Inhibition of interleukin-6 production for the treatment of multiple myeloma

描述（由申请人提供）：多发性骨髓瘤（MM）是一种分化的b细胞（浆细胞）恶性疾病，目前仍无法治愈。骨髓微环境（bone marrow microenvironment， BMM）通过持续表达和分泌趋化因子和细胞因子来支持MM细胞的生长和化疗耐药。最具特征的骨髓瘤生长因子是白细胞介素6 (IL-6)，在MM患者中血清中含量较高，与MM的发病机制直接相关。因此，IL-6的产生已被确定为抑制MM细胞生长和对化疗药物耐药的治疗靶点。该提案的目标是产生有效的IL-6产生抑制剂，作为单一药物使用，或作为当前治疗药物的添加剂，以提高多发性骨髓瘤治疗的整体治疗效果。我们的实验室最近报道了一类小分子量支架作为IL-6生产的有效抑制剂。该先导化合物能够抑制人血液中纳米摩尔浓度的IL-6的产生，其机制可能是文献中描述的其他抑制剂中唯一的。鉴于IL-6在多发性骨髓瘤发病机制中的核心作用，本研究的重点是阐明这类抑制剂作为单一药物和辅助药物治疗多发性骨髓瘤的作用模式和优化。本提案的目标是发现IL-6抑制的作用模式，通过在多发性骨髓瘤细胞中使用单一和辅助治疗来建立疗效，并设计和执行对端选择性合成以改善这些有效的IL-6抑制剂的获取。

DESCRIPTION (provided by applicant): Multiple myeloma (MM) is a malignant disorder of differentiated B-cells (plasma cells) and remains incurable. The growth and chemotherapeutic resistance of the MM cells is supported by the bone marrow microenvironment (BMM) through the continuous expression and secretion of chemokines and cytokines. The best-characterized myeloma growth factor is interleukin 6 (IL-6), which is found at high serum levels in MM patients, and has been directly related to the pathogenesis of MM. Consequently, IL-6 production has been identified as a therapeutic target to inhibit MM cell growth and resistance to chemotherapeutics. The goal of the proposal is to generate potent inhibitors of IL-6 production for the use as single agents, or as additives to current therapeutics, to enhance the overall therapeutic outcome of multiple myeloma treatment. Our lab has recently reported a class of small molecular weight scaffolds as potent inhibitors of IL-6 production. The lead compound was capable of inhibiting IL-6 production in human blood at nanomolar concentrations via a mechanism that may be unique among other inhibitors described in the literature. Given the central role of IL-6 in the pathogenesis of multiple myeloma, this proposal is focused on the elucidation of the mode of action and optimization of this class of inhibitors as single agents and adjuvant agents for the treatment of multiple myeloma. The goals of this proposal are to discover the mode of action for IL-6 inhibition, establishing efficacy by using single and adjuvant treatment in multiple myeloma cells and design and execute an enantioselective synthesis to improve access to these potent IL-6 inhibitors. PUBLIC HEALTH RELEVANCE: Multiple myeloma (MM) remains incurable and MM cells are intrinsically resistant to traditional chemotherapeutic drugs due to the activation of IL-6 mediated growth and survival pathways. We have discovered a potent IL-6 inhibitor capable of reducing IL-6 levels in stimulated human blood and killing MM cells. This project is focused on determining the mode of action of these agents and establishing efficacy in a range of MM cells under conditions that mimic the bone marrow microenvironment.