Targeted pharmacological depletion of serum amyloid P component for treatment of human amyloidosis

MB Pepys, J Herbert, WL Hutchinson, GA Tennent… - Nature, 2002 - nature.com
MB Pepys, J Herbert, WL Hutchinson, GA Tennent, HJ Lachmann, JR Gallimore, LB Lovat
Nature, 2002nature.com
The normal plasma protein serum amyloid P component (SAP) binds to fibrils in all types of
amyloid deposits, and contributes to the pathogenesis of amyloidosis. In order to intervene
in this process we have developed a drug, R-1-[6-[R-2-carboxy-pyrrolidin-1-yl]-6-oxo-
hexanoyl] pyrrolidine-2-carboxylic acid, that is a competitive inhibitor of SAP binding to
amyloid fibrils. This palindromic compound also crosslinks and dimerizes SAP molecules,
leading to their very rapid clearance by the liver, and thus produces a marked depletion of …
Abstract
The normal plasma protein serum amyloid P component (SAP) binds to fibrils in all types of amyloid deposits, and contributes to the pathogenesis of amyloidosis. In order to intervene in this process we have developed a drug, R-1-[6-[R-2-carboxy-pyrrolidin-1-yl]-6-oxo-hexanoyl]pyrrolidine-2-carboxylic acid, that is a competitive inhibitor of SAP binding to amyloid fibrils. This palindromic compound also crosslinks and dimerizes SAP molecules, leading to their very rapid clearance by the liver, and thus produces a marked depletion of circulating human SAP. This mechanism of drug action potently removes SAP from human amyloid deposits in the tissues and may provide a new therapeutic approach to both systemic amyloidosis and diseases associated with local amyloid, including Alzheimer's disease and type 2 diabetes.
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