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Radiocontrast Nephropathy: Redox Degradation Catalyst and Nitric Oxide Donor

放射性对比肾病：氧化还原降解催化剂和一氧化氮供体

基本信息

批准号：
8449038
负责人：
Zsuzsanna Kinga Zsengeller
金额：
$ 24.51万
依托单位：
RADIKAL THERAPEUTICS, INC.
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-05-01 至 2015-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8449038
关键词：
3-nitrotyrosine Acetylcysteine Acute Acute Kidney Failure Address Adenosine Animal Model Antioxidants Biological Models Blood Bolus Infusion Brain Breathing Cell Survival Cells Chemicals Clinical Colon Complex Complication Consensus Control Groups Coupled Creatinine Creatinine clearance measurement Cytoprotective Agent DNA Damage DNA Repair Dehydration Development Diabetes Mellitus Diagnostic Dialysis procedure Dose Drug Exposure Drug Kinetics Elderly Electron Microscopy Endotoxic Shock Exposure to Foundations Free Radicals GTP-Binding Proteins Gases Gelatinase A Gelatinases Generations Glucose Half-Life Heart Hematoxylin and Eosin Staining Method Histologic Hydration status Hydrogen Peroxide Hydroxyl Radical Hypoxia Image Immunologics Impairment Inflammation Inflammatory Injection of therapeutic agent Injury Intravenous Ischemia Kidney Kidney Diseases Kidney Failure Liver Lung Mediating Medical Mitochondrial Swelling Modality Modeling Mus Muscle Necrosis Nitric Oxide Nitric Oxide Donors Normal saline Nuclear Organ Oxidants Oxidation-Reduction Patients Peroxidases Peroxonitrite Pharmacodynamics Pharmacologic Substance Plasma Poly Adenosine Diphosphate Ribose Population Prevention Prophylactic treatment Prostaglandin-Endoperoxide Synthase Proteins Pyrrolidines Rattus Reactive Oxygen Species Renal Blood Flow Renal Tissue Renal function Reperfusion Injury Reperfusion Therapy Resuscitation Risk Rodent Rodent Model Serum Single-Blind Study Spleen Sprague-Dawley Rats Stomach Streptozocin Stress Structure of parenchyma of lung Superoxides System Testing Tissues Tubular formation arteriole base catalase catalyst cell injury clinically relevant comparative cytotoxicity design diabetic diabetic rat high risk immunoreactivity innovation intravenous administration kidney cell kidney medulla mimetics nephrogenesis neutrophil nitrosative stress novel p65 patient population prevent professor prophylactic public health relevance pyrrolidine receptor renal ischemia response small molecule transcription factor uptake vasoconstriction

项目摘要

DESCRIPTION (provided by applicant): We are developing a novel small molecule cytoprotective drug (R-100) for the prevention of contrast- induced nephropathy (CIN) following IV radiocontrast media (CM) injection. R-100 is a novel cell- permeable redox-active agent formed from the covalent fusion of 2 chemical moieties: 1) an organic nitrovasodilator that donates nitric oxide, and 2) a pyrrolidine nitroxide that acts as a trifunctional degradation catalyst of reactive oxygen species. In rats subjected to renal ischemia/reperfusion injury (RIRI), IV administration of R-100 prior to reperfusion reduced the 6 h elevations in serum creatinine, serum NGAL, tissue myeloperoxidase, and histologic score by 75-90% (p<10-14) and restored the reduction of creatinine clearance from 90% to 50% (p<0.01). In a murine RIRI model, 24 h creatinine elevations were entirely eliminated by a single dose of R-100 prior to reperfusion (p<0.01). Aim #1: Establish the pharmacodynamic (PD) profile of R-100 in models of CIN in healthy and diabetic rodents under conditions of normal hydration and aggressive volume loading Rats will be subjected to dehydration, prostaglandin synthetase inhibition, and an IV challenge of CM. A sham injury group will be compared to treatment of CM-challenged healthy rats with 3 dose levels of IV R-100, N-acetyl-cysteine (NAC), or vehicle control initiated 10 min before CM administration and continued for 48 h. Rats will then be evaluated at 48 h for renal function (and parameters reflecting renal injury, including protein release into the blood (NGAL, KIM-1), pro-inflammatory transcription factor expression (cytoplasmic I¿B¿ degradation, nuclear p65 translocation), histologic damage, and nuclear damage and DNA repair (PARP activation and nitrosative stress as noted by poly(ADP-ribose) and 3-nitrotyrosine (3-NT) tissue immunoreactivity). In order to better model the patient population at greatest risk of CIN, the optimal dose of R-100 will then be further evaluated, using the same experimental approach and design as before, but in rats previously rendered diabetic 2 weeks earlier by injection of streptozotocin (STZ). Finally, we will investigate whether further benefit may be obtained in the diabetic setting by combining the administration of R-100 with aggressive volume resuscitation. Aim #2: Establish the pharmacokinetics (PK) of R-100 in a rodent model of CIN We will carry out PK studies in rodents exposed to the same conditions utilized to generate CIN as in Aim #1. A full PK profile will be generated, to define plasma half-life, clearance, and volume of distribution. The exposure to cumulative plasma concentrations of R-100 and the renal tissue concentration of R-100 will be correlated with the morphologic, immunologic, and functional endpoints detailed in Aim #1, in order to construct a PD profile relating drug exposure to effect. The proposed studies will provide a rational foundation for advanced commercial development of R-100, with the intent that this product will serve as first-line prophylaxis in high-risk diabeic patients undergoing CM injection.

描述（由申请人提供）：我们正在开发一种新型小分子细胞保护药物（R-100），用于预防静脉注射放射性造影剂（CM）后造影剂肾病（CIN）。 R-100 是一种新型细胞渗透性氧化还原活性剂，由 2 个化学部分共价融合而成：1) 提供一氧化氮的有机硝基血管舒张剂，2) 吡咯烷氮氧化物，充当活性氧的三功能降解催化剂。在遭受肾缺血/再灌注损伤（RIRI）的大鼠中，再灌注前静脉注射 R-100 可将 6 小时内血清肌酐、血清 NGAL、组织髓过氧化物酶和组织学评分的升高降低 75-90% (p<10-14)，并将肌酐清除率的降低从 90% 恢复至 50% (p<0.01)。在小鼠 RIRI 模型中，再灌注前单剂量的 R-100 完全消除了 24 小时肌酐升高（p<0.01）。目标#1：在正常水合和剧烈容量负荷的条件下，在健康和糖尿病啮齿动物的 CIN 模型中建立 R-100 的药效学 (PD) 概况大鼠将经历脱水、前列腺素合成酶抑制和 CM 的 IV 攻击。将假损伤组与用 3 个剂量水平的 IV R-100、N-乙酰半胱氨酸 (NAC) 或载体对照对 CM 攻击的健康大鼠进行比较，在 CM 给药前 10 分钟开始并持续 48 小时。然后在 48 小时评估大鼠的肾功能（以及反映肾损伤的参数，包括蛋白质释放到血液中（NGAL、KIM-1）、促炎转录因子表达（细胞质 I¿B 降解、核 p65 易位）、组织学损伤、核损伤和 DNA 修复（由聚（ADP-核糖）和 3-硝基酪氨酸 (3-NT) 组织免疫反应性）。为了更好地模拟 CIN 风险最大的患者群体，将使用与之前相同的实验方法和设计进一步评估 R-100 的最佳剂量，但在 2 周前通过注射链脲佐菌素 (STZ) 导致糖尿病的大鼠中。最后，我们将研究通过联合服用以下药物是否可以在糖尿病患者中获得进一步的益处： R-100 具有积极的容量复苏功能。目标#2：在 CIN 啮齿动物模型中建立 R-100 的药代动力学 (PK) 我们将在暴露于与目标#1 中用于产生 CIN 相同条件的啮齿动物中进行 PK 研究。将生成完整的 PK 曲线，以定义血浆半衰期、清除率和分布体积。 R-100 累积血浆浓度和肾组织的暴露 R-100 的浓度将与目标 #1 中详述的形态学、免疫学和功能终点相关联，以便构建与药物暴露与效果相关的 PD 概况。拟议的研究将为 R-100 的高级商业开发提供合理的基础，旨在使该产品成为接受 CM 注射的高危糖尿病患者的一线预防药物。