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Kidney Week

Abstract: FR-PO190

Characterization of a Novel Macrocyclic Molecular Glue That Selectively Inhibits the Nucleoside Transporter ENT1 and Demonstrates Tissue Protection in Ischemic-Reperfusion AKI In Vivo

Session Information

  • AKI: Mechanisms
    October 25, 2024 | Location: Exhibit Hall, Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Acute Kidney Injury

  • 103 AKI: Mechanisms

Author

  • Olson, Matthew W., Rapafusyn Pharmaceuticals, Baltimore, Maryland, United States
Background

Acute kidney injury (AKI) from renal ischemia and reperfusion (IR) is a major clinical issue, particularly during the perioperative period, and lacks effective therapy. AKI is characterized by a sudden decline in renal function over hours to days from injuries within renal tissue architecture. We report the in-vitro and in-vivo profile of a novel macrocyclic molecular glue (RAP-0001) that exhibits potent and selective inhibition of equilibrative nucleoside transporter 1 (ENT1). These results and our mechanism of action provide a novel therapeutic strategy to mitigate renal damage following ischemic-reperfusion events that occur in cardiovasclar surgeries (CABG and TAVR). Preclinical molecular genetics (1-4), preclinical and human pharmacological evidence via a novel mechanism of action (5-12), and human clinical genetics (13-14) suggest that inhibition of ENT1 would be an effective approach.

Methods

Functional cell-based assays, Biophysical binding assays, X-ray crystallography, In vivo PK and efficacy studies.

Results

RAP-001 forms a ternary complex with FKPB12::RAP-0001::ENT1 on the intracellular side of the cell membrane. RAP-0001 is a potent and selective inhibitor of ENT1 forming molecular glue via the formation of a FKPB12::RAP-0001::ENT1 complex. Our X-ray structure of RAP-0001 bound to FKBP-12 shows the contacts RAP-0001 with FKBP12 where the solvent exposed region can contact ENT1. The efficacy of RAP-0001 was demonstrated in a rat ischemic-reperfusion acute kidney injury model where the compound conferred tissue protection as measured by biomarkers and histological data.

Conclusion

The data presented support the pusuit of IND enabling studies.