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Phase 1 and pre-clinical profiling of ESM-HDAC391, a myeloid-targeted histone deacetylase inhibitor, shows enhanced pharmacology and monocytopaenia
  • +14
  • Rebecca Furze,
  • Judit Molnar,
  • Nigel Parr,
  • Faiz Ahmad,
  • Yvette Henry,
  • David Howe,
  • Rajendra Singh,
  • Martin Toal,
  • Anna Bassil,
  • Sharon Bernard,
  • Robert Davis,
  • Adele Gibson,
  • Claire Maller,
  • Catriona Sharp,
  • David Tough,
  • Rab Prinjha,
  • Huw Lewis
Rebecca Furze
GlaxoSmithKline Research and Development

Corresponding Author:rebecca.c.furze@gsk.com

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Judit Molnar
GlaxoSmithKline Research and Development
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Nigel Parr
GlaxoSmithKline Research and Development
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Faiz Ahmad
GlaxoSmithKline Research and Development
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Yvette Henry
GlaxoSmithKline Research and Development
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David Howe
GlaxoSmithKline Research and Development
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Rajendra Singh
GlaxoSmithKline USA
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Martin Toal
GlaxoSmithKline Research and Development
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Anna Bassil
GlaxoSmithKline Research and Development
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Sharon Bernard
GlaxoSmithKline Research and Development
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Robert Davis
GlaxoSmithKline Research and Development
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Adele Gibson
GlaxoSmithKline Research and Development
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Claire Maller
GlaxoSmithKline Research and Development
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Catriona Sharp
GlaxoSmithKline Research and Development
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David Tough
GlaxoSmithKline Research and Development
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Rab Prinjha
GlaxoSmithKline Research and Development
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Huw Lewis
GlaxoSmithKline Research and Development
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Abstract

AIM: To improve the tolerability and therapeutic application of histone deacetylase inhibitors (HDACi), by application of an esterase-sensitive motif (ESM), to target pharmacological activity directly to mononuclear myeloid cells expressing the processing enzyme carboxylesterase-1 (CES1). METHODS. This first-in-human study comprised of single and multiple ascending dose cohorts to determine safety and tolerability. Pharmacodynamic parameters included acetylation, cytokine inhibition and intracellular concentrations of processed acid metabolite in isolated monocytes. Mechanistic work was conducted in vitro and in a CES1/Es1elo mouse strain. RESULTS. ESM-HDAC391 was well tolerated whilst showing robust targeted mechanistic engagement, as demonstrated by selective retention of compound and increased acetylation in monocytes plus inhibition of ex vivo stimulated cytokine production. Importantly, common clinical HDACi toxicities were not observed. ESM-HDAC391 treatment was accompanied by the novel finding of a dose-dependent monocyte depletion that was transient and reversible. In-depth characterisation of monocyte depletion in a transgenic mouse model (CES1/Es1elo) suggested that CSF1R loss on circulating cells contributes to ESM-HDAC-mediated depletion. Further mechanistic investigations using human monocytes in vitro demonstrated HDACi-mediated change in myeloid fate through modulation of CSF1R and downstream effects on cell differentiation. CONCLUSION. These findings demonstrate selective targeting of monocytes in humans using the ESM approach and identify monocytopaenia as a novel outcome of ESM-HDACi treatment, with implications for the potential benefit of these molecules in myeloid-driven diseases.
17 Jan 2022Submitted to British Journal of Clinical Pharmacology
18 Jan 2022Submission Checks Completed
18 Jan 2022Assigned to Editor
18 Jan 2022Reviewer(s) Assigned
16 Feb 2022Review(s) Completed, Editorial Evaluation Pending
18 Feb 2022Editorial Decision: Revise Major
19 Apr 20221st Revision Received
21 Apr 2022Submission Checks Completed
21 Apr 2022Assigned to Editor
21 Apr 2022Review(s) Completed, Editorial Evaluation Pending
29 Apr 2022Editorial Decision: Accept