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Small-molecule factor B inhibitor for the treatment of complement-mediated diseases.


ABSTRACT: Dysregulation of the alternative complement pathway (AP) predisposes individuals to a number of diseases including paroxysmal nocturnal hemoglobinuria, atypical hemolytic uremic syndrome, and C3 glomerulopathy. Moreover, glomerular Ig deposits can lead to complement-driven nephropathies. Here we describe the discovery of a highly potent, reversible, and selective small-molecule inhibitor of factor B, a serine protease that drives the central amplification loop of the AP. Oral administration of the inhibitor prevents KRN-induced arthritis in mice and is effective upon prophylactic and therapeutic dosing in an experimental model of membranous nephropathy in rats. In addition, inhibition of factor B prevents complement activation in sera from C3 glomerulopathy patients and the hemolysis of human PNH erythrocytes. These data demonstrate the potential therapeutic value of using a factor B inhibitor for systemic treatment of complement-mediated diseases and provide a basis for its clinical development.

SUBMITTER: Schubart A 

PROVIDER: S-EPMC6475383 | biostudies-literature | 2019 Apr

REPOSITORIES: biostudies-literature

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Small-molecule factor B inhibitor for the treatment of complement-mediated diseases.

Schubart Anna A   Anderson Karen K   Mainolfi Nello N   Sellner Holger H   Ehara Takeru T   Adams Christopher M CM   Mac Sweeney Aengus A   Liao Sha-Mei SM   Crowley Maura M   Littlewood-Evans Amanda A   Sarret Sophie S   Wieczorek Grazyna G   Perrot Ludovic L   Dubost Valérie V   Flandre Thierry T   Zhang Yuzhou Y   Smith Richard J H RJH   Risitano Antonio M AM   Karki Rajeshri G RG   Zhang Chun C   Valeur Eric E   Sirockin Finton F   Gerhartz Bernd B   Erbel Paulus P   Hughes Nicola N   Smith Thomas M TM   Cumin Frederic F   Argikar Upendra A UA   Haraldsson Börje B   Mogi Muneto M   Sedrani Richard R   Wiesmann Christian C   Jaffee Bruce B   Maibaum Jürgen J   Flohr Stefanie S   Harrison Richard R   Eder Jörg J  

Proceedings of the National Academy of Sciences of the United States of America 20190329 16


Dysregulation of the alternative complement pathway (AP) predisposes individuals to a number of diseases including paroxysmal nocturnal hemoglobinuria, atypical hemolytic uremic syndrome, and C3 glomerulopathy. Moreover, glomerular Ig deposits can lead to complement-driven nephropathies. Here we describe the discovery of a highly potent, reversible, and selective small-molecule inhibitor of factor B, a serine protease that drives the central amplification loop of the AP. Oral administration of t  ...[more]

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