title: Evaluation of the rapid plasma elimination of recombinant alpha 1-proteinase inhibitor: synthesis of polyethylene glycol conjugates with improved therapeutic potential.
abstract: Plasma-derived alpha 1-proteinase inhibitor (alpha 1PlI) is used for replacement therapy in patients with emphysema who have a deficiency of the protein. Future therapy with alpha 1PI with reactive site mutants of this inhibitor will probably require the use of recombinant-derived alpha 1PI (r alpha 1PI). However, the pharmacologic efficacy of r alpha 1PI in humans has been hindered, since r alpha 1PI is rapidly cleared from the circulation of experimental animals. Our studies of the metabolism of r alpha 1PI in mice demonstrate that the rapid clearance of r alpha 1PI is due to renal filtration. However, after preventing renal filtration by ligation of the renal arteries, we find that r alpha 1PI is metabolized in a manner similar to alpha 1PI. Conjugation of r alpha 1PI to polyethylene glycol of Mr approximately 4000 (PEG-4) greatly slows the clearance of r alpha 1PI. The PEG-4 r alpha 1PI conjugate is metabolized in a manner similar to alpha 1PI and has similar kinetic properties before and after oxidation with N-chlorosuccinimide. Moreover, proteinase complexes of PEG-4-r alpha 1PI are catabolized by the same hepatocyte receptor that binds alpha 1PI-proteinase complexes. The results of these studies lay the groundwork for the synthesis of pharmacologically effective r alpha 1PI derivatives with acceptable plasma retention times.
authors.affiliation: Department of Pathology, Duke University Medical Center, Durham, NC 27710.
authors.forename: A E
authors.initials: AE
authors.lastname: Mast
authors.forename: G
authors.initials: G
authors.lastname: Salvesen
authors.forename: H P
authors.initials: HP
authors.lastname: Schnebli
authors.forename: S V
authors.initials: SV
authors.lastname: Pizzo
mesh_terms: D000818:Animals; D006801:Humans; D051379:Mice; D009504:Neutrophils / Q000201:enzymology; D010196:Pancreatic Elastase / Q000378:metabolism; D011092:Polyethylene Glycols / Q000138:chemical synthesis / Q000627:therapeutic use*; D011994:Recombinant Proteins / Q000138:chemical synthesis / Q000493:pharmacokinetics / Q000627:therapeutic use; D000515:alpha 1-Antitrypsin / Q000138:chemical synthesis / Q000493:pharmacokinetics* / Q000627:therapeutic use
chemical_list: D011994:Recombinant Proteins; D000515:alpha 1-Antitrypsin; D011092:Polyethylene Glycols; D010196:Pancreatic Elastase