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DDD x > Week 5 Part 1 > Flashcards

Week 5 Part 1 Flashcards

1
Q

What are the advantages of peptidic drugs?

A
  1. High selectivity and potency
  2. Good efficacy, safety and tolerability
  3. Mechanism of action well understood
  4. Predictable metabolism?
  5. Lower risk of drug-drug interaction
  6. Well-defined synthesis
  7. Shorter development time
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2
Q

What are the disadvantages of peptidic drugs?

A
  1. Short half-life and fast elimination
  2. Lower stability
  3. Sensitive to proteolytic degradation
  4. Usually not orally available
  5. SC, IM, Intranasal expensive formulation
  6. Potential immunogenicity
  7. High cost of synthesis
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3
Q

What is somatostatin?

A
  1. A releasing inhibiting factor released from the hypothalamus
  2. Suppresses growth hormone secretion
  3. Plays an important role in pancreatic degradation and other gut function
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4
Q

What gives a very hydrophobic surface of the peptide?

A

Phenylalanine-phenylalanine and then D-tryptophan

Enable to bind to lipoproteins

Increase half life

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5
Q

What are the factors underlying short half-lives of peptides after I.v. Administration?

A
  1. Proteolytic degradation by plasma pro teases or tissue/cell bound proteases
  2. Rapid clearance by glomerular filtration in kidney
  3. Tissue endocytosis (e.g. liver) followed by proteosome degradation
  4. Some small peptide have unusually long half-lives due to binding to plasma proteins
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6
Q

What molecules are readily filtered in the kidney with a glomeruli pore size ~8nm?

A

Molecules less than 5 kDa

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7
Q

What molecules are less rapidly eliminated?

A
  1. Larger polypeptides
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8
Q

What globular proteins are retained in the circulation?

A

Proteins >50-70kDa with diameter of ~90 A

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9
Q

What does octreotide bind to?

A
  1. Lipoproteins
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10
Q

What is NT-proET1 sensitive to?

A
  1. Lung proteases

2. Cleaved before it gets to the circulation

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11
Q

What has a really long half-life?

A

CT-proET-1

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12
Q

What cannot you predict of peptides from?

A
  1. Rates of metabolism

2. Size

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13
Q

What is endothelin?

A
  1. A very potent vasoconstrictor
  2. Cause blood pressure change if you inject of 0.7 microgram into rats
  3. Blood pressure change that lasts for 60 minutes
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14
Q

What is the clearance of endothelin?

A
  1. Half life of about 20 seconds

2. Not due to metabolism [very rapid half life due to receptor binding]

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15
Q

What do you need to know the relationship of?

A
  1. Circulating half life and biological effect
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16
Q

What is ETB receptor?

A
  1. Activation triggers short lasting vasodilation

2. expressed through vasculature on the endothelium - cleared very rapidly in the lungs

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17
Q

What is crucial in process of drug development?

A
  1. Understanding biology
  2. Stability
  3. clearance mechanism
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18
Q

What is dipeptidyl peptidase 4 (DPP4)?

A
  1. A membrane bound peptidase found widely in the vasculature
  2. Plays a critical role in the degradation of some peptides in the circulation
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19
Q

What are the proteolytic activity of peptide degradation?

A
  1. Aspartyl proteases
  2. Cysteine Proteases
  3. Serine proteases
  4. Metallopeptidases
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20
Q

What is Aspartyl proteases?

A
  1. Frequently cleave dipeptide bonds between hydrophobic residues
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21
Q

What are examples of Aspartyl proteases?

A
  1. Renin
  2. Pepsin
  3. Cathepsin D + E
  4. Presenilins
  5. Beta-secretases (HIV protease)
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22
Q

What are examples of cysteine proteases?

A
  1. Variety of cathepsin, calpain, caspases and ubiquitin specific peptidase
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23
Q

What are examples of serine proteases?

A
  1. Trypsin
  2. Chymotrypsin
  3. Elastase
  4. Coagulation factors
  5. Thrombin
  6. tPA
  7. uPA
  8. Plasmin
  9. Dipeptidyl peptidase 4 (DPP4)
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24
Q

What are examples of metallopeptidases?

A
  1. Amino- and carboxy-peptidases
  2. Ace
  3. Neprilysin
  4. Matrix metallopeptidase
  5. ADAMTs
  6. ADAM peptidase families
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25
Q

What can you do with multiple peptidase?

A

Incubation

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26
Q

What do peptides have in the circulation?

A
  1. Poor cell penetration
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27
Q

What is the most relevant proteolytic activity?

A
  1. Cell surface peptidases
    - membrane anchored
    - transmembrane
  2. Soluble circulating peptidases
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28
Q

What are the stability ways to investigate the predict routes of peptide metabolism?

A
  1. Incubation with whole blood
  2. Endothelial cells
  3. Systemic administration
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29
Q

What are the strategy to prevent enzyme degradation?

A
  1. Modification of N- and C-termini
  2. Chemical modification of side chains, side chains substitution
  3. Backbone modification including use of D-amino acids
  4. Peptide cyclisation to increase peptidase resistance
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30
Q

What is the strategies for slow clearance?

A
  1. Conjugation to polymers
  2. Linkage/fusion with long-lives proteins
  3. Albumin tags
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31
Q

What is the most commonly observed modification of peptide (peptide resistance)

A
  1. The amide group
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32
Q

What is important in biological activity?

A
  1. Amino acid side group
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33
Q

What is important thing of D-amino acids?

A
  1. Reducing susceptibility to peptidases
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34
Q

What does D-amino acids change?

A
  1. The relative positions of side-chains groups on amino acids
  2. Cause a conformational change in the peptide backbone
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35
Q

What is the impact of D-amino acid Substitution?

A
  1. Reduced accessibility of peptide bonds
  2. Reduced affinity for specific peptidases (increased stability)
  3. No change, or an increase or decrease in biological activity depending on the role of specific residues in receptor binding
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36
Q

What is an example of a modified peptide?

A
  1. Desmopressin
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37
Q

What are the 2 critical modifications of Desmopressin?

A
  1. Arg8 change in L- to D-form
    - retains biological activity in the V2 receptor
    - eliminates side effect of raising blood pressure on V1
  2. Removal of N-terminal amino group
    - cyclic peptide
    - naturally occurring C-terminal amuse
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38
Q

What is Gonadotropin releasing hormone?

A
  1. Peptide that is released from hypothalamus into portal circulation between hypothalamus and anterior pituitary
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39
Q

exploiting biological effects on the pituitary

A
  1. De-sensitise the pituitary
    - no LH/FSH being secreted
  2. Use smaller doses of gonadotropin releasing hormone agonist which stimulates the pituitary
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40
Q

How do you block LH secretion?

A
  1. Give very high dose of GnRH which after receptor de-sensitisation and hence lose LH production
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41
Q

What is another area of exploitation when developing peptide medicine?

A
  1. Know something about the evolution of that peptide

2. Phylogenetic insights tells you which amino acids are likely to be critical in biological mechanism

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42
Q

In mammals

A
  1. GnRH is fully conserved
43
Q

What was N-terminal Sequence critical for?

A
  1. Receptor binding

2. Biological activity

44
Q

What did research show about glycine?

A
  1. If you changed it to D-amino acid, you convert GnRH into super agonist
  2. Much more potent in their receptor binding and receptor activation
45
Q

What was the first GnRH agonist to be licensed

A

Buserelin

46
Q

What was the simple modification done on Buserelin?

A
  1. Substitution of glycine via tertiary butyl-serine in the D-amino acid form
  2. At C terminal end, glycine has been changed to a amide structure (ethyl-amide)
47
Q

What is Buserelin?

A
  1. A superagonist
  2. Used since 1984
  3. 20-170 times more active than GnRH for
    Inducing LH and FSH
48
Q

What are the formulation of Buserelin?

A
  1. Nasal spray
  2. Injection
  3. Implant
49
Q

What are the Therapeutic indications of Buserelin?

A
  1. Female infertility
  2. Breast cancer
  3. Endometrial hyperplasia
  4. Endometriosis
  5. Uterine fibroids
  6. Prostate cancer
50
Q

What is an example of GnRH antagonist?

A
  1. Degarelix
51
Q

What does the structure of Degarelix retain?

A
  1. Structure retains C terminal amino acids/analogies important for receptor binding
  2. Modification in N terminal to receptor binding but avoid receptor activations
52
Q

What are the therapeutic use of Degarelix?

A
  1. Androgen-deprivation therapy in hormone dependent prostrate cancer
  2. Administered by s.c. Injection
53
Q

What are venoms?

A
  1. A source of biologically active peptides

2. Lead molecules for drug discovery

54
Q

What does many snakes contain?

A
  1. Small proteins called disintegrins which are antithrombotic
  2. Strongly inhibits platelet aggregation
55
Q

What do these small proteins of snake venom contain and what does it inhibit?

A
  1. Amino acid sequence RGS (Arg-Gly-Asp)

2. Inhibit fibrinogen binding to GP IIb/IIIa

56
Q

What do the RGD-containing venom disintegrin also bind to?

A
  1. Other integrin such as a51B1 (fibronectin receptor)
  2. AvB3 (vitronectin receptor)
  3. Lack specificity for GP IIb/IIIa
57
Q

What is barbourin?

A

73 amino acid disintegrin from the venom of southeastern pigmy rattle snake Sistrurus barbiuri which selectively inhibits fibrinogen binding to GP IIb/IIa and does not bind to other integrin through RGD-ligand sites

58
Q

What does selectivity of barbourin for GP IIb/IIIa due to?

A
  1. KGD (Lys-Gly-Asp)
59
Q

What does activity of barbourin and other disintegrin depend on?

A
  1. Tertiary structure resulting from multiple disulphide bridges
60
Q

What is Barbourin unsuitable for?

A
  1. Therapeutic because of size, structural complexity and potential antigenicity
61
Q

What are GLP-1 receptor agonist?

A
  1. Class of drugs increasingly used for treating type 2 diabetes
62
Q

What did snake venom lead to?

A

potentiating peptide from Bothrops jararaca led to ACE inhibitors

63
Q

What is crucial for angiotensin?

A

Enzyme system that degraded bradykinin

64
Q

Snake venom

A

Anticoagulant

65
Q

Gila monster

A

GLP1 agonists

66
Q

Cone snails

A

conotoxins

67
Q

What does activity of Barbourin and other disintegrin depend on?

A
  1. Tertiary structure resulting from multiple disulphide bridges
68
Q

Why is barbourin unsuitable as a therapeutic?

A
  1. Size
  2. Strucutral complexity
  3. Potential antigenicity
69
Q

What is Eptifibatide?

A

Short peptide

7 amino acids long

70
Q

What is Eptifibatide stabilized by?

A

disulfide bridge

71
Q

What does H-arginine retain?

A

Lysine specifity

Retains the other amino acids critical for binding

72
Q

Why is proline introduced?

A

Makes the sequence more compact

73
Q

What is the indications of Eptifibatide?

A
  1. Teo reduce the risk of acute cardiac ischemic event in patient with unstable angina
  2. Receive non surgery medical treatment
  3. Undergoing percutaneous coronary intervention
74
Q

What is formulation of Eptifibatide?

A

Infusion

75
Q

What are the features of synthetic peptide for Eptifibatide?

A
  1. No N-terminal NH2-group
  2. C-terminal amide
  3. Cyclic peptide (disulfide bridge)
  4. Proline constraint on peptide backbone
76
Q

Why is GLP-1 agonist used?

A

Modification to improve stability and half life

77
Q

Money to treat life-style disease

A

➢ Diabetes market set to reach $60bn globally by 2025 based on 9 major world markets

78
Q

What are GLP-1 receptor agonist?

A

A class of drugs increasingly used for treating type 2 diabetes

79
Q

Features of GLP-1 agonist

A

➢ Currently 5-marketed drugs in this class, all injection formulations, representing more than $2 billion in 2013 global sales

80
Q

What is the market size for GLP-1 agonist expected to reach?

A

Nearly $8 billion by 2020

81
Q

What does peptide exendin 4 have?

A

Anti-diabetic effect

But it cause hypoglyemia as it stimulated insulin release

82
Q

What is Exenatide?

A

First of GLP-1 agonist to be licensed

83
Q

What is exenatide?

A
  1. GLP-1 agonist medication
  2. Belonging to the group of incretin mimetics
  3. Approved in 2005 for treating type 2 diabetes mellitus by subcutaneous injection
84
Q

What is exenatide a synthetic version of?

A
  1. Exendin 4
  2. A hormone found in the saliva of Gila monster
  3. 39-amino acid peptide
  4. Insulin secretagogue with glucoregulatory effect
85
Q

How is exenatide manufactured by?

A

Chemical synthesis

86
Q

What is therapeutic advantage of exenatide ?

A

Resistant to breakdown by DPP-IV

87
Q

What is an advantage of Exendin-4?

A

Resistance to dipeptidyl peptidase 4 degradation

88
Q

How is Exenatide used?

A
  1. Injected s.c. twice daily

or on a weekly basis with a long-acting formulation

89
Q

What are approved GlP-1 receptor agonist

A
  1. Exenatide
  2. Liraglutide
  3. Albiglutide
  4. Dulaglutide
  5. Lixisenatide
  6. Semaglutide
90
Q

What is Liraglutide?

A

First GLP-1 agonist to be licensed

91
Q

What is difference of Liraglutide to GLP1?

A

They had a modified with a palmitic acid (C16) side chain to promote binding to albumin to increase its half-life from a few minutes to 10h

92
Q

Liraglutide

A

typical albumin tag- fatty acid side chain that makes it stick to albumin and gives it a longer circulating half life

93
Q

What is rationale for Liraglutide?

A

Albumin acts as a carrier for fatty acids

94
Q

What is average half life for Liraglutide?

A

10 hours

95
Q

What does Albiglutide have?

A

2 copies of GLP-1 at the N terminal of albumin

96
Q

What is Albiglutide?

A
  1. GLP-1 analogue linked to albumin

2. 645 amino acid protein with 17 disulfide bridges

97
Q

What are 2 copies of modified human GLP-1?

A
  1. Amino acid 1-30 and 31-60
98
Q

What is the synthesis of Albiglutide?

A
  1. Bioengineered in yeast
  2. saccharomyces cerevisiae
  3. Recombinant DNA technology
99
Q

After S.c. injection what does Albiglutide reach?

A

Maximum blood concentration after 3-5 days with steady state achieved 3-5 weeks

100
Q

What is the half life of Albiglutide?

A

4-7 days

Allow once- weekly administration

101
Q

What is Dulaglutide?

A

GLP-1 agonist consisting of GLP-1 (7-37) covalently linked to an Fc fragment of human IGg4

Used for treating type 2 diabetes with once weekly administration

102
Q

What is Lixisenatide?

A

6 lysine C-terminal extension which improves the half life to 2-4 hours

103
Q

What is Semaglutide?

A

Has lys swapped for arginine to make it a more simple target for modification of side chain

DDD x (17 decks)

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