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Saracatinib is an efficacious clinical candidate for fibrodysplasia ossificans progressiva
Eleanor Williams, Jana Bagarova, Georgina Kerr, Dong-Dong Xia, Elsie S. Place, Devaveena Dey, Yue Shen, Geoffrey A. Bocobo, Agustin H. Mohedas, Xiuli Huang, Philip E. Sanderson, Arthur Lee, Wei Zheng, Aris N. Economides, James C. Smith, Paul B. Yu, Alex N. Bullock
Eleanor Williams, Jana Bagarova, Georgina Kerr, Dong-Dong Xia, Elsie S. Place, Devaveena Dey, Yue Shen, Geoffrey A. Bocobo, Agustin H. Mohedas, Xiuli Huang, Philip E. Sanderson, Arthur Lee, Wei Zheng, Aris N. Economides, James C. Smith, Paul B. Yu, Alex N. Bullock
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Research Article Bone biology Therapeutics

Saracatinib is an efficacious clinical candidate for fibrodysplasia ossificans progressiva

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Abstract

Currently, no effective therapies exist for fibrodysplasia ossificans progressiva (FOP), a rare congenital syndrome in which heterotopic bone is formed in soft tissues owing to dysregulated activity of the bone morphogenetic protein (BMP) receptor kinase ALK2 (also known as ACVR1). From a screen of known biologically active compounds, we identified saracatinib as a potent ALK2 kinase inhibitor. In enzymatic and cell-based assays, saracatinib preferentially inhibited ALK2, compared with other receptors of the BMP/TGF-β signaling pathway, and induced dorsalization in zebrafish embryos consistent with BMP antagonism. We further tested the efficacy of saracatinib using an inducible ACVR1Q207D-transgenic mouse line, which provides a model of heterotopic ossification (HO), as well as an inducible ACVR1R206H-knockin mouse, which serves as a genetically and physiologically faithful FOP model. In both models, saracatinib was well tolerated and potently inhibited the development of HO, even when administered transiently following soft tissue injury. Together, these data suggest that saracatinib is an efficacious clinical candidate for repositioning in FOP treatment, offering an accelerated path to clinical proof-of-efficacy studies and potentially significant benefits to individuals with this devastating condition.

Authors

Eleanor Williams, Jana Bagarova, Georgina Kerr, Dong-Dong Xia, Elsie S. Place, Devaveena Dey, Yue Shen, Geoffrey A. Bocobo, Agustin H. Mohedas, Xiuli Huang, Philip E. Sanderson, Arthur Lee, Wei Zheng, Aris N. Economides, James C. Smith, Paul B. Yu, Alex N. Bullock

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Figure 2

Saracatinib is a selective inhibitor of BMP versus TGF-β type I receptor activity in cells.

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Saracatinib is a selective inhibitor of BMP versus TGF-β type I receptor...
(A) IC50 inhibition curves for saracatinib against purified recombinant ALK1-6 kinase domains were determined using a LANCE Ultra TR-FRET kinase assay (PerkinElmer). Reactions contained 10 nM kinase, 50 μM peptide substrate, and 10 μM ATP. Data shown are plotted as mean ± SD. (n = 3 independent replicates). (B) Representative inhibition curves for saracatinib against constitutively active BMP (caALK1, 2 and 3) and activin/TGF-β (caALK4 and 5) type I receptors, based on the activity of BMP responsive promoter element LUC (BRE-Luc) and TGF-β responsive LUC (CAGA-Luc) reporters in C2C12 and 293T cells, respectively. Data shown are representative of more than 3 independent experiments, with data plotted as mean ±SEM. (n = 3 replicates). (C) IC50 inhibition curves for saracatinib against the signaling induced by indicated ligands based on the activity of BRE-Luc (BMP ligands) and CAGA-Luc (activin/TGF-β ligands) reporters stably expressed in MDA-MB-231 cells. Data shown are plotted as mean ± SD. (n ≥ 3 independent replicates). (D) Western blot analyses showing the inhibitory activity of saracatinib against BMP7-induced phosphorylation of SMAD1/5, as well as TGF-β–dependent phosphorylation of SMAD2 in C2C12 cells.

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