Qi Pan1, Shushan Lin2, Yu Li3, Liang Liu3, Xiaoping Li4, Xianglei Gao4, Jiangyu Yan4, Baohua Gu2, Xiaofeng Chen2, Wenjia Li2, Xinfa Tang2, Chao Chen5, Lixin Guo6. 1. Department of Endocrinology, National Center of Gerontology, Beijing Hospital, Beijing, China. 2. Biologics Institute, HEC Pharm R&D Co., Ltd., Guangdong, China. 3. Department of Pharmacology, HEC Pharm R&D Co., Ltd., Guangdong, China. 4. Department of Biologics, HEC Pharmaceutical Co., Ltd., Guangdong, China. 5. Department of Biologics, HEC Pharmaceutical Co., Ltd., Guangdong, China. Electronic address: chchao1987@gmail.com. 6. Department of Endocrinology, National Center of Gerontology, Beijing Hospital, Beijing, China. Electronic address: glxwork2016@163.com.
Abstract
BACKGROUND: Fibroblast growth factor 21 (FGF21) has become a promising therapeutic target for metabolic diseases such as type 2 diabetes (T2D), obesity and non-alcoholic steatohepatitis. However, the clinical application of natural FGF21 molecule is limited because of its instability in vitro and short half-life in vivo. To improve FGF21's therapeutic property, we screened high receptor binding FGF21 analogs and made FGF21-Fc-GLP-1 dual-targeted constructs to investigate their activity in a number of experiments . METHODS: Utilizing phage display high-throughput screening we identified mutations that could improve β-Klotho binding property of FGF21. IgG4 Fc was fused to FGF21 variants to extend the in vivo half-life. We further explored the potential synergistic actions of FGF21 with the incretin glucagon-like peptide-1 (GLP-1) by generating GLP-1-Fc-FGF21 dual agonists. FINDINGS: Two Fc-FGF21 variants showed enhanced β-Klotho binding affinity in vitro as well as improved glucose lowering effect in vivo. One of the dual agonists, GLP-1-Fc-FGF21 D1, provided potent and sustained glucose lowering effect in diabetic mice models. It also demonstrated superior weight loss effect to GLP-1 or FGF21 alone. Moreover, GLP-1-Fc-FGF21 D1 exhibited strong anti-NASH effect in the high-fat diet-induced ob/ob model as it improved liver function, serum and hepatic lipid profile and reduced NAFLD activity score with an efficacy superior to either FGF21 or GLP-1 analogs alone. INTERPRETATION: This novel GLP-1/FGF21 dual agonist is worth clinical development for the treatment of T2D, obesity and NASH. FUNDING: HEC Pharm R&D Co., Ltd, National natural science fund of China.
BACKGROUND:Fibroblast growth factor 21 (FGF21) has become a promising therapeutic target for metabolic diseases such as type 2 diabetes (T2D), obesity and non-alcoholic steatohepatitis. However, the clinical application of natural FGF21 molecule is limited because of its instability in vitro and short half-life in vivo. To improve FGF21's therapeutic property, we screened high receptor binding FGF21 analogs and made FGF21-Fc-GLP-1 dual-targeted constructs to investigate their activity in a number of experiments . METHODS: Utilizing phage display high-throughput screening we identified mutations that could improve β-Klotho binding property of FGF21. IgG4 Fc was fused to FGF21 variants to extend the in vivo half-life. We further explored the potential synergistic actions of FGF21 with the incretin glucagon-like peptide-1 (GLP-1) by generating GLP-1-Fc-FGF21 dual agonists. FINDINGS: Two Fc-FGF21 variants showed enhanced β-Klotho binding affinity in vitro as well as improved glucose lowering effect in vivo. One of the dual agonists, GLP-1-Fc-FGF21 D1, provided potent and sustained glucose lowering effect in diabeticmice models. It also demonstrated superior weight loss effect to GLP-1 or FGF21 alone. Moreover, GLP-1-Fc-FGF21 D1 exhibited strong anti-NASH effect in the high-fat diet-induced ob/ob model as it improved liver function, serum and hepatic lipid profile and reduced NAFLD activity score with an efficacy superior to either FGF21 or GLP-1 analogs alone. INTERPRETATION: This novel GLP-1/FGF21 dual agonist is worth clinical development for the treatment of T2D, obesity and NASH. FUNDING: HEC Pharm R&D Co., Ltd, National natural science fund of China.