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SLC6A19 inhibition facilitates urinary neutral amino acid excretion and lowers plasma phenylalanine
Heike J. Wobst, … , John P. Throup, Joel C. Barrish
Heike J. Wobst, … , John P. Throup, Joel C. Barrish
Published November 8, 2024
Citation Information: JCI Insight. 2024;9(21):e182876. https://doi.org/10.1172/jci.insight.182876.
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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 6

JNT-517 increases urinary neutral amino acid excretion in healthy human volunteers, reproducing the Hartnup aminoaciduria signature caused by genetic loss of SLC6A19 function.

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JNT-517 increases urinary neutral amino acid excretion in healthy human ...
Pharmacodynamics of JNT-517 in SAD (A–C) and MAD (D–G) cohorts. Urine amino acids excreted over various time periods (0–24 hours, 0–8 h, 8-24 hours) are shown. (A) Fold changes of urinary amino acid concentrations (in mmol/mol creatinine) following a single dose of JNT-517, calculated relative to predose baseline in samples collected over 8 hours following compound administration from 10–170 mg. FCs represent average FC for all participants at each dose level. Hartnup amino acid data were adapted from the Utrecht cohort reported by Haijes et al. (11). (B) Total 24 hour Hartnup and non-Hartnup amino acids (in mg) excreted following single ascending doses (10–170 mg) of JNT-517. (C) Total amount of urinary Phe excreted over 24 hours following single ascending doses (10–170 mg) of JNT-517. (D) Total 24 hour Hartnup amino acids excreted on days 1, 7, and 14 in MAD cohorts (dose levels 25 mg BID, 75 mg BID, 150 mg QD). (E–G) Total urinary Phe excreted on days 1, 7, and 14 in multiple ascending dose cohorts 0–24 hours (E), 0–8 hours (F) and 8–24 hours (G) after dose. Hartnup AAs are the sum of Ala, Asn, Gln, Ile, Leu, Phe, Ser, Thr, Tyr, Val. Non-Hartnup AAs are the sum of Arg, Cys, Glu, Gly, Lys, Pro. Values represent mean ± SD for n = 5–6 individuals dosed with placebo or active compound per cohort. BID, twice daily; PBO, placebo; QD, once daily

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