MITOFUSIN AGONISTS TO TREAT NEURODEGENERATIVE DISEASE

Mitofusin agonists for the treatment of neurodegenerative diseases Gerald W Dorn II, MD Mitochondria in Motion, Inc. Washington University in St Louis School of Medicine Abstract: There are a number of rare neurodegenerative diseases, including Amyotrophic Lateral Sclerosis (ALS) and Huntington’s Disease (HD), for which there is no available or effective therapy and which lead to significant morbidity and mortality in affected populations. Mitochondria in Motion, Inc. will develop and produce investigational first-in-class small molecule mitofusin agonists, under an FDA approved IND, to treat these conditions. Mitofusin agonists enhance mitochondrial fitness, metabolism, and trafficking within cells, thus improving homeostatic functioning and injury-responses of cells adversely impacted by genetic mitochondrial dysfunction. Our published disease focus for mitofusin agonists was Charcot-Marie-Tooth disease type 2A, caused by mutations in our drug’s protein target, Mitofusin 2. Here, we hypothesized that intervention with a mitofusin agonist would have beneficial effects on other genetic peripheral neuropathies with a mitochondrial component, which is supported by our preclinical data in ALS and HD patient-derived cells. Thus, we will fill an unmet healthcare need and build a commercial enterprise to serve the ~20,000 Americans with ALS and the ~150,000 Americans suffering from or at genetic risk for developing HD, their caregivers and families. In this Phase I STTR we propose to optimize the pharmacokinetic properties of mitofusin agonists for systemic administration and blood-brain-barrier penetration (Aim 1), and complete in vivo feasibility and validation studies of mitofusin agonists to delay disease progression in the well characterized SOD1G93A mouse model of ALS. Our deliverable in Phase I will be a mitofusin agonist(s) ready for STTR Phase II IND-enabling studies and validation in an expanded number of orphan diseases, to prepare for future first-in-human trials.Narrative: Amyotrophic lateral sclerosis (ALS) is a tragic condition that causes rapidly progressive muscle weakness and atrophy, ultimately leading to complete paralysis and death in 3-5 years. It is called Lou Gehrig’s Disease for the afflicted baseball player; the physicist Stephen Hawking was one of the rare individuals who lived with ALS for decades. There are only 2 FDA-approved therapies, with minimal effects on disease progression and outcome. Our biotechnology start-up company, Mitochondria in Motion, Inc., developed a new class of drugs called mitofusin agonists that correct abnormalities in experimental ALS models. We will make our compounds more andquot;drug-likeandquot; and demonstrate proof of concept that mitofusin agonists can halt or reverse progression of ALS in a humanized mouse model, bringing us closer to first-in-human trials.