New research on the experimental drug, NU-9, invented and developed by two Northwestern University scientists to treat ALS (amyotrophic lateral sclerosis), shows it is more effective than existing FDA-approved drugs for the disease.More importantly, NU-9 has an enhanced effect when given in combination with those drugs, riluzole and edaravone. The drug was invented by Richard B. Silverman, the Patrick G. Ryan/Aon Professor at Northwestern, and animal studies were carried out by P. Hande Ozdinler, associate professor of neurology at Northwestern University Feinberg School of Medicine.
The research, published recently in Scientific Reports, showed NU-9 lengthened the axons of diseased upper motor neurons in an SOD1 ALS mouse model. This new finding about lengthening axons of diseased neurons further illustrates NU-9’s benefits.
The axon is the segment of the upper motor neuron that connects the brain to the spinal cord and makes the corticospinal tract, which degenerates in ALS patients. Deteriorating axons contribute to the swift and fatal paralysis of ALS patients.
“For a drug to be effective, it is important for that drug to improve axon outgrowth and axon health,” said co-lead study author Ozdinler. “This is very important for connecting the brain and the spinal cord and for revitalizing the motor neuron circuitry that degenerates in patients.”
In ALS, movement-initiating nerve cells in the brain (upper motor neurons) and muscle-controlling nerve cells in the spinal cord (lower motor neurons) die.
In research published last year, Northwestern scientists showed NU-9 improved two important factors that cause upper motor neurons to become diseased in ALS: protein misfolding and protein aggregation inside the cell. Both these factors become toxic to the neuron and are common in ALS patients and neurodegeneration overall. That research showed the NU-9 compound stopped neurons from degenerating so much that the diseased neurons became similar to healthy control neurons after 60 days of treatment in two different mouse models of ALS.
NU-9 moving toward clinical trials
NU-9 is moving toward clinical trials. The company, AKAVA Therapeutics, started last year by Silverman, is carrying out animal safety studies needed for the drug (now called AKV9 in the company) to receive FDA approval to become an Investigational New Drug. Those studies include determining dose level and toxic effects.
“If everything goes well, we hope to start with healthy volunteers in a Phase 1 clinical trial early in 2023,” said co-lead study author Silverman.
Depending on FDA response to the Phase 1 results, a Phase II trial to administer the drug to ALS patients could begin in early 2024.
NU-9 has a new mechanism of action, and it needs to be tested in humans for its efficacy in the treatment of ALS,” Silverman said.
“It is a long process — possibly 10 to 12 years — to discover and bring a new drug to the market,” Silverman said. “But this drug has us very excited and hopeful about its possibilities to improve the lives of ALS patients, who have been without hope for so long.”
Other Northwestern authors on this study include Barış Genç, Mukesh Gautam, Benjamin Helmold, Nuran Koçak, Aksu Günay and Gashaw Goshu.
Dr. Ozdinler received training in the fields of molecular biology, genetics, biotechnology, cell biology, anatomy and neuroscience. She is the recipient of Harvard NeuroDiscovery Center and NUCATS Translational Innovation awards. She was recruited to be the founding director of the 2nd Les Turner ALS Laboratory at Northwestern, which focused on the
biology and pathology of upper motor neurons. She is now a faculty member to the Chemistry Life Sciences Processes Institute, Les Turner ALS, Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, and Robert H. Lurie Comprehensive Cancer Research Centers.
Ozdinler lab focuses on the biology and pathology of upper motor neurons with respect to health and neurodegeneration. Ozdinler Lab is a member of Chemistry of Life Processes Institute, Les Turner ALS Center , Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, and Robert H. Lurie Comprehensive Cancer Research
Centers at Northwestern. Their overall goals are to reveal the underlying causes of upper motor neuron vulnerability and to develop effective treatment strategies for diseases that affect voluntary movement.
Available Positions at Ozdinler Lab:
* Open positions for WORK-STUDY students in the Weinberg College of Arts and Sciences. e-mail: b-genc@northwestern.edu
* Open positions for postdoctoral fellows who have expertise and interest in motor neuron biology and disease. e-mail: ozdinler@northwestern.edu
For more information about Ozdinler Lab and about Dr. Hande Ozdinler
central nervous system disorders, including Parkinson’s disease, cerebral palsy, amyotrophic lateral sclerosis, addiction, and epilepsy. Other therapeutic areas include cancer (melanoma and hepatocellular carcinoma), lysosomal storage diseases, such as Gaucher’s disease, and bacterial infection. Numerous drugs are known to function as specific
inhibitors of particular enzymes. For some enzyme targets, where potent reversible inhibitors are desired, computer modeling based on X-ray crystal structures initiates the research (high-throughput screening also may be used). For enzyme targets where inactivators are desired and when little is known about the enzyme’s molecular mechanism of action, chemical model studies are designed to determine reasonable nonenzymatic pathways applicable to the enzyme. For those enzymes, mechanism-based inactivators are designed and synthesized and inactivation mechanisms investigated. The enzymes are isolated from either mammalian tissue or from overexpressed cells containing recombinant enzymes. Collaborations are developed in X-ray crystallography and preclinical studies.
