to ensure coupling completion. The PEG24 coupling process is repeated as necessary if a positive Kaiser test is noted. The automated methods were resumed to complete the synthesis of the rest of sequence and the FA was coupled as noted in Example 1. The cleavage, disulfide linkage formation, thioacetal linkage formation and purification were done as previously described in Examples 1 and 2. The purity assessed by RP-HPLC was found to be >95%, with the observed molecular weight of 6475.0 Dalton; matching the theoretical calculated molecular weight of 6475.4 Dalton.


Example 4

Example 4 is a polypeptide represented by the following description (SEQ ID NO:144) HOOC—(CH2)18—CO-(γGlu)-EKEKEKG-PEG24-EK-βAla-RSS[CFGKRIDRIGHQSGLGC]PSFRHGSPSSGAPPPS-NH2


(Thioacetal Linkage)

Below is a depiction of the structure of Example 4 using the standard single letter code for L-Amino Acids except for the γ-Glutamic, Glycine at position 8, βAlanine, and Cysteine residues where the structures of the residues have been expanded.




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Example 4 was synthesized in a substantially similar manner as Example 3. The purity assessed by RP-HPLC for Example 4 was found to be >95%, with the observed molecular weight of 6474.6 Dalton; matching the theoretical calculated molecular weight of 6474.4 Dalton.


Example 5

Example 5 is a polypeptide represented by the following description (SEQ ID NO:146) HOOC—(CH2)18—CO-(γGlu)-EKEKEKGEKPRSS[CFGKRIDRIGHYSGLGC]PSFRHGSPSSGAPPPS-NH2


(Thioacetal Linkage)

Below is a depiction of the structure of Example 5 using the standard single letter code for L-Amino Acids except for the γ-Glutamic and Cysteine residues where the structures of the residues have been expanded.




embedded image


Example 5 was synthesized in a substantially similar manner as described for Example 2. The purity assessed by RP-HPLC for Example 5 was found to be >95%, with the observed molecular weight of 5406.8 Dalton; matching the theoretical calculated molecular weight of 5407.1 Dalton.


Example 6

Example 6 is a polypeptide represented by the following description (SEQ ID NO:158) HOOC—(CH2)18—CO-(γGlu)-EKEKEKG-PEG24-EK-βAla-RSS[CFGGKIDRIGHYSGLGC]PSFRHGSPSSGAPPPS-NH2


(Thioacetal Linkage)



embedded image


Example 6 was synthesized in a substantially similar manner as described for Example 3. The purity assessed by RP-HPLC for Example 6 was found to be >95%, with the observed molecular weight of 6409.6 Dalton; matching the theoretical calculated molecular weight of 6410.3 Dalton.


Example 7

Example 7 is a polypeptide represented by the following description (SEQ ID NO:159) HOOC—(CH2)18—CO-(γGlu)-EKEKEKG-PEG24-EK-βAla-RSS[CFGGKIDRIGHQSGLGC]PSFRHGSPSSGAPPPS-NH2


(Thioacetal Linkage)



embedded image


Example 7 was synthesized in a substantially similar manner as described for Example 3. The purity assessed by RP-HPLC for Example 7 was found to be >95%, with the observed molecular weight of 6375.2 Dalton, matching the theoretical calculated molecular weight of 6375.2 Dalton.


The polypeptides according to Examples 8 through Example 140 (SEQ ID NO:28-44, 46-59, 61-106, 108-143, 145, 147-157, 160-167) listed in Table 1 are prepared substantially using the procedures as described in Examples 1-3. For instance, Examples 8-16 and 18-55 (SEQ ID NO:28-36, 38-59 and 61-77) contain a disulfide linkage and are prepared substantially as described by the procedure of Example 1. Examples 17 and 56-140 (SEQ ID NO:37 and 78-106, 108-143, 145, 147-157, 160-167) contain a thioacetal linkage and are prepared substantially as described by the procedure of Example 2. Further, Examples 61-62, 75, 77, 78, 82, 84, 95, 102, 106, 109, 110, 115, 121, 124, 125, 129, 130, 132 and 133 (SEQ ID NO:83, 84, 97, 99, 100, 104, 106, 118, 125, 129, 132, 133, 138, 145, 149, 150, 154, 155, 157, 160) contain PEG24 or PEG12 which is introduced substantially as described by the procedure of Example 3, and Examples 83, 86-94, 96-100, 103-105, 107, 108, 111, 113, 116-120, 122, 123, 126 (SEQ ID NO:105, 109-117, 119-123, 126-128, 130-131, 134, 136, 139-143, 147-148, 151) contain (AEEA)4, (AEEA)6, or (AEEA)8, which is introduced using standard amino acid coupling methods substantially as described in Example 2.














TABLE 1








C-C






SEQ
Disulfide
Calculated
Found


Example

ID
or
MW
MW


Number
Polypeptide Name
NO
Thioacetal
(avg)
(avg)




















human
SLRRSS[CFGGRMDRIGAQSGL
1
Disulfide
3080.4
3080.5


ANP
GC]NSFRY-OH









rat ANP
SLRRSS[CFGGRIDRIGAQSGLG
2
Disulfide
3062.4
3062.5



CINSFRY-OH









rat ANP
SLRRSS[CFGGRIDRIGAQSGLG
173
Disulfide
3061.4
3061.2


amidated
C]NSFRY-NH2









1
HOOC-(CH2)18-CO-(γGlu)-
45
Disulfide
5293.9
5293.4



EKEKEKGS-4Pal-







RRSS[CFGGRIDRIGHQSGLGC]







PSFRHGGPSSGAPPPS-NH2









2
HOOC-(CH2)18-CO-(γGlu)-
60
Thioacetal
5307.9
5308.6



EKEKEKGS-4Pal-







RRSS[CFGGRIDRIGHQSGLGC]







PSFRHGGPSSGAPPPS-NH2









3
HOOC-(CH2)18-CO-(γGlu)-
107
Thioacetal
6475.4
6475.0



EKEKEKG-PEG24-EK-βAla-







RSS[CFGKRIDRIGHQSGLGC]PS







FRHGGKSSGAPPPS-NH2









4
HOOC-(CH2)18-CO-(γGlu)-
144
Thioacetal
6474.4
6474.6



EKEKEKG-PEG24-EK-βAla-







RSS[CFGKRIDRIGHQSGLGC]PS







FRHGSPSSGAPPPS-NH2









5
HOOC-(CH2)18-CO-(γGlu)-
146
Thioacetal
5407.1
5406.8



EKEKEKGEKPRSS[CFGKRIDRI







GHYSGLGCJPSFRHGSPSSGAPP







PS-NH2









6
HOOC-(CH2)18-CO-(γGlu)-
158
Thioacetal
6410.3
6409.6



EKEKEKG-PEG24-EK-βAla-







RSS[CFGGKIDRIGHYSGLGC]PS







FRHGSPSSGAPPPS-NH2









7
HOOC-(CH2)18-CO-(γGlu)-
159
Thioacetal
6375.2
6375.2



EKEKEKG-PEG24-EK-βAla-







RSS[CFGGKIDRIGHQSGLGC]PS







FRHGSPSSGAPPPS-NH2









8
HOOC-(CH2)18-CO-(γGlu)-
28
Disulfide
4343.9
4344.0



EKEKEKGSLRRSS[CFGGRIDRI







GAQSGLGCINSFRY-NH2









9
HOOC-(CH2)18-CO-(γGlu)-
29
Disulfide
4328.9
4329.0



EKEKEKGSLRRSS[CFGGRIDRI







GAQSGLGC]NSFR-4Pal-NH2









10
HOOC-(CH2)18-CO-(γGlu)-
30
Disulfide
4364.0
4363.8



EKEKEKGSLRRSS[CFGGRIDRI







GA-4Pal-SGLGC]NSFRY-NH2









11
HOOC-(CH2)18-CO-(γGlu)-
31
Disulfide
4379.0
4378.4



EKEKEKGS-4Pal-







RRSS[CFGGRIDRIGAQSGLGC]







NSFRY-NH2









12
HOOC-(CH2)18-CO-(γGlu)-
32
Disulfide
4349.0
4348.4



EKEKEKGSLRRSS[CFGGRIDRI







GA-4Pal-SGLGCJNSFR-4Pal-NH2









13
HOOC-(CH2)18-CO-(γGlu)-
33
Disulfide
4435.1
4434.6



EKEKEKGSLRRSS[CF-4Pal-







GRIDRIGAQSGLGC]NSFRY-







NH2









14
HOOC-(CH2)18-CO-(γGlu)-
34
Disulfide
4399.0
4398.8



EKEKEKGS-4Pal-







RRSS[CFGGRIDRIGA-4Pal-







SGLGC]NSFRY-NH2









15
HOOC-(CH2)18-CO-(γGlu)-
35
Disulfide
4363.9
4363.8



EKEKEKGS-4Pal-







RRSS[CFGGRIDRIGAQSGLGC]







NSFR-4Pal-NH2









16
HOOC-(CH2)18-CO-(γGlu)-
36
Disulfide
4502.1
4501.8



EKEKEKGSHRRSS[CFHGRIDRI







HAQSGLGC]NSFRH-NH2









17
HOOC-(CH2)18-CO-(γGlu)-
37
Thioacetal
4359.0
4359.3



EKEKEKGSLRRSS[CFGGRIDRI







GAQSGLGCINSFRY-OH









18
HOOC-(CH2)18-CO-(γGlu)-
38
Disulfide
4324.9
4324.6



EKEKEKGSHRRSS[CFGGRIDRI







GAQSGLGC]PSFRH-NH2









19
HOOC-(CH2)18-CO-(γGlu)-
39
Disulfide
5171.8
5171.9



EKEKEKGS-4Pal-







KRSS[CFGGKIDRIGAQSGLGC]







PSFRHGGPSSGAPPPS-NH2









20
HOOC-(CH2)18-CO-(γGlu)-
40
Disulfide
4347.0
4346.4



EKEKEKGS-4Pal-







RRSS[CFGGRIDRIGAQSGLGC]







PSFR-4Pal-NH2









21
HOOC-(CH2)18-CO-(γGlu)-
41
Disulfide
5227.9
5227.2



EKEKEKGS-4Pal-







RRSS[CFGGRIDRIGAQSGLGC]







PSFRHGGPSSGAPPPS-NH2









22
HOOC-(CH2)18-CO-(γGlu)-
42
Disulfide
4335.9
4335.8



EKEKEKGS-4Pal-







RRSS[CFGGRIDRIGAQSGLGC]







PSFRH-NH2









23
HOOC-(CH2)18-CO-(γGlu)-
43
Disulfide
5238.9
5238.8



EKEKEKGS-4Pal-







RRSS[CFGGRIDRIGAQSGLGC]







PSFR-4Pal-GGPSSGAPPPS-NH2









24
HOOC-(CH2)18-CO-(γGlu)-
44
Disulfide
4413.0
4413.0



EKEKEKGS-4Pal-







RRSS[CFGGRIDRIGHQSGLGC]







PSFR-4Pal-NH2









25
HOOC-(CH2)18-CO-(γGlu)-
46
Disulfide
5791.5
5790.6



EKEKEKGS-4Pal-







RRSS[CFGGRIDRIGHQSGLGC]







PSFRHRITAREDKQGYA-NH2









26
HOOC-(CH2)18-CO-(γGlu)-
47
Disulfide
5757.4
5756.8



EKEKEKGS-4Pal-







RRSS[CFGGRIDRIGHQSGLGC]







PSFRHRITAREDKQGEA-NH2









27
HOOC-(CH2)18-CO-(γGlu)-
48
Disulfide
5304.9
5305.3



EKEKEKGS-4Pal-







RRSS[CFGGRIDRIGHQSGLGC]







PSFR-4Pal-GGPSSGAPPPS-NH2









28
HOOC-(CH2)18-CO-(γGlu)-
49
Disulfide
5336.0
5337.0



EKEKEKGE-4Pal-







RRSS[CFGGRIDRIGHQSGLGC]







PSFRH-GGPSSGAPPPS-NH2









29
HOOC-(CH2)18-CO-(γGlu)-
50
Disulfide
5235.9
5236.5



EKEKEKGS-4Pal-







RRSS[CFGGRIGRIGHQSGLGC]







PSFRHGGPSSGAPPPS-NH2









30
HOOC-(CH2)18-CO-(γGlu)-
51
Disulfide
5237.9
5237.4



EKEKEKGS-4Pal-







KRSS[CFGGKIDRIGHQSGLGC]







PSFRHGGPSSGAPPPS-NH2









31
HOOC-(CH2)18-CO-(γGlu)-
52
Disulfide
5186.8
5186.0



EKEKEKGS-4Pal-







KRSS[CFGGKIDRIG-Dap-







QSGLGC]PSFRHGGPSSGAPPPS







-NH2









32
HOOC-(CH2)18-CO-(γGlu)-
53
Disulfide
5352.0
5351.2



EKEKEKGE-4Pal-







KRSS[CFGGKIDRIGHQSGLGC]







PSFRHGPSSGAPPPSE-NH2









33
HOOC-(CH2)18-CO-(γGlu)-
54
Disulfide
5180.8
5180.0



EKEKEKGS-4Pal-







KRSS[CFGGKIDRIGHQSGLGC]







PSFRHGPSSGAPPPS-NH2









34
HOOC-(CH2)18-CO-(γGlu)-
55
Disulfide
5261.0
5260.8



EKEKEKGS-4Pal-







KRSS[CFGGKIDRIGHQSGLGC]







PSFRHKITAKEDE-NH2









35
HOOC-(CH2)18-CO-(γGlu)-
56
Disulfide
5265.9
5265.0



EKEKEKGS-4Pal-







KRSS[CFGGRIDRIGHQSGLGC]







PSFRHGGPSSGAPPPS-NH2









36
HOOC-(CH2)18-CO-(γGlu)-
57
Disulfide
5265.9
5265.2



EKEKEKGS-4Pal-







RRSS[CFGGKIDRIGHQSGLGC]







PSFRHGGPSSGAPPPS-NH2









37
HOOC-(CH2)18-CO-(γGlu)-
58
Disulfide
5236.9
5236.2



EKEKEKGS-4Pal-







RRSS[CFGGRIDRIGHQSGLGC]







PSFRH-GPSSGAPPPS-NH2









38
HOOC-(CH2)18-CO-(γGlu)-
59
Disulfide
5329.0
5328.4



EKEKEKGS-4Pal-







RRSS[CFGGRIDRIGHYSGLGC]







PSFRHGGPSSGAPPPS-NH2









39
HOOC-(CH2)18-CO-(γGlu)-
61
Disulfide
5124.7
5124.0



EKEKEKGS-4Pal-







RRSS[CFGGRIDRIGHQSGLGC]







PSFRHSGAPPPSE-NH2









40
HOOC-(CH2)18-CO-(γGlu)-
62
Disulfide
5288.9
5288.5



EKEKEKGEKERSS[CFGGRIDRI







GHQSGLGC]PSFRHGGPSSGAP







PPS-NH2









41
HOOC-(CH2)18-CO-(γGlu)-
63
Disulfide
4902.5
4902.1



EKEKEKGRSS[CFGGRIDRIGHQ







SGLGC]PSFRHGGPSSGAPPPS-







NH2









42
HOOC-(CH2)18-CO-(γGlu)-
64
Disulfide
5194.8
5194.2



EKEKEKGEKGRSS[CFGGRIDRI







GHYSGLGC]PSFRH-







GPSSGAPPPS-NH2









43
HOOC-(CH2)18-CO-(γGlu)-
65
Disulfide
4909.5
4909.2



EKEKEKGRSS[CFGGKIDRIGHY







SGLGC]PSFRHGGPSSGAPPPS-







NH2









44
HOOC-(CH2)18-CO-(γGlu)-
66
Disulfide
5295.9
5295.5



EKEKEKGEKERSS[CFGGKIDRI







GHYSGLGC]PSFRHGGPSSGAP







PPS-NH2









45
HOOC-(CH2)18-CO-(γGlu)-
67
Disulfide
5223.9
5223.5



EKEKEKGEKGRSS[CFGGKIDRI







GHYSGLGC]PSFRHGGPSSGAP







PPS-NH2









46
HOOC-(CH2)18-CO-(γGlu)-
68
Disulfide
5136.8
5136.0



EKEKEKGRRSS[CFGGKIDRIGH







YSGLGC]PSFRHKGPSSGAPPPS







-NH2









47
HOOC-(CH2)18-CO-(γGlu)-
69
Disulfide
4980.6
4980.0



EKEKEKGRSS[CFGGKIDRIGHY







SGLGC]PSFRHKGPSSGAPPPS-







NH2









48
HOOC-(CH2)18-CO-(γGlu)-
70
Disulfide
4973.6
4973.2



(APPPS)G]-







EKERSS[CFGGKIDRIGHYSGLG







C]PSFRHGGPSSGAPPPS-NH2









49
HOOC-(CH2)18-CO-(γGlu)-
71
Disulfide
5323.9
5323.5



EKEKEKGEKERSS[CFGGRIDRI







GHYSGLGCJPSFRHGGPSSGAP







PPS-NH2









50
HOOC-(CH2)18-CO-(γGlu)-
72
Disulfide
5380.0
5379.0



EKEKEKGEKGRSS[CFGGRIDRI







GHYSGLGC]PSFRHKGGPSSGA







PPPS-NH2









51
HOOC-(CH2)18-CO-(γGlu)-
73
Disulfide
5217.9
5217.6



EKEKEKGEKGRSS[CFGGRIDRI







GHYSGLGCJPSLRHGGPSSGAP







PPS-NH2









52
HOOC-(CH2)18-CO-(γGlu)-
74
Disulfide
5214.9
5214.3



EKEKEKGEKGRSS[CFGGKIDRI







GKYSGLGCJPSFRHGGPSSGAP







PPS-NH2









53
HOOC-(CH2)18-CO-(γGlu)-
75
Disulfide
5185.9
5185.2



EKEKEKGEKGRSS[CFGGRIDRI







GKYSGLGC]PSFRHGPSSGAPPP







S-NH2









54
HOOC-(CH2)18-CO-(γGlu)-
76
Disulfide
5265.9
5265.6



EKEKEKGEK-βAla-







RSS[CFGGRIDRIGHYSGLGC]PS







FRHGGPSSGAPPPS-NH2









55
HOOC-(CH2)18-CO-(γGlu)-
77
Disulfide
5291.9
5291.3



EKEKEKGEKPRSS[CFGGRIDRI







GHYSGLGC]PSFRHGGPSSGAP







PPS-NH2









56
HOOC-(CH2)18-CO-(γGlu)-
78
Thioacetal
5279.9
5279.4



EKEKEKGEK-βAla-







RSS[CFGGRIDRIGHYSGLGC]PS







FRHGGPSSGAPPPS-NH2









57
HOOC-(CH2)18-CO-(γGlu)-
79
Thioacetal
5306.0
5305.3



EKEKEKGEKPRSS[CFGGRIDRI







GHYSGLGC]PSFRHGGPSSGAP







PPS-NH2









58
HOOC-(CH2)18-CO-(γGlu)-
80
Thioacetal
5279.9
5279.4



EKEKEKGKE-βAla-







RSS[CFGGRIDRIGHYSGLGC]PS







FRHGGPSSGAPPPS-NH2









59
HOOC-(CH2)18-CO-(γGlu)-
81
Thioacetal
5337.0
5336.4



EKEKEKGEKGRSS[CFGKRIDRI







GHYSGLGCJPSFRHGGPSSGAP







PPS-NH2









60
HOOC-(CH2)18-CO-(γGlu)-
82
Thioacetal
5222.9
5222.0



EKEKEKGEK-ßAla-







RSS[CFGGRIDRIGHYSGLGC]PS







FRHGPSSGAPPPS-NH2









61
HOOC-(CH2)18-CO-(γGlu)-
83
Thioacetal
6436.3
6436.8



EKEKEKG-PEG24-S-4Pal-







RRSS[CFGGRIDRIGHQSGLGC]







PSFRHGGPSSGAPPPS-NH2









62
HOOC-(CH2)18-CO-(γGlu)-
84
Thioacetal
6408.3
6409.0



EKEKEKG-PEG24-EK-βAla-







RSS[CFGGRIDRIGHYSGLGC]PS







FRHGGPSSGAPPPS-NH2









63
HOOC-(CH2)18-CO-(γGlu)-
85
Thioacetal
5245.9
5245.8



EKEKEKGEK-ßAla-







RSS[CFGGRIDRIGHYSGLGC]PS







LRHGGPSSGAPPPS-NH2









64
HOOC-(CH2)18-CO-(γGlu)-
86
Thioacetal
5309.0
5309.0



EKEKEKGSK-βAla-







RSS[CFGKRIDRIGHYSGLGC]PS







FRHGGPSSGAPPPS-NH2









65
HOOC-(CH2)18-CO-(γGlu)-
87
Thioacetal
5237.9
5238.1



EKEKEKGSK-ßAla-







RSS[CFGGRIDRIGHYSGLGC]PS







FRHGGPSSGAPPPS-NH2









66
HOOC-(CH2)18-CO-(γGlu)-
88
Thioacetal
5210.8
5210.1



EKEKEKGS-4Pal-







RRSS[CFGGRIDRIGHQSGLGC]







PSFRHGG--SSGAPPPS-NH2









67
HOOC-(CH2)18-CO-(γGlu)-
89
Thioacetal
5339.0
5339.0



EKEKEKGS-4Pal-







RRSS[CFGGRIDRIGHQSGLGC]







PSFRHGGKSSGAPPPS-NH2









68
HOOC-(CH2)18-CO-(γGlu)-
90
Thioacetal
5444.2
5444.0



EKEKEKGS-4Pal-







RRSS[CFGGRIDRIGHQSGLGC]







PSFRHGGPPS-Aib-KPPPK-NH2









69
HOOC-(CH2)18-CO-(γGlu)-
91
Thioacetal
5279.9
5279.4



EKEKEKGS-4Pal-







RRSS[CFGGRIDRIGHQSGLGC]







PSFRHGGPSSGAPPPS-NH2









70
HOOC-(CH2)18-CO-(γGlu)-
92
Thioacetal
5251.9
5251.2



EKEKEKGEK-ßAla-







RSS[CFGGRIDRIGHYSGLGC]PS







FRHGGPSSGAPPPS-NH2









71
HOOC-(CH2)18-CO-(γGlu)-
93
Thioacetal
5416.2
5416.0



EKEKEKGS-4Pal-







RRSS[CFGGRIDRIGHQSGLGC]







PSFRHGGPPS-Aib-KPPPK-NH2









72
HOOC-(CH2)18-CO-(γGlu)-
94
Thioacetal
5310.9
5311.2



EKEKEKGS-4Pal-







RRSS[CFGGRIDRIGHQSGLGC]







PSFRHGGKSSGAPPPS-NH2









73
HOOC-(CH2)14-CO-(γGlu)-
95
Thioacetal
5254.9
5254.2



EKEKEKGEK-ßAla-







RSS[CFGGRIDRIGHYSGLGC]PS







FRHGGKSSGAPPPS-NH2









74
HOOC-(CH2)18-CO-(γGlu)-
96
Thioacetal
5311.0
5310.6



EKEKEKGEK-ßAla-







RSS[CFGGRIDRIGHYSGLGC]PS







FRHGGKSSGAPPPS-NH2









75
HOOC-(CH2)18-CO-(γGlu)-
97
Thioacetal
6467.3
6467.0



EKEKEKG-PEG24-S-4Pal-







RRSS[CFGGRIDRIGHQSGLGC]







PSFRHGGKSSGAPPPS-NH2









76
HOOC-(CH2)18-CO-(γGlu)-
98
Thioacetal
5282.9
5282.4



EKEKEKGEK-βAla-







RSS[CFGGRIDRIGHYSGLGC]PS







FRHGGKSSGAPPPS-NH2









77
HOOC-(CH2)18-CO-(γGlu)-
99
Thioacetal
5910.7
5910.4



EKEKEKG-PEG12-EK-βAla-







RSS[CFGGRIDRIGHYSGLGC]PS







FRHGGKSSGAPPPS-NH2









78
HOOC-(CH2)18-CO-(γGlu)-
100
Thioacetal
6439.3
6439.0



EKEKEKG-PEG24-EK-βAla-







RSS[CFGGRIDRIGHYSGLGC]PS







FRHGGKSSGAPPPS-NH2









79
HOOC-(CH2)18-CO-(γGlu)-
101
Thioacetal
5382.1
5381.6



EKEKEKGS-4Pal-







RRSS[CFGKRIDRIGHQSGLGC]







PSFRHGGKSSGAPPPS-NH2









80
HOOC-(CH2)18-CO-(γGlu)-
102
Thioacetal
5382.1
5381.0



EKEKEKGS-4Pal-







RRSS[CFGRKIDRIGHQSGLGC]







PSFRHGGKSSGAPPPS-NH2









81
HOOC-(CH2)18-CO-(γGlu)-
103
Thioacetal
5417.1
5416.2



EKEKEKGS-4Pal-







RRSS[CFGKRIDRIGHYSGLGC]







PSFRHGGKSSGAPPPS-NH2









82
HOOC-(CH2)18-CO-(γGlu)-
104
Thioacetal
5938.7
5938.2



EKEKEKG-PEG12-S-4Pal-







RRSS[CFGGRIDRIGHQSGLGC]







PSFRHGGKSSGAPPPS-NH2









83
HOOC-(CH2)18-CO-(γGlu)-
105
Thioacetal
5919.6
5919.2



EKEKEKG-(AEEA)4-S-4Pal-







RRSS[CFGGRIDRIGHQSGLGC]







PSFRHGGKSSGAPPPS-NH2









84
HOOC-(CH2)18-CO-(γGlu)-
106
Thioacetal
6572.6
6572.0



EKEKEKG-PEG24-S-4Pal-







RRSS[CFGGRIDRIGHQSGLGC]







PSFRHGGPPS-Aib-KPPPK-NH2









85
HOOC-(CH2)18-CO-(γGlu)-
108
Thioacetal
5319.0
5318.6



EKEKEKGEK-ßAla-







RSS[CFGKRIDRIGHQSGLGC]PS







FRHGGKSSGAPPPS-NH2









86
HOOC-(CH2)18-CO-(γGlu)-
109
Thioacetal
6209.9
6209.0



EKEKEKG-(AEEA)6-S-4Pal-







RRSS[CFGGRIDRIGHQSGLGC]







PSFRHGGKSSGAPPPS-NH2









87
HOOC-(CH2)18-CO-(γGlu)-
110
Thioacetal
6571.4
6570.6



EKEKEKG-(AEEA)8-S-4Pal-







RRSS[CFGKRIDRIGHQSGLGC]







PSFRHGGKSSGAPPPS-NH2









88
HOOC-(CH2)18-CO-(γGlu)-
111
Thioacetal
5927.7
5927.4



EKEKEKG-(AEEA)4-EK-ßAla-







RSS[CFGKRIDRIGHQSGLGC]PS







FRHGGKSSGAPPPS-NH2









89
HOOC-(CH2)18-CO-(γGlu)-
112
Thioacetal
6218.0
6217.6



EKEKEKG-(AEEA)6-EK-βAla-







RSS[CFGKRIDRIGHQSGLGC]PS







FRHGGKSSGAPPPS-NH2









90
HOOC-(CH2)18-CO-(γGlu)-
113
Thioacetal
5679.4
5678.4



(AEEA)8-EK-ßAla-







RSS[CFGKRIDRIGHQSGLGC]PS







FRHGGKSSGAPPPS-NH2









91
HOOC-(CH2)18-CO-(γGlu)-
114
Thioacetal
6535.3
6534.9



EKEKEKG-(AEEA)8-S-4Pal-







RRSS[CFGGRIDRIGHYSGLGC]







PSFRHGGKSSGAPPPS-NH2









92
HOOC-(CH2)18-CO-(γGlu)-
115
Thioacetal
6245.0
6245.0



EKEKEKG-(AEEA)6-S-4Pal-







RRSS[CFGGRIDRIGHYSGLGC]







PSFRHGGKSSGAPPPS-NH2









93
HOOC-(CH2)18-CO-(γGlu)-
116
Thioacetal
6472.2
6471.9



EKEKEKG-(AEEA)8-EK-ßAla-







RSS[CFGGRIDRIGHYSGLGC]PS







FRHGGKSSGAPPPS-NH2









94
HOOC-(CH2)18-CO-(γGlu)-
117
Thioacetal
6181.9
6181.6



EKEKEKG-(AEEA)6-EK-βAla-







RSS[CFGGRIDRIGHYSGLGC]PS







FRHGGKSSGAPPPS-NH2









95
HOOC-(CH2)18-CO-(γGlu)-
118
Thioacetal
6502.4
6502.3



EKEKEKG-PEG24-S-4Pal-







RRSS[CFGGRIDRIGHYSGLGC]







PSFRHGGKSSGAPPPS-NH2









96
HOOC-(CH2)18-CO-(γGlu)-
119
Thioacetal
6244.0
6243.5



EKEKEKG-(AEEA)6-S-4Pal-







RRSS[CFGGRIDRIGHYSGLGC]







PSFRHGSPSSGAPPPS-NH2









97
HOOC-(CH2)18-CO-(γGlu)-
120
Thioacetal
6350.2
6350.0



EKEKEKG-(AEEA)6-S-4Pal-







RRSS[CFGGRIDRIGHYSGLGC]







PSFRHGGPPS-Aib-KPPPK-NH2









98
HOOC-(CH2)18-CO-(γGlu)-
121
Thioacetal
6180.9
6180.0



EKEKEKG-(AEEA)6-EK-βAla-







RSS[CFGGRIDRIGHYSGLGC]PS







FRHGSPSSGAPPPS-NH2









99
HOOC-(CH2)18-CO-(γGlu)-
122
Thioacetal
5962.7
5962.4



EKEKEKG-(AEEA)4-EK-ßAla-







RSS[CFGKRIDRIGHYSGLGC]PS







FRHGGKSSGAPPPS-NH2









100
HOOC-(CH2)18-CO-(γGlu)-
123
Thioacetal
6253.0
6252.3



EKEKEKG-(AEEA)6-EK-βAla-







RSS[CFGKRIDRIGHYSGLGC]PS







FRHGGKSSGAPPPS-NH2









101
HOOC-(CH2)18-CO-(γGlu)-
124
Thioacetal
5353.0
5352.2



EKEKEKGEK-ßAla-







RSS[CFGKRIDRIGHYSGLGC]PS







FRHGSPSSGAPPPS-NH2









102
HOOC-(CH2)18-CO-(γGlu)-
125
Thioacetal
6510.4
6510.0



EKEKEKG-PEG24-EK-βAla-







RSS[CFGKRIDRIGHYSGLGC]PS







FRHGGKSSGAPPPS-NH2









103
HOOC-(CH2)18-CO-(γGlu)-
126
Thioacetal
5961.7
5961.2



EKEKEKG-(AEEA)4-EK-βAla-







RSS[CFGKRIDRIGHYSGLGC]PS







FRHGSPSSGAPPPS-NH2









104
HOOC-(CH2)18-CO-(γGlu)-
127
Thioacetal
6316.1
6316.2



EKEKEKG-(AEEA)6-S-4Pal-







RRSS[CFGKRIDRIGHYSGLGC]







PSFRHGGKSSGAPPPS-NH2









105
HOOC-(CH2)18-CO-(γGlu)-
128
Thioacetal
6252.0
6251.4



EKEKEKG-(AEEA)6-EK-βAla-







RSS[CFGKRIDRIGHYSGLGC]PS







FRHGSPSSGAPPPS-NH2









106
HOOC-(CH2)18-CO-(γGlu)-
129
Thioacetal
6509.4
6508.8



EKEKEKG-PEG24-EK-βAla-







RSS[CFGKRIDRIGHYSGLGC]PS







FRHGSPSSGAPPPS-NH2









107
HOOC-(CH2)18-CO-(γGlu)-
130
Thioacetal
6605.4
6605.0



EKEKEKG-(AEEA)8-S-4Pal-







RRSS[CFGKRIDRIGHYSGLGC]







PSFRHGSPSSGAPPPS-NH2









108
HOOC-(CH2)18-CO-(γGlu)-
131
Thioacetal
6542.3
6542.4



EKEKEKG-(AEEA)8-EK-ßAla-







RSS[CFGKRIDRIGHYSGLGC]PS







FRHGSPSSGAPPPS-NH2









109
HOOC-(CH2)18-CO-(γGlu)-
132
Thioacetal
6538.5
6538.5



EKEKEKG-PEG24-S-4Pal-







RRSS[CFGKRIDRIGHQSGLGC]







PSFRHGGKSSGAPPPS-NH2









110
HOOC-(CH2)18-CO-(γGlu)-
133
Thioacetal
6573.5
6573.6



EKEKEKG-PEG24-S-4Pal-







RRSS[CFGKRIDRIGHYSGLGC]







PSFRHGGKSSGAPPPS-NH2









111
HOOC-(CH2)18-CO-(γGlu)-
134
Thioacetal
6159.9
6158.4



EKEKEKG-(AEEA)6-S-4Pal-







βAla-







RSS[CFGGRIDRIGHYSGLGC]PS







FRHGSPSSGAPPPS-NH2









112
HOOC-(CH2)18-CO-(γGlu)-
135
Thioacetal
5416.1
5416.2



EKEKEKGS-4Pal-







RRSS[CFGKRIDRIGHYSGLGC]







PSFRHGSPSSGAPPPS-NH2









113
HOOC-(CH2)18-CO-(γGlu)-
136
Thioacetal
6315.1
6314.0



EKEKEKG-(AEEA)6-S-4Pal-







RRSS[CFGKRIDRIGHYSGLGC]







PSFRHGSPSSGAPPPS-NH2









114
HOOC-(CH2)18-CO-(γGlu)-
137
Thioacetal
5379.1
5378.1



EKEKEKGEKPRSS[CFGKRIDRI







GHYSGLGCJPSFRHGSPSSGAPP







PS-NH2









115
HOOC-(CH2)18-CO-(γGlu)-
138
Thioacetal
6572.5
6571.8



EKEKEKG-PEG24-S-4Pal-







RRSS[CFGKRIDRIGHYSGLGC]







PSFRHGSPSSGAPPPS-NH2









116
HOOC-(CH2)18-CO-(γGlu)-
139
Thioacetal
6422.2
6421.8



EKEKEKG-(AEEA)6-







EKPRSS[CFGKRIDRIGHYSGLG







CJPSFRHSGSPSSGAPPPSG-NH2









117
HOOC-(CH2)18-CO-(γGlu)-
140
Thioacetal
6516.3
6516.0



EKEKEKG-(AEEA)6-S-4Pal-







RRSS[CFGKRIDRIGHYSGLGC]







PSFRHGSGSPSSGAPPPSG-NH2









118
HOOC-(CH2)18-CO-(γGlu)-
141
Thioacetal
6471.2
6471.0



EKEKEKG-(AEEA)8-EK-βAla-







RSS[CFGGRIDRIGHYSGLGC]PS







FRHGSPSSGAPPPS-NH2









119
HOOC-(CH2)18-CO-(γGlu)-
142
Thioacetal
6217.0
6216.3



EKEKEKG-(AEEA)6-EK-ßAla-







RSS[CFGKRIDRIGHQSGLGC]PS







FRHGSPSSGAPPPS-NH2









120
HOOC-(CH2)18-CO-(γGlu)-
143
Thioacetal
6507.3
6507.0



EKEKEKG-(AEEA)8-EK-ßAla-







RSS[CFGKRIDRIGHQSGLGC]PS







FRHGSPSSGAPPPS-NH2









121
HOOC-(CH2)18-CO-(γGlu)-
145
Thioacetal
6438.3
6438.4



EKEKEKG-PEG24-EK-βAla-







RSS[CFGGRIDRIGHYSGLGC]PS







FRHGSPSSGAPPPS-NH2









122
HOOC-(CH2)18-CO-(γGlu)-
147
Thioacetal
6278.0
6277.6



EKEKEKG-(AEEA)6-







EKPRSS[CFGKRIDRIGHYSGLG







CJPSFRHGSPSSGAPPPS-NH2









123
HOOC-(CH2)18-CO-(γGlu)-
148
Thioacetal
6568.4
6568.0



EKEKEKG-(AEEA)8-







EKPRSS[CFGKRIDRIGHYSGLG







CJPSFRHGSPSSGAPPPS-NH2









124
HOOC-(CH2)18-CO-(γGlu)-
149
Thioacetal
6679.6
6679.4



EKEKEKG-PEG24-







EKPRSS[CFGKRIDRIGHYSGLG







CJPSFRHSGSPSSGAPPPSG-NH2









125
HOOC-(CH2)18-CO-(γGlu)-
150
Thioacetal
6535.4
6535.2



EKEKEKG-PEG24-







EKPRSS[CFGKRIDRIGHYSGLG







C]PSFRHGSPSSGAPPPS-NH2









126
HOOC-(CH2)18-CO-(γGlu)-
151
Thioacetal
6712.9
6712.8



EKEKEKG-(AEEA)8-







EKPRSS[CFGKRIDRIGHYSGLG







C]PSFRHSGSPSSGAPPPSG-NH2









127
HOOC-(CH2)18-CO-(γGlu)-
152
Thioacetal
5372.1
5371.8



EKEKEKGEKPRSS[CFGKRIDRI







GHQSGLGCJPSFRHGSPSSGAPP







PS-NH2









128
HOOC-(CH2)18-CO-(γGlu)-
153
Thioacetal
5381.1
5380.8



EKEKEKGEK-βAla-







RSS[CFGKRIDRIGHYSGLGC]PS







FRHGSPSSGAPPPS-NH2









129
HOOC-(CH2)18-CO-(γGlu)-
154
Thioacetal
5798.7
5798.7



EKEKEKG-PEG24-EK-βAla-







RSS[CFGKRIDRIGHYSGLGC]PS







FRHGGP-NH2









130
HOOC-(CH2)18-CO-(γGlu)-
155
Thioacetal
5763.6
5763.8



EKEKEKG-PEG24-EK-βAla-







RSS[CFGKRIDRIGHQSGLGC]PS







FRHGGP-NH2









131
HOOC-(CH2)18-CO-(γGlu)-
156
Thioacetal
5573.2
5572.2



EKEKEKGEKPRSS[CFGKRIDRI







GHQSGLGC]PSFRHGSGSPSSG







APPPSG-NH2









132
HOOC-(CH2)18-CO-(γGlu)-
157
Thioacetal
6644.5
6644.0



EKEKEKG-PEG24-







EKPRSS[CFGKRIDRIGHQSGLG







CJPSFRHSGSPSSGAPPPSG-NH2









133
HOOC-(CH2)18-CO-(γGlu)-
160
Thioacetal
6545.4
6544.8



EKEKEKG-PEG24-







EKPRSS[CFGKGIDRIGHQSGLG







CJPSFRHSGSPSSGAPPPSG-NH2









134
HOOC-(CH2)18-CO-(γGlu)-
161
Thioacetal
5349.1
5348.4



EKEKEKGEKPRSS[CFGKRIDRI







G-Orn-







QSGLGCJPSFRHGSPSSGAPPPS-







NH2









135
HOOC-(CH2)18-CO-(γGlu)-
162
Thioacetal
5384.1
5383.8



EKEKEKGEKPRSS[CFGKRIDRI







G-Orn-







YSGLGCJPSFRHGSPSSGAPPPS-







NH2









136
HOOC-(CH2)18-CO-(γGlu)-
163
Thioacetal
5365.0
5364.6



EKEKEKGEKPRSS[CFG-Dap-







RIDRIGHYSGLGCJPSFRHGSPS







SGAPPPS-NH2









137
HOOC-(CH2)18-CO-(γGlu)-
164
Thioacetal
5330.0
5329.8



EKEKEKGEKPRSS[CFG-Dap-







RIDRIGHQSGLGCJPSFRHGSPS







SGAPPPS-NH2









138
HOOC-(CH2)18-CO-(γGlu)-
165
Thioacetal
5265.9
5266.1



EKEKEKGEKPRSS[CFGG-Dap-







IDRIGHYSGLGCJPSFRHGSPSS







GAPPPS-NH2









139
HOOC-(CH2)18-CO-(γGlu)-
166
Thioacetal
5230.9
5230.8



EKEKEKGEKPRSS[CFGG-Dap-







IDRIGHQSGLGC]PSFRHGSPSS







GAPPPS-NH2









140
HOOC-(CH2)18-CO-(γGlu)-
167
Thioacetal
5426.2
5426.4



EKEKEKGEKPRSS[CFGKRIDRI







GRYSGLGCJPSFRHGSPSSGAPP







PS-NH2









Example 141

Example 141 is a polypeptide represented by the following description (SEQ ID NO: 168). BFA-EKEKEKGEKGRSS[CFGGKIDRIGHYSGLGC]PSFRHGGPSSGAPPPS-NH2


(Disulfide Linkage)
BFA Means Bifurcated Fatty Acid

Below is a depiction of the structure of Example 141 using the standard single letter L-amino acid codes.




embedded image


The peptide backbone of Example 141 was synthesized using Fluorenylmethyloxycarbonyl (Fmoc)/tert-Butyl (t-Bu) chemistry on a Symphony-X, 24-channel multiplex peptide synthesizer (Gyros Protein Technologies, Inc.). The solid support used consists of low loading 4-(2′,4′-Dimethoxyphenyl-Fmoc-aminomethyl)-phenoxyacetamido-norleucyl-4-Methylbenzhydrylamine resin (Fmoc-Rink-MBHA Low Loading resin, EMD Millipore), (100-200 mesh) with a 1% DVB cross-linked polystyrene core and a substitution range of 0.3-0.4 meq/g. Standard sidechain protecting groups were used for all Fmoc-L-Amino Acids used. Fmoc deprotection prior to each coupling step was done by treatment with 20% Piperidine in DMF, (1×4 minutes and 1×10 minutes 7) with nitrogen mixing followed by 6×DMF washing cycles. All amino acid couplings were performed for 1 hour using the Fmoc Amino Acid (0.3 M in DMF), N, N. N′,N′-Tetramethyl-O-(1H-benzotriazol-1-yl)uronium hexafluorophosphate (HBTU, Ambeed Inc; 0.9 M in DMF) and N,N-Diisopropylethylamine (DIPEA; 1.2 M in DMF), at a 9-fold molar excess of AA/HBTU and a 12-fold molar excess of DIPEA over the theoretical resin loading level. After the primary sequence of the peptide was synthesized and the final Fmoc-deprotection and washes were completed.


Attachment of the fatty acid (BFA) moiety was accomplished by manual addition of a 2-3-fold excess of 13-tert-butoxy-2-tert-butoxycarbonyl-13-oxo-2-undecyl-tridecanoicacid which was dissolved in 5-7 mL of DMF and transferred to the Symphony-X reaction vessel followed by the addition of 2-3-fold excess diisopropylcarbodiimide (DIC) and 2-3 fold excess of ethyl-cyano(hydroxyamino)acetate (Oxyma). The reaction time for the BFA coupling was ˜18 hours, after which point the resin was washed 3× with DMF and a Kaiser test was performed to ensure coupling completion. After the acylation was completed, the peptidyl resin was transferred, as a DCM slurry, to disposable fritted plastic syringe fitted with Teflon stopcock and further washed with DCM were done, finally, the resin was thoroughly air-dried. The dry resin was then treated with 10 mL of cleavage cocktail consisting of trifluoroacetic acid (TFA), water, 3,6-dioxa-1,8-octanedithiol (DODT), triisopropylsilane (TIPS), (TFA:Water:DODT:TIPS: 92.5:2.5:2.5:2.5 v/v) for 2 hours at room temperature. After the 2 hr incubation, the resin was filtered off and collected in a 50 ml conical disposable tube containing 35 mL of cold diethyl ether (−20° C.) to precipitate the crude peptide. The peptide/ether suspension was then centrifuged at 4000 rpm for 2 min to form a solid pellet, the supernatant was decanted, and the solid pellet was triturated with ether two additional times and dried in vacuo.


Disulfide Linkage Formation

The crude peptide was solubilized in a 50 mL falcon tube with ˜50 mL of a 10% acetonitrile solution in 0.1% TFA-H2O. The solution was then added to an Erlenmeyer flask placed on a magnetic stirrer with requisite spin vane, diluted to 100 mL total volume with 0.1% TFA-H2O (˜5 mg/mL crude peptide concentration) and then treated with several drops of a saturated Iodine in methanol solution until a faint yellow color persists. The reaction was stirred at RT for 10 minutes at which point the excess iodine was quenched with a few drops of 0.1 M aqueous ascorbic acid.


HPLC Purification

The crude oxidation solution was then directly loaded onto a Waters semi-prep HPLC system and purified on a Symmetry C18 (7 μm, 19×300 mm; Waters) with linear gradients of 100% acetonitrile and 0.1% TFA/water buffer system (10-40% over 70 minutes). The purity of the peptide was assessed using analytical LC-MS and pooling criteria was >90%. The main pool of Example 141 was found to be >95.0%. Subsequent lyophilization of the final main product pool yields the lyophilized peptide as a TFA salt. The molecular weight was determined by analytical LC-MS (obsd:=5194.2; Calc=5194.8).


Example 142

Example 142 is a polypeptide represented by the following description (SEQ ID NO:169). (BFAEN2-βAla)-EKEKEKG-PEG24-EK-βAla-RSS[CFGGKIDRIGHYSGLGC]PSFRHGGKSSGAPPPS-NH2


(Thioacetal Linkage)

BFAEN2 means Bifurcated Fatty Acid Enantiomer 2


Below is a depiction of the structure of Example 142 using the standard single letter amino code with the exception of βAla where the structure of the amino acid has been expanded.




embedded image


The peptide backbone of Example 142 was synthesized as described for Example 141. An exception to the synthetic method was the coupling of Fmoc-N-amido-PEG24-OH which required a pause in the automated synthesis protocol. The PEG24 residue coupling was accomplished by the manual addition of, a 3-fold excess of Fmoc-N-amido-PEG24-OH (BroadPharm) dissolved in 5 mL of DMF and transferred to the Symphony-X reaction vessel followed by the addition of 2-fold excess of diisopropylcarbodiimide (DIC) and 2-fold excess of ethyl-cyano(hydroxyamino)acetate (Oxyma). The reaction time for the coupling was ˜18 hours, after which point the resin was washed 3× with DMF and a Kaiser test was performed to ensure coupling completion. The automated methods were resumed to complete the synthesis of the rest of sequence and the fatty acid was coupled as described below.


Attachment of BFAEN2-βAla

Attachment of the fatty acid was accomplished by manual addition of a 1.5 fold excess of 2-[[3-(2,5-dioxypyrrolidin-1-yl)oxy-3-oxo-propyl]carbamoyl]-2-undecyl-tridecanedioic acid and 3-fold excess of N,N-Diisopropylethylamine (DIPEA) which were dissolved in 5-7 mL of DMF and transferred to the Symphony-X reaction vessel. The reaction time for the FA coupling was ˜18 hours, after which point the resin was washed 3× with DMF. The cleavage was then performed as described for Example 141, followed by disulfide linkage formation as described in Example 141.


Thioacetal Linkage Formation

The crude oxidation solution was then directly loaded onto a Waters semi-prep HPLC and purified on a Symmetry C18 (7 μm, 19×300 mm; Waters) with linear gradients of 100% acetonitrile and 0.1% TFA/water buffer system (10-40% over 70 minutes). The purity of the fractions was assessed using LC-MS and pooling criteria is >80% for fractions to be used for the thioacetal conversion. These fractions are combined and diluted 1:1 with a 50% mixture of acetonitrile-H2O. The disulfide linkage was first reduced by addition of 1 mL of a 0.25M aqueous solution of Tris(2-carboxyethyl)phosphine (TCEP, TCI America) and then 400-500 uL of neat triethylamine (TEA, Sigma Aldrich) is added to bring the pH of solution to >7. After 10 minutes, 50-100 uL of diiodomethane (TCI America) was added followed by an additional 50-100 uL of TEA. The reaction is monitored by LC-MS and conversion is completed withing ˜18 hours.


The crude thioacetal solution is diluted 1:1 with H2O and then loaded onto a Waters semi-prep HPLC system and purified on a Symmetry C18 (7 μm, 19×300 mm; Waters) with linear gradients of 100% acetonitrile and 0.1% formic acid/water buffer system (5-35% over 70 minutes). The purity of the peptide is assessed using LC-MS and pooling criteria is >90% and ˜100 uL of neat TFA is added to the pooled fractions. The main pool of Example 142 was found to be >95.0%. Subsequent lyophilization of the final main product pool yields the lyophilized peptide TFA salt. The molecular weight was determined by analytical LC-MS (obsd:=6452.5; Calc=6453.4).


Example 143

Example 143 is a polypeptide represented by the following description (SEQ ID NO:170) (BFAEN2-βAla)-EKEKEKG-PEG24-E-4Pal-KRSS[CFGKKIDRIGHYSGLGC]PSFRHGGKSSGAPPPS-NH2


(Thioacetal Linkage)



embedded image


Example 143 was synthesized substantially as described in Example 142. The molecular weight was determined by LC-MS (obsd:=6601.6; Calc=6601.5).


Example 144

Example 144 is a polypeptide represented by the following description (SEQ ID NO:171) (BFAEN2-βAla)-EKEKEKG-PEG24-EK-βAla-RSS[CFGKRIDRIGHQSGLGC]PSFRHGSPSSGAPPPS-NH2


(Thioacetal Linkage)



embedded image


Example 144 was synthesized substantially as described for Example 142. The molecular weight was determined by LC-MS (obsd:=6515.6; Calc=6516.4).


Example 145

Example 145 is a polypeptide represented by the following description (SEQ ID NO: 172) (BFAEN2-γGlu)-KEKEKG-PEG24-EK-βAla-RSS[CFGGKIDRIGHYSGLGC]PSFRHGSPSSGAPPPS-NH2


(Thioacetal Linkage)



embedded image


Example 145 was synthesized substantially as described for Example 142 with the attachment of the BFAEN2-γGlu as described below.


Attachment of BFAEN2-γGlu

Attachment of the fatty acid was accomplished by manual addition of 1.5 fold excess of 2-[[(1S)-1-tert-butoxycarbonyl-4-(2,5-dioxopyrrolidin-1-yl)oxy-4-oxo-butyl]carbamoyl]-2-undecyl-tridecanedioic acid and 3-fold excess of N,N-Diisopropylethylamine (DIPEA) which were dissolved in 5-7 mL of DMF and transferred to the Symphony-X reaction vessel. The reaction time for the FA coupling was ˜18 hours, after which point the resin was washed 3× with DMF. The cleavage was then performed as described for Example 141.


Disulfide linkage formation, followed by thioaetal linkage formation was performed as described in Example 142.


The molecular weight was determined by LC-MS (obsd:=6381.6; Calc=6381.2).


In Vitro Function
Functional Activity Assays:

Functional activity of the ANP polypeptides is determined in NPR-A-expressing HEK-293 clonal cell lines as explained below.


Full-Length cDNA Cloning and Generation of Cell Lines Overexpressing Natriuretic Peptide Receptors (NPRs)


All sequences were verified by full-length sequencing performed by ACGT DNA Sequencing Services (Wheeling, IL). The target cDNA was cloned into pJTI R4 CMV-TO MCS pA vector and then co-transfected with pJT1R4 Int vector into Jump-in™ T-Rex™ HEK293 cells for mammalian inducible expression using Jump-in™ T-Rex™ HEK293 kit and Lipofectamine LTX and Plus Reagent following manufacturer's protocols, as briefly described below.


Jump-in™ T-Rex™ HEK293 cells were plated in a BioCOAT® poly-D-lysine coated 6-well plate (Becton Dickinson, cat no. 354413) at 1 million cells/well in 2 mL culture medium and incubated for 18 h at 37° C. and 5% CO2 to 50-70% confluence. A cDNA mix was made in a 50 mL tube by adding 1.5 μg target cDNA, 1.5 μg pJT1R4 Int vector, 3 μL Plus Reagent, and 300 μL Opti-MEM I sequentially into the tube. A reagent mix was made in a separate 50 mL tube by adding 7.5 μL Lipofectamine LTX into 300 μL Opti-MEM I. The mixtures were incubated for 5 min at room temperature. The cDNA mix was then transferred into the reagent mix, mixed well, and incubated for additional 30 min at room temperature. A 500 μL of cDNA/Lipofectamine complex was then transferred to the wells of the cell plate in which the culture medium was changed to 2 mL of transfection medium containing DMEM with 4.5 g/L D-glucose supplemented with 10% FBS-HI and 20 mM HEPES. Transfected cells were cultured for 48 h in an incubator at 37° C. and 5% CO2. A subclone or pool from each overexpressing cell line was maintained in culture medium with the addition of 2 mg/mL G418 sulfate for the clone selection based on its built-in resistance to G418 sulfate for at least 3 weeks with medium changed every 2-3 days.


NPRs were overexpressed in T-Rex™ HEK293 cells following the induction with 300 ng/mL tetracycline in culture medium for 48 h. Induced cell lines in an exponential growth phase were treated with 0.05% trypsin-EDTA for a few seconds at room temperature, harvested in cell medium containing FBS to neutralize the trypsin, counted, and cryopreserved at the density of 2 million cells/mL in cell preservation solution containing FBS-HI with 5% DMSO. Cryopreserved cells were stored at −80° C. for a few days prior to transferring to a liquid nitrogen tank. Induced cell lines were then used for suspension assays to measure the activity of polypeptides to stimulate cGMP production in cGMP assays or for the preparation of cell membranes to measure the binding activity of polypeptides in competitive radioligand binding assays, as described below.


Human and Rat NPRA cGMP Activity Assays


Cells overexpressing human or rat NPRA were plated in 96-well assay plates and stimulated in the presence of assay buffer (normalized as 0% response), human ANP, amidated rat ANP (100 nM, normalized as 100% response), or varying concentrations of test polypeptides. Test polypeptides were added starting at 10 μM concentration and at 10-fold decreasing concentrations to obtain 8-point concentration-response curves (i.e., 10 μM to 1 pM). The quantity of cGMP generated was detected using HTRF® technology and normalized to maximum amount produced by 100 nM amidated rat ANP and the minimum amount produced by assay buffer. Detailed steps are outlined below.


Stock solutions of test polypeptides (2 mM) dissolved in DMSO were first diluted 100-fold in assay buffer containing HBSS with Ca2+ and Mg2+, 5 mM HEPES, 0.5 mM IBMX, and 0.1% BSA or 0.1% casein (pH 7.4). The polypeptides were further serially diluted in 1:10 dilution steps in assay buffer containing 0.1% BSA or 0.1% casein to generate 8-point 2× working stock solutions ranging from 20 μM to 2 μM.


A 10 μL cell suspension containing 4000 cells was plated in Costar® half-area white opaque 96-well plates (Corning, cat no. 3693). Then 10 μL of assay buffer (basal activity), 200 nM of amidated rat ANP (maximum activity) or 2× working stock solutions of test polypeptides were transferred into the plate. Final concentration of DMSO in each well was 0.5%. The plate was shaken for 15 sec and then incubated for 40 min at room temperature.


The cGMP generated was measured using cGMP kit following the manufacturer's directions, as described below.


Cyclic GMP (cGMP) standards provided in the kit were serially diluted 1:3 ranging from 1 μM to 0.17 nM in assay buffer containing 0.1% BSA plus 0.5% DMSO or 0.1% casein plus 0.5% DMSO. The cGMP standards (20 μL) were then transferred to a separate Costar® 3693 plate.


The cGMP production was terminated, and the cGMP content was measured by sequentially adding 10 μL of cGMP-d2 and 10 μL of anti-cGMP-Cryptate, which were previously diluted 1:50 in lysis buffer provided in the kit. The plate was shaken for 15 sec, incubated for 2 h at room temperature in dark, and read in a Pherastar® FSX plate reader (BMG LABTECH, Ortenberg, Germany) at 337 nm for excitation and 665 nm/620 nm for emission.


The ratios of 665 nm/620 nm multiplied by 10000 were plotted with log-scale cGMP standard concentrations to generate a standard curve using an internally created 4-parameter nonlinear regression curve fitting template. The quantity of cGMP produced by cells overexpressing NPRA was interpolated using the cGMP standard curve. A 100% response was determined from wells in the presence of a saturating concentration of amidated rat ANP (100 nM). A 0% response was determined from wells containing assay buffer. The 8-point concentration-response curve for test polypeptides (10 μM to 1 μM) was fitted to a 4-parameter model using Prism 9 (GraphPad Software, Inc., San Diego, CA) to determine potency (EC50) values and maximal activation (% Max).


Data for exemplary analogs and hANP are shown in Table 2 below.









TABLE 2







Functional cGMP Potency (EC50) for exemplary ANP


polypeptides and Comparator polypeptide hANP. EC50


is the concentration of polypeptide causing half-


maximal simulation in a dose response curve.












cGMP Assay
cGMP Assay



SEQ
(EC50, pM) w/BSA
(EC50, pM) w/Casein












Ex
ID NO
hNPRA
rNPRA
hNPRA
rNPRA















human ANP
1
205
315
177
279


rat ANP
173
138
114
128
73


(amidated)


1
45
11617
81882
335
1810


2
60
93424
1272591
1016
14104


3
107
6918
958800
980
36550


4
144
6185
518700
813
22525


5
146
33887
276367
679
1132


6
158
33292
596480
1532
30482


7
159
69562
1166520
5668
184378


8
28
81280
38048
1496
493


9
29
100500
46740
1874
509.4


10
30
64190
88400
1308
501


11
31
24435
24690
1020
242


12
32
108700
85470
1517
670


13
33
145200
24000
1919
241


14
34
27740
37810
685
1172


15
35
57270
32560
912
254


16
36
54690
480450
807
4068


17
37
153100
360700
20500
9044


18
38
17090
43200
460
693


19
39
67250
258900
852
1830


20
40
129100
104185
2902
1391


21
41
27780
268400
824
1950


22
42
25060
191900
840
1688


23
43
125100
218900
3491
1681


24
44
20980
66080
560
702.65


25
46
12030
57300
436
654


26
47
17770
119200
682
803


27
48
18760
130000
130
807


28
49
11270
92910
131
1028


29
50
32162
1906500
482
16842


30
51
16670
123000
302
1128


31
52
13845
795250
332
12216


32
53
27400
358600
246
1434


33
54
22230
112000
199
383


34
55
26090
421600
291
1202


35
56
12200
178600
118
427


36
57
18000
86480
118
277


37
58
14400
84550
196
461


38
59
16040
40528
317
373


39
61
9968
93270
276
439


40
62
23025
294700
351
2040


41
63
29140
239100
224
1136


42
64
24980
69030
358
533


43
65
27616
76275
301
605


44
66
33107
93038
431
1346


45
67
25210
84210
362
510


46
68
21250
88260
230
460


47
69
24340
119500
299
650


48
70
50470
91800
611
755


49
71
29940
87000
299
667


50
72
22510
143850
614
1929


51
73
11110
82660
361
909


52
74
24710
823400
293
10950


53
75
14870
779700
484
7118


54
76
19275
77200
369
796


55
77
18450
34580
451
493


56
78
145000
1376000
855
11250


57
79
48840
357200
1157
9505


58
80
103500
1378000
1218
7151


59
81
25340
381100
622
2495


60
82
81660
962300
453
4827


61
83
9002
462700
912
31950


62
84
17330
588400
2164
25520


63
85
63802
784650
1090
10607


64
86
24500
366100
758
3402


65
87
81970
893300
614
7415


66
88
140300
1747000
826
9770


67
89
138833
1554000
1218
18773


68
90
96830
1284000
924
12110


69
91
61450
804500
801
20150


70
92
92520
711900
1836
11770


71
93
15629
594165
594
21018


72
94
46448
1065885
588
40544


73
95
5822
76416
1233
26019


74
96
171400
1133000
1588
5816


75
97
16950
532600
1059
23795


76
98
79940
607000
2618
8278


77
99
46200
637400
1274
15720


78
100
19740
626900
2389
33370


79
101
4581
261100
273
3437


80
102
4750
364050
234
3550


81
103
5714
126883
388
1914


82
104
32610
835700
623
25400


83
105
38405
860150
1043
16680


84
106
9727
546900
1011
24610


85
108
13200
418900
361
7785


86
109
25190
867700
1021
17940


87
110
3375
463100
621
8866


88
111
16280
1048000
520
11450


89
112
10790
819000
806
13800


90
113
19720
734300
452
13230


91
114
13860
549000
1003
16170


92
115
10110
289700
772
12380


93
116
53160
702300
1653
51990


94
117
73900
1299000
1604
56960


95
118
7026
321800
771
12296


96
119
12715
400650
720
12168


97
120
7870
198300
720
9146


98
121
40865
625250
1842
17890


99
122
13600
455100
800
6290


100
123
6584
272900
944
10910


101
124
11590
138200
282
1340


102
125
3492
154100
749
15090


103
126
12320
375700
567
2138


104
127
4473
311500
527
2632


105
128
9179
135300
461
4383


106
129
4332
186800
741
9631


107
130
3773
149100
646
3775


108
131
6141
193050
497
11224


109
132
2558
276400
488
16840


110
133
2207
89140
580
5318


111
134
31730
568300
1532
13430


112
135
7471
93460
376
1541


113
136
6021.5
149150
621
6356


114
137
10440
72210
976
1206


115
138
2830
100000
726
5646


116
139
8969
205400
745
3832


117
140
9174
199800
922
6041


118
141
31120
681700
3323
55700


119
142
12820
623400
493
17930


120
143
10000
695800
542
25430


121
145
35290
368120
2573
29800


122
147
6380
149800
490
3772


123
148
9546
147300
902
3990


124
149
3982
74302
656
4508


125
150
5169
80170
736
4851


126
151
6372
88530
1093
3756


127
152
41490
341300
703.2
2015


128
153
23670
498000
566
2013


129
154
2957
59410
1006.
2277


130
155
1273
197400
669.1
9165


131
156
37560
815850
392
2159


132
157
5304
259533
704
9386


133
160
302200
1447000
38680
580500


134
161
84730
2253000
930
191900


135
162
104100
6517000
497
185900


136
163
100100
2428000
1379
32890


137
164
155300
2189000
769
76860


138
165
1410000
3796000
5349
71710


139
166
2870000
1729000
19700
200000


140
167
11690
4178000
692
41100









As seen in Table 2, in the presence of BSA, exemplary ANP polypeptides have agonist activities as determined by hNPR-A assays, which are lower than the native ligand hANP. However, when the assays are conducted in the presence of casein (instead of serum albumin) as a nonspecific blocker, which does not interact with the fatty acid moieties of the analyzed molecules, the exemplary ANP polypeptides have agonist activities which are comparable to hANP.


Human and Rat NPRB cGMP Activity Assays


Functional activity of the ANP polypeptides is determined in NPR-B-expressing HEK-293 clonal cell lines as explained below.


Cells overexpressing human or rat NPRB were plated in 96-well assay plates and stimulated in the presence of assay buffer (normalized as 0% response), human CNP-22 (1 μM, normalized as 100% response), or varying concentrations of test polypeptides. Test polypeptides were added starting at 10 μM concentration and at 10-fold decreasing concentrations to obtain 10-point concentration-response curves (i.e., 10 μM to 0.01 μM). The quantity of cGMP generated was detected using HTRF® technology and normalized to the maximum amount produced by 1 μM human CNP-22 and the minimum amount produced by assay buffer. Detailed steps are outlined below.


Stock solutions of test polypeptides (2 mM) dissolved in DMSO were first diluted 100-fold in assay buffer containing HBSS with Ca2+ and Mg2+, 5 mM HEPES, 0.5 mM IBMX, and 0.1% BSA or 0.1% casein (pH 7.4). The polypeptides were further serially diluted in 1:10 dilution steps in assay buffer containing 0.1% BSA or 0.1% casein to generate 10-point 2× working stock solutions ranging from 20 μM to 0.02 μM.


A 15 μL assay buffer (basal activity), 1 μM human CNP-22 (maximum activity) or 2× working stock solutions of test polypeptides were transferred into a Costar® 3693 plate. A 15 μL cell suspension containing 4000 cells was then plated. Final concentration of DMSO in each well was 0.5%. The plate was shaken for 15 sec and then incubated for 40 min at room temperature.


The cGMP generated was measured using cGMP kit following the manufacturer's directions as described below.


Cyclic GMP (cGMP) standards provided in the kit were serially diluted 1:3 ranging from 1 μM to 0.17 nM in assay buffer containing 0.1% BSA plus 0.5% DMSO or 0.1% casein plus 0.5% DMSO. The cGMP standards (30 μL) were transferred to a separate Costar® 3693 plate.


The cGMP production was terminated, and the cGMP content was measured by sequentially adding 15 μL of cGMP-d2 and 15 μL of anti-cGMP-Cryptate which were previously diluted 1:50 in lysis buffer provided in the kit. The plate was shaken for 15 sec, incubated for 2 h at room temperature in dark, and read in a Pherastar® FSX plate reader at 337 nm for excitation and 665 nm/620 nm for emission.


The ratios of 665 nm/620 nm multiplied by 10000 were plotted with log-scale cGMP standard concentrations to generate a standard curve using an internally created 4-parameter nonlinear regression curve fitting template. The quantity of cGMP produced by cells overexpressing NPRB was interpolated using the cGMP standard curve. A 100% response was determined from wells in the absence of test polypeptide and the presence of a saturating concentration of human CNP-22 (1 μM). A 0% response was determined from wells containing assay buffer. The 10-point concentration-response curve for test polypeptides (10 μM to 0.01 μM) was fitted to a 4-parameter model using Prism 9 to determine potency (EC50) values and maximal activation (% Max).


Similar to hANP, none of the exemplary polypeptides exhibited significant agonist activity at NPR-B.


In Vivo Studies
Pharmacokinetics in Male Sprague Dawley Rats:

The pharmacokinetics of the exemplary analogs are evaluated following a single subcutaneous administration of 200 nM/kg to male Sprague Dawley rats. Blood samples are collected over 120 hours, and resulting individual plasma concentrations are used to calculate pharmacokinetic parameters. Peptide plasma (K3 EDTA) concentrations are determined using a qualified LC/MS method that measured the intact mass of the ANP polypeptide. Each peptide and an analog as an internal standard are extracted from 100% specie specified plasma using methanol with 0.1% formic acid. A Thermo Q-Exactive, High Resolution Instrument, and a Thermo Easy Spray PepMap are combined for LC/MS detection. Mean pharmacokinetic parameters are shown in Table 3.









TABLE 3







Mean Pharmacokinetic Parameters of Peptides Following


a Single Subcutaneous Administration of 200


nMol/kg to Male Sprague Dawley Rats.














CL/F




Ex
SEQ ID NO
mL/kg/Hours
hours
















1
45
20.6
11



4
144
4.3
15



6
158
6.5
17



7
159
3.3
19



8
28
41.9
15



29
50
32.7
12



30
51
12.6
16



56
78
11.2
36



61
83
64.9
6



62
84
23.7
10



75
97
10.9
17



76
98
7.1
30











Studies in the Salty drinking water/Unilateral Nephrectomy/Aldosterone (SAUNA) Mouse Model


The effect of Exemplary ANP polypeptides is investigated in the Salty drinking water/Unilateral Nephrectomy/Aldosterone (SAUNA) Mouse Model, murine model of heart failure induced by chronic aldosterone infusion. After acclimation for approximately 2 weeks, heart failure is induced in male C57BL/6N (Taconic) mice by uninephrectomy, continuous d-aldosterone infusion and 1.0% sodium chloride in drinking water for 4 weeks (Tanaka et al., 2016; Valero-Munoz, Li, Wilson, Boldbaatar, et al., 2016; Valero-Munoz, Li, Wilson, Hulsmans, et al., 2016; Yang, Kong, Shuai, Zhang, & Huang, 2020; Yoon et al., 2021). Approximately two weeks after induction of the heart failure protocol, mice are distributed into groups to provide comparable variance in body weight and blood pressure (measured in conscious mice with a noninvasive tail cuff system (Kent Scientific); mice are randomized using Block Randomized Allocation Tool (BRAT, Eli Lilly and Company). Once randomized, mice are treated once daily via subcutaneous (SC) injection of an ANP polypeptide (0.4 mg/kg). Blood pressure is monitored weekly for the duration of the study. Two weeks after initiation of treatment (4 weeks post induction of heart failure) mice are anesthetized with isoflurane, intubated via tracheotomy and chest opened to expose the heart and allow placement of a pressure volume catheter (Transonic). The pressure volume (PV) catheter is introduced into the left ventricle via apical stab with a 27G needle. Calibration of the PV catheter is performed according to the manufacturer's instructions. Data are analyzed with LabChart pro software (AD Instruments). After PV loop measurements, mice are sacrificed, and ratio of heart weight to tibia length is used for indicator of hypertrophy.


The effect of Example 8 was investigated using the SAUNA Mouse Model described above. Administration of Example 8 resulted in decrease in blood pressure, heart weight and tibia length, and reduced left ventricle diastolic pressure.


In Vivo Monkey Studies—cGMP Levels


In vivo monkey studies were conducted as described in detail below. Young adult-to-adult male cynomolgus monkeys were given a single dose subcutaneously (SC). Blood was collected predose and at various pre-determined timepoints throughout the study period. Aliquot of cynomolgus monkey plasma was received for cyclic cGMP (cGMP) measurement and stored at −80° C. prior to use.


Control Plasma

Control plasma was made for determining the recovery rate of spike-in cGMP using Enzo cGMP complete ELISA kit (Enzo Life Sciences, Inc, Farmingdale, NY, cat no. ADI-901-164). Briefly, blood from male Sprague Dawley rats (Inotiv, Indianapolis, IN), about 7 months old, was collected in a BD Vacutainer EDTA tube (Becton Dickinson, Franklin Lakes, NJ, cat no. BD-367856) with volume of approximate 4 mL through retro orbital bleeding. Plasma was prepared by spinning the tube in an Eppendorf Refrigerated Centrifuge 5810R (Brinkman Instruments, Inc, Westbury, NY) at 3500 rpm (3000×g) for 10 min at 4° C. Plasma was collected as Positive Control plasma. Cyclic GMP (cGMP standard from Enzo cGMP complete ELISA kit) was added to the positive control plasma at a final concentration of additional 40 nM. Positive Control and Spiked-in Control plasma were aliquoted and stored at −80° C.


Assay Method—Monkey Plasma cGMP ELISA


The cGMP content was measured using the Enzo cGMP complete ELISA kit following the manufacturer's directions with modifications as described below. The cGMP standards provided in the kit were diluted 1:3 ranging from 50 nM to 0.023 nM in 1× assay buffer that was diluted in water from 2× assay buffer provided in the kit. The cGMP standards (150 L) were transferred to a 96-well polypropylene plate (Thermo Scientific, cat no. 442587).


Plasma samples were thawed from −80° C. and diluted 1:20 in 1× assay buffer in the above plate with a final volume of 150 μL. Assay buffer was added (150 μL) for both a non-specific binding control (in the absence of cGMP antibody) and a maximum binding control (in the absence of competing cGMP) in duplicate wells. Positive Control and Spiked-in Control plasma were diluted 1:20 in 1× assay buffer with a final volume of 150 μL in duplicate wells of the above plate. All diluted plasma was mixed by pipetting up and down several times.


Acetylation reagent mix was prepared by adding 1-part of acetic anhydride into 2-parts of triethylamine provided in the kit and mixing well using Vortex (Scientific Industries, Inc, Bohemia, NY). All controls, standards, and plasma samples were acetylated by adding 15 μL of acetylation reagent mix into the plate, one column at a time, and shaking for 1 min on a Titer Plate Shaker (Lab-Line Instrument, Inc., Melrose Park, IL) at room temperature. The plate was shaken for an additional 1 min following the acetylation of the last column to ensure the reaction was completed.


Acetylated controls, standard and plasma samples were transferred (100 μL) to an ELISA plate (n=1). Then 50 μL of cGMP conjugate were added to each well followed by the addition of 50 μL cGMP antibody to each well except for two non-specific binding wells, in which 50 μL of 1× assay buffer were added. The plate was then sealed and shaken for 2 h at room temperature on the plate shaker. Following this incubation, the plate was washed five times using 200 μL of 1× wash buffer diluted in water from 5× wash buffer provided in the kit. Then, 200 μL of para-Nitrophenylphosphate (pNpp) were added to each well. The plate was sealed with a new plate sealer and shaken in dark for 1 h at room temperature on the plate shaker. Finally, 50 μL of stop solution were added to each well to stop the enzyme reaction. The plate was then read at 405 nm using SpectraMax Plus (Molecular Devices, San Jose, CA).


Replicates

N=3 monkeys per group.


Data Analysis

The mean absorbance at 405 nm (O.D. 405 nm) for the non-specific binding controls was subtracted from the O.D. 405 nm of all samples. The subtracted O.D. 405 nm of all samples were then normalized with the mean subtracted O.D. 405 nm of the maximum binding controls as B/B0%. B/B0% of cGMP standards were then plotted with log scale cGMP standard concentrations to generate a standard curve using an internally created 4-parameter nonlinear regression curve fitting template. The quantity of total cGMP presented in the experimental samples was interpolated using this standard curve in the template. The net cGMP changes (nM) were calculated by subtracting cGMP value of each animal which was measured in the plasma prior to dosing the respective polypeptide as shown in Table 4 (predosing, Time 0) from cGMP value of the same animal at each time point postdose. Microsoft Excel (Microsoft, Redmond, WA) was used to graph cGMP (nK, mean±SEM) and net cGMP changes (nM, mean±SEM) at varying time points. Monkey cGMP Data is shown in Table 4.











TABLE 4







Example
Dose
Net cGMP (nM) Change from Baseline















#
(nmol/kg)
0.083 h
0.25 h
0.5 h
1 h
2 h
4 h
8 h





1
100
2.21
9.18
18.73
27.34
37.39
34.82
22.24


2
30
1.39
4.06
4.07
4.19
−0.22
0.08
3.28


2
100
2.8
12.56
11.31
8.62
0.5
2.54
6.66


2
300
6.7
33
43.45
37.82
32.01
24.72
37.43


2
1000
10.16
57.63
98.81
103.78
64
10.35
41.22


3
100
4.1
17.89
27.34
31.14
32.56
32.25
25.95


4
3
−0.83
−0.4
−0.15
−0.79
−0.76
−0.47
3.72


4
10
NT
NT
NT
NT
4.57
12.42
14.86


4
30
NT
NT
NT
NT
21.5
32.08
34.86


4
100
NT
NT
NT
NT
49.51
59.41
42.29


4
100
3.5
13.15
22.17
20.35
21.06
23.76
15.58


4
300
NT
NT
NT
NT
98.01
85.85
53.11


6
25
−2.93
0.03
1.5
1.64
6.23
7.98
20.26


7
25
−1.1
−1.04
2.16
2.41
1.45
3.9
14.3


7
25
0.2
1.69
4.14
2.62
3.84
6.17
11.73


7
50
−0.94
0.47
0.93
4.95
5.72
13.07
24.58


7
100
2.42
8.95
11.78
17.22
22.56
27.89
41.05


7
300
−1
9.8
23.08
37.7
53.76
54.16
44.13


29
100
2.13
3.52
9.03
10.14
15.28
17.75
26.8


56
100
−2.8
−0.66
−0.65
−0.51
−1.82
1.83
10.57


61
100
4.41
24.85
27.32
28.35
25.21
28.38
33.73


81
100
5.6
32.08
37.47
43.98
38.64
31.25
23.05


89
100
6.83
20.73
33.07
35.04
36.11
42.86
36.71


106
100
3.54
19.8
25.25
24.83
26.38
26.16
14.03


127
50
−0.87
4.09
8.84
8.13
8.92
10.25
13.28


132
25
2.96
11.54
25
29.41
28.64
28.7
24.12


136
50
3.25
12.48
20.78
12.12
9.42
8.76
7.65


144
100
5.9
18.26
27.08
36.51
35.21
27.1
20.15


145
25
−0.82
2.94
4.37
3.19
8.88
11.23
17.87











Example
Net cGMP (nM) Change from Baseline
















#
12 h
24 h
36 h
48 h
72 h
96 h
120 h
144 h
168 h





1
19.05
16.84
17.46
12.14
9.81
10.89
8.92
9.71
8.18


2
3.34
8.88
NT
6.46
6.21
4.47
4.89
6.49
5.95


2
6.31
10.19
NT
5.05
4.47
8.44
4.3
1.77
7.01


2
36.62
37.61
NT
24.8
19.18
23.07
17.55
15.69
18.7


2
31.77
38.08
NT
27.41
22.49
25.37
19.01
19.69
20.33


3
26.49
19.56
16.01
10.79
9.28
9.23
9.96
8.99
9.69


4
7.53
5.4
11.74
2.99
0.03
−1.15
−0.02
0.16
−2.03


4
16
14.43
20.84
16.53
5.18
1.93
0.69
−0.1
0.3


4
30.33
20.57
26.96
17.93
5.07
7.97
9.92
7.07
9.85


4
29.13
13.98
18.07
11.58
8.8
5.89
8.1
3.77
8.04


4
14.92
11.14
8.97
5.62
2.9
4.82
4.43
5.24
2.94


4
38.75
17.46
17.49
15.02
12.59
12.35
12.49
10.25
12.43


6
25.73
23.75
22.42
16.24
9.97
11.47
4.62
6.86
5.86


7
15.75
20.19
20.61
19.48
19.25
11.24
11.21
12.51
8.98


7
13.86
19.02
NT
13.22
15.29
9.34
11.44
6.92
6.98


7
23.51
29.66
NT
20.37
18.64
19.24
14.1
12.83
16.25


7
44.99
49.08
NT
35.54
30.5
25.93
22.6
22.79
25.47


7
37.1
42.53
NT
25.82
19.1
23.36
16.05
17.85
13.2


29
28.52
31.75
32.52
21.75
12.46
12.31
8.52
8.28
4.1


56
12.11
17.03
16.59
11.66
11.45
9.32
9.31
7.36
1.99


61
23.51
27.96
24.75
11.81
14.82
20.25
12.15
18
11.81


81
27.6
22.83
24.25
15.44
12.4
10.48
12.63
9.54
7


89
33.87
30.9
24.59
16.29
15.56
12.74
18.95
12.03
8.03


106
17.64
9.38
12.13
8.71
5.67
6.4
7.88
7.54
7.66


127
18.76
20.16
19.43
18.43
12.9
11.67
9.32
9.3
9.36


132
20.96
19.79
17.54
12.7
13.11
11.68
13.22
11.64
7.08


136
7.65
11.83
11.18
5.65
2.61
2.05
2.71
3.72
3.36


144
13.2
10.23
9.57
7.11
5.22
6.83
3.5
4.48
8.71


145
22.09
24.61
31.53
21.81
21
14.82
14.4
11.99
5.89









As can be seen from Table 4, administration of the polypeptides of Examples 1, 2, 3, 4, 6, 7, 29, 56, 61, 81, 89, 106, 127, 132, 136, 144 and 145, respectively, to monkeys resulted in increased net cGMP levels.


In Vivo Dog Studies—cGMP Levels


In vivo dog studies were conducted as described in detail below. Young adult-to-adult male purebred beagle dogs of Labcorp stock colony, maintained at Labcorp-Madison, were given a single dose subcutaneously (SC). Blood was collected predose and at various pre-determined timepoints throughout the study period. Aliquot of beagle dog plasma was received for cyclic cGMP (cGMP) measurement and stored at −80° C. prior to use.


Control Plasma

Control plasma was made for determining the recovery rate of spike-in cGMP using Enzo cGMP complete ELISA kit (Enzo Life Sciences, Inc, Farmingdale, NY, cat no. ADI-901-164). Briefly, blood from male Sprague Dawley rats (Inotiv, Indianapolis, IN), about 7 months old, was collected in a BD Vacutainer EDTA tube (Becton Dickinson, Franklin Lakes, NJ, Cat #BD-367856) with volume of approximate 4 mL through retro orbital bleeding. Plasma was prepared by spinning the tube in an Eppendorf Refrigerated Centrifuge 5810R (Brinkman Instruments, Inc, Westbury, NY) at 3500 rpm (3000×g) for 10 min at 4° C. Plasma was collected as Positive Control plasma. Cyclic GMP (cGMP standard from Enzo cGMP complete ELISA kit) was added to the positive control plasma at a final concentration of additional 40 nM. Positive Control and Spiked-in Control plasma were aliquoted and stored at −80° C.


Assay Method—Dog Plasma cGMP ELISA


The cGMP content was measured using the Enzo cGMP complete ELISA kit following the manufacturer's directions with modifications as described below. The cGMP standards provided in the kit were diluted 1:3 ranging from 50 nM to 0.023 nM in 1× assay buffer that was diluted in water from 2× assay buffer provided in the kit. The cGMP standards (150 L) were transferred to a 96-well polypropylene plate (Thermo Scientific, cat no. 442587).


Plasma samples were thawed from −80° C. and diluted 1:20 and 1:40 in 1× assay buffer in the above plate with a final volume of 150 μL. Assay buffer was added (150 μL) for both a non-specific binding control (in the absence of cGMP antibody) and a maximum binding control (in the absence of competing cGMP) in duplicate wells. Positive Control and Spiked-in Control plasma were diluted 1:20 in 1× assay buffer with a final volume of 150 μL in duplicate wells of the above polypropylene plate. All diluted plasma was mixed by pipetting up and down several times.


Acetylation reagent mix was prepared by adding 1-part of acetic anhydride into 2-parts of triethylamine provided in the kit and mixing well using Vortex (Scientific Industries, Inc, Bohemia, NY). All controls, standards, and plasma samples were acetylated by adding 15 μL of acetylation reagent mix into the above polypropylene plate, 8 wells in one column at a time, and shaking for 1 min on a Titer Plate Shaker (Lab-Line Instrument, Inc., Melrose Park, IL) at room temperature. The plate was shaken for an additional 1 min following the acetylation of the last column to ensure the reaction was completed.


Acetylated controls, standard and plasma samples were transferred (100 μL) to an ELISA plate (n=1). Then 50 μL of cGMP conjugate were added to each well followed by the addition of 50 μL cGMP antibody to each well except for two non-specific binding wells, in which 50 μL of 1× assay buffer was added. The plate was then sealed and shaken for 2 h at room temperature on the plate shaker. Following this incubation, the plate was washed five times using 200 μL of 1× wash buffer diluted in water from 5× wash buffer provided in the kit. Then, 200 μL of para-Nitrophenylphosphate (pNpp) were added to each well. The plate was sealed with a new plate sealer and shaken in dark for 1 h at room temperature on the plate shaker. Finally, 50 μL of stop solution were added to each well to stop the enzyme reaction. The plate was then read at 405 nm using SpectraMax Plus (Molecular Devices, San Jose, CA).


Replicates

N=3 dogs per group.


Data Analysis

The mean absorbance at 405 nm (O.D. 405 nm) for the non-specific binding controls was subtracted from the O.D. 405 nm of all samples. The subtracted O.D. 405 nm of all samples were then normalized with the mean subtracted O.D. 405 nm of the maximum binding controls as B/B0%. B/B0% of cGMP standards were then plotted with log scale cGMP standard concentrations to generate a standard curve using an internally created 4-parameter nonlinear regression curve fitting template. The quantity of total cGMP presented in the experimental samples was interpolated using this standard curve in the template. The net cGMP changes (nM) were calculated by subtracting cGMP value of each animal which was measured in the plasma prior to dosing the respective polypeptide as shown in Table 5 (predosing, Time 0) from cGMP value of the same animal at each time point postdose. Microsoft Excel (Microsoft, Redmond, WA) was used to graph cGMP (nM, mean±SEM) and net cGMP changes (nM, mean±SEM) at varying time points. Dog cGMP Data is shown in Table 5.











TABLE 5







Example
Dose
Net cGMP (nM) Change from Baseline















#
(nmol/kg)
0.083 h
0.25 h
0.5 h
1 h
2 h
4 h
8 h





2
60
−5.29
1.61
40.41
101
29.72
60.64
68.79


4
50
3.08
11.23
25.02
58.72
73.34
122.98
157.34


7
50
−4.03
0.2
28.04
77.61
66.51
124.76
173.62











Example
Net cGMP (nM) Change from Baseline
















#
12 h
24 h
36 h
48 h
72 h
96 h
120 h
144 h
168 h





2
83.51
90.36
80.86
80.82
64.85
58.58
47.41
43.47
19.04


4
147.25
111.73
81.07
74.31
75.82
64.23
80.48
77.03
65.74


7
173.41
132.42
95.64
98.09
80.96
77.23
92.7
103.94
70.12









As can be seen from Table 5, administration of the polypeptides of Examples 2, 4 and 7, respectively, to dogs resulted in increased net cGMP levels.











SEQUENCES



rANP (rat ANP)



SEQ ID NO: 1



SLRRSS[CFGGRIDRIGAQSGLGC]NSFRY



(disulfide linkage between C7 and C23)







hANP (human ANP)



SEQ ID NO: 2



SLRRSS[CFGGRMDRIGAQSGLGC]NSFRY



(disulfide linkage between C7 and C23)







Formula I



SEQ ID NO: 3



X1X2X3RSSCFX9X10X11IX13RIG







X17X18SGLGCPSX26RX28X29



wherein:



X1 is absent, S or E,



X2 is absent, L, K, 4-Pal, H or E,



X3 is absent, R, B-Ala, P, K, E or G,



X9 is G, 4-Pal or H,



X10 is G, K, R or Dap,



X11 is R, K, G or Dap,



X13 is D or G,



X17 is A, H, Dap, K, R or Orn,



X18 is Q, Y or 4-Pal,



X26 is F or L,



X28 is Y, H or 4-Pal, and



X29 is either absent, GGP or



selected from SEQ ID NO: 4-20,



and the C-terminal amino acid



is optionally amidated.







SEQ ID NO: 4



SGAPPPE







SEQ ID NO: 5



KITAKEDE







SEQ ID NO: 6



GPSSGAPPPE







SEQ ID NO: 7



GPSSGAPPPS







SEQ ID NO: 8



GGSSGAPPPS







SEQ ID NO: 9



GGPSSGAPPPS







SEQ ID NO: 10



KGPSSGAPPPS







SEQ ID NO: 11



GGKSSGAPPPS







SEQ ID NO: 12



GGPPS-Aib-KPPPK







SEQ ID NO: 13



GSPSSGAPPPS







SEQ ID NO: 14



RITAREDKQGYA







SEQ ID NO: 15



RITAREDKQGEA







SEQ ID NO: 16



GSPSSGAPPPS-PEG24-G







SEQ ID NO: 17



SGSPSSGAPPPSG







SEQ ID NO: 18



GGESSGEPPPSEE







SEQ ID NO: 19



GSGSPSSGAPPPSG







SEQ ID NO: 20



SGSPSSGAPPPSEEEG







Formula II



SEQ ID NO: 21



Fatty acid-Z1-Z2-Z3-X1X2X3RSSCFX9X10X11I







DRIGX17X18SGLGCX24SX26RX28



wherein



Fatty acid is a C16-C26 fatty acid,



Z1 comprises an amino acid selected



from γGlu, E and β-Ala,



Z2 is either absent or comprises a four



to ten amino acid sequence comprising



amino acids independently selected from



E, K, G, P, A and S, and



Z3 is either absent or comprises a



polyethylene glycol or a



(2-[2-(2-amino-ethoxy)-ethoxy]-acetyl)



moiety,



and the C-terminal amino acid



is optionally amidated.







SEQ ID NO: 22



EKEKEKG







SEQ ID NO: 23



EPEPEPG







SEQ ID NO: 24



APPSG







SEQ ID NO: 25



KEKEKG







SEQ ID NO: 26



EKEKEKE







SEQ ID NO: 27



X1X2X3RSSCFX9X10X11IX13RIGX17







X18SGLGCPSX26RX28X29



wherein:



X1 is S or E,



X2 is K or 4-Pal,



X3 is R, B-Ala or K,



X9 is G,



X10 is G or K,



X11 is R or K,



X13 is D or G,



X17 is H,



X18 is Q or Y,



X26 is F,



X28 is H,



and







X29 is selected from



(SEQ ID NO: 9)



GGPSSGAPPPS,







(SEQ ID NO: 11)



GGKSSGAPPPS,



and







(SEQ ID NO: 13)



GSPSSGAPPPS,



and the C-terminal amino acid



is optionally amidated.







SEQ ID NO: 28-167



Examples 1-140 respectively as



listed in Table 1







SEQ ID NO: 168-172



Examples 141-145 respectively.



(amidated rat ANP)



SEQ ID NO: 173



SLRRSS[CFGGRIDRIGAQSGLGC]NSFRY-NH2



(disulfide linkage between C7 and C23)





Claims
  • 1. A polypeptide comprising:
  • 2. The polypeptide of claim 1, or a pharmaceutically acceptable salt thereof, comprising a disulfide linkage or a thioacetal linkage between cysteine at position 7 and cysteine at position 23 of SEQ ID NO:3.
  • 3. The polypeptide of claim 1 or 2, or a pharmaceutically acceptable salt thereof, further comprising a fatty acid conjugated to the amino acid present at the N terminus of the polypeptide, and comprising a structure:
  • 4. The polypeptide of any one of claims 1 to 3, or a pharmaceutically acceptable salt thereof, wherein X1 is S or E,X2 is K or 4-Pal,X3 is R, β-Ala or K,X9 is G,X10 is G or K,X11 is R or K,X13 is D or G,X17 is H,X18 is Q or Y,X26 is F,X28 is H, andX29 is selected from GGPSSGAPPPS (SEQ ID NO:9), GGKSSGAPPPS (SEQ ID NO:11), and GSPSSGAPPPS (SEQ ID NO:13).
  • 5. The polypeptide of claim 3 or 4, or a pharmaceutically acceptable salt thereof, wherein the fatty acid is a C16-C22 fatty acid.
  • 6. The polypeptide of claim 5, or a pharmaceutically acceptable salt thereof, wherein the Z1 is γ-Glu.
  • 7. The polypeptide of claim 6, or a pharmaceutically acceptable salt thereof, wherein the Z2 comprises a sequence selected from EKEKEKG (SEQ ID NO:22), EPEPEPG (SEQ ID NO:23) and APPSG (SEQ ID NO:24).
  • 8. The polypeptide of claim 7, or a pharmaceutically acceptable salt thereof, wherein the Z3 is absent or selected from (polyethylene glycol)m wherein m is 12 or 24, and ((2-[2-(2-amino-ethoxy)-ethoxy]-acetyl))n wherein n is 4, 6 or 8.
  • 9. The polypeptide of any one of claims 1 to 8 or a pharmaceutically acceptable salt thereof, wherein the polypeptide is selected from SEQ ID NO:28 to 167.
  • 10. The polypeptide of any one of claims 1 to 9, or a pharmaceutically acceptable salt thereof, wherein the polypeptide is selected from SEQ ID NO:28, 45, 50, 51, 78, 83, 84, 97, 98, 144, 158 and 159.
  • 11. The polypeptide of any one of claims 1 to 10 or a pharmaceutically acceptable salt thereof, wherein the C terminal is amidated.
  • 12. The polypeptide of any one of claims 1 to 11, or a pharmaceutically acceptable salt thereof, wherein the polypeptide is an agonist of NPR-A.
  • 13. A pharmaceutical composition comprising the polypeptide of any one of claims 1 to 12 or a pharmaceutically acceptable salt thereof, and at least one pharmaceutically acceptable carrier, diluent, or excipient.
  • 14. The pharmaceutical composition of claim 13, wherein the composition is formulated for subcutaneous (SQ) or intravenous (IV) administration.
  • 15. The pharmaceutical composition of claim 14, wherein the composition is formulated for SQ administration.
  • 16. A method for treating a cardiovascular disease (CVD) comprising administering to a patient in need thereof, an effective amount of a polypeptide of any one of claims 1 to 12, or a pharmaceutically acceptable salt thereof, or the pharmaceutical composition of claim 13.
  • 17. The method of claim 16, wherein the CVD is heart failure.
  • 18. The method of claim 17, wherein the heart failure is HFpEF.
  • 19-25. (canceled)
CROSS REFERENCE TO RELATED APPLICATIONS

This application claims priority to U.S. Provisional Application 63/418,048 filed Oct. 21, 2022, the content of which is incorporated herein by reference in its entirety.

Provisional Applications (1)
Number Date Country
63418048 Oct 2022 US