Q1 · BIOLOGY
Article
Author: Nelson, Erek ; Zacarias, Magdalena Ortiz ; Selig, Roland ; Michalak, Gregory ; Schwab, Matthias ; Ab, Eiso ; Shapiro, David ; Muerdter, Thomas E ; Heinkele, Georg ; Jung, Birgit ; Weissbach, Markus ; Cui, Wei ; Felgendreff, Philipp ; Poso, Antti ; Zender, Lars ; Laufer, Stefan ; Theisgen, Stephan ; Amiot, Bruce ; Rist, Elke ; Biskup, Saskia ; Chen, Harvey ; Abu Rmilah, Anan A ; Li, Kewei ; Pfaffenroth, Bent ; Zhou, Wei ; Premsrirut, Prem K ; Longerich, Thomas ; Zwirner, Stefan ; Minshew, Anna ; Koenigsrainer, Alfred ; Sipos, Bence ; Kloevekorn, Philip ; Gruenheit, Nicole ; Trompak, Omelyan ; Klotz, Sabrina ; Jia, Yao ; Wuestefeld, Torsten ; Haag, Mathias ; Gries, Katharina ; Albrecht, Wolfgang ; Schuette, Svenja ; Moschopoulou, Athina A ; Nyberg, Scott
Diminished hepatocyte regeneration is a key feature of acute and chronic liver diseases and after extended liver resections, resulting in the inability to maintain or restore a sufficient functional liver mass. Therapies to restore hepatocyte regeneration are lacking, making liver transplantation the only curative option for end-stage liver disease. Here, we report on the structure-based development and characterization (nuclear magnetic resonance [NMR] spectroscopy) of first-in-class small molecule inhibitors of the dual-specificity kinase MKK4 (MKK4i). MKK4i increased liver regeneration upon hepatectomy in murine and porcine models, allowed for survival of pigs in a lethal 85% hepatectomy model, and showed antisteatotic and antifibrotic effects in liver disease mouse models. A first-in-human phase I trial (European Union Drug Regulating Authorities Clinical Trials [EudraCT] 2021-000193-28) with the clinical candidate HRX215 was conducted and revealed excellent safety and pharmacokinetics. Clinical trials to probe HRX215 for prevention/treatment of liver failure after extensive oncological liver resections or after transplantation of small grafts are warranted.