The aptamer BC 007 for treatment of dilated cardiomyopathy: evaluation in Doberman  Pinschers of efficacy and outcomes

Abstract Aims Aptamer BC 007, a 15‐mer single‐strand DNA oligonucleotide (5'‐GGTTGGTGTGGTTGG‐3'), was developed to neutralize functional autoantibodies that bind to the extracellular domains of G protein‐coupled receptors (GPCR‐AAB), leading to the modulation of receptor‐mediated signallin...

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Main Authors: Sabine Werner, Gerd Wallukat, Niels‐Peter Becker, Katrin Wenzel, Johannes Müller, Ingolf Schimke, Gerhard Wess
Format: Article
Language:English
Published: Wiley 2020-06-01
Series:ESC Heart Failure
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Online Access:https://doi.org/10.1002/ehf2.12628
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author Sabine Werner
Gerd Wallukat
Niels‐Peter Becker
Katrin Wenzel
Johannes Müller
Ingolf Schimke
Gerhard Wess
author_facet Sabine Werner
Gerd Wallukat
Niels‐Peter Becker
Katrin Wenzel
Johannes Müller
Ingolf Schimke
Gerhard Wess
author_sort Sabine Werner
collection DOAJ
description Abstract Aims Aptamer BC 007, a 15‐mer single‐strand DNA oligonucleotide (5'‐GGTTGGTGTGGTTGG‐3'), was developed to neutralize functional autoantibodies that bind to the extracellular domains of G protein‐coupled receptors (GPCR‐AAB), leading to the modulation of receptor‐mediated signalling cascades that induce pathophysiological states. Among the GPCR‐AAB, there are those directed against the β1‐adrenergic receptor (β1‐AAB) that are highly present in patients with dilated cardiomyopathy (DCM) and are increasingly accepted as disease drivers. Using Doberman Pinschers (DP) with DCM, which possess similarities with human DCM among these β1‐AAB positivity for that the disease‐driving role in DP DCM was demonstrated, the safety of BC 007, efficacy for neutralizing β1‐AAB, and the DP's outcome were investigated. Methods and results Fourteen client‐owned β1‐AAB‐positive DP with electrocardiographically and echocardiographically indicated DCM were treated with BC 007. For controlling, two groups were created: 14 β1‐AAB‐positive DP with DCM not treated with BC 007 (Control 1) and 14 DP with DCM closely matched to the BC 007‐treated DP (Control 2), retrospectively selected from the institutional database of DP. After treatment, DP were monitored both echocardiographically, and for β1‐AAB, and survival curves were calculated. Based on clinical and laboratory examination, no adverse effects associated with BC 007 treatment were observed during the study. Forty‐eight hours after treatment, the DP's blood was free of β1‐AAB, which led to a reduction or stabilization of left ventricular end‐systolic volume (ESVI) during β1‐AAB free time in 10 of the treated DP. In one DP, where β1‐AAB returned after 3 months and ESVI worsened again, a second BC 007 treatment after 9 months again cleared the blood from β1‐AAB and improved the ESVI. Compared with the controls, DP treated with BC 007 showed a significantly longer survival time [572 days, interquartile range (IQR) 442–840 days] vs. Control group 1 (266 days, IQR 97–438 days; logrank: P = 0.009) and Control group 2 (229 days, IQR 174–319 days; logrank: P = 0.012). Conclusions Treatment with BC 007 for β1‐AAB neutralization was safe, resulted in a long‐lasting reduction of β1‐AAB combined with improved cardiac function and prolonged the survival of DP with DCM. Using a natural large animal model of DCM considered superior to small animal models of immunization‐induced cardiomyopathy, combined with a study design comparable with clinical trials, we believe that our results provide the basis for optimism that treatment with BC 007 might also be effective in human patients with DCM.
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spelling doaj-art-c608d71d41d0477aaa087d99bc15f66e2025-02-03T10:25:46ZengWileyESC Heart Failure2055-58222020-06-017384485510.1002/ehf2.12628The aptamer BC 007 for treatment of dilated cardiomyopathy: evaluation in Doberman  Pinschers of efficacy and outcomesSabine Werner0Gerd Wallukat1Niels‐Peter Becker2Katrin Wenzel3Johannes Müller4Ingolf Schimke5Gerhard Wess6Department of Cardiology, Clinic of Small Animal Medicine Ludwig‐Maximilians‐University Munich GermanyDepartment of Research & Development, Berlin Cures GmbH Berlin GermanyDepartment of Research & Development, Berlin Cures GmbH Berlin GermanyDepartment of Research & Development, Berlin Cures GmbH Berlin GermanyDepartment of Research & Development, Berlin Cures GmbH Berlin GermanyDepartment of Research & Development, Berlin Cures GmbH Berlin GermanyDepartment of Cardiology, Clinic of Small Animal Medicine Ludwig‐Maximilians‐University Munich GermanyAbstract Aims Aptamer BC 007, a 15‐mer single‐strand DNA oligonucleotide (5'‐GGTTGGTGTGGTTGG‐3'), was developed to neutralize functional autoantibodies that bind to the extracellular domains of G protein‐coupled receptors (GPCR‐AAB), leading to the modulation of receptor‐mediated signalling cascades that induce pathophysiological states. Among the GPCR‐AAB, there are those directed against the β1‐adrenergic receptor (β1‐AAB) that are highly present in patients with dilated cardiomyopathy (DCM) and are increasingly accepted as disease drivers. Using Doberman Pinschers (DP) with DCM, which possess similarities with human DCM among these β1‐AAB positivity for that the disease‐driving role in DP DCM was demonstrated, the safety of BC 007, efficacy for neutralizing β1‐AAB, and the DP's outcome were investigated. Methods and results Fourteen client‐owned β1‐AAB‐positive DP with electrocardiographically and echocardiographically indicated DCM were treated with BC 007. For controlling, two groups were created: 14 β1‐AAB‐positive DP with DCM not treated with BC 007 (Control 1) and 14 DP with DCM closely matched to the BC 007‐treated DP (Control 2), retrospectively selected from the institutional database of DP. After treatment, DP were monitored both echocardiographically, and for β1‐AAB, and survival curves were calculated. Based on clinical and laboratory examination, no adverse effects associated with BC 007 treatment were observed during the study. Forty‐eight hours after treatment, the DP's blood was free of β1‐AAB, which led to a reduction or stabilization of left ventricular end‐systolic volume (ESVI) during β1‐AAB free time in 10 of the treated DP. In one DP, where β1‐AAB returned after 3 months and ESVI worsened again, a second BC 007 treatment after 9 months again cleared the blood from β1‐AAB and improved the ESVI. Compared with the controls, DP treated with BC 007 showed a significantly longer survival time [572 days, interquartile range (IQR) 442–840 days] vs. Control group 1 (266 days, IQR 97–438 days; logrank: P = 0.009) and Control group 2 (229 days, IQR 174–319 days; logrank: P = 0.012). Conclusions Treatment with BC 007 for β1‐AAB neutralization was safe, resulted in a long‐lasting reduction of β1‐AAB combined with improved cardiac function and prolonged the survival of DP with DCM. Using a natural large animal model of DCM considered superior to small animal models of immunization‐induced cardiomyopathy, combined with a study design comparable with clinical trials, we believe that our results provide the basis for optimism that treatment with BC 007 might also be effective in human patients with DCM.https://doi.org/10.1002/ehf2.12628Anti‐beta1‐adrenergic receptor antibodiesBC 007CardiomyopathyDoberman PinscherHeard failureTreatment
spellingShingle Sabine Werner
Gerd Wallukat
Niels‐Peter Becker
Katrin Wenzel
Johannes Müller
Ingolf Schimke
Gerhard Wess
The aptamer BC 007 for treatment of dilated cardiomyopathy: evaluation in Doberman  Pinschers of efficacy and outcomes
ESC Heart Failure
Anti‐beta1‐adrenergic receptor antibodies
BC 007
Cardiomyopathy
Doberman Pinscher
Heard failure
Treatment
title The aptamer BC 007 for treatment of dilated cardiomyopathy: evaluation in Doberman  Pinschers of efficacy and outcomes
title_full The aptamer BC 007 for treatment of dilated cardiomyopathy: evaluation in Doberman  Pinschers of efficacy and outcomes
title_fullStr The aptamer BC 007 for treatment of dilated cardiomyopathy: evaluation in Doberman  Pinschers of efficacy and outcomes
title_full_unstemmed The aptamer BC 007 for treatment of dilated cardiomyopathy: evaluation in Doberman  Pinschers of efficacy and outcomes
title_short The aptamer BC 007 for treatment of dilated cardiomyopathy: evaluation in Doberman  Pinschers of efficacy and outcomes
title_sort aptamer bc 007 for treatment of dilated cardiomyopathy evaluation in doberman pinschers of efficacy and outcomes
topic Anti‐beta1‐adrenergic receptor antibodies
BC 007
Cardiomyopathy
Doberman Pinscher
Heard failure
Treatment
url https://doi.org/10.1002/ehf2.12628
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