Safe and Effective Cynomolgus Monkey GLP-Tox Study with Repetitive Intrathecal Application of a TGFBR2 Targeting LNA-Gapmer Antisense Oligonucleotide as Treatment Candidate for Neurodegenerative Disorders

• Published in: Pharmaceutics Vol. 14; no. 1; p. 200
• Main Authors: Peters, Sebastian, Wirkert, Eva, Kuespert, Sabrina, Heydn, Rosmarie, Johannesen, Siw, Friedrich, Anita, Mailänder, Susanne, Korte, Sven, Mecklenburg, Lars, Aigner, Ludwig, Bruun, Tim-Henrik, Bogdahn, Ulrich
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 15.01.2022; MDPI
• Subjects: Alzheimer's disease; Amyotrophic lateral sclerosis; Animals; antisense oligonucleotide therapy; Autophagy; Clinical trials; Drug dosages; GLP-ToxStudy; Medical prognosis; Mutation; neurodegeneration; neurogenesis; Pharmaceuticals; Spinal cord; Stem cells; TGFβ-signaling; Toxicology; antisense oligonucleotide therapy; TGFβ-signaling; GLP-ToxStudy; neurodegeneration; neurogenesis; amyotrophic lateral sclerosis; LNA
• ISSN: 1999-4923; 1999-4923
• DOI: 10.3390/pharmaceutics14010200

The capability of the adult central nervous system to self-repair/regenerate was demonstrated repeatedly throughout the last decades but remains in debate. Reduced neurogenic niche activity paralleled by a profound neuronal loss represents fundamental hallmarks in the disease course of neurodegenerative disorders. We and others have demonstrated the endogenous TGFβ system to represent a potential pathogenic participant in disease progression, of amyotrophic lateral sclerosis (ALS) in particular, by generating and promoting a disequilibrium of neurodegenerative and neuroregenerative processes. The novel human/primate specific LNA Gapmer Antisense Oligonucleotide "NVP-13", targeting TGFBR2, effectively reduced its expression and lowered TGFβ signal transduction in vitro and in vivo, paralleled by boosting neurogenic niche activity in human neuronal progenitor cells and nonhuman primate central nervous system. Here, we investigated NVP-13 in vivo pharmacology, safety, and tolerability following repeated intrathecal injections in nonhuman primate cynomolgus monkeys for 13 weeks in a GLP-toxicology study approach. NVP-13 was administered intrathecally with 1, 2, or 4 mg NVP-13/animal within 3 months on days 1, 15, 29, 43, 57, 71, and 85 in the initial 13 weeks. We were able to demonstrate an excellent local and systemic tolerability, and no adverse events in physiological, hematological, clinical chemistry, and microscopic findings in female and male Cynomolgus Monkeys. Under the conditions of this study, the no observed adverse effect level (NOAEL) is at least 4 mg/animal NVP-13.