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1.
Nat Biomed Eng ; 2(11): 822-830, 2018 11.
Article in English | MEDLINE | ID: mdl-30918745

ABSTRACT

At present there are no drugs for the treatment of chronic liver fibrosis that have been approved by the Food and Drug administration of the United States. Telmisartan, a small-molecule antihypertensive drug, displays antifibrotic activity, but its clinical use is limited because it causes systemic hypotension. Here, we report the scalable and convergent synthesis of macromolecular telmisartan prodrugs optimized for preferential release in diseased liver tissue. We optimized the release of active telmisartan in fibrotic liver to be depot-like (that is, a constant therapeutic concentration) through the molecular design of telmisartan brush-arm star polymers, and show that these lead to improved efficacy and to the avoidance of dose-limiting hypotension in both metabolically and chemically induced mouse models of hepatic fibrosis, as determined by histopathology, enzyme levels in the liver, intact-tissue protein markers, hepatocyte necrosis protection, and gene-expression analyses. In rats and dogs, the prodrugs are retained long-term in liver tissue and have a well-tolerated safety profile. Our findings support the further development of telmisartan prodrugs that enable infrequent dosing in the treatment of liver fibrosis.


Subject(s)
Angiotensin II Type 1 Receptor Blockers/therapeutic use , Drug Design , Liver Cirrhosis/drug therapy , Prodrugs/therapeutic use , Telmisartan/therapeutic use , Angiotensin II Type 1 Receptor Blockers/chemistry , Angiotensin II Type 1 Receptor Blockers/pharmacokinetics , Animals , Carbon Tetrachloride/toxicity , Disease Models, Animal , Female , Gene Expression Regulation/drug effects , Half-Life , Liver/metabolism , Liver Cirrhosis/chemically induced , Liver Cirrhosis/pathology , Male , Mice , Mice, Inbred BALB C , Polymers/chemistry , Prodrugs/chemistry , Prodrugs/pharmacokinetics , Rats , Rats, Sprague-Dawley , Telmisartan/chemistry
2.
Nat Biomed Eng ; 2(9): 707, 2018 Sep.
Article in English | MEDLINE | ID: mdl-31015683

ABSTRACT

In the version of this Article originally published, the author Peter Blume-Jensen was not denoted as a corresponding author; this has now been amended and the author's email address has been added. The 'Correspondence and requests for materials' statement was similarly affected and has now been updated with the author's initials 'P.B-J.'

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