Therapeutic potential of deuterium-stabilized (R)-pioglitazone-PXL065-for X-linked adrenoleukodystrophy.


Journal

Journal of inherited metabolic disease
ISSN: 1573-2665
Titre abrégé: J Inherit Metab Dis
Pays: United States
ID NLM: 7910918

Informations de publication

Date de publication:
07 2022
Historique:
revised: 02 05 2022
received: 14 02 2022
accepted: 03 05 2022
pubmed: 6 5 2022
medline: 20 7 2022
entrez: 5 5 2022
Statut: ppublish

Résumé

X-linked adrenoleukodystrophy (ALD) results from ABCD1 gene mutations which impair Very Long Chain Fatty Acids (VLCFA; C26:0 and C24:0) peroxisomal import and β-oxidation, leading to accumulation in plasma and tissues. Excess VLCFA drives impaired cellular functions (e.g. disrupted mitochondrial function), inflammation, and neurodegeneration. Major disease phenotypes include: adrenomyeloneuropathy (AMN), progressive spinal cord axonal degeneration, and cerebral ALD (C-ALD), inflammatory white matter demyelination and degeneration. No pharmacological treatment is available to-date for ALD. Pioglitazone, an anti-diabetic thiazolidinedione, exerts potential benefits in ALD models. Its mechanisms are genomic (PPARγ agonism) and nongenomic (mitochondrial pyruvate carrier-MPC, long-chain acyl-CoA synthetase 4-ACSL4, inhibition). However, its use is limited by PPARγ-driven side effects (e.g. weight gain, edema). PXL065 is a clinical-stage deuterium-stabilized (R)-enantiomer of pioglitazone which lacks PPARγ agonism but retains MPC activity. Here, we show that incubation of ALD patient-derived cells (both AMN and C-ALD) and glial cells from Abcd1-null mice with PXL065 resulted in: normalization of elevated VLCFA, improved mitochondrial function, and attenuated indices of inflammation. Compensatory peroxisomal transporter gene expression was also induced. Additionally, chronic treatment of Abcd1-null mice lowered VLCFA in plasma, brain and spinal cord and improved both neural histology (sciatic nerve) and neurobehavioral test performance. Several in vivo effects of PXL065 exceeded those achieved with pioglitazone. PXL065 was confirmed to lack PPARγ agonism but retained ACSL4 activity of pioglitazone. PXL065 has novel actions and mechanisms and exhibits a range of potential benefits in ALD models; further testing of this molecule in ALD patients is warranted.

Identifiants

pubmed: 35510808
doi: 10.1002/jimd.12510
pmc: PMC9545763
doi:

Substances chimiques

ATP Binding Cassette Transporter, Subfamily D, Member 1 0
ATP-Binding Cassette Transporters 0
Abcd1 protein, mouse 0
Fatty Acids 0
Fatty Acids, Nonesterified 0
PPAR gamma 0
Deuterium AR09D82C7G
Pioglitazone X4OV71U42S

Types de publication

Journal Article Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

832-847

Subventions

Organisme : National Institute of Health, USA
ID : NS114245

Informations de copyright

© 2022 Poxel SA. Journal of Inherited Metabolic Disease published by John Wiley & Sons Ltd on behalf of SSIEM.

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Auteurs

Pierre-Axel Monternier (PA)

Poxel SA, Lyon, France.

Jaspreet Singh (J)

Department of Neurology, Henry Ford Health System, Detroit, Michigan, USA.

Parveen Parasar (P)

Department of Neurology, Henry Ford Health System, Detroit, Michigan, USA.

Sheila DeWitt (S)

DeuteRx, LLC, Andover, Massachusetts, USA.

Vincent Jacques (V)

DeuteRx, LLC, Andover, Massachusetts, USA.

Eric Klett (E)

Department of Medicine, Division of Endocrinology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.

Navtej Kaur (N)

Department of Neurology, Henry Ford Health System, Detroit, Michigan, USA.

Tavarekere N Nagaraja (TN)

Department of Neurosurgery, Henry Ford Health System, Detroit, Michigan, USA.

David E Moller (DE)

Poxel SA, Lyon, France.

Sophie Hallakou-Bozec (S)

Poxel SA, Lyon, France.

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Classifications MeSH