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| bioavailability =
| bioavailability =
| protein_bound =
| protein_bound =
| metabolism = Liver
| metabolism = [[Liver]]
| elimination_half-life =
| elimination_half-life =
| excretion = Kidneys
| excretion = Kidneys

Revision as of 15:27, 21 March 2021

Onternabez
Clinical data
Routes of
administration		injection, oral, eyedrops
Legal status
Legal status
Pharmacokinetic data
MetabolismLiver
ExcretionKidneys
Identifiers
  • [(1R,2R,5R)-2-[2,6-Dimethoxy-4-(2-methyloctan-2-yl)phenyl]-7,7-dimethyl-4-bicyclo[3.1.1]hept-3-enyl]methanol
CAS Number
PubChem CID
ChemSpider
UNII
ChEBI
CompTox Dashboard (EPA)
Chemical and physical data
FormulaC27H42O3
Molar mass414.630 g·mol−1
3D model (JSmol)
  • CCCCCCC(C)(C)C1=CC(=C(C(=C1)OC)[C@H]2C=C([C@@H]3C[C@H]2C3(C)C)CO)OC
  • InChI=1S/C27H42O3/c1-8-9-10-11-12-26(2,3)19-14-23(29-6)25(24(15-19)30-7)20-13-18(17-28)21-16-22(20)27(21,4)5/h13-15,20-22,28H,8-12,16-17H2,1-7H3/t20-,21-,22+/m0/s1
  • Key:CFMRIVODIXTERW-FDFHNCONSA-N
 ☒NcheckY (what is this?)  (verify)

HU-308, aka HU308, PPP-003 and ARDS-003, is a cannabidiol (CBD)-derivative drug that acts as a potent cannabinoid agonist. It is highly selective for the CB2 receptor subtype in particular, with a selectivity of over 5,000 times greater for the CB2 receptor versus the CB1 receptor.[1][2][3] The synthesis and characterization took place in the laboratory of Prof. Mechoulam at the Hebrew University of Jerusalem, (the HU in HU-308), in the late 1990s. The pinene dimethoxy-DMH-CBD derivative HU-308 was identified decades ago as a potent peripheral CB2-selective agonist in Mechoulam et al. 1990,[1] and in Hanus et al. 1999.[2] HU-308 has shown very interesting properties such as anti-inflammatory, analgesic, neuroprotective, antitumor and anti-osteoporitic (anti-bone-loss) effects, and has been used as a pharmacological tool in numerous cannabinoid studies contributing to the progress in this field (e.g., Hanus et al. 1999;[2] Ofek et al. 2006;[4] Rajesh et al. 2007a,[5] Morales 2017[6]), including being named a pivotal advance in the NIH database in Rafesh 2007b for its discoveries, findings and results in attenuating oxidative stress, inflammatory response, and apoptosis (programmed cell death).[7] HU-308 is also classified as a non-steroidal anti-inflammatory drug (NSAID).[8]

Pharmacology

Osteoporosis

Cannabinoid receptors were first implicated in the regulation of bone mass by Karsak et al. (2004),[9] who found that CB2 knockout mice had markedly accelerated age-related trabecular bone loss and cortical expansion accompanied by increased activity of trabecular osteoblasts, increased numbers of osteoclasts, and decreased numbers of diaphyseal osteoblast precursors (Ofek et al. 2006).[4] CB2 receptors were expressed in osteoblasts, osteocytes, and osteoclasts. The selective CB2 agonist HU-308, but not the CB1 receptor agonist noladin ether, attenuated ovariectomy-induced bone loss and markedly stimulated cortical thickness through the suppression of osteoclast number and stimulation of endocortical bone formation.[4] Furthermore, HU-308 dose dependently increased the number and activity of endocortical osteoblasts and restrained trabecular osteoclastogenesis by inhibiting proliferation of osteoclast precursors.[4] These results, coupled with CB2 but not CB1 receptor mRNA expression during osteoblastic differentiation, suggested a role for CB2 receptors in bone remodeling. Such a role of CB2 but not CB1 receptors is also supported by a systematic genetic association study by Karsak et al. (2005) in human samples of postmenopausal osteoporosis patients and matched female control subjects, which found a very statistically significant association of single polymorphisms (P=0.0014) and haplotypes (P=0.0001) that encompassed the CNR2 gene on human chromosome 1p36, while finding no convincing association for the psychotropic CNR1 gene.[10] It is the non-psychotropic cannabinoid receptor type 2 gene that is found to be so strongly associated with human osteoporosis as P value of 0.0001.[10]

NeuroInflammation

HU308 promotes neural progenitor (NP) proliferation and neurogenesis of neural stem cells,[11] promotes neuroprotection and neurorepair, activates Phosphatidyl Inositol, and has important implications for neuronal survival under neuroinflammatory conditions occurring in animal models of neurodegenerative diseases, such as multiple sclerosis, Alzheimer disease, and Huntington's Disease,[12][13][14][15] and upon acute ischemic brain injury.[16] Attenuation of the inflammatory response in the brain has also been reported by activation of CB2 receptors in a study of pial vessels forming the blood–brain barrier, using a model of lipopolysaccharide-induced encephalitis (Ramirez et al. 2012), wherein activation of CB2 receptors decreased adhesion molecules in the brain tissue and leukocyte-endothelial adhesion in the pial vessels.[17] HU-308 protects both liver and blood vessel tissues against hepatic ischemia and reperfusion (blood circulatory system) injury by attenuating oxidative stress, inflammatory response and apoptosis via inhibition of TNF-α.[5] The role of CB2 receptors in endothelial cell activation and endothelial/inflammatory cell interactions, being critical steps not only in reperfusion injury, but also atherosclerosis and other inflammatory disorders, turned out to be very important, because selective CB2 cannabinoid agonist HU-308 decreased TNF-α-induced ICAM-1 and VCAM-1 expression in human liver sinusoidal endothelial cells (HLSECs) expressing CB2 receptors, as well as the adhesion of human neutrophils to HLSECs in vitro.[18] HU-308 reduces blood pressure, blocks defecation, and elicits anti-inflammatory and peripheral analgesic activity.[2][19] Currently, CBD (especially potent CBD derivatives like HU-308) generate considerable interest due to their beneficial neuroprotective, antiepileptic, anxiolytic, antipsychotic, anti-inflammatory and pain-relieving properties, therefore, the CBD scaffold becomes of increasing interest for medicinal chemists.[6]

Inflammation & Immune Modulation

HU-308 has an important functional outcome ~ the secretion of interleukin 6 (IL-6) and interleukin 10 (IL-10) with therapeutic immunomodulatory properties in vitro.[20] There is evidence that IL-6 may be used as an inflammatory marker for the more severe COVID-19 infections that have a poor prognosis for a favorable outcome because raised levels of IL-6 as well as troponin are associated with a poor prognosis in COVID-19.[21] Researchers Dr. Melanie Kelly and Dr. C. Lehmann at Panag Pharma, now merged with Tetra Bio-Pharma,[22][23][24][25] which owns the IP rights to HU-308,[26][27][28] showed with Drs. J Sardinha and J Zhou that HU 308 also mediates immune modulation in sepsis,[29] as well as displays antiallodynic activity (alleviates allodynic pain) in the rat hindpaw incision model of post-operative pain, is neuroprotective and improves motor performance in a mouse model of Huntington's Disease.[30] Continued work by Dr. MEM Kelly et al. showed HU-308 also dramatically fights the Cytokine Release Syndrome (CRS), also called cytokine release storm, that is seen in many diseases and conditions, including Acute Respiratory Distress Syndrome (ARDS), COVID-19, Sepsis, Septic Shock, Systemic Inflammatory Response Syndrome (SIRS), Cytokine Storm Syndrome (CSS), Multi-Organ Dysfunction Syndrome (MODS), Pneumonia, Uveitis, Corneal Neuropathic Pain Hyperalgesia, Photo-allodynia, Burning, Stinging, Dryness and Inflammation. The antinociceptive and anti-inflammatory effects of HU-308, but not Δ8THC or CBD, were mediated through CB2R, and it reduces cytokine storms in the eye, importantly, where corneal damage can result in an inflammatory response that involves the production of proinflammatory cytokines, neovascularization, recruitment of leukocytes, and release of neuropeptides producing inflammatory pain.[31][32][33] The Thapa et al. study on HU-308 in reducing Corneal Pain in 2018 is the first time a CB2R agonist has been demonstrated to reduce corneal pain.[33] HU-308 is a selective and highly potent agonist at CB2R and has previously been shown to reduce lipopolysaccharide-induced intraocular inflammation.[33][34]

Multi-Organ Dysfunction & Damage

While CB2 knockout mice developed enhanced inflammation and tissue injury from cisplatin-induced kidney damage, HU-308, working through the endocannabinoid system and the CB2 receptor, protected against cisplatin-induced kidney damage by attenuating inflammation and oxidative or nitrosative stress, and such selective CB2 agonists may represent a promising novel approach to prevent this devastating complication of chemotherapy.[35] Activation of the cannabinoid-2 (CB2) receptors (expressed predominantly in immune cells, and also to a much less extent in other cell types, e.g., endothelial and parenchymal cells) by recently recognized endogenous lipid mediators (the endocannabinoids) produced and present in virtually all tissues/organ systems,[36][37][38] or by selective synthetic CB2 agonists such as HU-308 in the pivotal advance by Rajesh et al. (2007),[7] has been shown to protect against tissue damage in various experimental models of ischemic-reperfusion injury,[7][39] atherosclerosis/cardiovascular inflammation,[40][41][42] and neurodegenerative,[43] gastrointestinal[44][45] and other disorders by limiting inflammatory cell chemotaxis/infiltration, activation and interrelated oxidative/nitrosative stress.[46][47][48][49] In vivo, HU308 treatment attenuated DSS-induced colitis mice associated with reduced colon inflammation and inhibited NLRP3 inflammasome activation in wild-type mice.[44] Furthermore, CB2 receptors are over-expressed in a variety of cancers, and CB2 activation may decrease the proliferation and growth of various cancer cells and tumors.[35][50] HU-308 was shown to reduce swelling, synovial join inflammation and destruction, in addition to lowering circulating antibodies against Collagen I.[51]

ARDS-003

HU-308, aka ARDS-03 for its ARDS fighting abilities, is currently in a collaboration study by Tetra Bio-Pharma, Targeted Pharmaceutical, LLC, George Mason University and the NIH at the university's top-level National Center for Biodefense and Infectious Diseases Biomedical Research Laboratory (BRL) against the lethal condition Acute Respiratory Distress Syndrome (ARDS) seen in COVID-19 patients.[52][53][54][55][56][57] Regulatory filings show that in late 2020 Tetra and Targeted designed short- to mid- term studies to gather additional data on the benefits of ARDS-003 in Sars-CoV-2 infected animal models for the prevention of ARDS in COVID-19.[58] A former Deputy Director of the NIH is heading the GMU research on ARDS-003, which is a novel, sterile, injectable, optimized, nanoemulsion form of HU-308 that has successfully undergone stringent safety and toxicology studies in accordance with U.S. FDA oversight, which were required before submitting an investigational new drug (IND) application in the US and a clinical trial application (CTA) in Canada for a Phase 1 research study through the Sars-CoV-2 regulatory fast track pathway.[56][59] The toxicology program was designed to the standards of the International Council for Harmonization of Technical Requirements for Pharmaceuticals for Human Use (ICH) for enabling a first-in-human clinical trial; and included general toxicology data for two species-specific studies to assess toxicity in major organ systems (cardiovascular, respiratory, nervous system) and genotoxicity, as well as the metabolism and pharmacokinetic distribution of the drug.[59] Tetra Bio-Pharma is the first endocannabinoid system (ECS) biotechnology company researching a cannabinoid treatment for ARDS and sepsis linked to COVID-19, pneumonia and other critical conditions, and the ARDS-003 pharmaceutical drug now has FDA approval to begin Phase I and Phase II clinical trials in human subjects for the reduction of cytokine storm, sepsis, and ARDS in COVID-19.[52][59] GMU researchers including the Co-Director, Center for Applied Proteomics and Molecular Medicine (CAPMM), are conducting three studies to assess the therapeutic efficacy of candidate interventions for COVID-19 in mouse models of angiotensin-converting enzyme 2 (ACE2) animals infected intranasally with SARS-CoV-2 to determine the survival advantage conferred by a therapeutic, to determine the survival advantage conferred by a therapeutic if an alternate course or dosing strategy needs to be followed, and to determine viral levels on day three post-infection when viral load in the lungs is expected to peak.[60] Dalton Pharma is producing the injectable drug for the GMU effort.[61]

Ocular Diseases

A 50-50 joint venture collaboration of Tetra Bio-Pharma and Altus Formulations, named TALLC, is developing a fast onset, a long-duration form of HU-308, called TA-A001, which is a non-opioid, non-steroidal small molecule of low molecular weight: (< 900 daltons) that selectively activates CB2 receptors mediating the human anti-inflammatory response, as an alternative to opioid medications and NSAIDs for ocular pain and dry eye disease.[62] TA-A001 uses the JV's patented SmartCelle nanotechnology, and a second formulation, called TA-P2005, is shown in preclinical studies to have twelve times more efficacy than if conventionally formulated and is expected to increase corneal access to the medication.[62] Ongoing studies seek to determine analgesic and anti-inflammatory effects of various dosages of TA-A001 in a corneal hyperalgesia model.[62] TA-A002 is a further topical treatment for treating the glaucoma and dry-eye disease.[62] TALLC's lead indication is the orphan disease keratoconus, for which it is submitting its application for orphan drug status.[62] On July 7, 2020, the United Kingdom Intellectual Property Office granted the TALLC patent GB2561009 for its novel SmartCelle nanotechnology.[63] It is the first patent granted in the series of SmartCelleT “smart micelle” patents applied for and the TA-A001 reformulation of HU-308 is considered, like HU-308, to also be a nonsteroidal anti-inflammatory drug (NSAID), which is a drug class that reduces pain and fever, prevents blood clots, and in higher doses decreases inflammation.[62]

HU-308 is non-psychoactive and not scheduled at the federal level in the United States.[64] It is a Schedule I controlled substance in the state of Florida making it illegal to buy, sell, or possess there.[65]

References

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See also

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