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. 2002 May 16;417(6886):254-9.
doi: 10.1038/417254a.

Targeted pharmacological depletion of serum amyloid P component for treatment of human amyloidosis

M B Pepys  1 , J Herbert, W L Hutchinson, G A Tennent, H J Lachmann, J R Gallimore, L B Lovat, T Bartfai, A Alanine, C Hertel, T Hoffmann, R Jakob-Roetne, R D Norcross, J A Kemp, K Yamamura, M Suzuki, G W Taylor, S Murray, D Thompson, A Purvis, S Kolstoe, S P Wood, P N Hawkins
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Targeted pharmacological depletion of serum amyloid P component for treatment of human amyloidosis

M B Pepys et al. Nature. .

Abstract

The normal plasma protein serum amyloid P component (SAP) binds to fibrils in all types of amyloid deposits, and contributes to the pathogenesis of amyloidosis. In order to intervene in this process we have developed a drug, R-1-[6-[R-2-carboxy-pyrrolidin-1-yl]-6-oxo-hexanoyl]pyrrolidine-2-carboxylic acid, that is a competitive inhibitor of SAP binding to amyloid fibrils. This palindromic compound also crosslinks and dimerizes SAP molecules, leading to their very rapid clearance by the liver, and thus produces a marked depletion of circulating human SAP. This mechanism of drug action potently removes SAP from human amyloid deposits in the tissues and may provide a new therapeutic approach to both systemic amyloidosis and diseases associated with local amyloid, including Alzheimer's disease and type 2 diabetes.

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