WO2014127316A2 - Proprotein convertase subtilisin/kexin type 9 (pcsk9) allosteric binding ligands to mudulate serum low density lipoprotein (ldl) levels - Google Patents

Proprotein convertase subtilisin/kexin type 9 (pcsk9) allosteric binding ligands to mudulate serum low density lipoprotein (ldl) levels Download PDF

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WO2014127316A2
WO2014127316A2 PCT/US2014/016640 US2014016640W WO2014127316A2 WO 2014127316 A2 WO2014127316 A2 WO 2014127316A2 US 2014016640 W US2014016640 W US 2014016640W WO 2014127316 A2 WO2014127316 A2 WO 2014127316A2
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ser
thr
leu
pcsk9
low density
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PCT/US2014/016640
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English (en)
French (fr)
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WO2014127316A4 (en
WO2014127316A3 (en
Inventor
Michael M. Muehlemann
Thomas E. Barta
Kyle D. MONROE
Jonathan William BOURNE
Margaret Thompson REECE
Vesa Nevalainen
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Srx Cardio, Llc
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Priority to AU2014216091A priority Critical patent/AU2014216091A1/en
Application filed by Srx Cardio, Llc filed Critical Srx Cardio, Llc
Priority to CA2901436A priority patent/CA2901436A1/en
Priority to SG11201506336XA priority patent/SG11201506336XA/en
Priority to EP14751148.9A priority patent/EP2956154A4/en
Priority to CN201480017801.7A priority patent/CN105378159A/zh
Priority to KR1020157025152A priority patent/KR20150127622A/ko
Priority to JP2015558178A priority patent/JP2016508722A/ja
Publication of WO2014127316A2 publication Critical patent/WO2014127316A2/en
Publication of WO2014127316A3 publication Critical patent/WO2014127316A3/en
Publication of WO2014127316A4 publication Critical patent/WO2014127316A4/en
Priority to US14/825,700 priority patent/US10287317B2/en
Priority to IL240583A priority patent/IL240583A0/en
Priority to HK16107087.1A priority patent/HK1219048A1/zh

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K35/00—Medicinal preparations containing materials or reaction products thereof with undetermined constitution
    • A61K35/12—Materials from mammals; Compositions comprising non-specified tissues or cells; Compositions comprising non-embryonic stem cells; Genetically modified cells
    • A61K35/37—Digestive system
    • A61K35/407—Liver; Hepatocytes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/13—Amines
    • A61K31/155—Amidines (), e.g. guanidine (H2N—C(=NH)—NH2), isourea (N=C(OH)—NH2), isothiourea (—N=C(SH)—NH2)
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/335—Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin
    • A61K31/365—Lactones
    • A61K31/366—Lactones having six-membered rings, e.g. delta-lactones
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/397—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having four-membered rings, e.g. azetidine
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/40—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/435—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
    • A61K31/44—Non condensed pyridines; Hydrogenated derivatives thereof
    • A61K31/4422—1,4-Dihydropyridines, e.g. nifedipine, nicardipine
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/495—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines
    • A61K31/4985—Pyrazines or piperazines ortho- or peri-condensed with heterocyclic ring systems
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/495—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines
    • A61K31/505—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K45/00—Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
    • A61K45/06—Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P3/00—Drugs for disorders of the metabolism
    • A61P3/06—Antihyperlipidemics
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P43/00—Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K7/00—Peptides having 5 to 20 amino acids in a fully defined sequence; Derivatives thereof
    • C07K7/04—Linear peptides containing only normal peptide links
    • C07K7/06—Linear peptides containing only normal peptide links having 5 to 11 amino acids
    • C—CHEMISTRY; METALLURGY
    • C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
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    • C12N9/00—Enzymes; Proenzymes; Compositions thereof; Processes for preparing, activating, inhibiting, separating or purifying enzymes
    • C12N9/14—Hydrolases (3)
    • C12N9/48—Hydrolases (3) acting on peptide bonds (3.4)
    • C12N9/50—Proteinases, e.g. Endopeptidases (3.4.21-3.4.25)
    • C12N9/64—Proteinases, e.g. Endopeptidases (3.4.21-3.4.25) derived from animal tissue
    • C12N9/6402—Proteinases, e.g. Endopeptidases (3.4.21-3.4.25) derived from animal tissue from non-mammals
    • C12N9/6405—Proteinases, e.g. Endopeptidases (3.4.21-3.4.25) derived from animal tissue from non-mammals not being snakes
    • C12N9/6408—Serine endopeptidases (3.4.21)
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K38/00—Medicinal preparations containing peptides

Definitions

  • PCSK9 Proprotein Convertase Subtilisin/Kexin Type 9 Allosteric Binding Ligands to Modulate Serum Low Density Lipoprotein (LDL) Levels
  • This invention is related to the field of hypercholesterolemia.
  • the invention provides compositions and methods to modulate circulating levels of low density lipoproteins by altering the conformation of the protein PCSK9 using a synthetic ligand and/or a synthetic ligand derivative having sequences of 3-8 amino acids ranging between 350 - 2,000 Da.
  • Altering the conformation of PCSK9 affects the interaction between PCSK9 and an endogenous low density lipoprotein receptor, and can lead to reduced or increased levels of circulating LDL-cholesterol.
  • High LDL-cholesterol levels are associated with increased risk for heart disease.
  • Low LDL-cholesterol levels may be problematic in other conditions, such as liver dysfunction; thus, there is also utility for ligands which can raise LDL levels. Background
  • LDL-C low density lipoprotein cholesterol
  • LDLRs LDL receptors
  • ADH Autosomal dominant hypercholesterolemia
  • FH familial hypercholesterolemia
  • apoBlOO familial defective apoBlOO
  • the low density lipoprotein (LDL) receptor (LDLR) mediates efficient endocytosis of VLDL, VLDL remnants, and LDL. As part of the endocytic process, the LDLR releases lipoproteins into hepatic endosomes.
  • LDL low density lipoprotein
  • This invention is related to the field of hypercholesterolemia.
  • the invention provides compositions and methods to modulate circulating levels of low density lipoproteins by altering the conformation of the protein PCSK9 using a synthetic ligand and/or a synthetic ligand derivative having sequences of 3-8 amino acids ranging between 350 - 2,000 Da.
  • Altering the conformation of PCSK9 affects the interaction between PCSK9 and an endogenous low density lipoprotein receptor, and can lead to reduced or increased levels of circulating LDL-cholesterol.
  • High LDL-cholesterol levels are associated with increased risk for heart disease.
  • Low LDL-cholesterol levels may be problematic in other conditions, such as liver dysfunction; thus, there is also utility for ligands which can raise LDL levels.
  • the present invention contemplates a method, comprising: a) providing; i) a PCSK9 protein, wherein said protein comprises a binding site that induces allosteric modulation and a low density lipoprotein receptor binding site; ii) a ligand capable of binding said binding site; iii) a plurality of hepatocyte cells comprising a low density lipoprotein receptor and low density lipoproteins; b) binding said synthetic ligand to said binding site, wherein said synthetic ligand induces a conformation shift of said protein; and c) modulating the affinity of said low density lipoprotein receptor binding site for said low density lipoprotein receptor by said conformational shift.
  • the binding site comprises His 417 , Lys 421 , Pro 446 , Trp 453 , Gin 454 , Glu 628 , Gly 629 , Asn 652 , and Thr 653 of the PCSK9 protein.
  • the synthetic ligand is an allosteric inhibitor ligand wherein said modulating decreases the affinity of said low density lipoprotein receptor binding site for said low density lipoprotein receptor such that internalization of said low density lipoprotein by said plurality of hepatocytes is increased.
  • the synthetic ligand is an allosteric enhancer ligand said modulating increases the affinity of said low density lipoprotein receptor binding site for said low density lipoprotein receptor such that internalization of said low density lipoprotein by said plurality of hepatocytes is decreased.
  • the conformational shift of said protein is selected from the group consisting of an induced fit shift and a biomechanical shift.
  • the synthetic ligand is a synthetic peptide selected from the group consisting of VYVRFW, VLELYW and ISDLSY.
  • the allosteric inhibitor is a peptide is selected from the group consisting of
  • the allosteric enhancer is a peptide is selected from the group consisting of SRX64, SRX67, SRX68, SRX69, SRX72 and SRX73.
  • the synthetic peptide comprises between approximately 3 - 8 amino acids.
  • the synthetic peptide is six amino acids.
  • the synthetic peptide is less than 1,300 Da.
  • the synthetic peptide ranges between approximately 466-1067 Da.
  • the synthetic peptide ranges between approximately 175-1,000 Da.
  • the present invention contemplates, a method, comprising: a) providing; i) a PCSK9 protein, wherein said protein comprises a binding site that induces allosteric modulation and a low density lipoprotein receptor binding site; ii) a synthetic ligand capable of binding said binding site; iii) a plurality of hepatocyte cells comprising a population of low density lipoprotein receptors; b) binding said synthetic ligand to said binding site, wherein said synthetic ligand induces a conformation shift of said protein; c) modulating said population of said low density lipoprotein receptors by said conformational shift.
  • the binding site comprises His 417 , Lys 421 , Pro 446 , Tip 453 , Gin 454 , Glu 628 , Gly 629 , Asn 652 , and Thr 653 of the PCSK9 protein
  • the synthetic ligand is an allosteric inhibitor ligand wherein said modulating increases said population of said low density lipoprotein receptors measurable on the cell surface of said plurality of hepatocytes.
  • the synthetic ligand is an allosteric enhancer ligand wherein said modulating decreases said population of said low density lipoprotein receptors measurable on the cell surface of said plurality of hepatocytes.
  • the conformational shift of said protein is selected from the group consisting of an induced fit shift and a biomechanical shift.
  • the ligand is a synthetic peptide selected from the group consisting of VYVRFW, VLELYW and ISDLSY.
  • the allosteric inhibitor peptide is selected from the group consisting of SRX55, SRX56, SRX60, SRX61, SRX62, SRX63, SRX64, SRX65 and SRX66.
  • the allosteric enhancer peptide is selected from the group consisting of SRX64, SRX67, SRX68, SRX69, SRX72 and SRX73.
  • the synthetic peptide comprises between approximately 3 - 8 amino acids. In one embodiment, the synthetic peptide is six amino acids. In one embodiment, the synthetic peptide is less than 1,300 Da. In one embodiment, the synthetic peptide ranges between approximately 466-1067 Da. In one embodiment, the synthetic peptide ranges between approximately 50-1,000 Da. In one embodiment, the present invention contemplates a compound of the formula:
  • n the number of amino acid residues, is an integer in the range 3-8; ii) the constituent amino acids are single enantiomers of independently selected natural or unnatural amino acids; iii) R2 and R3, are independently selected from the group consisting of hydrogen, a lower alkyl, a branched alkyl, a hydroxyalkyl, a cycloalkyl, a heterocycle, aryl, heteroaryl, acyl, substituted or unsubstituted benzoyl, alkyl or aryl sulfonyl (e.g. mesyl or tosyl) and carbamoyl (e.g.
  • Rl is selected from the group consisting of -OH and -NR4-R5;
  • R4 and R5, independently, are selected from the group consisting of hydrogen; a lower alkyl, an aryl, a cycloalkyl, an aromatic heterocycle, pyridine, tetrazole, alkoxy, cycloalkoxy;
  • R4 and R5 are joined as a heterocyle, such as piperidine; pyrrolidine;
  • the compound further comprises a negatively charged polar group.
  • the negatively charged polar group is selected from at least one of the group consisting of O-phosphate, O-sulfate, 5-0-, and a 5-N- tetrazole incorporated in said side- chains SI, S2, or Sn.
  • the side chain selected from the group consisting of SI, S2 and Sn comprises a phosphoserine.
  • the side chain SI comprises - CH2-NH-tetrazole.
  • the compound further comprises a glycine C- terminus.
  • the compound is selected from the group consisting of Val-Tyr- Val-Arg-Phe-Trp, P-Ala-Phe(3-CH2NH2)-Val-D-Ser(p)-Phe-Trp, Thr-Leu-Cys(CH2-Ph)-Thr- Trp-Ser-Ser-Ser(p), Thr-Leu-Asp(NHCH2Ph)-Thr-Trp-Ser-Ser(p), Thr-Leu- Gly(CH2CH2cyclohexyl)-Thr-T ⁇ -Ser-Ser-Ser( ⁇ Thr- Leu-Cys(CH2-Ph)-Thr-Trp(3-Me)-Ser-Ser-Ser(p), Val-Leu-Glu-Leu-Tyr-Trp, Leu-Asp-Leu- Phe-P
  • the compound comprises between approximately 3 - 8 amino acids. In one embodiment, the compound is six amino acids. In one embodiment, the compound is less than 1,300 Da. In one embodiment, the compound ranges between approximately 466-1067 Da. In one embodiment, the compound ranges between
  • the compound comprises a synthetic peptide.
  • the compound is formulated as a pharmaceutical composition.
  • the pharmaceutical composition further comprises a pharmaceutical drug.
  • the pharmaceutical drug is selected from the group consisting of a statin, a cardiovascular drug, a metabolic drug, and an antihypertensive drug.
  • the pharmaceutical drug is selected from the group consisting of ezetimibe, amlodipine besylate, sitagliptin, metformin, atorvastatin, rosuvastatin and simvastatin.
  • the pharmaceutical composition is formulated as selected from the group consisting of a tablet, a liquid, a gel, a capsule, a sachet, a microparticle, a liposome, a nanoparticle, a salt, a transdermal patch, an ointment, a lotion, a cream, a gel, a drop, a strip, a suppository, a spray and a powder.
  • the present invention contemplates a composition comprising a PCSK9 allosteric ligand ranging between approximately 350-1 ,500 Da. In one embodiment, the PCSK9 allosteric ligand is less than 1,300 Da. In one embodiment, the PCSK9 allosteric ligand comprises between approximately 3 - 6 amino acids. In one embodiment, the PCSK9 allosteric ligand ranges between approximately 550 - 1,000 Da. In one embodiment, the composition is a pharmaceutical composition. In one embodiment, the composition is a pharmaceutical composition, hi one embodiment, said administering further comprises a delivery system selected from the group including, but not limited to, liposomes, microparticles and nanoparticles. In one embodiment, the pharmaceutical composition comprises an effective dose of said ligand. In one embodiment, the pharmaceutical composition comprises salts. In one embodiment, the pharmaceutical composition is formulated for oral administration.
  • the present invention contemplates a method, comprising: a) administering a PCSK9 allosteric inhibitor peptide to a subject, wherein said subject has at least one symptom of a cardiovascular disease; and b) reducing said at least one symptom of cardiovascular disease by said PCSK9 allosteric inhibitor peptide administration.
  • said at least one symptom is reduced between 10% - 85%.
  • said at least one symptom is reduced between 20% - 65%.
  • said at least one symptom is reduced between 30% - 55%.
  • the cardiovascular disease comprises a coronary disease.
  • the cardiovascular disease comprises hypertension.
  • the cardiovascular disease comprises hypercholesterolemia.
  • the cardiovascular disease comprises atherosclerosis.
  • the at least one symptom comprises reduced circulating high density lipoprotein.
  • the at least one symptom comprises elevated circulating cholesterol.
  • the at least one symptom comprises elevated circulating low density lipoprotein.
  • the at least one symptom comprises high blood pressure.
  • the administering comprises an effective dose of said PCSK9 allosteric inhibitor peptide.
  • said administering further comprises a delivery system selected from the group including, but not limited to, liposomes, microparticles and nanoparticles.
  • the effective dose comprises a pharmaceutical composition.
  • the pharmaceutical composition comprises salts.
  • the pharmaceutical composition is formulated for oral administration.
  • the allosteric inhibitor peptide comprises between approximately 3 - 8 amino acids. In one embodiment, the allosteric inhibitor peptide is six amino acids. In one embodiment, the allosteric inhibitor peptide is less than 1 ,300 Da. In one embodiment, the allosteric inhibitor peptide ranges between approximately 466-1067 Da. In one embodiment, the allosteric inhibitor peptide ranges between approximately 175-1,000 Da.
  • the present invention contemplates a method, comprising: a) administering a PCSK9 allosteric enhancer peptide to a subject, wherein said subject has at least one symptom of a cardiovascular disease; and b) reducing said at least one symptom of cardiovascular disease by said PCSK9 allosteric inhibitor peptide administration.
  • the cardiovascular disease comprises hypercholesterolemia.
  • said at least one symptom comprises reduced circulating cholesterol.
  • said at least one symptom comprises elevated high density lipoprotein.
  • the at least one symptom comprises reduced low density lipoprotein.
  • the at least one symptom comprises low blood pressure, ha one embodiment, said at least one symptom is reduced between 10% - 85%.
  • the administering comprises an effective dose of said PCSK9 allosteric inhibitor peptide.
  • said administering further comprises a delivery system selected from the group including, but not limited to, liposomes, microparticles and nanoparticles.
  • the effective dose comprises a pharmaceutical composition.
  • the pharmaceutical composition comprises salts.
  • the pharmaceutical composition is formulated for oral administration.
  • the allosteric enhancer peptide comprises between approximately 3 - 8 amino acids. In one embodiment, the allosteric enhancer peptide is six amino acids.
  • the allosteric enhancer peptide is less than 1 ,300 Da. In one embodiment, the allosteric enhancer peptide ranges between approximately 466-1067 Da. In one embodiment, the allosteric enhancer peptide ranges between approximately 175-1 ,000 Da.
  • the present invention contemplates a method, comprising: a) administering a PCSK9 allosteric synthetic peptide to a subject, wherein said subject has at least one symptom of a liver disease; and b) reducing said at least one symptom of liver disease by said PCSK9 allosteric peptide administration.
  • the at least one symptom comprises elevated low density lipoprotein receptor density.
  • the at least one symptom comprises reduced low density lipoprotein receptor density.
  • said at least one symptom is reduced between 10% - 85%.
  • said at least one symptom is reduced between 20% - 65%.
  • said at least one symptom is reduced between 30% - 55%.
  • the PCSK9 allosteric synthetic peptide comprises a PCSK9 allosteric enhancer peptide. In one embodiment, the PCSK9 allosteric synthetic peptide comprises a PCSK9 allosteric inhibitor peptide.
  • the administering comprises an effective dose of said PCSK9 allosteric peptide. In one embodiment, said administering further comprises a delivery system selected from the group including, but not limited to, liposomes, microparticles and nanoparticles.
  • the effective dose comprises a pharmaceutical composition. In one embodiment, the pharmaceutical composition comprises salts. In one embodiment, the pharmaceutical composition is formulated for oral administration.
  • the allosteric synthetic peptide comprises between approximately 3 - 8 amino acids, hi one embodiment, the allosteric synthetic peptide is six amino acids. In one embodiment, the allosteric synthetic peptide is less than 1,300 Da. In one embodiment, the allosteric synthetic peptide ranges between approximately 466-1067 Da. In one embodiment, the allosteric synthetic peptide ranges between approximately 175-1,000 Da.
  • the present invention contemplates a method comprising: a) providing; i) a PCSK9 protein, wherein said protein comprises an allosteric modulation site and an orthosteric low density lipoprotein receptor (LDLR) binding site; and ii) an allosteric synthetic peptide capable of binding said allosteric modulation site; b) binding said allosteric synthetic peptide to said allosteric modulation site, wherein said allosteric synthetic peptide induces a conformational shift of said orthosteric LDLR binding site.
  • said binding of said allosteric synthetic peptide to said allosteric modulation site inhibits an induced fit conformational shift of said orthosteric LDLR binding site.
  • the binding induces a conformational shift of said PCSK9 protein.
  • the resulting PCSK9 conformational shift reduces the binding affinity of said orthosteric LDLR binding site interaction to a LDLR, wherein low density lipoprotein clearance is increased.
  • the conformational shift enhances dissociation of said orthosteric low density lipoprotein receptor binding site from a low density lipoprotein receptor.
  • the conformational shift reduces the orthosteric Cis-His Rich Domain (CHRD) binding site to a binding ligand (e.g., for example, to facilitate vesicle trafficking at low pH; DeVay et al, "Characterization of proprotein convertase subtilisin/kexin type 9 (PCSK9) trafficking reveals a novel lysosomal targeting mechanism via amyloid precursor-like protein 2 (APLP2)" J Biol Chem. 288(15): 10805-10818 (2013).
  • the orthosteric low density lipoprotein receptor binding site conformational shift comprises an induced fit inhibition.
  • the binding of said allosteric synthetic peptide reduces the conformational shift required for the induced fit of the orthosteric LDLR binding site of PCSK9, inhibiting the binding affinity of said orthosteric LDLR interaction, wherein low density lipoprotein clearance is increased.
  • the inducing of said orthosteric low density lipoprotein receptor binding site conformational shift is biomechanical.
  • the conformational shift results in biomechanical stiffening of the connecting loop between a PCSK9 catalytic domain and a PCSK9 C-terminal domain.
  • the biomechanical conformational shift comprises a translocational and/or rotational movement of amino acid alanine 443 side chain and/or backbone.
  • the biomechanical conformational shift comprises a translocational and/or rotational movement of amino acid valine 441 side chain and/or backbone. In one embodiment, the biomechanical conformational shift comprises a translocational and/or rotational movement of amino acid aspartic acid 422 side chain and/or backbone. In one embodiment, the biomechanical conformational shift comprises a translocational and/or rotational movement of amino acid threonine 162 side chain and/or backbone. In one embodiment, the biomechanical conformational shift comprises a translocational and/or rotational movement of amino acid proline 445 side chain and/or backbone.
  • the biomechanical conformational shift comprises a translocational and/or rotational movement of amino acid proline 446 side chain and/or backbone. In one embodiment, the biomechanical conformational shift comprises a reorientation and translocation of histidine 449 . In one embodiment, the biomechanical mechanism comprises the inhibition of the translocational and'or rotational movement of amino acid alanine 443 side chain and/or backbone. In one embodiment, the biomechanical mechanism comprises the inhibition of the translocational and/or rotational movement of amino acid valine 441 side chain and/or backbone. In one embodiment, the biomechanical mechanism comprises the inhibition of the
  • the biomechanical mechanism comprises the inhibition of the translocational and/or rotational movement of amino acid aspartic acid 422 side chain and/or backbone.
  • the biomechanical mechanism comprises the inhibition of the translocational and/or rotational movement of amino acid threonine 162 side chain and/or backbone.
  • the biomechanical mechanism comprises the inhibition of the translocational and/or rotational movement of amino acid proline 445 side chain and/or backbone.
  • the biomechanical mechanism comprises the inhibition of the translocational and/or rotational movement of amino acid proline 446 side chain and/or backbone.
  • the biomechanical shift comprises the inhibition of the translocational and/or rotational movement of histidine 449 side chain and/or backbone.
  • the allosteric synthetic peptide is VYVRFW. In one embodiment, the allosteric synthetic peptide is VLELYW. In one embodiment, the allosteric synthetic peptide is ISDLSY. In one embodiment, the allosteric synthetic peptide comprises between
  • the allosteric synthetic peptide is six amino acids. In one embodiment, the allosteric synthetic peptide is less than 1,300 Da. In one embodiment, the allosteric synthetic peptide ranges between approximately 466-1067 Da. In one embodiment, the allosteric synthetic peptide ranges between approximately 175-1,000 Da.
  • the present invention contemplates a compound of the formula:
  • n the number of amino acid residues, is an integer in the range 3-8; ii) the constituent amino acids are single enantiomers of independently selected natural or unnatural amino acids; iii) R2 and R3, are independently selected from the group consisting of hydrogen, a lower alkyl, a branched alkyl, a hydroxyalkyl, a cycloalkyl, a heterocycle, aryl, heteroaryl, acyl, substituted or unsubstituted benzoyl, alkyl or aryl sulfonyl (e.g. mesyl or tosyl) and carbamoyl (e.g.
  • Rl is selected from the group consisting of -OH and -NR4-R5;
  • R4 and R5, independently, are selected from the group consisting of hydrogen; a lower alkyl, an aryl, a cycloalkyl, an aromatic heterocycle, pyridine, tetrazole; alternatively, R4 and R5 are joined as a heterocyle, such as piperidine; pyrrolidine; morpholine; piperazine; a substituted heterocycle, such as 4-methylpiperazine; or a fused heterocycle, such as dihydroquinoline or indoline.
  • the compound further comprises a negatively charged polar group.
  • the negatively charged polar group includes, but is not limited to, O-phosphate, O-sulfate, or 5-0- or 5-N- tetrazole incorporated in the side-chain SI, S2, or S3.
  • the side chain SI, S2 or S3 comprises a phosphoserine.
  • the side chain SI comprises -CH2-NH-tetrazole.
  • the C- terminus comprises a glycine.
  • the compound comprises between approximately 3 - 8 amino acids.
  • the compound is six amino acids.
  • the compound is less than 1,300 Da.
  • the compound ranges between approximately 466-1067 Da.
  • the compound ranges between approximately 175-1,000 Da.
  • the compound comprises a synthetic peptide.
  • the present invention contemplates a compound of the formula:
  • the present invention contemplates a compound of the formula: -Ala-Phe(3-CH2NH2)-Val-D-Ser(p)-Phe-Trp.
  • the present invention contemplates a compound of the formula: Thr-Leu-Cys(CH2-Ph)-Thr-Trp-Ser-Sei--Ser(p).
  • the present invention contemplates a compound of the formula: Thr-Leu-Asp(NHCH2Ph)-Thr-Trp-Ser-Ser-Ser(p).
  • the present invention contemplates a compound of the formula: Thr-Leu-Gly(CH2CH2cyclohexyl)-Thr-Trp-Ser-Ser-Ser(p).
  • the present invention contemplates a compound of the formula:
  • the present invention contemplates a compound of the formula: Thr-Leu-Cys(CH2-Ph)-Thr-Trp(3-Me)-Ser-Ser-Ser(p).
  • the present invention contemplates a compound of the formula: Val-Leu-Glu-Leu-Tyr-Trp.
  • the present invention contemplates a compound of the formula: Leu-Asp-Leu-Phe-Phe-Ser.
  • the present invention contemplates a compound of the formula: Ile- Leu-Asp-Leu-Ser-Tyr.
  • the present invention contemplates a compound of the formula:
  • the present invention contemplates a compound of the formula: Ac-Trp-Ala-Ser(p).
  • the present invention contemplates a compound of the formula: Ac-Trp(5-F)-Ala-Ser(p)-morpholine.
  • the present invention contemplates a compound of the formula:
  • the present invention contemplates a compound of the formula: Ac-Tyr-Trp-Gly.
  • the present invention contemplates a compound of the formula: Phe(4-Ph)-Ala-Ser(p)-mo ⁇ holine.
  • the present invention contemplates a compound including, but not limited to, Val-Tyr-Val-Arg-Phe-Trp-NH2, Ala-Phe(3-CH2 H2)-Val-D-Ser(p)-Phe-T ⁇ -NH2, Thr-Leu-Cys(CH2-Ph)-Thr-T ⁇ -Ser-Ser-Ser(p)-NH2, Thr-Leu-Asp(NHCH2Ph)-Thr-T ⁇ -Ser- Ser-Ser( )-NH2, Thr-Leu-Gly(CH2CH2cyclohexyl)-Thr-T ⁇ -Ser-Ser-Ser(p)- H2, Thr-Leu- Hph-Thr ⁇ -Ser-Ser(p)-NH2, Thr-Leu-Cys(CH2-Ph)-Thr-T ⁇ (3-Me)-Ser-Ser-Ser( )-NH2, Thr-Leu-Cys(CH2-P
  • the present invention contemplates a compound including, but not limited to, Ac- ⁇ -Ser-Ser(p)-NHCH3, Ac-Tip-Ala-Set(p)-NHCH3, Ac-Trp-Ala-Ser(p)- ⁇ , Ac-T ⁇ -Ala-Ser(p)-4-methylpi ⁇ erizine, Ac-T -Ala-Ser(p)-piperidine ; Ac- ⁇ - Ala-Ser(p)-pyrrolidine.
  • the present invention contemplates a compound including, but not limited to, Ac-Thr-Leu-Cys(CH2-Ph)-Thr-T ⁇ -Ser-Ser-Ser(p), Ac-Thr-Leu-Asp(NHCH2Ph)- Thr-Trp-Ser-Ser-Ser(p), Ac-Thr-Leu-Gly(CH2CH2cyclohexyl)-Thr-T ⁇ -Ser-Ser-Ser(p), Ac- Thr-Leu-Hph-Thr- ⁇ -Ser-Ser(p), Ac-TTir-I ⁇ ys(CH2-Pn)-Thr-Trp(3-Me)-Ser-Ser- Ser(p), Ac-Val-Leu-Glu-Leu-Tyr- ⁇ , Ac-Leu-Asp-Leu-Phe-Phe-Ser, Ac-Ile-Leu-Asp-Leu- Ser-Tyr and Ac-
  • the present invention contemplates a compound including, but not limited to, Thr-Leu-Cys(CH2-Ph)-Thr-Trp-Ser-Ala-Ser(p), Thr-Leu-Asp(TNrHCH2Ph)-Thr ⁇ - Ser-Ala-Ser(p), Thr-Leu-Gly(CH2CH2cyclohexyl)-Thr-Trp-Ser-Ala-Ser(p), Tbr-Leu-Hph- Thr-Trp-Ser-Ala-Ser(p), Thr-Leu-Cys(CH2-Ph)-Thr-Trp(3-Me)-Ser-Ala-Ser(p) and Thr-Leu- Thr-T ⁇ -Ser-Ala-Ser( ).
  • the present invention contemplates a compound including, but not limited to, Thr-Leu-Cys(CH2-Ph)-Thr-Trp-Ser-Ala-Ser(p)-NH2, Thr-Leu-Asp(NHCH2Ph)- Thr ⁇ -Ser-Ala-Ser(p)-NH2, Thr-Leu-G ⁇
  • the present invention contemplates a compound including, but not limited to, ⁇ - ⁇ - ⁇ - € ⁇ 8( € ⁇ 2- ⁇ 3 ⁇ 4- ⁇ 1 ⁇ - ⁇ -86 ⁇ - ⁇ -86 ⁇ ( ⁇ ), Ac-Thr-Leu-Asp(NHCH2Ph)- Thr-Trp-Ser-Ala-Ser(p), Ac-Thr-Leu-Gly(CH2CH2cyclohexyl)-Thr-Trp-Ser-Ala-Ser(p), Ac- Thr-Leu-Hph-Thr-Trp-Ser-Ala-Ser(p), Ac-Thr-Leu-Cys(CH2-Ph)-Thr-T ⁇ (3-Me)-Ser-Ala- Ser(p) and ⁇ - ⁇ - ⁇ - ⁇ - ⁇ - ⁇ - ⁇ ).
  • the present invention contemplates a compound including, but not limited to, Ac-Thr-Leu-Cys(CH2-Ph)-Thr-T ⁇ -Ser-Ala-Sel-( )-NH2, Ac-Thr-Leu- Asp(NHCH2Ph)-Thr ⁇ -Ser-Ala-Ser(p)-NH2, Ac-Thr-Leu-Gly(CH2CH2cyclohexyl)-Thr- Trp-Ser-Ala-Ser(p)- H2, Ac-Thr-Leu-Hph-Thr-T -Ser-Ala-Ser( )-NH2, Ac-Thr-Leu- Cys(CH2-Ph)-Thr-T ⁇ (3-Me)-Ser-Ala-Ser( )-NH2, Ac-Thr-Leu-Thr ⁇ -Ser-Ala-Ser(p)-NH2.
  • the present invention contemplates a compound including, but not limited to, Thr-Leu-Cys(CH2-Ph)-Thr ⁇ -Ser-Ser(p), Thr-Leu-Asp(NHCH2Ph)-Thr ⁇ -Ser- Ser(p), Thr-Leu-Gly(CH2CH2cyclohexyl)-Thr-Trp-Ser-Ser(p), Thr-Leu-Hph-Thr- ⁇ -Ser- Ser(p), Thr-Leu-Cys(CH2-Ph)-Thr-T (3-Me)-Ser-Ser(p) and Thr-Leu-Thr- ⁇ -Ser-Ser(p).
  • the present invention contemplates a compound including, but not limited to, Ac-Thr-Leu-Cys(CH2-Ph)-Thr-T ⁇ -Ser-Ser(p)-NH2, Ac-Thr-Leu-Asp(NHCH2Ph)- Thr ⁇ -Ser-Ser(p)-NH2, Ac-Thr-Leu-Gly(CH2CH2cyclohexyl)-Thr-T ⁇ -Ser-Ser(p)-]SIH2, Ac-Thr-Leu-Hph-Tnr ⁇ -Ser-Ser(p)-NH2, Ac-Thr-Leu-Cys(CH2-Ph)-Thr ⁇ (3-Me)-Ser- Ser(p)-NH2 and Ac-Thr-Leu-Tlir ⁇ -Ser-Serfr)-NH2.
  • the present invention contemplates a compound including, but not limited to, Thr-Leu-Cys(CH2-Ph)-Thr-T ⁇ -Ala-Ser(p), Thr-Leu-Asp(NHCH2Ph)-Thr-Trp-Ala- Ser(p), Thr-Leu-Gly(CH2CH2cyclohexyl)-Thr-Trp-Ala-Ser(p),
  • the present invention contemplates a compound including, but not limited to, Ac-Thr-Leu-Cys(CH2-Pli)-Thr-Trp-Ala-Ser(p)-NH2, Ac-Thr-Leu-Asp(NHCH2Ph)- Thr-Trp-Ala-Ser(p)-NH2, Ac-Thr-Leu-Gly(CH2CH2cyclohexyl)-Thr-Trp-Ala-Ser(p)-NH2, Ac-Thr-Leu-Hph-Thr-Trp-Ala-Ser(p)-NH2, Ac-Thr-Leu-Cys(CH2-Ph)-Thr-T ⁇ (3-Me)-Ala- Ser(p)-NH2 and Ac-Thr-Thr-Leu-Cys(CH2-Ph)-Thr-T ⁇ (3-Me)-Ala- Ser(p)-NH2 and Ac-Thr-Thr-Leu-Cys(CH2-Ph)-Thr
  • the present invention contemplates a compound including, but not limited to, Thr-Leu-Cys(CH2-Ph)-Ala-Trp-Ser-Ser-Ser(p), Thr-Leu-Asp(NHCH2Ph)-Ala-Trp- Ser-Ser-Ser(p), Thr-Leu-Gly(CH2CH2cyclohexyl)-Ala-Trp-Ser-Ser-Ser(p), Thr-Leu-Hph-Ala- Trp-Ser-Ser-Ser(p), Ac-Thi--Leu-Cys(CH2-Ph)-Ala-Trp-Ser-Ser-Ser(p), Ac-Thr-Leu- Asp(NHCH2Ph)-Ala-Trp-Ser-Ser(p), Ac-Thr-Leu-Gly(CH2CH2cyclohexyl)-Ala-Trp-
  • the present invention contemplates a compound including, but not limited to, Thr-Leu-Cys(CH2-Ph)-Ser ⁇ -Ser-Ser-Ser(p), ⁇ 1 ⁇ - ⁇ - ⁇ 8 ( ⁇ € ⁇ 2 ⁇ 3 ⁇ 4-86 ⁇ - ⁇ - Ser-Ser-Ser(p), Thr-Leu-Gly(CH2CH2cyclohexyl)-Ser-T -Ser-Ser-Ser(p), Thr-Leu-Hph-Ser- Trp-Ser-Ser-Settp), Ac-Tlir-Leu-Cys(CH2-Ph)-Ser ⁇ -Ser-Ser(p), Ac-Thr-Leu- Asp(NHCH2Ph)-Ser- ⁇ -Ser-Ser(p), Ac-Thr-Leu-Gly(CH2CH2cyclohexyl)-Ser-Trp-Ser- Ser-Ser(
  • the present invention contemplates a compound including, but not limited to, Ac-Cys(CH2-Ph)-Thr ⁇ -Ser-Ser-Ser(jp), Ac-Asp(NHCH2Ph)-Thr ⁇ -Ser-Ser-
  • the present invention contemplates a compound including, but not limited to, BOC-Cys(CH2-Ph)-Thr-Trp-Ser-Ser-Ser(p), BOC-Asp(NHCH2Ph)-Thr ⁇ -Ser- Ser-Ser(p), BOC-Gly(CH2CH2cyclohexyl)-Thr-Trp-Ser-Ser(p), BOC-Hph-Thr ⁇ -Ser- 8 ⁇ -86 ⁇ ( ⁇ ), ⁇ - ⁇ 8( € ⁇ 2- ⁇ 3 ⁇ 4- ⁇ ⁇ - ⁇ -86 ⁇ -86 ⁇ -86 ⁇ ( )- ⁇ 2, ⁇ €- ⁇ 3 ⁇ ( ⁇ € ⁇ 2 ⁇ 3 ⁇ 4- ⁇ 1 ⁇ - ⁇ - Ser-Ser-Ser(p)-NH2, BOC-Gly(CH2CH2cyclohexyl)-Thr-Trp-Ser-Ser(p)-NH2 and BOC- Hph-Thr-Trp-
  • the present invention contemplates a compound including, but not limited to, Thr-Leu-Cys(CH3)-Thr-Trp-Ser-Ser-Ser(p), Thr-Leu-Cys(CH(CH3)2)-Thr-Trp-Ser- Ser-Ser(p), Thr-Leu-Cys(CH2-3,4-difluorophenyl)-Thr-Trp-Ser-Ser-Ser(p), Thr-Leu- Cys(CH2-3-hydroxyphenyl)-Thr-Trp-Ser-Ser(p), Thr-Leu-Cys(CH2-3-methyphenyl)-Thr- Trp-Ser-Ser-Ser(p) and Ac-Leu-Cys(CH2-Ph)-Thr-Trp-Ser-Ser-Ser(p)-NH2.
  • the present invention contemplates a compound having the formula ofPhe(4-Ph)-Gly(Et)-Ser(p)-morpholine.
  • the present invention contemplates a compound selected from the group consisting of Ac-Tyr-Trp(6-OMe)-Gly, Ac-Tyr(3-F)-Trp-Gly, pivaloyl-Tyr-Trp-Gly, mesyl-Tyr-Trp-Gly, BOC-Tyr-Trp-Gly,
  • the present invention contemplates a compound of the formula: Ac-D-Trp-D-Phe(3CF3)-D-Arg-NH2.
  • the present invention contemplates a compound of the formula: Ac-D-Trp-D-Phe(3Cl)-D-Arg-NH2.
  • the present invention contemplates a compound of the formula:
  • the present invention contemplates a compound of the formula: Ac-D-Trp-D-Phe-D-Arg.
  • the present invention contemplates a compound of the formula: NAc-NMe-D-Arg-D-Phe(30H)-D-Trp-NH2.
  • the present invention contemplates a compound of the formula: Ac-Arg-Phe(3CF3)-Gly.
  • the present invention contemplates a compound of the formula: Ac-Ala-Val-Arg-N(Me)(Ph3CF3).
  • the present invention contemplates a compound of the formula:
  • the present invention contemplates a compound of the formula: Ac-D-Arg-D-Phe(30H)-D-Trp-NH2.
  • the present invention contemplates a compound of the formula: Propionyl-D-Arg-D-Phe(30H)-D-Trp.
  • the present invention contemplates a compound of the formula:
  • the present invention contemplates a compound of the formula: Ac-Tyr-Val-Arg-Phe-Trp.
  • the present invention contemplates a compound of the formula: Val-Tyr-Asp-Arg-Phe-Trp.
  • the present invention contemplates a compound of the formula: Val-Tyr-Glu-Arg-Phe-Trp.
  • the present invention contemplates a pharmaceutical composition comprising a compound of the formula:
  • n the number of amino acid residues, is an integer in the range 3-8;
  • the constituent amino acids are single enantiomers of independently selected natural or unnatural amino acids;
  • R2 and R3 are independently selected from the group consisting of hydrogen, a lower alkyl, a branched alkyl, a hydroxyalkyl, a cycloalkyl, a heterocycle, aryl, heteroaryl, acyl, substituted or unsubstituted benzoyl, alkyl or aryl sulfonyl (e.g. mesyl or tosyl) and carbamoyl (e.g.
  • Rl is selected from the group consisting of -OH and - NR4-R5;
  • R4 and R5, independently, are selected from the group consisting of hydrogen; a lower alkyl, an aryl, a cycloalkyl, an aromatic heterocycle, pyridine, tetrazole; alternatively, R4 and R5 are joined as a heterocyle, such as piperidine; pyrrolidine; morpholine; piperazine; a substituted heterocycle, such as 4-methylpiperazine; or a fused heterocycle, such as dihydroquinoline or indoline.
  • the pharmaceutical composition further comprises a negatively charged polar group.
  • said negatively charged polar group is selected from at least one of the group consisting of O-phosphate, O-sulfate, or 5-0- or 5-N- tetrazole incorporated in the side-chain SI , S2, or S3.
  • the side chain SI, S2 or S3 comprises a phosphoserine.
  • the side chain SI comprises -CH2-NH-tetrazole.
  • the C-terminus comprises a glycine.
  • the pharmaceutical composition further comprises a statin.
  • the statin includes, but is not limited to, atorvastatin, rosuvastatin and/or simvastatin.
  • the pharmaceutical composition comprises an anti-diabetic drug.
  • the pharmaceutical composition comprises a cardiovascular drug.
  • the pharmaceutical composition comprises ezetimibe (Zetia ® ).
  • the pharmaceutical composition comprises an anti-hypertensive including, but not limited to, amlodipine besylate (Norvasc ® ).
  • the anti-diabetic drug includes, but not limited to, sitagliptin (Januvia ® ) and/or metformin.
  • the compound comprises between approximately 3 - 8 amino acids.
  • the compound is six amino acids.
  • the compound is less than 1 ,300 Da.
  • the compound ranges between approximately 466-1067 Da.
  • the compound ranges between approximately 175-1,000 Da.
  • the compound comprises a synthetic peptide.
  • compound refers to any exogenous molecule comprising natural amino acids capable of interacting with (i.e., for example, attaching, binding etc.) to a binding partner thereby altering the biological function of the binding partner.
  • Compounds/ligands may include, but are not limited to, an amino acid chain comprising at least two peptide bonds, antibodies, proteins, peptides, and/or tripeptides.
  • compounds/ligands may be derivatized by substitutents including, but not limited to, hydroxyls, sulfurs, amines, amides, ethers, esters, aliphatic chains, aromatic rings, aliphatic rings, subtituted aromatic rings and/or substituted aliphatic rings.
  • Such compounds/ligands may be an inhibitor compound/ligand, or an enhancer compound/ligand.
  • a compound/ligand may also include a "drug", thereby referring to any pharmacologically active substance capable of being administered, which achieves a desired effect.
  • Drugs or compounds/ligands can be synthetic or naturally occurring
  • synthetic ligand refers to a molecule comprising amino acids which is a ligand, and was designed ex vivo and is subsequently synthesized using in vitro, in vivo, or a combination of in vitro and in vivo means to produce a molecule of pre-specified characteristics (e.g., charge, shape, molecular weight) and is bound by another naturally occurring biomolecule to form a complex.
  • these synthetic ligands are smaller than a target natural biomolecule, more preferably these synthetic ligands are less than 1,300 Da, and more preferably are between 350 and 1,250 Da.
  • synthetic peptide refers to non-natural amino acid sequence of approximately 3-8 amino acids and ranging between approximately 350-1,500 Da.
  • a non-natural amino acid sequence of approximately 4-5 amino acids and ranging between approximately 550 - 1,000 Da.
  • a synthetic peptide is six amino acids and less than 1,300 Da, for example, ranging between approximately 466-1067 Da.
  • a synthetic peptide is made in accordance with Example V.
  • allosteric site refers to a ligand binding site, other than the native chemically active/receptor binding site that, when bound to an exogenous ligand, changes the shape and activity of a protein (as an enzyme).
  • an "allosteric enhancer peptide” refers to a ligand binding to an allosteric site that may increase the native activity and/or respective affinity(ies) of the protein (e.g., for example, a PCSK9 allosteric enhancer peptide).
  • an "allosteric inhibitor peptide” refers to a ligand binding to an allosteric site that may decrease the native activity and/or respective affinity(ies) of the protein (e.g., for example, a PCSK9 allosteric inhibitor peptide).
  • the binding site protein e.g., the binding site protein.
  • orthosteric site refers to a primary, unmodulated binding site of a ligand (e.g., for example, a peptide) to a receptor, binding and/or a catalytic site.
  • a ligand e.g., for example, a peptide
  • formation refers to a three-dimensional stereochemical configuration of an amino acid sequence. For example, any specific conformation results from a thermodynamic balance between steric interactions, hydrophobic interactions, hydrogen bonding, electrochemical bonding and/or salt bridge interactions between individual amino acids in an amino acid sequence.
  • thermodynamic balance refers to the introduction of an exogenous force or molecule (e.g., an inhibitor peptide) that may alter a first thermodynamic balance (conformation 1) into a second thermodynamic balance (conformation 2), or enhances the dynamic range and/or the type and/or the number of metastable folding states within a lone protein, and/or a protein-ligand complex, and/or a protein-protein complex.
  • an exogenous force or molecule e.g., an inhibitor peptide
  • a conformation shift may be predominantly exhibited under certain specific external conditions ( H, temperature, etc.) and/or during specific periods within the lifetime of a lone protein or multi-part complex, including but not limited to conditions preferential for molecular recognition, initial binding interaction, induced fit interaction, functional activity, and/or dissociation.
  • EGFA refers to the most amino EGF-like domain of the low density lipoprotein receptor.
  • the EGF-like domain may comprise an extracellular portion of the LDLR receptor.
  • LDL-R and "LDLR” as used herein, refers to an abbreviation for the low density lipoprotein receptor. The abbreviation may be in reference to the entire LDL-R receptor protein or any portion thereof. LDL-Rs reside on a cell surface and can bind to low density lipoproteins such that the LDL-R/LDL complex become internalized within a cell (i.e., for example, a hepatocyte), wherein the LDL is released and the LDL-R is recycled back to the cell surface.
  • a cell i.e., for example, a hepatocyte
  • binding interface refers to any collection of attractive interactions (i.e., for example, hydrogen bonding, electrostatic interactions, hydrophobic interactions, etc) between the functional groups (i.e., for example, hydroxyl, amide, amine, carboxyl, amidine, guanidine, hydrocarbon, sulfonyl etc.) of at least two different molecules.
  • the collection of attractive forces forms a stable molecular plane thereby forming a 'binding interface' between the at least two molecules.
  • induced fit refers to any acceptance of a peptide requiring a change in receptor conformation. Such a conformation may be facilitated by a translational / rotational movement of amino acid side chains and flexible loops, thereby rearranging the electrostatic and/or hydrophobic fields.
  • complex refers to any chemical association of two or more ions or molecules joined usually by weak electrostatic bonds rather than by covalent bonds.
  • a complex or composition may be formed between a peptide as described herein and a PCSK9 amino acid sequence, thereby creating a peptide/PCSK9 amino acid sequence complex or composition.
  • such complexes or compositions may also include, but are not limited to, an LDLR amino acid sequence or any portion thereof, including but not limited to the EGFA region.
  • hydrogen bond as used herein, an electrostatic attraction between a hydrogen atom in one polar molecule (as of water) and a small electronegative atom (as of oxygen, nitrogen, or fluorine) in usually another molecule of the same or a different polar substance.
  • salt bridge refers to any interaction or a combinations of interactions, such as hydrogen bonding and/or electrostatic interactions, which align cationic and anionic chemical structures in such a way that the charged moieties overlap.
  • interaction refers to any effect that one molecule and/or functional group may have on another molecule and/or functional group.
  • effects may include, but are not limited to, steric (i.e., for example, physical), electrostatic (i.e., for example, electrical attraction or repulsion), electromagnetic, hydrophilic, or hydrophobic effects.
  • overlap refers to any positioning of molecules in such a way that the electronic structure of one molecule is on top of, and extending past the border of another molecule, or be positioned in this way.
  • hypercholesterolemia refers to any medical condition wherein blood cholesterol levels are elevated above the clinically recommended levels. For example, if cholesterol is measured using low density lipoproteins (LDLs),
  • hypercholesterolemia may exist if the measured LDL levels are above, for example, approximately 70 mg dl. Alternatively, if cholesterol is measured using free plasma cholesterol, hypercholesterolemia may exist if the measured free cholesterol levels are above, for example, approximately 200-220 mg/dl.
  • At risk for refers to a medical condition or set of medical conditions exhibited by a patient which may predispose the patient to a
  • these conditions may result from
  • ⁇ ективное amount refers to a particular amount of a pharmaceutical composition comprising a therapeutic agent that achieves a clinically beneficial result (i.e., for example, a reduction of symptoms). Toxicity and therapeutic efficacy of such compositions can be determined by standard pharmaceutical
  • LD 50 the dose lethal to 50% of the population
  • ED 50 the dose therapeutically effective in 50% of the population
  • the dose ratio between toxic and therapeutic effects is the therapeutic index, and it can be expressed as the ratio LD 50 /ED5 0 .
  • Compounds that exhibit large therapeutic indices are preferred.
  • the data obtained from these cell culture assays and additional animal studies can be used in formulating a range of dosage for human use.
  • the dosage of such compounds lies preferably within a range of circulating concentrations that include the ED 50 with little or no toxicity. The dosage varies within this range depending upon the dosage form employed, sensitivity of the patient, and the route of administration.
  • symptom refers to any subjective or objective evidence of disease or physical disturbance observed by the patient.
  • subjective evidence is usually based upon patient self-reporting and may include, but is not limited to, pain, headache, visual disturbances, nausea and/or vomiting.
  • objective evidence is usually a result of medical testing including, but not limited to, body temperature, complete blood count, lipid panels, thyroid panels, blood pressure, heart rate, electrocardiogram, tissue and/or body imaging scans.
  • disease and/or disorder, refers to any impairment of the normal state of the living animal or plant body or one of its parts that interrupts or modifies the performance of the vital functions.
  • the terms “reduce,” “inhibit,” “diminish,” “suppress,” “decrease,” “prevent” and grammatical equivalents when in reference to the expression of any symptom in an untreated subject relative to a treated subject, mean that the quantity and/or magnitude of the symptoms in the treated subject is lower than in the untreated subject by any amount that is recognized as clinically relevant by any medically trained personnel.
  • the quantity and/or magnitude of the symptoms in the treated subject is at least 10% lower than, at least 25% lower than, at least 50% lower than, at least 75% lower than, and/or at least 90% lower than the quantity and/or magnitude of the symptoms in the untreated subject.
  • the terms “increase,” “enhance,” “elevate,” and grammatical equivalents (including “higher,” “larger,” etc.) when in reference to the expression of any symptom in an untreated subject relative to a treated subject mean that the quantity and/or magnitude of the symptoms in the treated subject is greater than in the untreated subject by any amount that is recognized as clinically relevant by any medically trained personnel.
  • the quantity and/or magnitude of the symptoms in the treated subject is at least 10% greater than, at least 25% greater than, at least 50% greater than, at least 75% greater than, and/or at least 90% greater than the quantity and/or magnitude of the symptoms in the untreated subject.
  • Attachment refers to any interaction between a medium (or carrier) and a drug. Attachment may be reversible or irreversible. Such attachment includes, but is not limited to, covalent bonding, ionic bonding, Van der Waals forces or friction, and the like.
  • a drug is attached to a medium (or carrier) if it is impregnated, incorporated, coated, in suspension with, in emulsion with, in solution with, mixed with, etc.
  • administered or “administering”, as used herein, refers to any method of providing a composition to a patient such that the composition has its intended effect on the patient.
  • An exemplary method of administering is by a direct mechanism such as, local tissue administration (i.e., for example, extravascular placement), oral ingestion, transdermal patch, topical, inhalation, suppository etc.
  • patient or "subject”, as used herein, is a human or animal and need not be hospitalized.
  • out-patients persons in nursing homes are
  • patients may comprise any age of a human or non-human animal and therefore includes both adult and juveniles (i.e., children). It is not intended that the term "patient” connote a need for medical treatment, therefore, a patient may
  • affinity refers to the measure of the thermodynamic tendency of two or more molecules to assemble to form a multi-part complex and to remain assembled in said complex.
  • the SRX55 ligand has a high affinity for PCSK9 and is thermodynamically favored to form a complex. It is understood that a change in conditions (e.g., pH during the receptor internalization process) For example, a decrease in the LDL affinity for LDLR and the two molecules may dissociate, or separate, from one another.
  • a compound or amino acid sequence refers to the source of a compound or amino acid sequence.
  • a compound or amino acid sequence may be derived from an organism or particular species.
  • a compound or amino acid sequence may be derived from a larger complex or sequence.
  • a compound or sequence may be derived by chemical modification of part or all of an amino acid sequence found in nature.
  • protein refers to any of numerous naturally occurring extremely complex substances (as an enzyme or antibody) that consist of amino acid residues joined by peptide bonds, contain the elements carbon, hydrogen, nitrogen, oxygen, usually sulfur. In general, a protein comprises amino acids having an order of magnitude within the hundreds.
  • peptide refers to any of various amides that are derived from three or more amino acids by combination of the amino group of one acid with the carboxyl group of another and are usually obtained by partial hydrolysis of proteins.
  • a peptide comprises amino acids having an order of magnitude within the tens or smaller.
  • pharmaceutically or “pharmacologically acceptable”, as used herein, refer to molecular entities and compositions that do not produce adverse, allergic, or other untoward reactions when administered to an animal or a human.
  • pharmaceutically acceptable carrier includes any and all solvents, or a dispersion medium including, but not limited to. water, ethanol, polyol (for example, glycerol, propylene glycol, and liquid polyethylene glycol, and the like), suitable mixtures thereof, and dimethylsulfoxide, vegetable oils, coatings, isotonic and absorption delaying agents, liposome, commercially available cleansers, and the like. Supplementary bioactive ingredients also can be incorporated into such carriers.
  • purified or isolated, as used herein, may refer to a peptide composition that has been subjected to treatment (i.e., for example, fractionation) to remove various other components, and which composition substantially retains its expressed biological activity.
  • substantially purified this designation will refer to a composition in which the protein or peptide forms the major component of the composition, such as constituting about 50%, about 60%, about 70%, about 80%, about 90%, about 95% or more of the composition (i.e., for example, weight/weight and/or weight/volume).
  • purified to homogeneity is used to include compositions that have been purified to 'apparent homogeneity” such that there is single protein species (i.e., for example, based upon SDS- PAGE or HPLC analysis).
  • a purified composition is not intended to mean that some trace impurities may remain.
  • substantially purified refers to molecules, such as amino acid sequences, that are removed from their natural environment, isolated or separated, and are ⁇ least 60% free, preferably 75% free, and more preferably 90% free from other components with which they are naturally associated.
  • An "isolated polypeptide” is therefore a substantially purified polypeptide.
  • biocompatible refers to any material does not elicit a substantial detrimental response in the host. There is always concern, when a foreign object is introduced into a living body, that the object will induce an immune reaction, such as an inflammatory response that will have negative effects on the host.
  • biocompatibility is evaluated according to the application for which it was designed: for example; a bandage is regarded a biocompatible with the skin, whereas an implanted medical device is regarded as biocompatible with the internal tissues of the body.
  • biocompatible materials include, but are not limited to, biodegradable and biostable materials.
  • amino acid sequence and “polypeptide sequence” as used herein, are interchangeable and to refer to a sequence of amino acids.
  • a “variant" of a protein is defined as an amino acid sequence which differs by one or more amino acids from a polypeptide sequence or any homolog of the polypeptide sequence.
  • the variant may have "conservative” changes, wherein a substituted amino acid has similar structural or chemical properties, e.g., replacement of leucine with isoleucine. More rarely, a variant may have "nonconservative” changes, e.g., replacement of a glycine with a tryptophan. Similar minor variations may also include amino acid deletions or insertions (i.e., additions), or both.
  • a “deletion” is defined as a change in amino acid sequence in which one or more amino acid residues, respectively, are absent.
  • An “insertion” or “addition” is that change in an amino acid sequence which has resulted in the addition of one or more amino acid residues.
  • derivative refers to any chemical modification of an amino acid. Illustrative of such modifications would include, but are not limited to, replacement of hydrogen by an alkyl, aryl, hydroxyl, sulfhydryl, sulfoxyl, sulfonyl, acyl, phosphoryl, alkoxyl, amino or amino heterocyclic group.
  • tyrosine is a 4-hydroxyl amino acid derivative of phenylalanine
  • phosphoserine is an O-phosphoric derivative of serine.
  • Other possible chemical modifications might include, but are not limited to, C-terminal amides, and acyl or sulfonyl N-terminal modifications.
  • binding includes any physical attachment or close association, which may be permanent or temporary. Generally, an interaction of hydrogen bonding, hydrophobic forces, van der Waals forces, covalent and ionic bonding etc., facilitates physical attachment between the molecule of interest and the analyte/target being measuring/affected.
  • the "binding" interaction may be brief as in the situation where binding causes a chemical reaction to occur. That is typical when the binding component is an enzyme and the analyte/target is a substrate for the enzyme. Reactions resulting from contact between the binding agent and the analyte/target are also within the definition of binding for the purposes of the present invention.
  • Figure 1 shows exemplary data of WT PCSK9 inhibition as measured by FACS in
  • HuH7 cells HuH7 cells were incubated for 18h in the absence (Cnt) or presence of 0.75 ⁇ g/mI PCSK9-WT protein alone (WT) or mixed with 100 ⁇ of various SRX peptides.
  • the level of LDLR at the cell surface was measured by FACS using anti human LDLR Ab and a suitable secondary Ab labeled with Alexa 647. Cell surface LDLR is reported relative to Cnt. % inhibition of activity was calculated as [SRX - WT] / [Cnt - WT] x 100.
  • FIG. 2 shows exemplary data of WT PCSK9 activity by numerous PCSK9 allosteric modulation peptides.
  • HuH7 cells were incubated in a 96-well plate for a total of 20h in the absence (Cnt) or presence of 1.0 ⁇ g/ml PCSK9-WT protein alone (WT) or mixed with 100 uM of various SRX peptides. After 16h, dil-LDL (5 ug/ml) wa s added to the incubation mixtures. After 4h, fluorescence was measured (Ex: 520 nm/ Em: 575nm; cutoff: 550nm). Dil-LDL uptake is calculated as RFU corrected for the number of cells.
  • FIG. 3 shows exemplary data of a mutated PCSK9 protein ("gain of function" (GOF)- D374Y) modulation by numerous PCSK9 allosteric modulation peptides.
  • HuH7 cells were incubated in a 96-well plate for a total of 20h in the absence (Cnt) or presence of 0.5 pg/ml PCSK9-D374 Y protein alone (DY) or mixed with 100 uM of various SRX peptides. After 16h, dil-LDL (5 ug/ml) was added to the incubation mixtures. After 4h, fluorescence was measured (Ex: 520 nm/ Em: 575nm; cutoff: 550nm). Dil-LDL uptake is calculated as RFU corrected for the number of cells.
  • GAF gain of function
  • FIG. 4 shows exemplary data of a mutated PCSK9 protein ('gain of function" GOF- D374Y) modulation showing dose dependent inhibition by SRX55, as measured by dil-LDL uptake in HuH7 cells.
  • HuH7 cells were incubated in a 96-well plate for a total of 20h in the absence (Cnt) or presence of 0.5 ⁇ g/ml PCSK9 GOF-D374Y protein alone (DY) or mixed with increasing concentrations of various SRX peptides. After 16h, dil-LDL (5 ug/ml) was added to the incubation mixtures.
  • FIG. 5 shows exemplary data of a mutated PCSK9 protein ("gain of function" GOF- D374Y) modulation showing dose-dependent inhibition by SRX55, as measured by dil-LDL uptake in HepG2 cells.
  • HepG2 cells were incubated in a 96-well plate for a total of 20h in the absence (Cnt) or presence of 2 ⁇ PCSK9 GOF-D374Y protein alone (DY) or mixed with increasing concentrations of SRX55 peptide.
  • dil-LDL 5 ug/ml
  • fluorescence was measured (Ex: 520 nm/ Em: 575nm; cutoff: 550nm).
  • Dil-LDL uptake is calculated as RFU corrected for the number of cells.
  • Figure 6 shows exemplary data of HepG2 cells were incubated in a 96-well plate for a total of 20h in the absence (Cnt) or presence PCSK9 protein alone (D374Y: 0.6 ug/ml; WT: 1.2 ug/ml) or mixed with increasing concentrations of SRX55 peptide. After 16h, dil-LDL (5 ug/ml) was added to the incubation mixtures. After 4h, fluorescence was measured (Ex: 520 nm/ Em: 575nm; cutoff: 550nm). Dil-LDL uptake is calculated as RFU corrected for the number of cells. The PCSK9 and -/+ SRX55 mixtures were pre-incubated for 3 hrs at 37C prior to addition to the cells.
  • PCSK9 and -/+ SRX55 mixtures were pre-incubated for 3 hrs at 37C prior to addition to the cells.
  • Figure 7 shows exemplary data of FL-83B cells were incubated in a 96-well plate for a total of 20h in the absence (Cnt) or presence PCSK9 protein alone (D374Y: 0.6 ug/ml; WT: 1.2 ug/ml) or mixed with increasing concentrations of SRX55 peptide.
  • PCSK9 protein alone D374Y: 0.6 ug/ml; WT: 1.2 ug/ml
  • SRX55 peptide SRX55 peptide.
  • dil-LDL 5 ug/ml
  • fluorescence was measured (Ex: 520 nm/ Em: 575nm; cutoff: 550nm).
  • Dil-LDL uptake is calculated as RFU corrected for the number of cells.
  • the PCSK9 and -/+ SRX55 mixtures were pre-incubated for 3 hrs at 37C prior to addition to the cells.
  • Figure 8 presents an illustrative embodiment showing the binding of an allosteric modulatory synthetic peptide (e.g., SRX55) to a PCSK9 protein.
  • the prodomain is shown in light blue.
  • the two halves of the PCSK9 "catalytic" domain are shown as yellow and dark blue, respectively.
  • the EGF-A binding site is shown as blue and yellow spacefill.
  • SRX55 an allosteric modulatory synthetic peptide
  • This invention is related to the field of hypercholesterolemia.
  • the invention provides compositions and methods to modulate circulating levels of low density lipoproteins by altering the conformation of the protein PCSK9 using a synthetic peptide and/or a synthetic peptide derivative sequences of 3-8 amino acids ranging between 350 - 2,000 Da. Altering the conformation of PCSK9 affects the interaction between PCSK9 and an endogenous low density lipoprotein receptor, and can lead to reduced or increased levels of circulating LDL-cholesterol. High LDL-cholesterol levels are associated with increased risk for heart disease. Low LDL-cholesterol levels may be problematic in other conditions, such as liver dysfunction; thus, there is also utility for peptides which can raise LDL levels.
  • Proprotein convertase subtilisin/kexin type 9 also known as PCS 9, is an enzyme that in humans is encoded by the PCSK9 gene.
  • Seidah et al. "The secretory proprotein convertase neural apoptosis-regulated convertase 1 (NARC-1): liver regeneration and neuronal differentiation" Proc. Natl. Acad. Sci. U.S.A. 100 (3): 928-933 (2003). Similar genes (orthologs) are found across many species. Many enzymes, including PSCK9, are inactive when they are first synthesized, because they have a section of peptide chains that blocks their activity; proprotein convertases remove that section to activate the enzyme.
  • An illustrative embodiment shows the binding of an allosteric modulatory synthetic peptide (e.g., SRX55) to a PCSK9 protein. See, Figure 8.
  • the prodomain is shown in light blue.
  • the two halves of the PCSK9 "catalytic" domain are shown as yellow and dark blue, respectively.
  • the EGF-A binding site is shown as blue and yellow spacefill.
  • S X55 (green) is shown binding to the allosteric ligand binding site.
  • the N-terminal helix is shown in white.
  • the PSCK9 gene encodes a proprotein convertase belonging to the proteinase subfamily of the secretory subtilase family.
  • the encoded protein is synthesized as a soluble zymogen that undergoes autocatalytic intramolecular processing in the endoplasmic reticulum.
  • the protein may function as a proprotein convertase.
  • a human PCSK9 amino acid sequence is:
  • PSCK9 is believed to play a regulatory role in cholesterol homeostasis. For example,
  • PCSK9 can bind to the epidermal growth factor-like repeat A (EGF-A) domain of the low- density lipoprotein receptor (LDL-R) resulting in LDL-R internalization and degradation.
  • EGF-A epidermal growth factor-like repeat A
  • LDL-R low- density lipoprotein receptor
  • PCSK9 inhibitors could result in such widespread usage having the potential to replace statins in certain conditions.
  • PCSK9 has medical significance because it acts in cholesterol homeostasis. Drugs that block PCSK9 biological actions are believed to lower circulating low-density lipoprotein cholesterol (LDL-C) levels (i.e., for example, by increasing the availability of LDL-Rs and, consequently, LDL-C clearance). Such drugs are beginning Phase III clinical trials to assess their safety and efficacy in humans, and to determine if they can improve outcomes in heart disease.
  • LDL-C low-density lipoprotein cholesterol
  • Annexin A2 is a C- terminal PCSK9-binding protein that regulates endogenous low density lipoprotein receptor levels
  • PCSK9 antibody drugs are in clinical trials (e.g., for example, Sanofi/Regeneron, Amgen, Pfizer, Novartis, Roche).
  • one disadvantage of antibody therapy is that the administration is performed by subcutaneous or intravenous injection.
  • a number of monoclonal antibodies that bind to PCSK9 near the catalytic domain that interact with the LDL-R and hence inhibit LDL-R/PCSK9 complex formation are currently in clinical trials. These antibodies include AMG145 (Amgen), lD05-IgG2 (Merck & Co.), and SAR236553/REGN727 (Aventis/Regeneron). Lambert et al, "The PCS 9 decade" J. Lipid Res. 53(12): 2515-2524 (2012).
  • Peptides that mimic the EGF-A domain of the LDL-R have been developed to inhibit LDL-R/PCSK9 complex formation. Shan et al., "PCS 9 binds to multiple receptors and can be functionally inhibited by an EGF-A peptide". Biochem. Biophys. Res. Commun. 375(1): 69-73 (2008).
  • Peptidic PCSK9 inhibitors of the EGF-A binding site were identified by screening both linear and disulfide-constrained phage-displayed peptide libraries. This approach identified a 13-amino acid peptide (Pep2-8) that includes structural mimicry of the natural binding domain of LDL receptor.
  • the peptide inhibitor binding site was determined to largely overlap with that of the EGF(A) domain; therefore, Pep2-8 acts a competitive inhibitor of LDL receptor binding. This is akin to the inhibition mechanism of anti-PC SK9 monoclonal antibodies, which also disrupt the interaction of the LDL receptor-EGF(A) domain with PCSK9. Zhang et al., "Identification of a Small Peptide That Inhibits PCSK9 Protein Binding to the Low Density Lipoprotein Receptor' J Biol Chem 289:942-955 (2014).
  • PCSK9 antisense oligonucleotides have been shown to increase expression of the LDL-R and decrease circulating total cholesterol levels in mice. Graham et al., "Antisense inhibition of proprotein convertase subtilisin/kexin type 9 reduces serum LDL in hyperlipidemic mice” J. Lipid Res. 48(4): 763-767 (2007). It has also been reported that a locked nucleic acid (Santaris Pharma) reduced PCSK9 mRNA levels in mice.
  • Variants of PCSK9 can reduce or increase circulating cholesterol. Abifadel et al.,
  • LDL-C is normally removed from the blood when it binds to an LDL-R on the surface of liver cells, and is internalized within the hepatocyte as a receptor-ligand complex.
  • PCSK9 binds to an LDL-R
  • the LDL-R is concomitantly degraded along with the complexed LDL particle.
  • the LDL-R is recycled after internalization thereby returning to the surface of the cell for removal of more cholesterol.
  • the invention relates to synthetic peptide sequences of 3-8 amino acids in length, and less than approximately 1,300 Da, having a modulation effect on PCSK9's ability to form an LDL-R/PCSK complex.
  • the synthetic peptides comprise a lipophilic N-terminal amino acid (e.g., phenylalanine).
  • the present invention contemplate the use of peptides that bind to a PCS 9 allosteric site.
  • the peptides decrease LDL-R/PCSK9 complex fonnation and are thereby useful to treat various diseases comprising lipid dysregulation.
  • the peptides increase LDL-R/PCSK9 complex formation and are thereby useful in research and development of therapies relevant to LDL dysregulation.
  • GAF gain-of-function
  • PCSK9 mutants may result in conditions including, but not limited to, hypercholesterolemia.
  • peptides e.g., synthetic peptides and/or synthetic peptide derivatives
  • a cell e.g., a hepatocyte
  • LEF loss-of-function
  • PCSK9 mutants may result in conditions comprising reduced low density lipoproteins and would be expected to result in hypocholesterolemia thereby reducing the risk of cardiovascular diseases, including but not limited to, coronary heart disease.
  • peptides that bind to a PCSK9 allosteric site that decrease the affinity of PCSK9's low density lipoprotein receptor binding site for a low density lipoprotein receptor on the surface of a cell e.g., a hepatocyte
  • PCSK9 allosteric peptides have several advantages over current therapeutic strategies to control LDL discussed above.
  • small PCSK9 allosteric peptides as contemplated herein, have the advantage that these peptides can be administered orally without immunological reactions seen with antibody administration, or systemic degradation problems as seen with nucleic acid administration (i.e., antisense or locked nucleic acids). Nonetheless, as these small peptides have long half-lives, encapsulation drug delivery systems, such as liposomes or other biodegradable protective compositions, will lengthen these half-lives to a greater extent than either antibodies or nucleic acids.
  • the data presented herein exemplifies sixteen (16) synthetic peptides having various effects on PCSK9's ability to bind to LDL-R mediated by binding to a PCSK9 allosteric site.
  • sixteen (16) synthetic peptides having various effects on PCSK9's ability to bind to LDL-R mediated by binding to a PCSK9 allosteric site.
  • three synthetic peptides were able to increase cell surface expression of LDL-R by 60-95%, by preventing WT PCSK9 /LDL-R complex formation, as measured by FACS in HuH7 cells.
  • one synthetic peptide (SRX55) was able to increase cell surface expression of LDL-R by 100%, by changing WT PCSK9/LDL-R complex affinity. See, Figure 1.
  • the present data shows an ability of PSCK9 allosteric synthetic peptides to modulate LDLR cell surface levels by binding a peptide to PCSK9.
  • Figure 1 the LDLR levels of a hepatocyte culture model (HuH7 cells) were measured by fluorescence activated cell sorting (FACS) in accordance with Example III.
  • Cell surface LDLR is reported as a percentage of Basal levels of LDLR, indicated by the Cnt_Amm.Bic, Cnt_Ac.Acid, and Cnt bars in the top graph. See, Figure 1 (top panel).
  • LDLR levels in the presence of exogenous PCSK9 is indicated as WT_Amm.Bic, WT-Ac.Acid, and WT, and Exogenous PCSK9 in combination with a tested peptide is indicated as SRX##.
  • the measured LDLR levels are reported as % versus basal controls (Cnt) of the respective group.
  • peptides e.g., an allosteric synthetic inhibitor peptide
  • examples of peptides which positively modulate (increase) LDLR cell surface level include SRX55, SRX56, SRX60, and SRX62
  • exemplary peptides e.g., an allosteric synthetic enhancer peptide
  • SRX69, SRX72, and SRX73 examples include SRX69, SRX72, and SRX73.
  • PCS 9:LDLR complex is demonstrated in Figures 2 through 7.
  • LDL internalization as reported by dil-LDL % uptake vs Cnt, can be modulated in a model hepatocyte cell line (HuH7) in the presence of the tested SRX peptides. See, Figure 2 (top panel). LDL internalization was shown to be positively modulated (increased) by allosteric synthetic inhibitor peptides such as SRX55, SRX 56, SRX60, and SRX67. LDL internalization can be negatively modulated (decreased) by allosteric synthetic enhancer peptides such SRX36, SRX61 , SRX64, SRX65, SRX66, and SRX73. The percent inhibition is shown, where positive modulation (increase) in LDL internalization is reported as >0% inhibition, and negative modulation (decrease) in LDL internalization is reported as ⁇ 0% inhibition. See, Figure 2 (bottom panel).
  • LDL internalization as reported by dil-LDL % uptake vs Cnt, can be modulated in a model hepatocyte cell line (HuH7) by the presence of the tested SRX peptides in combination with a clinically relevant pathologic gain-of-function D374Y exogenous PCSK9 (DY). See, Figure 3 (top panel). LDL internalization was shown to be positively modulated (increased) by allosteric synthetic inhibitor peptides such as SRX55, SRX 56, SRX60, SRX63, SRX64, and SRX66.
  • LDL internalization can be negatively modulated (decreased) by allosteric synthetic enhancer peptides such SRX36, SRX71 , SRX72, and SRX73.
  • the percent inhibition is shown, where positive modulation (increase) in LDL internalization is reported as >0% inhibition, and negative modulation (decrease) in LDL internalization is reported as ⁇ 0% inhibition. See, Figure 3 (bottom panel).
  • LDL internalization as reported by dil-LDL % uptake vs Cnt, can be positively modulated (increased) by the presence of allosteric synthetic inhibitor peptides (SRX55, SRX 60, SRX66 and SRX56) in combination with a clinically relevant pathologic gain-of-function D374Y PCSK9 (DY).
  • SRX55 was shown to have a positive modulation in a dose dependent manner. See, Figure 4 (top panel). The percent inhibition is shown, where positive modulation (increase) in LDL internalization is reported as >0% inhibition, note that SRX55 at 11.1 uM is within sampling noise of 0%. See, Figure 4 (bottom panel).
  • LDL internalization as reported by dil-LDL % uptake vs Cnt, can be positively modulated (increased) in a second model hepatocyte cell line (HepG2) in combination with a clinically relevant pathologic gain-of-function D374Y PCSK9 (DY) in a dose dependent manner with SRX55. See, Figure 5 (top panel). This positive modulation is further shown as a percent inhibition, where positive modulation (increase) in LDL internalization is reported as >0% inhibition. See, Figure 5 (bottom panel).
  • LDL internalization as reported by dil-LDL % uptake vs Cnt, can be positively modulated (increased) in a second hepatocyte cell line (HepG2) when pre incubated in combination with a clinically relevant pathologic gain-of-function D374Y PCSK9 (DY) or normal PCSK9 (WT) in a dose dependent manner with SRX55. See, Figure 6 (top panel). This positive modulation is further shown as percent inhibition, where positive modulation (increase) in LDL internalization is reported as >0% inhibition. See, Figure 6 (bottom panel).
  • LDL internalization as reported by dil-LDL % uptake vs Cnt, can be positively modulated (increased) in a third hepatocyte cell line (FL83B) when pre incubated in combination with a clinically relevant pathologic gain-of-function D374Y PCSK9 (DY) or normal PCSK9 (WT) in a dose dependent manner with SRX55. See, Figure 7 (top panel). This positive modulation is further shown as percent inhibition, where positive modulation (increase) in LDL internalization is reported as >0% inhibition. See, Figure 7 (bottom panel).
  • the most efficacious peptides (e.g., for example, SRX55; Compound 1) performed in consistent order across all assays and PCSK9 phenotypes. Improved peptides were then designed that were expected to have better drug-like properties, as they were designed based upon an analysis of the preliminary results. Typically, the design of these improved peptides have at least one of the first three amino acids from the C-terminus incorporated with a negatively charged polar group, such as a phosphate, a sulfate, a tetrazole or a carboxylic acid.
  • a negatively charged polar group such as a phosphate, a sulfate, a tetrazole or a carboxylic acid.
  • the polar group comprises a phosphate group:
  • the C-terminal glycine comprises a polar group: Compound 14: Ac-Tyr-Trp-Gly.
  • the constituent amino acids may be of defined stereochemistry, usually the natural "L” enantiomer and may have naturally occurring or synthetic side chains.
  • the peptide "N" terminus may be free, alkylated, sulfonated, or acylated.
  • the "C” terminus may be the carboxylic acid or an amide.
  • Tryptophan indole side chains may be substituted with alkyl, alkoxy, halo, carboxy, etc. to form other analogs.
  • Phenyalanine, tyrosine, and homophenylalanine phenyl moieties may have additional phenyl substitution, such as alkyl, alkoxy, halo, carboxy, etc.
  • Serine may be substituted in some examples by alanine.
  • Threonine may be substituted by serine or alanine.
  • Valine, leucine, and isoleucine may be interchanged in some analogs.
  • Amino acids with carboxylic acid side chains, such as aspartic acid may have the side chain derivatized as an amide.
  • the present invention contemplates the administration of a PCSK9 allosteric inhibitor peptide to a subject having a symptom of a cardiovascular disease.
  • the cardiovascular disease comprises hypercholesterolemia.
  • the cardiovascular disease comprises hypertension.
  • the hypercholesterolemia comprises elevated low density lipoprotein levels.
  • the present invention contemplates the administration of a PCSK9 allosteric inhibitor peptide to a subject having a symptom of a metabolic disease.
  • the metabolic disease comprises diabetes.
  • PCSK9 allosteric inhibitor synthetic peptide i.e., for example, SRX55
  • SRX55 a PCSK9 allosteric inhibitor synthetic peptide
  • the decrease in PCSK9/LDL-R complex formation results in an increase in the bioavailability of LDL-R receptors for binding to circulating LDL, thereby increasing the internalization and clearance of LDL by LDL-R.
  • PCSK9 allosteric inhibitor peptides result in increased bioavailability of hepatocyte cell LDL-Rs.
  • Hypercholesterolemia also spelled hypercholesterolaemia is the presence of high levels of cholesterol in the blood. It is a form of "hyperlipidemia” (elevated levels of lipids in the blood) and “hyperlipoproteinemia” (elevated levels of lipoproteins in the blood).
  • Hypercholesterolemia is typically due to a combination of environmental and genetic factors. Environmental factors include obesity and dietary choices. Genetic contributions are usually due to the additive effects of multiple genes, though occasionally may be due to a single gene defect such as in the case of familial hypercholesterolaemia.
  • Hypercholesterolemia Genetic abnormalities are in some cases completely responsible for hypercholesterolemia, such as in familial hypercholesterolemia where there is one or more genetic mutations in the autosomal dominant APOB gene, the autosomal recessive LDLRAP1 gene, autosomal dominant familial hypercholesterolemia (HCHOLA3) variant of the PCSK9 gene, or the LDL receptor gene.
  • Cholesterol is a sterol. It is one of three major classes of lipids which all animal cells utilize to construct their membranes and is thus manufactured by all animal cells. Plant cells do not manufacture cholesterol. It is also the precursor of the steroid hormones, bile acids and vitamin D. Since cholesterol is insoluble in water, it is transported in the blood plasma within protein particles (lipoproteins). Lipoproteins are classified by their density: very low density lipoprotein (VLDL), intermediate density lipoprotein (IDL), low density lipoprotein (LDL) and high density lipoprotein (HDL). Biggerstaff et al., (2004). "Understanding lipoproteins as transporters of cholesterol and other lipids" Adv Physiol Educ 28 (1-4): 105-6.
  • VLDL very low density lipoprotein
  • IDL intermediate density lipoprotein
  • LDL low density lipoprotein
  • HDL high density lipoprotein
  • lipoproteins carry cholesterol, but elevated levels of the lipoproteins other than HDL (termed non-HDL cholesterol), particularly LDL-cholesterol are associated with an increased risk of atherosclerosis and coronary heart disease.
  • LDL-cholesterol is associated with an increased risk of atherosclerosis and coronary heart disease.
  • Cera et al. (2004) "Atherogenic lipoprotein particles in atherosclerosis” Circulation 109(23 Suppl 1): III2-7.
  • higher levels of HDL cholesterol are protective.
  • Kontush et al. (2006) "Antiatherogenic small, dense HDL— guardian angel of the arterial wall?” Nat Clin Pract Cardiovasc Med 3(3): 144— 153.
  • Elevated levels of non-HDL cholesterol and LDL in the blood may be a consequence of diet, obesity, inherited (genetic) diseases (such as LDL receptor mutations in familial hypercholesterolemia), or the presence of other diseases such as diabetes and an underactive thyroid.
  • Total cholesterol is the amount of all of the fats in your blood. These fats are called lipids.
  • LDL low density lipoprotein
  • HDL high density lipoprotein
  • Cholesterol is measured in milligrams per deciliter (mg/dL). In conditions such as heart disease or diabetes, LDL cholesterol should stay below 100 mg/dL. If there is a risk for heart disease, LDL cholesterol should be lower than 130 mg/dL. In general, LDL cholesterol should be lower than 160 - 1 0 mg/dL. Alternative, HDL "good" cholesterol should be high. For example, HDL levels in men should be above 40 mg/dL, while HDL levels should be above 50 mg/dL for women.
  • hypercholesterolemia comprises a longstanding elevation of serum cholesterol that can lead to atherosclerosis.
  • Chronically elevated serum cholesterol contributes to formation of atheromatous plaques in the arteries. This can lead to progressive stenosis (narrowing) or even complete occlusion (blockage) of the involved arteries.
  • smaller plaques may rupture and cause a clot to form and obstruct blood flow.
  • Finn AV Nakano M, Narula J, Kolodgie FD, Virmani R (July 2010).
  • tissue ischemia may manifest as specific symptoms including, but not limited to, temporary ischemia of the brain (commonly referred to as a transient ischemic attack) may manifest as temporary loss of vision, dizziness and impairment of balance, aphasia (difficulty speaking), paresis (weakness) and paresthesia (numbness or tingling), usually on one side of the body.
  • Insufficient blood supply to the heart may manifest as chest pain
  • ischemia of the eye may manifest as transient visual loss in one eye.
  • Insufficient blood supply to the legs may manifest as calf pain when walking, while in the intestines it may present as abdominal pain after eating a meal.
  • hypocholesterolemia is the presence of abnormally low (hypo-) levels of cholesterol in the blood (-emia). Although the presence of high total cholesterol (hyper-cholesterolemia) correlates with cardiovascular disease, a defect in the body's production of cholesterol can lead to adverse consequences as well. Cholesterol is an essential component of mammalian cell membranes and is required to establish proper membrane permeability and fluidity. It is not clear if a lower than average cholesterol level is directly harmful; it is often encountered in particular illnesses.
  • Possible causes of low cholesterol include, but are not limited to, statins,
  • hyperthyroidism or an overactive thyroid gland, adrenal insufficiency, liver disease, malabsorption (inadequate absorption of nutrients from the intestines), such as in celiac disease, malnutrition, abetalipoproteinemia (a genetic disease that causes cholesterol readings below 50 mg/dl), hypobetalipoproteinemia (a genetic disease that causes cholesterol readings below 50 mg/dl, manganese deficiency, Smith-Lemli-Opitz syndrome, Marfan syndrome, leukemias and other hematological diseases.
  • abetalipoproteinemia a genetic disease that causes cholesterol readings below 50 mg/dl
  • hypobetalipoproteinemia a genetic disease that causes cholesterol readings below 50 mg/dl
  • manganese deficiency Smith-Lemli-Opitz syndrome
  • Marfan syndrome leukemias and other hematological diseases.
  • Diabetes affects more than 20 million Americans. Over 40 million Americans have prediabetes (which often develops before type 2 diabetes).Diabetes is usually a lifelong (chronic) disease in which there is a high level of sugar in the blood. Insulin is a hormone produced by the pancreas to control blood sugar. Diabetes can be caused by too little insulin, resistance to insulin, or both. To understand diabetes, it is important to first understand the normal process by which food is broken down and used by the body for energy.
  • glucose enters the bloodstream.
  • Glucose is a source of fuel for the body.
  • An organ called the pancreas makes insulin.
  • the role of insulin is to move glucose from the bloodstream into muscle, fat, and liver cells, where it can be used as fuel.
  • People with diabetes have high blood sugar because their body cannot move sugar into fat, liver, and muscle cells to be stored for energy. This is because either their pancreas does not make enough insulin or their cells do not respond to insulin normally.
  • Type 1 diabetes can occur at any age, but it is most often diagnosed in children, teens, or young adults. In this disease, the body makes little or no insulin. Daily injections of insulin are needed. The exact cause is unknown.
  • Type 2 diabetes makes up most diabetes cases. It most often occurs in adulthood. But because of high obesity rates, teens and young adults are now being diagnosed with it. Many people with type 2 diabetes do not know they have it.
  • Gestational diabetes is high blood sugar that develops at any time during pregnancy in a woman who does not have diabetes.
  • Diabetes symptoms may result from high blood sugar level and include, but are not limited to, blurry vision, excess thirst, fatigue, hunger, urinating often and weight loss.
  • Pharmaceutical Compositions include, but are not limited to, blurry vision, excess thirst, fatigue, hunger, urinating often and weight loss.
  • the present invention further provides pharmaceutical compositions (e.g., comprising the peptides described above).
  • the pharmaceutical compositions of the present invention may be administered in a number of ways depending upon whether local or systemic treatment is desired and upon the area to be treated. Administration may be topical (including ophthalmic and to mucous membranes including vaginal and rectal delivery), pulmonary (e.g., by inhalation or insufflation of powders or aerosols, including by nebulizer; intratracheal, intranasal, epidermal and transdermal), oral or parenteral. Parenteral administration includes intravenous, intraarterial, subcutaneous, intraperitoneal or intramuscular injection or infusion; or intracranial, (e.g., intrathecal or intraventricular), administration.
  • compositions and formulations for topical administration may include transdermal patches, ointments, lotions, creams, gels, drops, suppositories, sprays, liquids and powders.
  • Conventional pharmaceutical carriers, aqueous, powder or oily bases, thickeners and the like may be necessary or desirable.
  • compositions and formulations for oral, sublingual or buccal administration include powders or granules, suspensions or solutions in water or non-aqueous media, capsules, gels, drops, strips, gums, sachets or tablets. Thickeners, flavoring agents, diluents, emulsifiers, dispersing aids or binders may be desirable.
  • compositions and formulations for parenteral, intrathecal or intraventricular administration may include sterile aqueous solutions that may also contain buffers, diluents and other suitable additives such as, but not limited to, penetration enhancers, carrier compounds and other pharmaceutically acceptable carriers or excipients.
  • compositions of the present invention include, but are not limited to, solutions, emulsions, and liposome-containing formulations. These compositions may be generated from a variety of components that include, but are not limited to, preformed liquids, self-emulsifying solids and self-emulsifying semisolids.
  • the pharmaceutical compositions may further comprise other drugs, hormones, and/or peptides.
  • the pharmaceutical composition may further comprise a statin drug.
  • Statins or HMG-CoA reductase inhibitors are a class of drugs used to lower cholesterol levels by inhibiting the enzyme HMG-CoA reductase, which plays a role in the production of cholesterol in the liver. Increased cholesterol levels have been associated with cardiovascular diseases, and statins are therefore used in the prevention of these diseases.
  • HMG-CoA reductase inhibitors are a class of drugs used to lower cholesterol levels by inhibiting the enzyme HMG-CoA reductase, which plays a role in the production of cholesterol in the liver. Increased cholesterol levels have been associated with cardiovascular diseases, and statins are therefore used in the prevention of these diseases.
  • Lewington et al. "Blood cholesterol and vascular mortality by age, sex, and blood pressure: a meta-analysis of individual data from 61 prospective studies with 55,000 vascular deaths" Lancet
  • statins are most effective for treating cardiovascular disease (CVD) as a secondary prevention strategy, with questionable benefit in those with elevated cholesterol levels but without previous CVD.
  • CVD cardiovascular disease
  • Taylor et al. "Statins for the primary prevention of cardiovascular disease”. I Taylor, Fiona. Cochrane Database Syst Rev (1) (2011). Statins have rare but severe adverse effects, particularly muscle damage.
  • statins include, but are not limited to, atorvastatin (Lipitor ® and
  • Torvast ® fluvastatin (Lescol ® ), lovastatin (Mevacor ® , Altocor ® , Altoprev ® ), pitavastatin (Livalo ® , Pitava ® ), pravastatin (Pravachol ® , Selektine ® , Lipostat ® ), rosuvastatin (Crestor ® ) and simvastatin (Zocor ® , Lipex ® ).
  • a statin and another agent such as ezetimibe/simvastatin, are also available.
  • cardiovascular drugs include, but are not limited to, propranolol, digitalis, amlodipine besylate, and nifedipine.
  • cardiovascular drugs include, but are not limited to, propranolol, digitalis, amlodipine besylate, and nifedipine.
  • other pharmaceutical compositions may further include, but are not limited to, exetimibe (Zetia ® ), amlodipine besylate (Norvasc ® ), niacin, sitagliptin
  • the pharmaceutical formulations of the present invention may be prepared according to conventional techniques well known in the pharmaceutical industry. Such techniques include the step of bringing into association the active ingredients with the pharmaceutical carrier(s) or excipient(s). In general the formulations are prepared by uniformly and intimately bringing into association the active ingredients with liquid carriers or finely divided solid carriers or both, and then, if necessary, shaping the product.
  • compositions of the present invention may be formulated into any of many possible dosage forms such as, but not limited to, tablets, capsules, liquid syrups, soft gels, suppositories, and enemas.
  • the compositions of the present invention may also be formulated as suspensions in aqueous, non-aqueous or mixed media.
  • Aqueous suspensions may further contain substances that increase the viscosity of the suspension including, for example, sodium carboxymethylcellulose, sorbitol and/or dextran.
  • the suspension may also contain stabilizers.
  • the pharmaceutical compositions may be formulated and used as foams.
  • Pharmaceutical foams include formulations such as, but not limited to, emulsions, microemulsions, creams, jellies and liposomes. While basically similar in nature these formulations vary in the components and the consistency of the final product.
  • compositions of the present invention may additionally contain other adjunct components conventionally found in pharmaceutical compositions.
  • the compositions may contain additional, compatible, pharmaceutically-active materials such as, for example, antipruritics, astringents, local anesthetics or anti-infiammatory agents, or may contain additional materials useful in physically formulating various dosage forms of the compositions of the present invention, such as dyes, flavoring agents, preservatives, antioxidants, opacifiers, thickening agents and stabilizers.
  • additional materials useful in physically formulating various dosage forms of the compositions of the present invention such as dyes, flavoring agents, preservatives, antioxidants, opacifiers, thickening agents and stabilizers.
  • such materials when added, should not unduly interfere with the biological activities of the components of the compositions of the present invention.
  • the formulations can be sterilized and, if desired, mixed with auxiliary agents, e.g., lubricants, preservatives, stabilizers, wetting agents, emulsifiers, salts for influencing osmotic pressure, buffers, colorings, flavorings and/or aromatic substances and the like which do not deleteriously interact with the active pharmaceutical ingredient(s) of the formulation.
  • auxiliary agents e.g., lubricants, preservatives, stabilizers, wetting agents, emulsifiers, salts for influencing osmotic pressure, buffers, colorings, flavorings and/or aromatic substances and the like which do not deleteriously interact with the active pharmaceutical ingredient(s) of the formulation.
  • Dosing is dependent on severity and responsiveness of the disease state to be treated, with the course of treatment lasting from several days to several months, or until a cure is effected or a diminution of the disease state is achieved.
  • Optimal dosing schedules can be calculated from measurements of drug accumulation in the body of the patient. The administering physician can easily determine optimum dosages, dosing methodologies and repetition rates. Optimum dosages may vary depending on the relative potency of individual oligonucleotides, and can generally be estimated based on EC50S found to be effective in in vitro and in vivo animal models or based on the peptides described herein.
  • dosage is from 0.01 ⁇ g to 100 g per kg of body weight, and may be given once or more daily, weekly, monthly or yearly.
  • the treating physician can estimate repetition rates for dosing based on measured residence times and concentrations of the drug in bodily fluids or tissues.
  • HepG2/shPCSK9 or HuH7/shPCSK9 cells (1) lacking endogenous PCSK9 were seeded at 1 x 10 5 cells/well in a 12 well microplate (Greiner Bio-One). These cells were then incubated for 4h or overnight with 0.7 ⁇ ig/ml of either V5-tagged PCSK9 or its gain-of-function PCSK9- D374Y pre-incubated, or not, for 4h with each peptide at 50 ⁇ (or less if needed for the most active peptides).
  • the cells were then lysed in lx RIPA buffer (150 niM NaCl, 50 mM Tris- HC1, pH 8.0), containing 1% Nonidet P-40, 0.5% sodium deoxycholate, 0.1% SDS supplemented with lx complete protease inhibitor mixture (Roche Applied Science), and analyzed by Western blot.
  • lx RIPA buffer 150 niM NaCl, 50 mM Tris- HC1, pH 8.0
  • Nonidet P-40 0.5% sodium deoxycholate
  • SDS 0.1% SDS supplemented with lx complete protease inhibitor mixture (Roche Applied Science)
  • HuH7/shPCSK9 cells were incubated at 37°C for 4h as above with PCSK9 pre- incubated, or not, with each of the exemplified peptides used at 50 ⁇ (or less if needed for the most active peptides).
  • Benjannet et al. "Effects of the prosegment and pH on the activity of PCS 9: evidence for additional processing events" J Biol Chem. 285(52): 40965-40978 (2010).
  • the cells were then washed 3x with solution A (calcium/magnesium-free Dulbecco's PBS (Invitrogen) containing 0.5% bovine serum albumin (Sigma) and lg/liter glucose)). The cells were then incubated for 10 min at room temperature with lx Versene solution
  • the cells were analyzed by FACS for both propidium iodide (dead cells) and LDLR in live cells with Alexa Fluor 647 using the FACS BD LSR (BD Biosciences).
  • Cells such as HepG2, HuH7, FL83B or a cell line transfected with a short-hairpin PCSK9 knockdown sequence such as HepG2/shPCSK9, HuH7/shPCSK9, FL83B/shPCSK9, were seeded at 2 x 10 4 cells/well in a 96-well plate and cultured at 37 degC in RPMI + 10% FBS. After approximately 24 hours, the cell media was aspirated off and replaced with RPMI + 3-5 mg/mL LPDS (Lipoprotein Deficient Serum, Millipore) media for further
  • Peptide activity was assessed by culturing cells with: i) no SRX peptide/PCSK9 protein complex (control, Cnt); ii) PCSK9 protein; and iii) SRX peptide/PCSK9 complex.
  • dil-LDL Low density lipoprotein coupled with l,r-dioctadecyl-3,3,3',3 '-tetramethylindocarbocyanine perchlorate
  • Cell specimens were rinsed twice with PBS and then fluorescence measured with excitation at 360 nm and emission detected at 460 nm to measure DNA content. Cell specimens were then be incubated with a 0.1% SDS in a 0.1 N NaOH solution while being shaken for 10 minutes. Fluorescence of the dil-LDL in the specimens were quantified using excitation at 530 nm and resulting emission at 580 nm.
  • Fluorescence measurements of dil-LDLR were normalized to estimated cell numbers, determined from the Hoechst fluorescence. Data was analyzed for the different experimental conditions and reported as percentage relative fluorescence units (RFU) of the Cnt specimen. Percent inhibition was calculated as the difference in RFU of a peptide exposed specimen to the RFU of PCSK -no peptide, divided by the RFU difference in PCSK9-no peptide to RFU of Cnt specimen, also expressed as [(SRX:RFU) - (PCSK9-no peptide:RFU)] / [(PCSK9-no peptide:RFU) - (Cnt:RFU)] x 100.
  • peptides were manufactured using Fmoc (9-fluorenylmethyloxycarbonyl) chemistry (21st Century Biochemicals, 260 Cedar Hill St., Marlboro, MA 01752).
  • Fmoc 9-fluorenylmethyloxycarbonyl
  • the peptides are made using a polystyrene resin, functionalized with an appropriate linker, and the peptides are then manufactured using an Intavis RS Peptide Synthesizer (Germany) or manufactured by hand using glass peptide synthesis vessels fitted with coarse glass frits for removing reactants by vacuum (Chemglass).
  • the amino acids are added sequentially as follows: the amino acids are dissolved in either NMP (N-Methyl-2- pyrrolidone) or DMF (Dimethylformamide); these solvents are also used for washing the resin following each step.
  • NMP N-Methyl-2- pyrrolidone
  • DMF Dimethylformamide
  • the Fmoc-protected amino acid to be added is activated using either HATU (0-(7-azabenzotriazol-l-yl)-N,N,N',N'- tetramethyluronium hexafluorophosphate) or HCTU (2-(6-Chloro-lH-benzotriazole-l-yl)- 1,1,3,3-tetramethylaminium hexafluorophosphate); for a 4-fold stochiometric to be added
  • PCSK9 allosteric synthetic peptides are listed below:

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PCT/US2014/016640 2013-02-15 2014-02-15 Proprotein convertase subtilisin/kexin type 9 (pcsk9) allosteric binding ligands to mudulate serum low density lipoprotein (ldl) levels WO2014127316A2 (en)

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CN201480017801.7A CN105378159A (zh) 2013-02-15 2014-02-15 调节血清低密度脂蛋白（LDL）水平的前蛋白转化酶枯草杆菌蛋白酶/Kexin 9 型（PCSK9）变构结合配体
AU2014216091A AU2014216091A1 (en) 2013-02-15 2014-02-15 Proprotein convertase subtilisin/kexin type 9 allosteric binding ligands to modulate serum low density lipoprotein
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WO2014127316A4 (en) 2014-12-04
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