Therapeutic peptides © doc. PharmDr. Oldřich Farsa, PhD., 2020 Classification of therapeutic peptides 1. Hormones 1.1 Liberins a statins („releasing“&“inhibiting“) 1.2.Soma(to)tropin 1.3 Oxytocin, vasopressin and their analogues 1.4 Insulines, glucagon and GLP-1 analogues 1.5 Calcitonin 2. Blood factors of erythropoietine type 3. Colony stimulating factors 4. Non-specific antibodies One- and three-letter symbols of L--amino acid rests One-letter Three-letter A Ala alanine B Asx asparaginic acid or asparagine C Cys cysteine D Asp asparaginic acid E Glu glutamic acid F Phe phenylalanine G Gly glycine H His histidine I Ile isoleucine K Lys lysine L Leu leucine M Met methionine N Asn asparagine P Pro proline Q Gln glutamine R Arg arginine S Ser serine T Thr threonine U Sec selenocysteine V Val valine W Trp tryptofane X Xaa unknown or „other“ amino acid Y Tyr thyrosine Z Glx glutamic acid or glutamine (or compounds such as 4-carboxyglutamic acid 5-oxoproline) 1. Hormones 1.1 Liberins and statins („releasing“ & „inhibiting“) Gonadorelin (GnRH = LHRH) and its analogues ● hormone of hypothalamus ● stimulates releasing of folicules stimulating hormone (FSH) and luteinizing hormone (LH) from pituitary gland; GnRH receptors also in various non-reproductive tissues gonadorelin acetate Gonadorelini acetas EP buserelin Buserelinum EP goserelin Goserelinum EP Gonadorelin agonists Gonadorelin and its analogues Agonists leuprorelin (syn. leuprolide) Leuprorelinum EP Eligard ® ● longer-term application lowers testosterone levels  treatment of prostate cancer  treatment of sexual deviations OH OH OH O OH O NN H O O O N H O NH2 NH O NH NH NH2 CH3 CH3 N H N N H N H N H N H N H N H O O OH O O O O OH N H O OH OHO OH OH Gonadorelin and its analogues Agonists Short- and long term action of gonadorelin agonists ● long term action leads to receptors internalisation and stopping of the effect (due to decreasing LH and FSH levels and thus also levels of sexual hormones) Gonadorelin analogues Gonadorelin antagonists . CH3 COOH . CH3 COOH N H O N H Cl N H O N H OH N H O OH N H O N H O CH3 CH3 N H O N O N H O CH3 NH2 N O CH3 N NH N H CH3 CH3 N N H N H CH3 CH3 OO ganirelix N H O N H O Cl N H O N H O OH N H O OH N H O NH N H O CH3 CH3 N H NH2 NH N H O N O N H O CH3 NH2 O NH2 N O CH3 cetrorelix Gonadorelin and its analogues ● preparation: chemical synthesis ● usage: assisted reproduction, treatment of prostate cancer, sexual deviation ... ● advantages of analogues: significantly higher stability  longer elimination half-time   possibility of application in markedly longer intervals; a single injection of an agonist can replace a continuous infusion of gonadorelin Structure – activity relationships (SAR) ● replacement of Gly in position 6 with a more bulky amino acid leads to stability increase ● the sequence of the first three amino acids is needed for receptor binding and is kept in agonists ● antagonists have Trp in position 3 replaced with an non-physiologic amino acid, they bind to GnRH and avoid its action on receptors Corticotropin and its analogues Corticotropin = Adrenocorticotrophic hormone (ACTH); an anterior pituitary hormone that stimulates the adrenal cortex and its production of both gluco- and mineralocorticoids and growth of adrenal glands ● polypeptide of 39 amino acids; N-terminal 24 identical in all species ● N-terminal 24 AA are responsible for biologic activity; C-terminal 15 AA for immunospecificity corticotropin tetracosactide syn. cosyntropin [USAN] Tetracosactidum EP Synacten SynVL ● compound used as a standard for determination of tetracosactide by mass spectrometry Usage of corticotropin and tetracosactide ● diagnosis of adrenal glands function ● substitution treatment in lack of glucocorticoids ● substitution of depot administration of glucocorticoids in a long-term treatment N N N N H N N HOH N H N H N H N H N H NH OH O NH2 O OH O S CH3 O OHO O O N H N H N H O NH NH2 NH O O ONH O NH2 O NH CH3 CH3 O NH N H O N H N H N H NH2 O NH2 O NH NH2 NH O NH NH2 NH O O N H N H N H CH3 CH3 O O NH2 CH3CH3 O NH OH O OOH tetracosactide ● used since 1961 ● prepared by synthesis ● misused for doping in sport Protirelin – synthetic thyreotropin-releasing hormone (TRH) ● a hormone sythetized in paraventricular nucleus of hypothalamus, stimulating release of thyreotropin and prolactin from the anterior pituitary gland ● also neurotransmitter in CNS, takes part in food intake regulation, control of energy metabolism etc. N O NH2 O N H N O NH N H O protirelin 5-oxoprolyl-histidyl-prolinamide Protirelinum EP ● structure elucidated 1969, used approx. 1976 – 1991, then abandoned ● administered p.o. ● used as cognitive functions enhacer for treatment of post-traumatic conditions in injuries of brain and spinal cord and of neurodegeneration diseases (Alzheimer, Parkinson, motoric neuronal disease etc.) Metabolism of TRH and its regulation Somatostatin ● cyclic tetradecapeptide formed namely in hypothalamus, but also in peripheral nervous ● system, the gut, and other organs ● inhibits pituitary growth hormone (somatotropin) release and probably also release of TRH, prolactin,insulin and glucagon ● has impact to functions of kidneys, pancreas and GIT ● also acts as neurotransmitter in CNS („neuropeptide“) NH N H NH O O N H N H O O N H N H O CH3 OH NH2 O N H N H O O NH2 O N H N H O CH3OH O N H S NH2 N H O OH S O N H OH O O CH3 NH2 somatostatin Somatostatinum EP Somatostatin Eumedica inf. ● prepared by synthesis ● treatment of acromegaly 1.2 Soma(to)tropin = growth hormone (GH) ● peptide consisted of 191 AA secreted from anterior pituitary gland ● stimilates mitosis, growth and differentiation of cells of some tissues ● influences expression of genes and metabolism ● sequence of AA known since 1972, nucleotide sequence of the encoding gene since 1977 somatropin Somatropinum EP ● human, prepared by recombinant technology, used since 1985 ● substitution treatment of natural GH deficiency Genotropin ® , Humatrope ® , Nutropinaq ® , Omnitrope ® ... tertiary structure of porcine GH 1 MATGSRTSLL LAFGLLCLPW LQEGSAFPTI PLSRLFDNAM LRAHRLHQLA FDTYQEFEEA YIPKEQKYSF LQNPQTSLCF SESIPTPSNR EETQQKSNLE 100 101 LLRISLLLIQ SWLEPVQFLR SVFANSLVYG ASDSNVYDLL KDLEEGIQTL MGRLEDGSPR TGQIFKQTYS KFDTNSHNDD ALLKNYGLLY CFRKDMDKVE 200 201 TFLRIVQCRS VEGSCGF Primary structure of human somatropin Śomatropin (GH) analogues pegvisomant ● analogue – antagonist of human GH, in which 9 AA are changed; which enables it to block binding of native GH to its receptor by means of preventing receptor dimerisation ●pegylation is performed on 4 – 5 sites randomly selected from Phe1 and various 8 Lys residues ● prepared by the recombinant technology followed by a controlled reaction with oxiran (polyadition) which results to covalent binding of 4 – 5 polyoxoethylene chains of Mr  500 ● pegylation lowers antigenicity and prolongs the biologic half-time ● using: treatment of acromegaly 1.3 Oxytocin, vasopressins and their analogues Vasotocin = fylogenetic precursor of oxytocine and vasopressins in organisms lower than mammals ● prepared by synthesis ● used for triggering of the birth and enhancing of uterine contractions Oxytocinum EP; Oxytocin Ferring-Léčiva ® inj. sol. Oxytocin ● a cyclic nonapeptide released from the posterior pituitary gland (neurohypophysis) ● acts on smooth muscle cells, such as causing uterine contractions and milk ejection N O N H O NH S O S NHO NH N H O NH2 O NH2 NH2 O N H N H O NH2 NH O NH NH2 O O CH3 CH3 OH H-Cys-Tyr-Ile-Gln-Asn-Cys-Pro-Arg-Gly-NH2 Vasopressin(s) =antidiuretic hormone(s) (ADH) ● octapeptides released from the neurohypophysis of all vertebrates (precursor synthetized in hypothalamus) ● control body water content (regulation of kidneys, lungs etc.) ● potential neurotransmitters ● semi-synthetic derivatives used predominantly N O N H O NH S O S NHO NH N H O NH2 O NH2 NH2 O N H N H O NH2 NH O NH NH2 O O OH N O N H O NH S O S NHO NH O NH2 O NH2 NH2 O NH2 N H N H O O NH NH2 O O OH arginine-vasopressin argipressin ● predominant form of mammalian ADH lysine-vasopressin lypressin ● Suidae family only ● treatment of diabetes insipidus and low blood pressure Vasopressin analogues Desmopressin Desmopressinum EP ● cyclic pseudononapeptide ● prepared by synthesis ● antidiuretic (enuresis nocturna, ...) Vaspressin analogues Felypressin Felypressinum EP ● vasoconstrictor with reduced antidiuretic activity T T Terlipressin NH2Pro PheGly TyrCys LysGln GlyNH 2 Gly Asn Cys Gly H-Gly-Gly-Gly-Cys-Tyr-Phe-Gln-Asn-Cys-Pro-Lys-Gly-NH2 ● vasoconstrictor, treatment of variceal bleeding, circulation and septic shock Glypressin ® inj., Remestyp ® inj. 1.4 Insulines, glucagon and GLP-1 analogues Insuline ● Secreted mostly by -cells of Langerhans islets of pancreas ● Enables utilisation of glucose by cells of body ● First isolated by Banting and Best from dog´s pancreas in 1921 Human insuline TP C COOHF NS H Q N ES C Y Y C T A I V TVL LG E SV QI Y CC KN L R GENH2 L F G G L FV E Q C H YL NH 2 COOH chain B (30 AA) chain A (21 AA) ● formed from its precursor proinsuline consisted of 110 AA 10 20 30 40 50 60 MALWMRLLPL LALLALWGPD PAAAFVNQHL CGSHLVEALY LVCGERGFFY TPKTRREAED 70 80 90 100 110 LQVGQVELGG GPGAGSLQPL ALEGSLQKRG IVEQCCTSIC SLYQLENYCN 1-24 signal sequence; 25-54 chain B; 57-87 peptide C; 90-110 chain A ● today produced by recombinant technology, or by partial synthesis from the porcine one Insulinum humanum PhEur ● syn. humuline Bovine (cow´s) insuline Insulinum bovinum PhEur ● isolation from beef pancreases Porcine (swine) insuline Insulinum porcinum PhEur Insuline analogues human aspart Insulinum aspartum PhEur Novorapid ® ● recombinant technology insulin-lispro Insulinum lisprum PhEur ● recombinant Humalog ®, Liprolog ® insulin-detemir ● chain B has only 29 AA, tetradecanoyl (myristoyl) attached to LysB29 ● recombinant-semi synthetic Levemir ® insulin-glargin Gly21A -L-Arg30B -L-Arg31B -insulin Lantus® , Optisulin ® ● insulin of 1st choice in diabetes of 2nd type when oral antidiabetics are not satisfactory ●long T½ , typically administered 1x daily s.c. before sleeping insulin-glulisin Apidra ® Summary of the used insuline analogues Glucagone ● peptid consisted of 29 AA from pancreas supporting cleavage of liver glycogene and increasing glycaemia ● causes relaxation of smooth gastric muscules similarly to cholinergics Glucagonum PhEur ● isolated from porcine or bovine pancreases Glucagonum humanum PhEur ● produced by recombinant technology; AA sequence is identical ● usage: treament of serious hypoglycaemia, X-ray GIT diagnostic etc. GLP-1 analogues GLP-1: Glucagon-like peptide 1 = an intestinal hormone, which together with glucosedependent insulinotropic polypeptide(GIP)* potentiates insulin secretion induced by food ● potetiates all steps of insulin biosynthesis; has positive impact to function and surviving of -cells ● decreases redundant glucose production in liver, slows down stomach emptying leading to postprandial hypoglycaemia, its central effect leads to appetite decrease ( body weight loss), probably also positive effects to cardiovascular system ● disadvantages of GLP-1 as a drug: necessity of administration in a continual infusion, extremely short biological half-time T1/2 = 2 – 3 min (fast decomposition by peptidases)  need of more stable analogues *Both are known also as incretins. GLP-1 analogues liraglutide Victoza ® inj. sol. γ-L-glutamoyl(N-α-hexadecanoyl)-Lys26 , Arg34 -GLP-1(7–37) ● sequence of amino acid rests shares 97 % identity with the fragment 7-37 of the native GLP-1 ● strong binding to serum albumin, mutual association of molecules, does not come under glomerular filtration  T1/2 = 12.5 hours after s.c. injection ● improves functions of both  and  cells Calcitonin ● released from thyroidal C-cells ( = parafolicular cells – Baber 1876), in lower vertebrates from ultimobranchial bodies, originated from 5th branchial fissure ● peptide from 32 amino acid residues (salmon's – Onchorhyncus kisutch; human has 139 AA) ● receptors on osteoclasts (also in kidneys and brain) ●  excretion of Ca2+ from the bone (  calcaemia) ●  osteoclasts formation ● used together with Ca2+ for treatment of osteoporosis Calcitonin N N N H N H O NH2 O O NH N H N H N H N H S S N H NH2 O O O O OH O OH O O NH2 OH N H N HO O N H O N H O NH2 O N H NH O OH ONH NH2 O O NH O N H O N H N H O N NH O NH2 O N H OH N H O OH O O N H O NH NH NH2 O N H NH OH N H N H N H NH2 O O OH O O OH N H N HO O OH O ONH2 OH Calcitoninum salmonis EP = calcitonin salmon (synthetic; AA sequence coresponds with salmon hormon) Miacalcic® inj., nasal; Osteodon® ; Tonocalcin® 2. Blood factors of erythropoetine type Mr about 30 600 erythropoietin (EPO) = glycosylated protein from 165 AA Erythropoietini solutio concentrata EP = a solution containing a group of closely related glycoproteins, which are not to distinguish from the natural human erythopoietin (human urine erythropoietin, huEPO), from the point of view of 165 amino acids sequence and their average profile of glycosylation ● naturally released fromkidneys of adults and in liver of foetus ● stimulates stemcells of bone marrow to proliferation and differentiation ● produced in vitro mostly in rodent cell lines by a method based on the recombinant DNA ● technology ● INN names: epoetin + greek letter spelt in full (eg. epoetin beta) ● various epoetins differ in glycosylation, complex branched oligomeric sugar chains are attached ● treatment of anaemia in chronic kidney failure, missused for doping INN name: epoetin Year of discover y/approv al Production organism / tissue Mr CAS Glycosylatio n pattern Originator product/biosimila r Brand names ®, generic codes alfa 2000 Chinese hamster ovary 113427-24- 0 similar to uhEPO orig/biosim Eprex, Binocrit, Abseamed beta 1997 Chinese hamster ovary 122312-54-3 orig Neorecormo n gama 1990 C127 murine cells transfected with huEPO cRNA 28 000-31 000 130455-76-4 orig TYB-5220 delta 2002 - 2009 human fibrosarcoma cell line HT- 1080 261356-80-3 less Oacetyls in O- glycan chains; similar to uhEPO orig Dynepo epsilon 1995 154725-65-2 orig zeta 2007 Chinese hamster ovary 32 000-40 000 604802-70-2 biosim. of EPO alfa Silapo, Retacrit theta 2009 Chinese hamster ovary 762263-14-9 sugars represent 40 % of total Mr orig Biopoin, Eporatio kappa 2010 Chinese hamster ovary 11096-26-7 biosim. of EPO alfa Epoetin alfa BS injection ® Overview of epoetins Epoetins´ glycosylation Sites of N-glycosylation: Asn24, Asn38, Asn83 (= N24, N38, N83) Site of O-glycosylation: Ser126 (= S126) Epoetins´ glycosylation: some more specific occuring sugars CH3 O NH OH OH O OH OH OH O OH H H N-acetylneuraminic acid (= sialic acid) O OH OH OHOH O NH O CH3 O OHOH OH H HH H N-acetyllactosamine O OH CH3 OHOH OH H H L-fucose Epoetins´ glycosylation: secondary structure of N-attached oligosaccharide chains Epoetins´ glycosylation: secondary structure of N-attached oligosaccharide chains continued Epoetins´ glycosylation: secondary structure of N-attachedoligosaccharide chains continued Epoetins´ glycosylation: secondary structure of N-attached oligosaccharide chains continued Differences in individual epotins' glycosylation pattern: CZE in accordance with the European Pharmacopoea continued =epoetin alfa =epoetin alfa =epoetin zeta =epoetin delta Brinks V. et al., Pharm. Res. 28, 386-393 (2011) Epoetin conjugates Methoxy-polythylenglycol-epoetin beta Total Mr cca 60 000 N OO NH O EPO chain EPO chain O O O n Lys52 (Lys45) Attachement of poly(oxoethylene) chain to EPO by a „monamide“ linker Plasmatic T1/2 cca 139 h  „continuous erythropoietin receptor activator“, CERA Mircera ® (s.c. or i.v.) for treatment of anemia in chronic renal disease Epoetin analogues with altered protein sequence Darbepoetin alfa ● sequence of EPO alfa changed: Asn30, Thr32, Val87, Asn88 and Thr90  2 new sites of N-glycosylation  5 sites of N-glycosylation in total; 2 new oligosaccharide chains attached ●total Mr 30 000 – 37 000 ● recombinant ● indicated for treatment of anemia caused by a chemotherapy of non-myeloid cancers or by chronic renal failure Aranesp ® (originator); Nespo ® (biosimilar – approved in EU 2001 - 2008) OH LA A E E A L A A QN DE H R R T E W K G L S L L Y P V R Q A S V LQ F G N Q N L E F T G A V L YR G R ST DG I A G A I K C V V G A K V K C V K P D SQE A L S M A E CG YL L L G R T E N R T L A T T L R D L D S I AA P A K L FL R C S Y AK N V P L K L L NH2 Q R NT V L Q L NP S N F E T E VI T L TR P V E T T V A E I R S SD W Primary structure of darbepoetin alfa aglycone. New asparagine residues, to which new cabohydrate chains are attached, are in red, other changed amino acid residues in blue. Colony stimulating factors (CSFs) = proteins supporting survival and expansion of pluripotent stem cells and stimulate them to differentiation into various types of leukocytes GM-CSF: Granulocyte macrophage colony stimulating factor 10 20 30 40 50 MWLQSLLLLG TVACSISAPA RSPSPSTQPW EHVNAIQEAR RLLNLSRDTA 60 70 80 90 100 AEMNETVEVI SEMFDLQEPT CLQTRLELYK QGLRGSLTKL KGPLTMMASH 110 120 130 140 YKQHCPPTPE TSCATQIITF ESFKENLKDF LLVIPFDCWE PVQE signaling peptide GM-CSF Sites of glycosylation: O-: Ser22, Ser24, Ser26, Thr27; N-: Asn44, Asn54 https://www.uniprot.org/uniprot/P04141 Colony stimulating factors molgramostim = a factor stimulating granulocytes and macropfages coloies released from various kinds of blood cells ● not glycosylated ● stimulates differentiation and proliferation of leukocyte pluripotent stem cells into matured granulocytes and macrophages ● production by a recombinant technology using bacteria as host cells ● treatment of leukopenia in cancer chemotherapy or HIV infections Filgrastim and pegfilgrastim Filgrastim = human granulocytes colony-stimulating factor (G-CSF); glycosylated, 174 AA Sequence of filgrastim precursor ● treatment of neutropenia in cancer chemotheapy and in AIDS Pegfilgrastim has covalently attached PEG chain of Mr cca 20 000 on N-terminus ● longer elimination half-time ● recombinant and semi-synthetic production Human stem cell factor (SCF) 1 MEGICRNRVT NNVKDVTKLV ANLPKDYMIT LKYVPGMDVL PSHCWISEMV 51 VQLSDSLTDL LDKFSNISEG LSNYSIIDKL VNIVDDLVEC VKENSSKDLK 101 KSFKSPEPRL FTPEEFFRIF NRSIDAFKDF VVASETSDCV VSSTLSPEKD 151 SRVSVTKPFM LPPVAA ● ligand for the receptor-type protein-tyrosine kinase KIT ( synonym KITLG). ● plays an essential role in the regulation of cell survival and proliferation, hematopoiesis, stem cell maintenance, gametogenesis, mast cell development, migration and function, and in melanogenesis ● KITLG/SCF binding can activate several signaling pathways ● 166 AA ● two differentially glycosylated forms, LMW-SCF and HMW-SCF ● peripheral blood progenitor cell mobilization http://www.uniprot.org/uniprot/P21583 A recombinant form of SCF: ancestim (Stemgen ®) ● dimer ● non-glycosylated ● indicated for the setting of autologous peripheral blood progenitor cell transplantation in patients at risk of poor peripheral blood progenitor cell mobilisation combined with filgrastim ● temporarily approved e.g. in Canada and New Zealand, currently withdrawn ● replaced in therapy with a small molecule – plerixafor Mozobil ® http://www.medsafe.govt.nz/regulatory/ProductDetail.asp?ID=8093 4. Non-specific antibodies - interferons interferon 2 Interferoni alfa-2 solutio concentrata EP X1 = Lys 2a X1 = Arg2b ● antiviral activity during viral RNA and protein syntheses ● antiproliferation activity ● produced by a recombinant technology on bacteria Pegylated interferons  ● peginterferon 2a (Pegasys ® ) - on some Lys residues attached N2 , N6 -dicarboxyLys esterified with PEG-monomethylether of Mr about 20 000 – substitution is stable, free interferon is not released – peginterferon 2a interacts directly with receptors on surface of the infected cell – lowered activity (only 7 % of free interferon 2a ) is counterbalanced by much longer half-time – treatment of hepatitis B and C combined with ribavirin ● peginterferon 2b (Pegintron ® ) - only one PEG chain of Mr about 12 000 attached via urethane linker to a His, most frequently to His34 – urethane moiety is labile, free interferon 2b is released into the circulation and directly interacts with receptors – treatment of hepatitic C Pegylated interferons  Differences in their substitutions n n O O CH3 O O CH3 O NH NH NH O O NH O n O O CH3 NH N N O O His34 Lys 2a 2b interferon  = a glycosylated peptide consisted of 166 AA ● produced by fibroblasts in response to stimulation by a living or inactivated virus or doublestrained RNA ● treatment of multiple sclerosis Variants of interferon  ● 1a (Avonex ® , Betaferon ® , Rebif ® ) – Mr cca 20 000 – prepared by a recombinant technology on Chinese hamster ovary cell lines – preparations are not equally active probably due to different glycosylation – recommended i.m. application once weekly ● injected s.c. is much more painfull than 1b ● 1b (Extavia ® ) – Cys17 changed to Ser – recombinant technology on E. coli – s.c. application every other day interferon 1b ● released by human T-lymfocytes in response to viral infections and other agents ● imunomodulatory effects ● non-covalent dimer of 2 identicas monomers consisted of 141 AA Sequence of the monomer: ● production by recombinant technology on bacteria ● supporting treatment of idiopatic lung fibrosis; only increases the hope of patients live to see lungs transplantation