Oxcia is a pioneer in the new and exciting research area that explores the role of oxidative DNA damage in inflammation and fibrosis and how this can be used in novel treatments. OXC-201 (TH5487) is a new type of DDR treatment that blocks inflammation and fibrosis by inhibiting an enzyme, OGG1. OXC-201 is in the preclinical phase with the potential to become a “first-in-class” treatment for interstitial pulmonary fibrosis (ILD) disease, which includes idiopathic pulmonary fibrosis (IPF). In addition, there are several other promising indications, e.g. sepsis and acute respiratory distress syndrome (ARDS).
Idiopathic pulmonary fibrosis (IPF)
IPF is a severe fibrotic disease with elements of chronic inflammation. It is associated with the formation of permanent fibrotic scars, significant loss of organ function, increased mortality and high costs for society. The cause is unknown but several risk factors include age, gender, smoking and genetic factors. Pulmonary fibrosis can also develop as a complication of inflammatory disease such as rheumatoid arthritis. Average survival is 3-5 years after diagnosis (Swedis Pulmonary Medicini Association 2019).
Today, there is no medical treatment that cures pulmonary fibrosis. Two approved drugs, Esbriet and Ofev, slow down the rate of disease progression but have limited use due to side-effects and contraindications. The only treament that can prolong life is a lung transplant. New treatments are urgently needed to reduce the large unmet medical need.
Oxcia’s OXC-201 is an orally available first-in class small molecule targeting the DNA repair enzyme, OGG1. OXC-201 is a novel approach to treat pulmonary fibrosis, blocking the inflammation and preventing the development of fibrosis. The goal of Oxcia’s research is to target the underlying inflammation and fibrosis in IPF and potentially halt the disease.
Mechanism of action
In inflammation and fibrosis, the tissue is exposed to oxidative stress, which causes oxidative damage to DNA. OGG1 is a protein that binds to these damaged bases and plays an important role in the transcriptional regulation of gene expression in conditions of inflammation and fibrosis. OGG1 binds to DNA and mediates the assembly of transcriptional protein complexes including the transcription factor NF-κB.
The result is an upregulation of inflammatory and profibrotic substances, such as chemokines, cytokines and extracellular matrix proteins e.g. collagen leading to activation of the immune response and eventually tissue repair. Severe inflammatory and fibrotic diseases are often associated with an exaggerated immune response and impaired tissue repair. Through inhibition of OGG1 we can modify the dysregulated immune response and inhibit the development of fibrosis and the tissue damage.
“At Oxcia, we are proud to follow in the footsteps of Prof Tomas Lindahl, who won the Nobel Prize for discovering the base excision repair pathway including OGG1. We have developed the first and most advanced OGG1 inhibitor.“— Christina Kaldéren, Preclinical Director
Key supporting data
OXC-201, has been evaluated in disease models and shown to exhibit a combination of anti-inflammatory and anti-fibrotic effects, inhibiting the production of inflammatory mediators such as TNFα and inhibiting the major hallmarks of fibrogenesis such as TGFβ and collagen1 deposition.
OGG1’s implication in fibrogenesis, combined with its role in inflammation, highlights this enzyme as a promising therapeutic target for ILD, e.g., IPF treatment. Oxcia’s OGG1 inhibitor has preliminary data showing that it protects from acute lung inflammation and pulmonary fibrosis (1). It has furthermore potential to become a promising future treatment of pulmonary fibrosis as a consequence of viral infection (e.g. Covid 19).
The OGG1 inhibitor is protected by patent in the major countries.
Status and plan
Further research of OXC-201 is ongoing, investigating whether it is a suitable clinical drug candidate. Studies on selectivity, ADME (Absorption, Distribution, Metabolism and Elimination), PK-PD (pharmacokinetics-pharmacodynamics relationships) are performed with the goal of initiating safety pharmacology in 2023.
Oxcia is also exploring other indications where OXC-201 has therapeutic potential.
- Small-molecule-mediated OGG1 inhibition attenuates pulmonary inflammation and lung fibrosis in a murine lung fibrosis model, Lloyd Tanner, Andrew Single, Ravi Kiran Varma Bhongir, Moritz Heusel, Tirthankar Mohanty, Christoffer Karlsson, Lang Pan, Carl-Magnus Clausson, Jesper Bergwik, Ke Wang, Cecilia Andersson, Riya Oommen, Jonas Erjefält, Johan Malmström, Olov Wallner, Istvan Boldogh, Thomas Helleday, Christina Kalderén, Arne Egesten, Nature Comm. 2023; 14: 643
- Optimization of N-Piperidinyl-Benzimidazolone Derivatives as Potent and Selective Inhibitors of 8-Oxo-Guanine DNA Glycosylase 1, Olov Wallner, Armando Cázares-Körner, Emma Rose Scaletti, Geoffrey Masuyer, Tove Bekkhus, Torkild Visnes , Kirill Mamonov, Florian Ortis, Thomas Lundbäck, Maria Volkova, Tobias Koolmeister, Elisée Wiita, Olga Loseva, Monica Pandey, Evert Homan, Carlos Benítez-Buelga, Jonathan Davies, Martin Scobie, Ulrika Warpman Berglund, Christina Kalderén, Pål Stenmark, Thomas Helleday, Maurice Michel, ChemMedChem, 2023 Jan 3;18(1):e202200310, PMID: 36128847
- 8-Oxoguanine targeted by 8-oxoguanine DNA glycosylase 1 (OGG1) is central to fibrogenic gene activation upon lung injury, Lang Pan, Wenjing Hao, Yaoyao Xue, Ke Wang, Xu Zheng, Jixian Luo, Xueqing Ba, Yang Xiang, Xiaoqun Qin, Jesper Bergwik, Lloyd Tanner, Arne Egesten, Allan R. Brasier, Istvan Boldogh, Nucleic Acids Research, 24 Jan 2023, PMID: 3665127
- Pharmacological OGG1 inhibition decreases murine allergic airway inflammation, Lloyd Tanner, Jesper Bergwik, Ravi K. V. Bhongir, Lang Pan, Caijuan Dong, Olov Wallner, Christina Kalderén, Thomas Helleday, Istvan Boldogh, Mikael Adner, Arne Egesten, Frontiers in Pharmacology, 17 October 2022, PMID: 36324676
- TH5487, a small molecule inhibitor of OGG1, attenuates pulmonary fibrosis by NEDD4L-mediated OGG1 degradation, Huayu Ling, Chuge Song , Yaowei Fang, Yu Yin, Zijun Wu, Yahong Wang, Zhiliang Xu, Shenglan Gao, Ao Li , Gang Liu, Chemico-Biological Interactions, Volume 362, 1 August 2022, PMID: 36651270
- Defects in 8-oxo-guanine repair pathway cause high frequency of C > A substitutions in neuroblastoma. , van den Boogaard ML, Oka R, Hakkert A, Schild L, Ebus ME, van Gerven MR, Zwijnenburg DA, Molenaar P, Hoyng LL, Dolman MEM, Essing AHW, Koopmans B, Helleday T, Drost J, van Boxtel R, Versteeg R, Koster J, Molenaar JJ. Proc Natl Acad Sci U S A. 2021 Sep 7;118(36):e2007898118. PMID: 34479993
- Small molecule inhibitor of OGG1 blocks oxidative DNA damage repair at telomeres and potentiates methotrexate anticancer effects. , Baquero JM, Benítez-Buelga C, Rajagopal V, Zhenjun Z, Torres-Ruiz R, Müller S, Hanna BMF, Loseva O, Wallner O, Michel M, Rodríguez-Perales S, Gad H, Visnes T, Helleday T, Benítez J, Osorio A. Sci Rep. 2021 Feb 10;11(1):3490. PMID: 33568707
- NEIL1 and NEIL2 Are Recruited as Potential Backup for OGG1 upon OGG1 Depletion or Inhibition by TH5487. , Hanna BMF, Michel M, Helleday T, Mortusewicz O. Int J Mol Sci. 2021 Apr 27;22(9):4542. PMID: 33925271
- OGG1 Inhibitor TH5487 Alters OGG1 Chromatin Dynamics and Prevents Incisions. , Hanna BMF, Helleday T, Mortusewicz O. Biomolecules. 2020 Oct 26;10(11):1483. PMID: 33114607
- Targeting OGG1 arrests cancer cell proliferation by inducing replication stress. ,Visnes T, Benítez-Buelga C, Cázares-Körner A, Sanjiv K, Hanna BMF, Mortusewicz O, Rajagopal V, Albers JJ, Hagey DW, Bekkhus T, Eshtad S, Baquero JM, Masuyer G, Wallner O, Müller S, Pham T, Göktürk C, Rasti A, Suman S, Torres-Ruiz R, Sarno A, Wiita E, Homan EJ, Karsten S, Marimuthu K, Michel M, Koolmeister T, Scobie M, Loseva O, Almlöf I, Unterlass JE, Pettke A, Boström J, Pandey M, Gad H, Herr P, Jemth AS, El Andaloussi S, Kalderén C, Rodriguez-Perales S, Benítez J, Krokan HE, Altun M, Stenmark P, Berglund UW, Helleday T. Nucleic Acids Res. 2020 Dec 2;48(21):12234-12251. PMID: 33211885
- Computational and Experimental Druggability Assessment of Human DNA Glycosylases. , Michel M, Visnes T, Homan EJ, Seashore-Ludlow B, Hedenström M, Wiita E, Vallin K, Paulin CBJ, Zhang J, Wallner O, Scobie M, Schmidt A, Jenmalm-Jensen A, Warpman Berglund U, Helleday T. ACS Omega. 2019 Jul 5;4(7):11642-11656. PMID: 31460271
- Small-molecule inhibitor of OGG1 suppresses proinflammatory gene expression and inflammation. , Visnes T, Cázares-Körner A, Hao W, Wallner O, Masuyer G, Loseva O, Mortusewicz O, Wiita E, Sarno A, Manoilov A, Astorga-Wells J, Jemth AS, Pan L, Sanjiv K, Karsten S, Gokturk C, Grube M, Homan EJ, Hanna BMF, Paulin CBJ, Pham T, Rasti A, Berglund UW, von Nicolai C, Benitez-Buelga C, Koolmeister T, Ivanic D, Iliev P, Scobie M, Krokan HE, Baranczewski P, Artursson P, Altun M, Jensen AJ, Kalderén C, Ba X, Zubarev RA, Stenmark P, Boldogh I, Helleday T. Science. 2018 Nov 16;362(6416):834-839. PMID: 30442810
- Germline variation in the oxidative DNA repair genes NUDT1 and OGG1 is not associated with hereditary colorectal cancer or polyposis. , Mur P, Jemth AS, Bevc L, Amaral N, Navarro M, Valdés-Mas R, Pons T, Aiza G, Urioste M, Valencia A, Lázaro C, Moreno V, Puente XS, Stenmark P, Warpman-Berglund U, Capellá G, Helleday T, Valle L. Hum Mutat. 2018 Sep;39(9):1214-1225. PMID: 29900613