Abstract MerTK, a TAM (Tyro3, Axl, MerTK) family RTK, is expressed on phagocytic cells. Its normal function is to dampen innate immune responses to self-antigens. MerTK is an indirect phosphatidylserine (PtdSer) receptor: PtdSer-binding TAM ligands (Gas6 or Protein S) bridge interactions between MerTK and PtdSer externalized on apoptotic cells (ACs), resulting in AC internalization (efferocytosis). Ensuing MerTK signaling leads to anti-inflammatory M2 macrophage polarization, suppression of pro-inflammatory cytokine production, and a tolerogenic outcome. Tumors are rich in ACs and TAM ligands. Syngeneic tumors implanted in MerTK −/− mice exhibit impaired growth and metastasis compared with those implanted in WT mice. Moreover, MerTK aberrantly expressed on hematological and epithelial malignancies promotes survival and chemoresistance. Thus, pharmacological inhibition of MerTK may have clinical benefit by increasing availability of dead tumor cell antigens, blocking tumor-induced immunosuppression, or blocking tumor cell survival. Here we describe novel and potent MerTK-selective and Mer-Axl small molecule inhibitors that block both MerTK in vitro kinase activity and MerTK autophosphorylation and downstream signaling in cells. Moreover, compounds were able to inhibit phagocytosis of ACs by MerTK-expressing human primary macrophages, and they block activation of MerTK in vivo. The MerTK inhibitors were not overtly cytotoxic or antiproliferative, and did not block the activity of TLR or T cell immune effector pathways. Limited off-target activity was observed in an in vitro kinase panel. Activity of these novel MerTK inhibitors in tumor models is currently under investigation.

Abstract The transcription factor Nrf2 (nuclear factor erythroid-derived-2-like 2) is a key mediator of the anti-oxidant response. Nrf2 can be activated by alkylating its chaperone, Keap-1, resulting in a retardation of Nrf2 degradation, and increased Nrf2 in the cytoplasm. Upon translocation to the nucleus, Nrf2 binds an Antioxidant Response Element (ARE), which leads to the transcription of antioxidant gene products, many of which may be cytoprotective. Activation of the Nrf2 pathway may be useful against a wide-range of disorders, such as multiple sclerosis, psoriasis, and Huntington’s Disease, among others. For example, monomethylfumarate (MMF), the active component of the multiple sclerosis drug, dimethylfumarate (DMF), has been shown to activate the Nrf2-pathway at therapeutic concentrations. However, MMF also serves as an agonist of the niacin receptor, which is likely responsible for the flushing side-effect seen in patients taking DMF. We have discovered a novel class of molecules that are potent activators of Nrf2 and are inactive at the niacin receptor, yet are efficacious in vivo in a model of multiple sclerosis. Lead candidate R970 is an orally-bioavailable small molecule activator of Nrf2 (EC50 = 1 uM; MMF EC50 = 127 uM), which is inactive at the niacin receptor (0% activity at 500 uM; MMF EC50 ca. 1 uM). Additionally, R970 is selective against a range of kinase, G-protein-coupled receptor, ion-channel, and transporter targets. When dosed orally in a murine model of multiple sclerosis, R970 delayed the onset and also suppressed clinical disease. Further exploration with R970 and other selective activators of Nrf2 is ongoing and may yield a next-generation Nrf2-therapeutic, with an improved side-effect profile.

Abstract Introduction: In normal tissue homeostasis, interaction of phosphatidylserine externalized on apoptotic cells (ACs) with the TAM (Tyro3, Axl MerTK) family RTK MerTK, via its ligands Gas6 and Protein S, leads to AC phagocytosis (efferocytosis). The resulting clearance of AC antigens, immunosuppressive M2 macrophage polarization, and suppression of pro-inflammatory cytokine production promotes tolerance to AC-derived self-antigens. This homeostatic response is coopted in tumors, which are abundant in both ACs and TAM ligands, leading to a blunted anti-tumor immune response. Syngeneic tumors implanted in MerTK -/- mice exhibit poor growth and metastasis, correlating with enhanced production of pro-inflammatory cytokines, splenocyte proliferation, and decreased IL-10 compared with those implanted in WT mice. Moreover, MerTK aberrantly expressed on hematological and epithelial malignancies promotes survival and chemoresistance. Thus, pharmacological inhibition of MerTK may have clinical benefit by increasing availability of dead tumor cell antigens and promoting an anti-tumor immune response, or by directly blocking tumor cell survival. We have therefore developed small molecule inhibitors of MerTK. Methods: MerTK kinase activity was assayed using ADP-Glo. Cellular MerTK activity was stimulated in HUVEC or H1299 cells using anti-MerTK crosslinking and measured by immunoprecipitation followed by anti-phospho-MerTK blot, or by downstream phospho-Akt Ser 473 using HTRF. A high content assay was used to measure cell number, apoptosis and proliferation. Effects on immune function were tested in human primary dendritic cells (LPS-induced IL-23 production) and human primary T cells (anti-CD3/CD28-induced IL-2 production or IL-2 induced phospho-STAT5). Efferocytosis of apoptotic Jurkat cells by human primary macrophages was detected by flow cytometry. For the PD assay, MerTK expressing tumors were grown in nude mice. 30-60 minutes post-compound dosing, MerTK was stimulated in vivo for 1hr. Tumors were snap frozen and tumor lysates were blotted with anti-phospho-MerTK antibodies. Anti-tumor efficacy was studied in syngeneic models. Results: Here we describe novel MerTK-selective and Mer-Axl small molecule inhibitors that potently block MerTK in biochemical assays. These compounds exhibit selectivity for TAM family members in an in vitro kinase panel. In cells, antibody-induced MerTK phosphorylation as well as downstream phosphorylation of Akt was inhibited by both classes of compounds with EC50 <100nM. Moreover, MerTK kinase inhibition blocked efferocytosis. Overt cytotoxic or antiproliferative effects were not observed and, importantly, compounds did not block the activity of TLR and T cell immune effector pathways. Compounds inhibited MerTK phosphorylation in tumor tissue in vivo. Anti-tumor activity of these novel MerTK inhibitors is under investigation in syngeneic mouse models both as single agents and in combinations. Conclusions: We have discovered potent and novel small molecule inhibitors of MerTK that may have clinical benefit by both direct anti-tumor effects and by enhancing the anti-tumor immune response. Note: This abstract was not presented at the conference. Citation Format: Sacha J. Holland, Alexander M. Owyang, Sylvia Braselmann, Chrystelle Lamagna, Sothy Yi, Chi Young, Roy Frances, Arthur Bagos, Meagan Chan, Ernest Tai, Stacey Siu, Gary Park, David Lau, Matt Duan, Rao Kolluri, Jiaxin Yu, Ihab Darwish, Somasekhar Bhamidipati, Donald G. Payan, Esteban Masuda. Small molecule inhibitors of the anti-inflammatory TAM receptor MerTK [abstract]. In: Proceedings of the Second CRI-CIMT-EATI-AACR International Cancer Immunotherapy Conference: Translating Science into Survival; 2016 Sept 25-28; New York, NY. Philadelphia (PA): AACR; Cancer Immunol Res 2016;4(11 Suppl):Abstract nr B060.

Abstract Introduction: MerTK, a TAM (Tyro3, Axl, MerTK) family RTK, is expressed on phagocytic myeloid and epithelial cells. Its normal function is to dampen innate immune responses to self-antigens. MerTK is an indirect phosphatidylserine (PtdSer) receptor: PtdSer-binding TAM ligands, Gas6 or Protein S, bridge interactions between MerTK and PtdSer externalized on apoptotic cells (ACs), resulting in AC internalization (efferocytosis). Ensuing MerTK signaling leads to anti-inflammatory M2 macrophage polarization, suppression of pro-inflammatory cytokine production, and a tolerogenic outcome. Tumors are rich in ACs and TAM ligands. Syngeneic tumors implanted in MerTK -/- mice exhibit impaired growth and metastasis compared with those implanted in WT mice, correlating with enhanced production of pro-inflammatory cytokines, splenocyte proliferation, and decreased IL-10. Moreover, MerTK aberrantly expressed on hematological and epithelial malignancies promotes survival and chemoresistance. Thus, pharmacological inhibition of MerTK may have clinical benefit by increasing availability of dead tumor cell antigens, blocking tumor induced immunosuppression, or directly promoting tumor cell survival. We have therefore developed small molecule inhibitors of MerTK. Methods: MerTK kinase activity was assayed using ADP-Glo. Cellular MerTK activity was stimulated in HUVEC or H1299 cells using anti-MerTK crosslinking and measured by immunoprecipitation followed by anti-phospho-MerTK blot, or by downstream phospho-Akt Ser 473 using HTRF. A high content assay was used to measure cell proliferation, DNA content and apoptosis. Immune effector assays were LPS-induced IL-23 production in human primary dendritic cells and anti-CD3/CD28-induced IL-2 production or IL-2 induced phospho-STAT5 in human primary T cells. Efferocytosis of CFSE-labeled apoptotic Jurkat cells by anti-CD14-labeled human primary macrophages was detected by flow cytometry. Results: Here we describe novel MerTK-selective and Mer-Axl small molecule inhibitors that potently block MerTK in biochemical assays. These compounds exhibit selectivity for TAM family members in an in vitro kinase panel. In cells, antibody-induced MerTK phosphorylation as well as downstream phosphorylation of Akt was inhibited by both compounds with EC50 <100nM. Compounds were not overtly cytotoxic or antiproliferative and, importantly, do not block the activity of TLR and T cell immune effector pathways. Compounds also phenocopied the inhibition of efferocytosis observed using a MerTK blocking antibody. In vivo activity of these novel MerTK inhibitors is under investigation in PD and tumor models. Conclusions: We have discovered potent and novel small molecule inhibitors of MerTK that may have clinical benefit by both direct anti-tumor effects and by enhancing the anti-tumor immune response. Citation Format: Sacha J. Holland, Alex M. Owyang, Sothy Yi, Chi Young, Sylvia Braselmann, Roy Frances, Arthur Bagos, Ernest Tai, Stacey Siu, Gary Park, David Lau, Matt Duan, Rao Kolluri, Somasekhar Bhamidipati, Ihab Darwish, Matthew Duncton, Rajinder Singh, Esteban Masuda, Donald G. Payan. Small molecule inhibitors of the anti-inflammatory TAM receptor MerTK. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 4869.

The 5′‐AMP‐activated protein kinase (AMPK) is a key regulator of energy homeostasis. Pharmacologic activation of AMPK is beneficial in treating metabolic disorders and improving exercise endurance. We previously identified small molecule AMPK activators that improved glucose tolerance and running endurance. These compounds reduced cellular oxygen consumption and increased AMP/ATP and ADP/ATP ratios, demonstrating that AMPK activation is due to a change in energy status which results from altered mitochondrial respiration. Further biochemical studies showed that the target appeared to be mitochondrial complex I. In vivo metabolite profiling indicated that there was an up‐regulation of fatty acid oxidation, ketogenesis and catabolism of branched chain amino acids in the compound‐treated mice. The up‐regulation in fatty acid catabolism was supported by a clear reduction of fat pads in treated mice. Furthermore, UCP1 protein expression was increased in the white adipose tissues. Taken together, our results demonstrate beneficial outcomes by AMPK activation through mitochondrial regulation. These studies should help to provide a molecular understanding for the physiological effects of AMPK activation and for the therapeutic applications of AMPK activators.

Modulation of mitochondrial function through inhibiting respiratory complex I activates a key sensor of cellular energy status, the 5'-AMP-activated protein kinase (AMPK). Activation of AMPK results in the mobilization of nutrient uptake and catabolism for mitochondrial ATP generation to restore energy homeostasis. How these nutrient pathways are affected in the presence of a potent modulator of mitochondrial function and the role of AMPK activation in these effects remain unclear. We have identified a molecule, named R419, that activates AMPK in vitro via complex I inhibition at much lower concentrations than metformin (IC50 100 nM vs 27 mM, respectively). R419 potently increased myocyte glucose uptake that was dependent on AMPK activation, while its ability to suppress hepatic glucose production in vitro was not. In addition, R419 treatment of mouse primary hepatocytes increased fatty acid oxidation and inhibited lipogenesis in an AMPK-dependent fashion. We have performed an extensive metabolic characterization of its effects in the db/db mouse diabetes model. In vivo metabolite profiling of R419-treated db/db mice showed a clear upregulation of fatty acid oxidation and catabolism of branched chain amino acids. Additionally, analyses performed using both 13C-palmitate and 13C-glucose tracers revealed that R419 induces complete oxidation of both glucose and palmitate to CO2 in skeletal muscle, liver, and adipose tissue, confirming that the compound increases mitochondrial function in vivo. Taken together, our results show that R419 is a potent inhibitor of complex I and modulates mitochondrial function in vitro and in diabetic animals in vivo. R419 may serve as a valuable molecular tool for investigating the impact of modulating mitochondrial function on nutrient metabolism in multiple tissues and on glucose and lipid homeostasis in diabetic animal models.

Uncontrolled mucosal immunity in the gastrointestinal tract of humans results in chronic inflammatory bowel disease (IBD), such as Crohn disease and ulcerative colitis. In early clinical trials as well as in animal models, IL-12 has been implicated as a major mediator of these diseases based on the ability of anti-p40 mAb treatment to reverse intestinal inflammation. The cytokine IL-23 shares the same p40 subunit with IL-12, and the anti-p40 mAbs used in human and mouse IBD studies neutralized the activities of both IL-12 and IL-23. IL-10-deficient mice spontaneously develop enterocolitis. To determine how IL-23 contributes to intestinal inflammation, we studied the disease susceptibility in the absence of either IL-23 or IL-12 in this model, as well as the ability of recombinant IL-23 to exacerbate IBD induced by T cell transfer. Our study shows that in these models, IL-23 is essential for manifestation of chronic intestinal inflammation, whereas IL-12 is not. A critical target of IL-23 is a unique subset of tissue-homing memory T cells, which are specifically activated by IL-23 to produce the proinflammatory mediators IL-17 and IL-6. This pathway may be responsible for chronic intestinal inflammation as well as other chronic autoimmune inflammatory diseases.

Cytokines of the interleukin-1 (IL-1) family, such as IL-1 alpha/beta and IL-18, have important functions in host defense, immune regulation, and inflammation. Insight into their biological functions has led to novel therapeutic approaches to treat human inflammatory diseases. Within the IL-1 family, IL-1 alpha/beta, IL-1Ra, and IL-18 have been matched to their respective receptor complexes and have been shown to have distinct biological functions. The most prominent orphan IL-1 receptor is ST 2. This receptor has been described as a negative regulator of Toll-like receptor-IL-1 receptor signaling, but it also functions as an important effector molecule of T helper type 2 responses. We report a member of the IL-1 family, IL-33, which mediates its biological effects via IL-1 receptor ST 2, activates NF-kappaB and MAP kinases, and drives production of T(H)2-associated cytokines from in vitro polarized T(H)2 cells. In vivo, IL-33 induces the expression of IL-4, IL-5, and IL-13 and leads to severe pathological changes in mucosal organs.