Inhalation of the novel tryptophan hydroxylase 1 inhibitor TPT-004 alleviates pulmonary arterial hypertension

Inhaled pharmacotherapies are promising treatment options for patients with pulmonary arterial hypertension (PAH), as they minimize extrapulmonary adverse effects. Recently, we developed a highly specific tryptophan hydroxylase 1 inhibitor (TPHi): TPT-004. We hypothesized that repetitive nose-only i...

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Hauptverfasser: Legchenko, Ekaterina (VerfasserIn) , Chouvarine, Philippe (VerfasserIn) , Hysko, Klea (VerfasserIn) , Qadri, Fatimunnisa (VerfasserIn) , Wesolowski, Radoslaw (VerfasserIn) , Specker, Edgar (VerfasserIn) , Glage, Silke (VerfasserIn) , Meier, Martin (VerfasserIn) , Schwarz, Katharina (VerfasserIn) , Heineke, Jörg (VerfasserIn) , Pohlmann, Gerhard (VerfasserIn) , Ramazanoglu, Mehmet (VerfasserIn) , Bader, Michael (VerfasserIn) , Hansmann, Georg (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: August 2025
In: American journal of respiratory cell and molecular biology
Year: 2025, Jahrgang: 73, Heft: 2, Pages: 288-298
ISSN:1535-4989
DOI:10.1165/rcmb.2024-0365OC
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1165/rcmb.2024-0365OC
Verlag, lizenzpflichtig, Volltext: https://www-atsjournals-org.ezproxy.medma.uni-heidelberg.de/doi/10.1165/rcmb.2024-0365OC
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Verfasserangaben:Ekaterina Legchenko, Philippe Chouvarine, Klea Hysko, Fatimunnisa Qadri, Radoslaw Wesolowski, Edgar Specker, Silke Glage, Martin Meier, Katharina Schwarz, Joerg Heineke, Gerhard Pohlmann, Mehmet Ramazanoglu, Michael Bader, Georg Hansmann

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245 1 0 |a Inhalation of the novel tryptophan hydroxylase 1 inhibitor TPT-004 alleviates pulmonary arterial hypertension  |c Ekaterina Legchenko, Philippe Chouvarine, Klea Hysko, Fatimunnisa Qadri, Radoslaw Wesolowski, Edgar Specker, Silke Glage, Martin Meier, Katharina Schwarz, Joerg Heineke, Gerhard Pohlmann, Mehmet Ramazanoglu, Michael Bader, Georg Hansmann 
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520 |a Inhaled pharmacotherapies are promising treatment options for patients with pulmonary arterial hypertension (PAH), as they minimize extrapulmonary adverse effects. Recently, we developed a highly specific tryptophan hydroxylase 1 inhibitor (TPHi): TPT-004. We hypothesized that repetitive nose-only inhalation of TPT-004 alleviates PAH and pulmonary vascular remodeling in the Sugen 5416/hypoxia (SuHx) rat model. Male Sprague Dawley rats were divided into three groups: ConNx (control animals kept in room air during the study); SuHx+vehicle (rats injected with the VEGFR2 inhibitor SU5416 and then exposed to chronic hypoxia for 3 weeks, followed by 10 days recovery and subsequent 4 weeks of daily vehicle inhalations; and SuHx+TPHi (SuHx-exposed rats after recovery treated with daily inhalations of the TPH1 inhibitor, TPT-004, for 4 weeks). Closed-chest right-left heart catheterization and cardiac magnetic resonance imaging were performed in spontaneously breathing rats. Histological and mRNA-sequencing analyses were performed on lungs. SuHx-exposed rats had severe PAH, right ventricle (RV) hypertrophy, and RV dilation. In comparison with SuHx-exposed rats, TPHi-treated SuHx rats had significantly lower RV systolic pressure (67.25 vs. 51.47 mm Hg; P < 0.0001), normalized RV end-systolic volume (182.6 vs. 105.1 μl; P < 0.0001), and improved RV ejection fraction by cardiac magnetic resonance imaging (47.9 vs. 66.8%; P < 0.0001). Inhaled TPT-004 did not affect left ventricular (LV) end-diastolic or systemic blood pressure. TPT-004 therapy reversed pulmonary vascular remodeling and alveolar macrophage infiltration. RNA sequencing unraveled TPHi-induced changes in pulmonary gene expression: increased cell adhesion as well as reduced cell motility and migration; suppressed extracellular matrix remodeling; modulated immune response; and suppressed pulmonary vascular remodeling by means of modulating proliferation, apoptosis, and homeostasis. Taken together, TPT-004 is an effective therapeutic PAH agent that does not cause any hemodynamic adverse effects in rodents, and thus, should be tested further towards a clinical phase 1b/phase 2 study in patients with PAH. 
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