title: Potent and selective inhibition of human cathepsin K leads to inhibition of bone resorption in vivo in a nonhuman primate.
abstract: Cathepsin K is a cysteine protease that plays an essential role in osteoclast-mediated degradation of the organic matrix of bone. Knockout of the enzyme in mice, as well as lack of functional enzyme in the human condition pycnodysostosis, results in osteopetrosis. These results suggests that inhibition of the human enzyme may provide protection from bone loss in states of elevated bone turnover, such as postmenopausal osteoporosis. To test this theory, we have produced a small molecule inhibitor of human cathepsin K, SB-357114, that potently and selectively inhibits this enzyme (Ki = 0.16 nM). This compound potently inhibited cathepsin activity in situ, in human osteoclasts (inhibitor concentration [IC]50 = 70 nM) as well as bone resorption mediated by human osteoclasts in vitro (IC50 = 29 nM). Using SB-357114, we evaluated the effect of inhibition of cathepsin K on bone resorption in vivo using a nonhuman primate model of postmenopausal bone loss in which the active form of cathepsin K is identical to the human orthologue. A gonadotropin-releasing hormone agonist (GnRHa) was used to render cynomolgus monkeys estrogen deficient, which led to an increase in bone turnover. Treatment with SB-357114 (12 mg/kg subcutaneously) resulted in a significant reduction in serum markers of bone resorption relative to untreated controls. The effect was observed 1.5 h after the first dose and was maintained for 24 h. After 5 days of dosing, the reductions in N-terminal telopeptides (NTx) and C-terminal telopeptides (CTx) of type I collagen were 61% and 67%, respectively. A decrease in serum osteocalcin of 22% was also observed. These data show that inhibition of cathepsin K results in a significant reduction of bone resorption in vivo and provide further evidence that this may be a viable approach to the treatment of postmenopausal osteoporosis.
authors.affiliation: Department of Bone and Cartilage Biology, SmithKline Beecham Pharmaceuticals, King of Prussia, Pennsylvania 19406, USA.
authors.forename: G B
authors.initials: GB
authors.lastname: Stroup
authors.forename: M W
authors.initials: MW
authors.lastname: Lark
authors.forename: D F
authors.initials: DF
authors.lastname: Veber
authors.forename: A
authors.initials: A
authors.lastname: Bhattacharyya
authors.forename: S
authors.initials: S
authors.lastname: Blake
authors.forename: L C
authors.initials: LC
authors.lastname: Dare
authors.forename: K F
authors.initials: KF
authors.lastname: Erhard
authors.forename: S J
authors.initials: SJ
authors.lastname: Hoffman
authors.forename: I E
authors.initials: IE
authors.lastname: James
authors.forename: R W
authors.initials: RW
authors.lastname: Marquis
authors.forename: Y
authors.initials: Y
authors.lastname: Ru
authors.forename: J A
authors.initials: JA
authors.lastname: Vasko-Moser
authors.forename: B R
authors.initials: BR
authors.lastname: Smith
authors.forename: T
authors.initials: T
authors.lastname: Tomaszek
authors.forename: M
authors.initials: M
authors.lastname: Gowen
mesh_terms: D000818:Animals; D015415:Biomarkers; D001862:Bone Resorption; D056657:Cathepsin K; D002403:Cathepsins / Q000037:antagonists & inhibitors*; D003094:Collagen; D024042:Collagen Type I; D003546:Cysteine Endopeptidases / Q000378:metabolism*; D015853:Cysteine Proteinase Inhibitors / Q000494:pharmacology*; D005260:Female; D006801:Humans; D008252:Macaca fascicularis; D015394:Molecular Structure; D010010:Osteoclasts / Q000187:drug effects* / Q000502:physiology; D010052:Ovariectomy; D010455:Peptides; D011323:Primates; D051381:Rats
chemical_list: D015415:Biomarkers; D024042:Collagen Type I; D015853:Cysteine Proteinase Inhibitors; D010455:Peptides; C052929:collagen type I trimeric cross-linked peptide; D003094:Collagen; D002403:Cathepsins; D003546:Cysteine Endopeptidases; C534130:CTSK protein, human; D056657:Cathepsin K; C534132:Ctsk protein, mouse; C534133:Ctsk protein, rat