Id |
Subject |
Object |
Predicate |
Lexical cue |
T259 |
0-4 |
Sentence |
denotes |
5.2. |
T260 |
5-71 |
Sentence |
denotes |
Safety and Efficacy Concerns of MLN4760 and Dx600 ACE2 Inhibitors. |
T261 |
72-211 |
Sentence |
denotes |
It is known that the catalytic cleft of ACE2 consists of two peptidase subdomains: one membrane-distal and the other one membrane-proximal. |
T262 |
212-332 |
Sentence |
denotes |
Their weak interactions are consistent with the ability to transition from open to the closed ACE2 conformation [28,90]. |
T263 |
333-608 |
Sentence |
denotes |
Indeed, the two subdomains undergo a large hinge-bending motion in which membrane-proximal subdomain remains almost unchanged, while membrane-distal subdomain moves to close the distance between the two subdomains, mimicking the opening/closing movement of a clam shell [90]. |
T264 |
609-899 |
Sentence |
denotes |
ACE2 open conformation likely reflects free state of the enzyme available to catch substrates (or inhibitors), then, when the ACE2 receptor binds to a substrate, the membrane-distal subdomain closes around the substrate (or the inhibitor), finally performing the enzymatic activity [24,90]. |
T265 |
900-1080 |
Sentence |
denotes |
Interestingly, in cryo–electron microscopy structures of full-length human ACE2, only the closed/substrate-bound conformation of ACE2 was observed in the spike-ACE2 complexes [28]. |
T266 |
1081-1325 |
Sentence |
denotes |
Since human ACE2 is assembled on cell surface as a homodimer [28], binding of the spike protein trimer onto ACE2 dimer suggests simultaneous binding of two spike protein trimers to substrate-bound conformer of ACE2 homodimer on plasma membrane. |
T267 |
1326-1582 |
Sentence |
denotes |
The spike binding sites on ACE2 homodimer are localized above the membrane-distal peptidase subdomain of each ACE2 monomer, nevertheless neither ACE2 shedding nor ACE2 binding to spike proteins have been shown to inhibit ACE2 enzymatic activity [16,17,24]. |
T268 |
1583-1850 |
Sentence |
denotes |
On the other hand, the S-protein-binding region of membrane-distal ACE2 subdomain is not significantly perturbed by the receptor conformational changes and maintains the ability to associate with soluble spike proteins independently on open/closed conformations [24]. |
T269 |
1851-2053 |
Sentence |
denotes |
Interestingly, an ACE2 specific inhibitor (MLN-4760) has been shown to induce the closed (inhibitor-bound) ACE2 structure [90] and to retain its inhibitory effects on sACE2 bound to spike proteins [24]. |
T270 |
2054-2254 |
Sentence |
denotes |
MLN4760 is a potent and selective human ACE2 inhibitor (IC50 = 0.44 nM against soluble human ACE2) whose synthesis produces a racemic mixture of two diastereomers that showed 75:25 ratio for Isomer A: |
T271 |
2255-2364 |
Sentence |
denotes |
Isomer B [113,114] and the purified isomer B is the isomer commercially available from Merck Millipore [114]. |
T272 |
2365-2550 |
Sentence |
denotes |
Testing MLN-4760 racemic mixture and its isomers, it was observed a concentration-dependent inhibition of recombinant human (rh)ACE or rhACE2 activities with all three inhibitors [114]. |
T273 |
2551-2901 |
Sentence |
denotes |
The isomer B was less selective (near minimal-maximal rhACE inhibition range 10−6M-10−4M) than the racemate or the isomer A (near minimal-maximal rhACE inhibition range 10−6M-10−2M) and less effective (near maximal rhACE2 inhibition at 10−7M) than the racemate or the isomer A (near maximal rhACE2 inhibition at 10−8 M) for rhACE2 versus rhACE [114]. |
T274 |
2902-3268 |
Sentence |
denotes |
Moreover, all three inhibitors exerted a significantly higher inhibitory activity against soluble than membrane-bound forms of (m)ACE2 (near maximal mACE2 inhibition at 10−6M), being the isomer B more selective and effective than the racemate or the isomer A for mACE2 vs. mACE expressed on the surface of mononuclear cells (or CD34 hematopoietic progenitors) [114]. |
T275 |
3269-3368 |
Sentence |
denotes |
A second ACE2 inhibitor, Dx600, produced similar results to those obtained with the isomer B [114]. |
T276 |
3369-3535 |
Sentence |
denotes |
Another study evaluated the inhibitory activity of both MLN-4760 and DX600 (either the linear conformational form or the disulfide bridged cyclic variant) inhibitors. |
T277 |
3536-3747 |
Sentence |
denotes |
In this report, the experiments were performed at pH 6.5 [115], a pH at which rhACE2 proteolysis operates at maximal activity [79] and a condition that resembles hypercapnic acidosis which may occur during SARS. |
T278 |
3748-4084 |
Sentence |
denotes |
MLN-4760 was still able to strongly and specifically inhibit rhACE2 activity (near maximal inhibition at 10−8 M), preventing rhACE2-driven Ang II degradation into Ang (1–7), whereas DX600 (either linear or cyclic variant) inhibits rhACE2 at relatively higher concentration (near maximal inhibition at 10−6 M–10−7 M, respectively) [115]. |
T279 |
4085-4229 |
Sentence |
denotes |
Altogether these data indicate that the racemate or the isomer A are more effective in inhibiting soluble forms of ACE2 than isomer B and Dx600. |
T280 |
4230-4583 |
Sentence |
denotes |
Therefore, these inhibitors at opportune (low) concentrations are expected to preferentially reduce systemic sACE2 activity, while preserving the ACE2 activity of (local) membrane-associated forms of ACE2, knowing that catalytic activity of circulating ACE2 was undetectable in human plasma of healthy subjects due to an endogenous ACE2 inhibitor [116]. |
T281 |
4584-4939 |
Sentence |
denotes |
Since MLN-4760 inhibitor promotes the closed ACE2 conformation [90] which is the preferential conformer for virus binding [28], MLN-4760 is expected to not prevent viral entry; nevertheless, its inhibitory function on ACE2 pathway might work on the positive feedback loops (above described) that ultimately favour ACE2 membrane expression and viral entry. |
T282 |
4940-5057 |
Sentence |
denotes |
A potential risk factor of inhibiting the Ang II metabolization into Ang 1–7 could be the increase of blood pressure. |
T283 |
5058-5567 |
Sentence |
denotes |
Although ACE2 pathway inhibition might lead to hypertensive effects, treatment with MLN-4760 for 4-5 weeks had no effect on blood pressure when administered 10 mg/kg/day in drinking water in wild type mice [117] nor in male (mRen2)27 transgenic hypertensive rats (administered 30 mg/kg/day subcutaneously via mini-osmotic pumps) [118], suggesting that hypertensive activity mediated by ACE2 inhibition is promptly balanced by compensatory mechanisms either in normal or hypertensive blood pressure conditions. |
T284 |
5568-5773 |
Sentence |
denotes |
In addition, injections of MLN4760 into the nucleus tractus solitarii has been shown to reduce the baroreceptor reflex in rats, suggesting a role for ACE2 in controlling a reflex bradycardia (see [39,44]). |
T285 |
5774-6008 |
Sentence |
denotes |
Finally, chronic inhibition of ACE2 with MLN-4760 led to increase of ACE, albuminuria and glomerular injury in streptozotocin-induced diabetic mice, indicating a possible adverse effect of the inhibitor in a diabetic background [119]. |
T286 |
6009-6182 |
Sentence |
denotes |
Extensive experiments have been also performed with DX600, a specific peptide ACE2 inhibitor that exhibited a mixed competitive and non-competitive type of inhibition [120]. |
T287 |
6183-6280 |
Sentence |
denotes |
Actually, several reports describing Dx600 inhibitor administration in mice suggest its safe use. |
T288 |
6281-6561 |
Sentence |
denotes |
Of interest, a report described its (safe) use alone (1 mg/kg per day) by nasal inhalation for 3 days in a mouse model of endotoxin-induced lung inflammation [121]; however, this inhibitor is less efficacious than MLN-4760 in inhibiting the soluble forms of human rACE2 [114,115]. |
T289 |
6562-6758 |
Sentence |
denotes |
Altogether these reports on administration of ACE2 inhibitors do not reveal significant adverse impacts or mortality in experimental animals, which suggests their safety in chronic administration. |
T290 |
6759-6858 |
Sentence |
denotes |
This was also confirmed in human clinical trials with MLN-4760 (clinical name: ORE1001, see later). |
T291 |
6859-7378 |
Sentence |
denotes |
Of interest, a report showed that on day 28 post-myocardial infarction, adult male Sprague-Dawley rats that had received MLN-4760 (also called C16) 25 mg/mL/day by daily intraperitoneal injection (as a solution of 42 mg/mL in distilled water) tended to have lower left ventricular pulse pressure, mean arterial pressures and left ventricular relaxation time constant-Tau compared to untreated group (see table 2 of the paper) [52], suggesting a possible protective role of ACE2 inhibition in post-myocardial infarction. |
T292 |
7379-7659 |
Sentence |
denotes |
Therefore, MLN-4760 might be helpful not only for COVID-19 but also in targeted therapies for pathologies correlated with an excessive increase of ACE2 activity that may involve heart, lung, liver, colon or other tissues/organs expressing ACE2 such as blood and endothelial cells. |
T293 |
7660-7886 |
Sentence |
denotes |
As an example, GL1001 (old name of MLN-4760) showed to produce an anti-inflammatory activity in a mouse model of colitis [122], highlighting the importance of the yin-yang balance of ACE/ACE2 pathways (“in medio stat virtus”). |