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SLC6A19 inhibition facilitates urinary neutral amino acid excretion and lowers plasma phenylalanine
Heike J. Wobst, Andreu Viader, Giovanni Muncipinto, Ryan Hollibaugh, Daniel van Kalken, Christopher T. Burkhart, Susan M. Cantin, Rachel M. Bates, Yannik Regimbald-Dumas, Liam Gross, Mitchell T. Antalek, Joshua E. Zweig, Frank Wu, T. Justin Rettenmaier, Matthew T. Labenski, Nicholas Pullen, Heather S. Blanchette, Jaclyn L. Henderson, Haoling H. Weng, Toby A. Vaughn, Dean G. Brown, John P. Throup, Joel C. Barrish
Heike J. Wobst, Andreu Viader, Giovanni Muncipinto, Ryan Hollibaugh, Daniel van Kalken, Christopher T. Burkhart, Susan M. Cantin, Rachel M. Bates, Yannik Regimbald-Dumas, Liam Gross, Mitchell T. Antalek, Joshua E. Zweig, Frank Wu, T. Justin Rettenmaier, Matthew T. Labenski, Nicholas Pullen, Heather S. Blanchette, Jaclyn L. Henderson, Haoling H. Weng, Toby A. Vaughn, Dean G. Brown, John P. Throup, Joel C. Barrish
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Clinical Research and Public Health Clinical trials Metabolism

SLC6A19 inhibition facilitates urinary neutral amino acid excretion and lowers plasma phenylalanine

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Abstract

BACKGROUND The toxic accumulation of phenylalanine (Phe) in the brain underlies the neurological presentation of phenylketonuria (PKU). Solute carrier family 6 member 19 (SLC6A19) is the major transporter responsible for the (re)absorption of Phe in the kidney and intestine. Here, we describe the characterization of the first small molecule SLC6A19 inhibitor to enter clinical development for the treatment of PKU.METHODS C57Bl/6J WT and Pahenu2 mice were dosed with an inhibitor of SLC6A19 to investigate the effects on urinary amino acids and plasma Phe. In a phase 1 study, healthy human volunteers were dosed with JNT-517, an investigational oral inhibitor of SLC6A19. The primary objective of the study was safety. Secondary objectives included pharmacokinetic and pharmacodynamic studies.RESULTS Inhibition of SLC6A19 increased the urinary excretion of Phe in a mouse model of PKU, thereby reducing plasma Phe levels. JNT-517, an investigational oral SLC6A19 inhibitor, was found to be safe and well tolerated and increased the urinary excretion of Phe in a phase 1 healthy volunteer study.CONCLUSIONS These data indicate that pharmacological inhibition of SLC6A19 presents a promising approach to lower toxic elevated levels of amino acids found in PKU and related amino acid metabolism disorders by facilitating their renal elimination.TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN12622001222730.FUNDING The studies in this paper were funded by Jnana Therapeutics.

Authors

Heike J. Wobst, Andreu Viader, Giovanni Muncipinto, Ryan Hollibaugh, Daniel van Kalken, Christopher T. Burkhart, Susan M. Cantin, Rachel M. Bates, Yannik Regimbald-Dumas, Liam Gross, Mitchell T. Antalek, Joshua E. Zweig, Frank Wu, T. Justin Rettenmaier, Matthew T. Labenski, Nicholas Pullen, Heather S. Blanchette, Jaclyn L. Henderson, Haoling H. Weng, Toby A. Vaughn, Dean G. Brown, John P. Throup, Joel C. Barrish

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Figure 3

JN-170 lowers plasma Phe in Pahenu2 mice mimicking classic PKU or hyperphenylalaninemia.

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JN-170 lowers plasma Phe in Pahenu2 mice mimicking classic PKU or hyperp...
(A) JN-170 pharmacokinetics in male Pahenu2 mice after a single oral dose (n = 6). (B) Changes in 12 hour urine amino acid excretion in male Pahenu2 mice treated with JN-170 (n = 4–6 per dose) or vehicle (veh, n = 24) or in mice with heterozygous or homozygous loss of Slc6a19 (data adapted from (14)). Data are displayed as log FC. (C) 12-hour urine Phe excretion in mice treated with vehicle (n = 24) or JN-170 (n = 6); 1-way ANOVA with Tukey’s post hoc analysis. (D) Plasma Phe in male Pahenu2 mice treated with vehicle (n = 24) or 50, 100, 200, or 250 mg/kg JN-170 (n = 6); 2-way ANOVA with Dunnett’s post hoc analysis to compare vehicle versus JN-170 groups (statistical analysis shown for comparison of vehicle to 250 mg/kg JN-170). (E–G) Plasma Phe in male Pahenu2 mice fed defined amino acid diets to modulate basal plasma Phe levels. Mice were fed 0.75% Phe (E, n = 17–22), 0.45% Phe (F, n = 4–9) or 0.225% Phe (G, n = 11–17) for 2 weeks prior to administration of a single 200 mg/kg dose of JN-170 or vehicle; 2-way ANOVA with Šidák’s post hoc analysis.**P < 0.01, ***P < 0.001, ****P < 0.0001; All data represent mean ± SD.

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