A group of peptide-based, long-acting,
stable, highly selective
cholecystokinin 1 receptor (CCK-1R) agonists with the potential to
treat obesity has been identified and characterized, based on systematic
investigation of synthetic CCK-8 analogues with N-terminal linkage
to fatty acids. Sulfated Tyr in such compounds was stable in neutral
buffer. CCK-1R selectivity was achieved mostly by introducing d-N-methyl-Asp instead of Asp at the penultimate
position of CCK-8. Our compound 9 (NN9056) showed similar
in vitro CCK-1R potency and CCK-1R affinity as CCK-8, very high selectivity
for CCK-1R over the cholecystokinin 2 receptor (CCK-2R), strong
reduction of food intake in lean pigs for up to 48 h after one subcutaneous
injection without adverse effects, a plasma half-life of 113 h in
minipigs after intravenous injection, and acceptable chemical stability
in a neutral liquid formulation. In addition, we found a highly selective
CCK-2R agonist by replacing Gly in a CCK-8 derivative with Glu.
Background/Objectives Cholecystokinin (CCK) is a regulator of appetite and energy intake in man. The aim of this study was to determine the effect of NN9056, a long-acting CCK-1 receptor-selective CCK analogue, on food intake and body weight (BW) in obese Göttingen Minipigs. Subjects/Methods Tolerability of NN9056 and acute effects on food intake, pancreas histology, amylase and lipase levels were assessed in lean domestic pigs in doses up to 100 nmol/kg (n = 3-4). Subsequently, obese Göttingen Minipigs were treated subcutaneously (s.c.) once daily for 13 weeks with vehicle, NN9056 low dose (regulated from 5 to 2 nmol/kg) or NN9056 high dose (10 nmol/kg) (n = 7-8). Food intake was measured daily and BW twice weekly. At the end of the treatment period, an intravenous glucose tolerance test (IVGTT) and a 24-h exposure profile was obtained. Data are mean ± SD. Results The acute studies in domestic pigs showed significant and dose-dependent effect of NN9056 on food intake, acceptable tolerability and no histopathological signs of pancreatitis. Sub-chronic treatment in obese Göttingen Minipigs was also well tolerated and accumulated food intake was significantly lower in both treated groups compared to vehicle, with no significant difference between the dose levels of NN9056 (41.8 ± 12.6, 51.5 ± 13.8 and 86.5 ± 19.5 kg in high-dose, lowdose and vehicle groups, respectively, p = 0.012 and p < 0.0001 for low and high dose vs. vehicle, respectively). Accordingly, there was a weight loss in both treated groups vs. a weight gain in the vehicle group (−7.2 ± 4.6%, −2.3 ± 3.2% and 12.3 ± 3.9% in the high-dose, low-dose and vehicle groups, respectively, p < 0.0001 for both vs. vehicle). IVGTT data were not significantly different between groups. Conclusion NN9056, a long-acting CCK-1 receptor-selective CCK analogue, significantly reduced food intake and BW in obese Göttingen Minipigs after once daily s.c. dosing for 13 weeks.
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