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Treatment Of Cystic Fibrosis: Encouraging New Results For Miglustat
ScienceDaily (July 21, 2009) - Miglustat is a drug currently under phase 2
clinical trials on patients suffering from cystic fibrosis (1). Its
potential for treating the disease was discovered in 2006 thanks to the work
of Frédéric Becq's team at the Institute of Cell Physiology and Biology
(CNRS/Université de Poitiers), funded by the associations Vaincre la
Mucoviscidose, MucoVie66, La Pierre Le Bigaut and ABCF2.
In new work to be published on 1 August 2009 in the American Journal of
Respiratory Cell and Molecular Biology, the researchers show that daily,
long-term treatment of human cystic fibrosis cells with low doses of
miglustat corrects the main pathological abnormalities. They are therefore
extremely hopeful that miglustat will prove effective with patients, and
become the first drug able to treat the disease rather than the symptoms.
Cystic fibrosis is a genetic disease, transmitted jointly by both parents,
and affects around 6000 people in France. It is caused by the dysfunction of
a membrane protein (CFTR), present especially in the epithelial cells in the
lungs, which controls exchange of water and mineral salts between the cell
and the exterior. On the cell level, the disease manifests itself by the
absence of chloride secretion, sodium hyperabsorption, deregulation of
calcium homeostasis, and heightened inflammatory response. This results in
thickening of the mucus that lines the bronchial tubes and the pancreatic
ducts, leading to lung infections and digestive disorders. At the current
time, there is no treatment that cures cystic fibrosis. In order to
alleviate the symptoms, extremely strict daily treatment is necessary.
In 2006, Frédéric Becq's team at the Institute of Cell Physiology and
Biology (CNRS/Université de Poitiers) showed that a drug called miglustat
restored the activity of the CFTR protein and could thus temporarily correct
the specific phenotype characteristic of cystic fibrosis. Used to treat two
rare diseases (Gaucher's disease and Niemann-Pick type C disease), its
safety and tolerance had already been assessed, and clinical trials could be
rapidly begun in September 2007.
In the new study published in American Journal of Respiratory Cell and
Molecular Biology, the researchers show that daily treatment of human
respiratory cells that are homozygous for the F508del mutation with low
concentrations of miglustat leads to progressive, sustained and reversible
correction of the diseased phenotype. The researchers cultured diseased
human respiratory cells in the presence of miglustat for two months. The
correction observed in the cells takes place after 3-4 days, and then
stabilizes. When the treatment is stopped, the cells revert to the diseased
phenotype. The low doses used (3 micromolars) mean that they can be
administered to patients and that their presence in the bloodstream causes
no problems.
This study is the first that shows that a cystic fibrosis cell can acquire a
sustained non-diseased phenotype when treated daily with a pharmacological
agent. The researchers are therefore very optimistic about the results of
the clinical trials under way.
(1) The clinical study is being carried out by the Actelion pharmaceutical
laboratory on 15 patients suffering from cystic fibrosis and carrying the
delta F508 mutation (F508del), which is the most common and the most serious
of the mutations affecting children with cystic fibrosis. The results will
be known in the coming weeks
ScienceDaily (July 21, 2009) - Miglustat is a drug currently under phase 2
clinical trials on patients suffering from cystic fibrosis (1). Its
potential for treating the disease was discovered in 2006 thanks to the work
of Frédéric Becq's team at the Institute of Cell Physiology and Biology
(CNRS/Université de Poitiers), funded by the associations Vaincre la
Mucoviscidose, MucoVie66, La Pierre Le Bigaut and ABCF2.
In new work to be published on 1 August 2009 in the American Journal of
Respiratory Cell and Molecular Biology, the researchers show that daily,
long-term treatment of human cystic fibrosis cells with low doses of
miglustat corrects the main pathological abnormalities. They are therefore
extremely hopeful that miglustat will prove effective with patients, and
become the first drug able to treat the disease rather than the symptoms.
Cystic fibrosis is a genetic disease, transmitted jointly by both parents,
and affects around 6000 people in France. It is caused by the dysfunction of
a membrane protein (CFTR), present especially in the epithelial cells in the
lungs, which controls exchange of water and mineral salts between the cell
and the exterior. On the cell level, the disease manifests itself by the
absence of chloride secretion, sodium hyperabsorption, deregulation of
calcium homeostasis, and heightened inflammatory response. This results in
thickening of the mucus that lines the bronchial tubes and the pancreatic
ducts, leading to lung infections and digestive disorders. At the current
time, there is no treatment that cures cystic fibrosis. In order to
alleviate the symptoms, extremely strict daily treatment is necessary.
In 2006, Frédéric Becq's team at the Institute of Cell Physiology and
Biology (CNRS/Université de Poitiers) showed that a drug called miglustat
restored the activity of the CFTR protein and could thus temporarily correct
the specific phenotype characteristic of cystic fibrosis. Used to treat two
rare diseases (Gaucher's disease and Niemann-Pick type C disease), its
safety and tolerance had already been assessed, and clinical trials could be
rapidly begun in September 2007.
In the new study published in American Journal of Respiratory Cell and
Molecular Biology, the researchers show that daily treatment of human
respiratory cells that are homozygous for the F508del mutation with low
concentrations of miglustat leads to progressive, sustained and reversible
correction of the diseased phenotype. The researchers cultured diseased
human respiratory cells in the presence of miglustat for two months. The
correction observed in the cells takes place after 3-4 days, and then
stabilizes. When the treatment is stopped, the cells revert to the diseased
phenotype. The low doses used (3 micromolars) mean that they can be
administered to patients and that their presence in the bloodstream causes
no problems.
This study is the first that shows that a cystic fibrosis cell can acquire a
sustained non-diseased phenotype when treated daily with a pharmacological
agent. The researchers are therefore very optimistic about the results of
the clinical trials under way.
(1) The clinical study is being carried out by the Actelion pharmaceutical
laboratory on 15 patients suffering from cystic fibrosis and carrying the
delta F508 mutation (F508del), which is the most common and the most serious
of the mutations affecting children with cystic fibrosis. The results will
be known in the coming weeks