The effects of the anti-hepcidin Spiegelmer NOX-H94 on inflammation-induced anemia in cynomolgus monkeys

Blood. 2013 Mar 21;121(12):2311-5. doi: 10.1182/blood-2012-09-456756. Epub 2013 Jan 24.

Abstract

Anemia of chronic inflammation is the most prevalent form of anemia in hospitalized patients. A hallmark of this disease is the intracellular sequestration of iron. This is a consequence of hepcidin-induced internalization and subsequent degradation of ferroportin, the hepcidin receptor and only known iron-export protein. This study describes the characterization of novel anti-hepcidin compound NOX-H94, a structured L-oligoribonucleotide that binds human hepcidin with high affinity (Kd = 0.65 ± 0.06 nmol/L). In J774A.1 macrophages, NOX-H94 blocked hepcidin-induced ferroportin degradation and ferritin expression (half maximal inhibitory concentration = 19.8 ± 4.6 nmol/L). In an acute cynomolgus monkey model of interleukin 6 (IL-6)-induced hypoferremia, NOX-H94 inhibited serum iron reduction completely. In a subchronic model of IL-6-induced anemia, NOX-H94 inhibited the decrease in hemoglobin concentration. We conclude that NOX-H94 protects ferroportin from hepcidin-induced degradation. Therefore, this pharmacologic approach may represent an interesting treatment option for patients suffering from anemia of chronic inflammation.

MeSH terms

  • Anemia / drug therapy*
  • Anemia / etiology*
  • Anemia / pathology
  • Animals
  • Anti-Inflammatory Agents / administration & dosage
  • Anti-Inflammatory Agents / pharmacology
  • Anti-Inflammatory Agents / therapeutic use
  • Antimicrobial Cationic Peptides / antagonists & inhibitors
  • Cells, Cultured
  • Disease Models, Animal
  • Drug Evaluation, Preclinical
  • Erythrocytes / drug effects
  • Erythrocytes / metabolism
  • Hemoglobins / analysis
  • Hemoglobins / drug effects
  • Hepcidins
  • Inflammation / complications*
  • Inflammation / drug therapy*
  • Interleukin-6 / administration & dosage
  • Interleukin-6 / adverse effects
  • Iron / blood
  • Iron / metabolism
  • Iron Metabolism Disorders / chemically induced
  • Macaca fascicularis
  • Macrophages / drug effects
  • Macrophages / metabolism
  • Male
  • Mice
  • Oligoribonucleotides / administration & dosage
  • Oligoribonucleotides / pharmacology
  • Oligoribonucleotides / therapeutic use*

Substances

  • Anti-Inflammatory Agents
  • Antimicrobial Cationic Peptides
  • HAMP protein, human
  • Hamp protein, mouse
  • Hemoglobins
  • Hepcidins
  • Interleukin-6
  • Oligoribonucleotides
  • NOX-H94
  • Iron