Extending Mironid's PDE4 activator programme: Hyperparathyroidism as a second clinical indication

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Human parathyroid hormone (PTH) is produced by four parathyroid glands located in the neck and regulates the level of calcium and phosphate in the blood by controlling reabsorption from urine, uptake from the digestive tract and resorption from calcium reservoirs in the bone.Hyperparathyroidism results in excessive release of parathyroid hormone into the blood and is one of the most common endocrine disorders, often caused by either a benign tumour in one or more parathyroid glands or as a secondary consequence of chronic kidney disease. Left untreated, the chronic elevation of PTH in hyperparathyroidism causes a variety of debilitating symptoms and can even become life-threatening when the levels of calcium in the blood become unacceptably high. The prevalence of hyperparathyroidism is increasing as a consequence of rising rates of obesity, diabetes and associated kidney disease.Mironid, a Glasgow based biotech company founded by research teams from Strathclyde and Heriot-Watt Universities, has developed the first molecules that activate particular enzymes called PDE4 long isoforms that normally degrade an important signalling molecule called cAMP. cAMP is usually very tightly regulated but in hyperparathyroidism is over produced in certain locations within the kidney and bone as a result of excessive stimulation by PTH. Mironid's innovation offers a novel approach to targeting hyperparathyroidism at the site of PTH action in the kidney and bone, by increasing the degradation of cAMP, thereby reducing cAMP signalling and allowing better management of the symptoms and pathology of hyperparathyroidism.This proposal aims to build upon a previous successful Innovate UK BMC funded Mironid project (Year 2017: Project No: 102841) that has already resulted in important progress towards treating another kidney disease, Autosomal Dominant Polycystic Kidney Disease, also caused by defective cAMP signalling. As part of this current proposal, new molecules will be tested in translational models of hyperparathyroidism and will be profiled in assays to identify the most appropriate molecule for advanced testing and ultimately for progression into human trials which could begin as early as 2025\.