MIF is a proinflammatory cytokine that has been implicated in the pathogenesis of sepsis, arthritis, and other inflammatory diseases. Antibodies against MIF are effective in experimental models of inflammation, and there is interest in strategies to inhibit its deleterious cytokine activities. Here we identify a mechanism of inhibiting MIF pro-inflammatory activities by targeting MIF tautomerase activity. We designed small molecules to inhibit this tautomerase activity; a lead molecule, "ISO-1 ((S,R)-3-(4-hydroxyphenyl)-4,5-dihydro-5-isoxazole acetic acid methyl ester)," significantly inhibits the cytokine activity in vitro. Moreover, ISO-1 inhibits tumor necrosis factor release from macrophages isolated from LPStreated wild type mice but has no effect on cytokine release from MIFdeficient macrophages. The therapeutic importance of the MIF inhibition by ISO-1 is demonstrated by the significant protection from sepsis, induced by cecal ligation and puncture in a clinically relevant time frame. These results identify ISO-1 as the first small molecule inhibitor of MIF proinflammatory activities with therapeutic implications and indicate the potential of the MIF active site as a novel target for therapeutic interventions in human sepsis.MIF is an important pro-inflammatory cytokine that has been implicated in the pathogenesis of inflammatory disorders (1-6). Administration of neutralizing anti-MIF antibodies has proven therapeutically effective in numerous animal models of systemic inflammation, including Gram-negative, Grampositive, and polymicrobial sepsis, arthritis, and autoimmune diabetes (1-4, 7, 8). Circulating MIF levels are elevated in animals with sepsis and in patients with severe sepsis and septic shock (1). These and other results indicate that inhibiting MIF is a promising approach to develop new anti-inflammatory agents.Three-dimensional x-ray crystallography of MIF shows that the molecule exists as a homotrimer (9 -11). This trimer possesses the ability to catalyze the tautomerization of the non-physiological substrates DL-dopachrome methyl esters (supplemental Fig. 1) into their corresponding indole derivatives (11,12). Crystallographic analysis of MIF complexed with p-hydroxyphenylpyruvic acid, a known MIF substrate (13), has revealed an active site which lies in a hydrophobic cavity formed between two adjacent subunits of the homotrimer (14). Tautomerase activity is an evolutionarily ancient phenomenon, which early life forms presumably utilized for synthesis, but there is no evidence that modern species use this in synthetic pathways. We reasoned that molecules that bind this site could be useful to target MIF function, because the tautomerase activity is expendable. We have designed a molecule to fit into the catalytic site and shown that (S,R)-3-(4-hydroxyphenyl)-4,5-dihydro-5-isoxazole acetic acid methyl ester (ISO-1) 2 is a potent inhibitor of MIF tautomerase activity (15). The crystal structure of MIF complexed to ISO-1 reveals that ISO-1 binds to the enzymatic active site.
MATERIALS AND MET...