Identification

Name
Cerliponase alfa
Accession Number
DB13173
Type
Biotech
Groups
Approved, Investigational
Biologic Classification
Protein Based Therapies
Recombinant Enzymes
Description

Cerliponase alfa is an enzyme replacement treatment for a specific form of Batten disease. It was the first FDA-approved treatment to slow loss of walking ability (ambulation) in symptomatic pediatric patients 3 years of age and older with late infantile neuronal ceroid lipofuscinosis type 2 (CLN2), also known as tripeptidyl peptidase-1 (TPP1) deficiency. Intraventricular administration of the drug allows significant uptake into the brain. Cerliponase alfa was approved in April, 2017 (as Brineura).

Protein chemical formula
Not Available
Protein average weight
59.0 Da (glycosylated)
Sequences
>Cerliponase alfa Sequence
SYSPEPDQRRTLPPGWVSLGRADPEEELSLTFALRQQNVERLSELVQAVSDPSSPQYGKY
LTLENVADLVRPSPLTLHTVQKWLLAAGAQKCHSVITQDFLTCWLSIRQAELLLPGAEFH
HYVGGPTETHVVRSPHPYQLPQALAPHVDFVGGLHRFPPTSSLRQRPEPQVTGTVGLHLG
VTPSVIRKRYNLTSQDVGSGTSNNSQACAQFLEQYFHDSDLAQFMRLFGGNFAHQASVAR
VVGQQGRGRAGIEASLDVQYLMSAGANISTWVYSSPGRHEGQEPFLQWLMLLSNESALPH
VHTVSYGDDEDSLSSAYIQRVNTELMKAAARGLTLLFASGDSGAGCWSVSGRHQFRPTFP
ASSPYVTTVGGTSFQEPFLITNEIVDYISGGGFSNVFPRPSYQEEAVTKFLSSSPHLPPS
SYFNASGRAYPDVAALSDGYWVVSNRVPIPWVSGTSASTPVFGGILSLINEHRILSGRPP
LGFLNPRLYQQHGAGLFDVTRGCHESCLDEEVEGQGFCSGPGWDPVTGWGTPNFPALLKT
LLNP
Download FASTA Format
Synonyms
  • Immature cell growth-inhibiting gene 1 protein
  • Immature human tripeptidyl-peptidase 1
  • Immature lysosomal pepstatin-insensitive protease
  • Immature tripeptidyl-peptidase I
External IDs
BMN 190 / BMN-190
Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
BrineuraKit150 mg/5mLIntraventricularBiomarin International Limited2017-04-27Not applicableUs
Categories
UNII
X8R2D92QP1
CAS number
151662-36-1

Pharmacology

Indication

Cerliponase alfa is a treatment for late infantile neuronal ceroid lipofuscinosis type 2 (CLN2) disease to decelerate the progressive motor function decline in patients 3 years of age and older. CLN2 disease is a form of Batten disease, a rare inherited neurodegenerative disorder and is associated with seizures, ataxia, rapid loss of language and motor functions, blindness, and early death [4]. It is caused by the lack the lysosomal enzyme tripeptidyl peptidase-1 (TPP1) and subsequent accumulation of lysosomal storage materials normally metabolized by this enzyme in the central nervous system.

Associated Conditions
Pharmacodynamics

Cerliponase alfa contains the active substance tripeptidyl peptidase-1 (rhTPP1), a recombinant human lysosomal exopeptidase which cleaves the N-terminal of tripeptides with a broad substrate specificity. Cerliponase alfa slows the progressive decline in motor function caused by abnormal motor signalling in the brain by restoring the normal levels and activity of TPP1.

Mechanism of action

The mature form of enzyme contains 5 consensus N-glycosylation sites with high mannose, phosphorylated high mannose and complex glycosylation structures. It is taken up by LINCL fibroblasts and translocated to the lysosomes through the Cation Independent Mannose-6-Phosphate Receptor (CI-MPR, also known as M6P/IGF2 receptor). Cerliponase alfa is activated in the lysosome under low pH conditions and the activated proteolytic form of rhTPP1 cleaves tripeptides from the N-terminus of stored proteins.

TargetActionsOrganism
UCation-independent mannose-6-phosphate receptor
ligand
Human
Absorption

Refer to FDA Label

Volume of distribution

The estimated CSF volume of distribution of cerliponase alfa following intraventricular infusion of 300mg of Brineura (median Vss = 245 mL) exceeds the typical CSF volume (100 mL) [Label].

Protein binding
Not Available
Metabolism

Predicted to be metabolized through peptide hydrolysis.

Route of elimination
Not Available
Half life

Refer to FDA Label

Clearance

Refer to FDA Label

Toxicity

No data from carcinogenicity, genotoxicity, and fertility studies. Unwanted effects of cerliponase alfa treatment include pyrexia, ECG abnormalities, decreased CSF protein, seizure and hypersensitivity.

Affected organisms
  • Humans and other mammals
Pathways
Not Available
Pharmacogenomic Effects/ADRs
Not Available

Interactions

Drug Interactions
DrugInteraction
AcetaminophenThe serum concentration of Cerliponase alfa can be increased when it is combined with Acetaminophen.
AmiodaroneThe serum concentration of Cerliponase alfa can be increased when it is combined with Amiodarone.
AmlodipineThe serum concentration of Cerliponase alfa can be increased when it is combined with Amlodipine.
AmsacrineThe serum concentration of Cerliponase alfa can be increased when it is combined with Amsacrine.
AzithromycinThe serum concentration of Cerliponase alfa can be increased when it is combined with Azithromycin.
Benzyl alcoholThe serum concentration of Cerliponase alfa can be increased when it is combined with Benzyl alcohol.
BepridilThe serum concentration of Cerliponase alfa can be increased when it is combined with Bepridil.
BromocriptineThe serum concentration of Cerliponase alfa can be increased when it is combined with Bromocriptine.
CaffeineThe serum concentration of Cerliponase alfa can be increased when it is combined with Caffeine.
CaptoprilThe serum concentration of Cerliponase alfa can be increased when it is combined with Captopril.
Food Interactions
Not Available

References

General References
  1. Guhaniyogi J, Sohar I, Das K, Stock AM, Lobel P: Crystal structure and autoactivation pathway of the precursor form of human tripeptidyl-peptidase 1, the enzyme deficient in late infantile ceroid lipofuscinosis. J Biol Chem. 2009 Feb 6;284(6):3985-97. doi: 10.1074/jbc.M806943200. Epub 2008 Nov 26. [PubMed:19038967]
  2. Zhang Y, Chen LY, Han X, Xie W, Kim H, Yang D, Liu D, Songyang Z: Phosphorylation of TPP1 regulates cell cycle-dependent telomerase recruitment. Proc Natl Acad Sci U S A. 2013 Apr 2;110(14):5457-62. doi: 10.1073/pnas.1217733110. Epub 2013 Mar 18. [PubMed:23509301]
  3. Pal A, Kraetzner R, Gruene T, Grapp M, Schreiber K, Gronborg M, Urlaub H, Becker S, Asif AR, Gartner J, Sheldrick GM, Steinfeld R: Structure of tripeptidyl-peptidase I provides insight into the molecular basis of late infantile neuronal ceroid lipofuscinosis. J Biol Chem. 2009 Feb 6;284(6):3976-84. doi: 10.1074/jbc.M806947200. Epub 2008 Nov 26. [PubMed:19038966]
  4. Intracerebroventricular Cerliponase Alfa (BMN 190) in Children with CLN2 Disease: Interim Results from a Phase 1/2, Open-Label, Dose-Escalation Study [Link]
External Links
KEGG Drug
D10813
PubChem Substance
347911440
ChEMBL
CHEMBL3544921
Wikipedia
Cerliponase_alfa
FDA label
Download (793 KB)

Clinical Trials

Clinical Trials
PhaseStatusPurposeConditionsCount
1, 2Active Not RecruitingTreatmentCLN2 Disease / CLN2 Disorder / Jansky-Bielschowsky Disease / Juvenile Neuronal Ceroid Lipofuscinosis / Late-Infantile Neuronal Ceroid Lipofuscinosis Type 21
1, 2CompletedTreatmentCLN2 Disease / Jansky-Bielschowsky Disease / Juvenile Neuronal Ceroid Lipofuscinosis / Late-Infantile Neuronal Ceroid Lipofuscinosis Type 21
2Enrolling by InvitationTreatmentCLN2 Disease / CLN2 Disorder / Jansky-Bielschowsky Disease / Juvenile Neuronal Ceroid Lipofuscinosis / Late-Infantile Neuronal Ceroid Lipofuscinosis Type 21

Pharmacoeconomics

Manufacturers
Not Available
Packagers
Not Available
Dosage forms
FormRouteStrength
KitIntraventricular150 mg/5mL
Prices
Not Available
Patents
Not Available

Properties

State
Liquid
Experimental Properties
Not Available

Taxonomy

Description
Not Available
Kingdom
Organic Compounds
Super Class
Organic Acids
Class
Carboxylic Acids and Derivatives
Sub Class
Amino Acids, Peptides, and Analogues
Direct Parent
Peptides
Alternative Parents
Not Available
Substituents
Not Available
Molecular Framework
Not Available
External Descriptors
Not Available

Targets

Kind
Protein
Organism
Human
Pharmacological action
Unknown
Actions
Ligand
General Function
Transporter activity
Specific Function
Transport of phosphorylated lysosomal enzymes from the Golgi complex and the cell surface to lysosomes. Lysosomal enzymes bearing phosphomannosyl residues bind specifically to mannose-6-phosphate r...
Gene Name
IGF2R
Uniprot ID
P11717
Uniprot Name
Cation-independent mannose-6-phosphate receptor
Molecular Weight
274372.42 Da
References
  1. Meng Y, Sohar I, Wang L, Sleat DE, Lobel P: Systemic administration of tripeptidyl peptidase I in a mouse model of late infantile neuronal ceroid lipofuscinosis: effect of glycan modification. PLoS One. 2012;7(7):e40509. doi: 10.1371/journal.pone.0040509. Epub 2012 Jul 6. [PubMed:22792360]

Drug created on April 28, 2017 13:55 / Updated on August 02, 2018 06:48