Transcript Slide 1

Disaggregation of a-Synuclein by
way of Isradipine
John Chi, Mike DeSalvio, Kevin Ip, Khine Win, Michael Nguyen
Specific Aims
Show the effectiveness of subcutaneous
administration of calcium channel blockers
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Determine safe dosage
 Effective concentration
Determine effectiveness of Isradipine against
a-synuclein plaques
 Restore affected areas by decreasing the
intracellular calcium levels
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Objectives
Show spatiotemporal control through
subcutaneous injection
 Prevent cell death in PD patients
 Mitigate the effect of Lewy Bodies
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Affects Alzheimer's as well as Parkinson’s disease
Background & Significance
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Isradipine: dihydropyridine
 Calcium channel blocker
○ Treats high blood pressure and reduces risk of
stroke
 Approved small molecule
○ Multiple trade names
Dynacirc
Prescal
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http://en.wikipedia.org/wiki/File:Isradipine.png
Parkinson’s Disease
Neurodegenerative disorder
 100-200 people in 100,000
 Average age of onset 55 to 60
 Annual cost approximately $11 billion
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http://www.wolframalpha.com/input/?i=parkinsons+disease
Parkinson’s Disease
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Impairs motor skills, cognitive
processes, and other functions
 Tremors
 Rigidity
 Bradykinesia
 Postural instability
http://www.wolframalpha.com/input/?i=parkinsons+disease
Parkinson’s Disease
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Diminished cognitive processes
 Executive dysfunction
○ Planning
○ Abstract thinking
○ Initiating appropriate actions
○ Inhibiting inappropriate actions
 Eventually develop into dementia
 Accompanied by behavior and mood
alterations
Parkinson’s Disease
Idiopathic
 Various hypotheses
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 Viral
 Genetic
 Lewy Bodies
http://www2.kumc.edu/coa/images/AMED900/Dementia/DementiaSyndromeGraph.gif
Lewy Bodies
Alpha-Synuclein
 Eventually accumulate in substantia nigra
 Accumulate in various parts of the brain
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 Olfactory bulb
 Medulla oblongata
 Pontine tegmentum
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Leads to cell death
http://shirley-kwan.com/wp-content/uploads/2007/09/lewy.jpg
Current Research
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Improving quality of life
 Therapy and exercise
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Neuroprotection
 Drug treatment to slow, stop, reverse
progression of PD
Neuroprotection
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Anti-apoptotic drugs
Antiglutamatergic agents
Monoamine oxidase-B inhibitors
Calcium channel blockers
Growth factors
Current Treatments
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Levodopa (L-DOPA)
MAO-B inhibitors
Amantadine
Anticholinergics
Surgery
Treatment Standard: L-Dopa
http://www.3dchem.com/imagesofmolecules/Levodopa.jpgc
Isradipine background
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IC50 34+-8 uM
60-65% excreted in urine
25-30% excreted through feces
5-15% actually absorbed into the blood
Decrease responsiveness
○ Administer intravenously
http://images.containerstore.com/images/catalog11966/11966.jpg
Research Design & Methods
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Overview
 Isradipine as a therapeutic approach
 Experimental approach
 Proposed Pre-Clinical trials
 Prospective Clinical trials
Mechanism of α-synuclein cytotoxicity
Figure: Fibrilization
pathway
Native unfolded
monomer
•Β-sheet rich oligomers
or protofibrils
•Fibrils
•Lewy body
α-synuclein
protein
Reference: http://www.molecularneurodegeneration.com/content/4/1/9
Proposed Therapeutic Approach
Cav1.3
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SNc main ion channels:
 Cav1.3 (voltage gated)
 NMDAR (iGluR, ligand gated)
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L-type Calcium channel
Regulate spontaneous pace making activity
Modulator of neuronal spiking behavior
Binding site on α1D sub unit
Isradipine (1,4- dihydropyridine) as inhibitor
Theorized mechanism:
 Conformational changes by binding
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Ca2+ influx control approach
Research Proposal (Intro)
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Quantification of effect on targeted drug
delivery approach:
 Behavior study
 Calcium imaging (striatum & sN)
 Immunohistochemistry staining by Caspase-
3 antibody to determine apoptotic cells
 Clinical phase I
Time frame: 4-6 months
 Potential pitfall: Low blood pressure
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Comparison with other methods
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Rifampicine (Lewy body approach)
 Antibiotic to treat TB & Leprosy
 Disintegrate α-syn fibrils
 Inhibit fibrils formation by stabilization monomer and
oligomers
 No animal models
 Correlation with PD symptoms not yet tested
 Might enhance toxicity if protofibril cytotoxicity hypothesis is
true
Reference: Adphrodite Kapurniotu. Targeting α-synuclein in Parkinson’s Disease. chemibiol 2004;11:1476-
Comparison with other methods
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Β-synuclein protein (Gene therapy approach)
 Subfamily of synuclein family
 Concentrated in presynaptic nerve terminals (133AA)
 Not found in Lewy body inclusions
 Studies indicate inhibition of α-syn aggregation
 Overexpression by upregulating the gene:
○ Human β-syn transgenic mice
○ Transfected by lentivector
 Major fall back: random insertion of gene might cause
cancer and other mutations
Comparison with other methods
α-synnuclein
protofibrils
Inhibition by β–synuclein
(Green color)
Reference: Dr.Igor Tsigelny. Modelling molecular basic of Parkinson’s disease. SDSU review. Winter 2007:52-57
Advantages of our approach
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No effective inhibitor drug for aS protofibrils
aggregation yet
Indirect method to manipulate Ca2+ influx
No tendency to cause gene therapy related
implications such as mutation
Use of approved drug (Isradipine)
Targeted drug delivery
Recent studies shows non-targeted delivery
results in reduction in LID
Potential to fast-track clinical trial
Most beneficial if couple with gene therapy in
future
Proposed Pre-Clinicals
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Administer 6-Hydroxydopamine in mice
to induce lesions (40 specimens)
Wait two weeks until lesions mature
Administer Isradipine to 20 mice (Dose
2x/day)
Administer equivalent volume of saline
to the other 20 mice
Sacrifice mice at the end of 18 weeks
Pre-Clinical
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Use B6D2F1/J Mice (Jackson Labs)
 Transgenic Studies
 Behavior Studies
 Bioassays for drugs, pathogens, nutrients
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Study Groups: PD, PD + L-DOPA, PD+
Placebo, Wild-Type
Drug Delivery
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Injection of Time Release Pellet
 Various Concentrations (ex. 0.1 mg/kg/day)
 14-day life
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Location: Subcutaneously
 Between shoulder blades (The “scruff”)
Matrix of Mice Groups
6-OHDA
L-DOPA
Isradipine
Saline
Group 1
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Group 2
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Group 3
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Group 4
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Group 5
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Group 6
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Group 7
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Group 8
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Pitfalls & Solutions
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Undue drop in Blood Pressure
 Concentration kept low
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Mouse difference in Metabolic Rate
 Select for: 4 weeks old, 15-20 grams
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Effects not from isradipine
 Perform Histology to determine
Future Clinical Trials
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Phase I
 50 Volunteers
 Early- to Mid-Stage Parkinson’s
 Blinded Trial
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Drug
 L-DOPA +/- Isradipine
 Extended Release Formulation
○ Packaged in Microspheres
Goal of Phase I Trials
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Isradipine Effective
 Reduces Adverse Involuntary Movements
 Did not Drop BP dangerously Low
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Improves Quality of Life
 More control over Movement
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Not a replacement for L-DOPA
 Works in conjunction with L-DOPA
Prospective Clinical Trials
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Phase I: 50 volunteer patients, blind trial
 Covered by SBIR
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Phase II: 200 patients double blind
 Covered by NIH
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Phase III: 2000 patients double blind
 Investors: VC’s and Industry Sponsors
Budget Overview
$100,000 for 6 months
 We plan to borrow equipment
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 PCR, Ultra Centrifuge, and lab equipment
 Outsource for DNA sequencing and blots if
necessary
 Capitalize on help of 4 Interns for lab work
 Rent small work space in Fullerton, Ca
Salary Information
Name
Michael Nguyen
Michael DeSalvio
Kevin Ip
John Chi
Khine Win
Lab Technician
Animal Technician
Base Salary
Months
Effort
Requested Salary
$80,000
5
25%
$8,333
$82,000
3
35%
$7,175
$80,000
4
20%
$5,333
$75,000
5
25%
$7,812
$77,000
5
20%
$6,416
$25/hr
5
10%
$3,000
$25/hr
5
10%
$3,000
$41,069
Equipment Costs
Description
Cost
Bio-Rad Gel Doc1000 Imager Cabinet w/ Transilluminator
$2,000
Labnet International MultiGene Mini Personal Thermal Cycler
$2,700
Nuaire Nu 425-600 Option A-P2 Lab Hood 72"
$2,500
Fileserver
$1,500
Laboratory laptops x 5 (Apple MacBook Pro 15”)
2 Experimental PC Workstations
Refrigerator
Summit VT 225 Lab Freezer (-30 deg C)
Liquid Nitrogen System
$10,000
$1000
$500
$1,600
$800
$22,800
•The Bio-Rad Imager is required for the imaging studies
•The Thermal Cycler is required to determine
•The Nuaire fume hood is necessary for manipulating organic
compounds such
as fura2 for cell staining and histological studies.
Facility Rental
Facility Rental: $9,515
 Fullerton Business Center #140
 1501 E Orangethorpe Ave, Fullerton, CA
92831
 Space Size: 1,522 sqft
 Property Type: Office / R&D
 Price Per Sqft: $1.25
 Rent: $1,903 FS
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Laboratory Costs
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Laboratory Supplies: $10,000
Laboratory supplies include items such as
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safety equipment
gloves
oligonucleotides
fura2
isradipine
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Test tubes
Scales
Slides
Burners
Syringes
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Flasks
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Estimated at approximately $5,000 for
startup and $1,000/mo.
Research Strategy
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Run preclinical trials
 Determine effect or Ca++ channel blockers on
adrenergic neurons in Substantia Nigra
Citations
Questions