AG-348 enhances pyruvate kinase activity in red blood cells from patients with pyruvate kinase deficiency

Blood. 2017 Sep 14;130(11):1347-1356. doi: 10.1182/blood-2016-11-753525. Epub 2017 Jul 31.

Abstract

Pyruvate kinase (PK) deficiency is a rare genetic disease that causes chronic hemolytic anemia. There are currently no targeted therapies for PK deficiency. Here, we describe the identification and characterization of AG-348, an allosteric activator of PK that is currently in clinical trials for the treatment of PK deficiency. We demonstrate that AG-348 can increase the activity of wild-type and mutant PK enzymes in biochemical assays and in patient red blood cells treated ex vivo. These data illustrate the potential for AG-348 to restore the glycolytic pathway activity in patients with PK deficiency and ultimately lead to clinical benefit.

MeSH terms

  • Anemia, Hemolytic, Congenital Nonspherocytic
  • Animals
  • Enzyme Activation / drug effects
  • Enzyme Activators / chemistry
  • Enzyme Activators / pharmacology*
  • Enzyme Activators / therapeutic use*
  • Erythrocytes / drug effects
  • Erythrocytes / enzymology*
  • Humans
  • Kinetics
  • Mice
  • Piperazines
  • Pyruvate Kinase / deficiency*
  • Pyruvate Kinase / drug effects
  • Pyruvate Kinase / metabolism*
  • Pyruvate Metabolism, Inborn Errors
  • Quinolines / chemistry
  • Quinolines / pharmacology*
  • Quinolines / therapeutic use*
  • Recombinant Proteins / metabolism
  • Sulfonamides / chemistry
  • Sulfonamides / pharmacology*
  • Sulfonamides / therapeutic use*
  • Tissue Donors

Substances

  • Enzyme Activators
  • Piperazines
  • Quinolines
  • Recombinant Proteins
  • Sulfonamides
  • mitapivat
  • Pyruvate Kinase

Supplementary concepts

  • Pyruvate Kinase Deficiency of Red Cells