Delivery of an erythropoietin-Fc fusion protein by inhalation in humans through an immunoglobulin transport pathway.
A novel drug delivery platform has been developed that utilizes a naturally occurring receptor known as the neonatal Fc receptor (FcRn). The receptor is specific for the Fc fragment of IgG and is expressed in epithelial cells where it functions to transport immunoglobulins across these cell barriers. It has been shown that FcRn is expressed in both the upper and central airways in non-human primates as well as in humans. Pulmonary delivery of an erythropoietin- Fc fusion molecule (EpoFc) was previously demonstrated in non-human primates using this FcRn pathway. We have now conducted a phase I clinical study to test whether the FcRn pathway functioned similarly in man using human erythropoietin (Epo) fused to the Fc portion of human IgG1. The design was a three leg, non-randomized study conducted in healthy male volunteers with rising doses (3, 10, and 30 microg/kg) of the fusion protein targeted to the central lung regions. Using a target range of 10-30% vital capacity and 15 breaths per minute, approximately 70% of the lung-deposited dose of aerosolized EpoFc was delivered safely and effectively to the central lung regions. We showed dose-dependent concentrations of the fusion protein in the serum and an increase in circulating reticulocytes was evident in the highest dose group, thus demonstrating that large therapeutic molecules can be delivered to humans via the lung, with retention of biological activity, using the FcRn-mediated transport pathway.
Dumont
Jennifer A
JA
Syntonix Pharmaceuticals, Inc., Waltham, Massachusetts 02451, USA. jdumont@syntx.com
Bitonti
Alan J
AJ
Clark
Darren
D
Evans
Sean
S
Pickford
Matthew
M
Newman
Stephen P
SP
D000280:Administration, Inhalation; D000293:Adolescent; D000328:Adult; D000336:Aerosols; D004305:Dose-Response Relationship, Drug; D016503:Drug Delivery Systems; D004921:Erythropoietin / Q000008:administration & dosage* / Q000097:blood / Q000493:pharmacokinetics; D015395:Histocompatibility Antigens Class I / Q000008:administration & dosage* / Q000097:blood / Q000378:metabolism / Q000502:physiology; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009330:Nebulizers and Vaporizers; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D011961:Receptors, Fc / Q000008:administration & dosage* / Q000097:blood / Q000378:metabolism / Q000502:physiology; D011993:Recombinant Fusion Proteins / Q000008:administration & dosage* / Q000097:blood / Q000493:pharmacokinetics; D012156:Reticulocytes / Q000378:metabolism; D016284:Technetium Tc 99m Pentetate; D014797:Vital Capacity
D000336:Aerosols; D015395:Histocompatibility Antigens Class I; D019275:Radiopharmaceuticals; D011961:Receptors, Fc; D011993:Recombinant Fusion Proteins; D004921:Erythropoietin; C100688:Fc receptor, neonatal; D016284:Technetium Tc 99m Pentetate