1. Phase 1 Clinical Study of siRNA Targeting Carbohydrate Sulphotransferase 15 in Crohn's Disease Patients with Active Mucosal Lesions.
- Author
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Suzuki K, Yokoyama J, Kawauchi Y, Honda Y, Sato H, Aoyagi Y, Terai S, Okazaki K, Suzuki Y, Sameshima Y, Fukushima T, Sugahara K, Atreya R, Neurath MF, Watanabe K, Yoneyama H, and Asakura H
- Subjects
- Biopsy methods, Dose-Response Relationship, Drug, Drug Monitoring methods, Endoscopic Mucosal Resection methods, Female, Fibrosis, Gastrointestinal Agents pharmacology, Humans, Injections, Intralesional, Male, Oligoribonucleotides, Antisense pharmacology, Patient Acuity, Treatment Outcome, Chondroitin Sulfates biosynthesis, Chondroitin Sulfates metabolism, Crohn Disease diagnosis, Crohn Disease drug therapy, Crohn Disease pathology, Intestinal Mucosa drug effects, Intestinal Mucosa metabolism, Intestinal Mucosa pathology, Membrane Glycoproteins antagonists & inhibitors, Membrane Glycoproteins metabolism, RNA, Small Interfering pharmacology, Sulfotransferases antagonists & inhibitors, Sulfotransferases metabolism
- Abstract
Background and Aims: Carbohydrate sulphotransferase 15 [CHST15] is a specific enzyme biosynthesizing chondroitin sulphate E that binds various pathogenic mediators and is known to create local fibrotic lesions. We evaluated the safety of STNM01, a synthetic double-stranded RNA oligonucleotide directed against CHST15, in Crohn's disease [CD] patients whose mucosal lesions were refractory to conventional therapy., Methods: This was a randomized, double-blind, placebo-controlled, concentration-escalation study of STNM01 by a single-dose endoscopic submucosal injection in 18 CD patients. Cohorts of increasing concentration of STNM01 were enrolled sequentially as 2.5nM [n = 3], 25nM [n = 3], and 250nM [n = 3] were applied. A cohort of placebo [n = 3] was included in each concentration. Safety was monitored for 30 days. Pharmacokinetics was monitored for 24h. The changes from baseline in the segmental Simple Endoscopic Score for CD [SES-CD] as well as the histological fibrosis score were evaluated., Results: STNM01 was well tolerated and showed no drug-related adverse effects in any cohort of treated patients. There were no detectable plasma concentrations of STNM01 at all measured time points in all treatment groups. Seven of nine subjects who received STNM01 showed reduction in segmental SES-CD at Day 30, when compared with those who received placebo. Histological analyses of biopsy specimens revealed that STNM01 reduced the extent of fibrosis., Conclusion: Local application of STNM01 is safe and well tolerated in CD patients with active mucosal lesions., (Copyright © 2016 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
- Published
- 2017
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