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SSR69071, a novel treatment of airway inflammation and cardiovascular disease

Human leukocyte elastase (HLE) is a proteinase capable of degrading a variety of proteins. Under normal circumstances, natural inhibitors control the proteolytic activity of HLE. However, an imbalance between elastase and these endogenous inhibitors may result in several pathophysiological states such as chronic obstructive pulmonary disease, asthma, emphysema, cystic fibrosis and chronic inflammatory diseases. It is anticipated that an orally active HLE inhibitor could be useful for the treatment of these diseases.

Despite the therapeutic implications of elastase inhibitors the drug development community has so far failed to make major advances in the development of this therapeutic class. Aventis have developeda formulation of alpha-1 protease inhibitor, an endogenous protease inhibitor. Dyax are developing a similar molecule. With regards to small molecule inhibitors, most advanced is Ono’s Sivelestat (ONO-5046) which is a neutrophil elastase inhibitor, launched in 2002 for the treatment of acute lung injury caused by systemic inflammatory response syndrome (SIRS). This molecule is in earlier stage development for idiopathic pulmonary fibrosis (IPF) and chronic airway infection. Both Roche and Dainippon have also recently advanced inhibitors into phase I trials for the treatment of lung conditions.

One of the most recent elastase inhibitors to have been reported is Sanofi-Synthelabo’s SSR69071. We introduced this molecule in the previous edition of TherapeuticAdvances  describing its efficacy in a model of coronary ischemia and reperfusion. SSR69071 is nanomolar inhibitor of human, rat, mouse and rabbit elastases. Oral treatment of mice with SSR69071 inhibits HLE activity measured in recovered bronchoalveolar lavage fluid from mice, and potently decreases acute lung hemorrhage induced by HLE (ED50=2.8 mg/kg po). Furthermore, SSR69071 prevents carrageenan and HLE-induced paw edema in rats after oral administration.

In addition to previously reported cardiovascular efficacy, SSR69071 may also represent an excellent candidate for the treatment of inflammatory disease in particular, because of its good penetration in respiratory tissues, diseases characterized by airway inflammation.

Entry date Friday, April 11, 2003

Adapted from Kapui et al, J Pharmacol Exp Ther 2003 Feb 11; [epub ahead of print]

Biochemical and pharmacological characterization of SSR69071, a novel orally active elastase inhibitor.

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