Targetable and Inhalable Nanoparticle Based Combination Therapy for PAH - Contact PD/PI: Ahsan, Fakhrul
PROJECT SUMMARY:
Pulmonary arterial hypertension (PAH) is a debilitating and deadly disease of the pulmonary circulation;
although relatively rare, PAH affects persons of every ethnic group, race, gender, and age, including
newborns. Current anti-PAH medications (prostacyclin analogs, endothelin receptor antagonists, and
phosphodiesterase-5 inhibitors) require cumbersome intravenous and subcutaneous injections, lack pulmonary
selectivity, suffer from instability, produce systemic side effects, and fail to cure the underlying cause of the
disease. Because PAH pathophysiology is entwined with multiple cellular and molecular pathways, single-drug
therapy only modestly improves pulmonary hemodynamics and fails to restrain disease progression. Various
combinations of anti-PAH drugs have recently been studied, but patient outcomes remain disappointing. Being
predominantly vasodilators, the currently approved drugs do not reverse pulmonary vascular remodeling and
abate right heart dysfunction, a major cause of deaths in PAH. We propose to circumvent indwelling catheter-
and needle-based administration of drugs, intensify pulmonary selectivity, and reverse the pathogenesis of the
disease to improve patient outcomes by formulating a combination of two drugs in nanocarriers equipped with
a pulmonary homing device. We hypothesize that inhalable and targetable nanoparticles containing a
vasodilator and an antioxidant will ameliorate pulmonary vasoconstriction, reverse pulmonary arterial
remodeling, and abate right heart enlargement and failure in PAH. We will test this hypothesis by developing a
targetable nanocarrier-based combination therapy that will simultaneously target two pathways of PAH
pathogenesis: oxidative stress and Rho-kinase pathways. The system will consist of nanoparticles containing
Cu/Zn superoxide dismutase, a superoxide scavenger, and fasudil, a Rho-kinase inhibitor and potent
vasodilator. The outer surface of the particles will be coated with a cyclic peptide, CAR (CARSKNKDC), that
accumulates preferentially in the hypertensive pulmonary arteries of PAH rats. We have generated compelling
preliminary data in support of the central hypothesis of this project, and documented the feasibility of the
delivery system in peer-reviewed publications. We will use various cellular, intact organ and rodent models of
PAH to generate preclinical datastepping-stones for development of an efficacious drug therapyand address
an unmet medical need. This work is highly innovative because ligand-equipped inhalable particles containing
two drugs will relieve PAH symptoms, eliminate the need for needles and catheters, diminish systemic
vasodilation, reverse vascular remodeling, attenuate right heart dysfunction, ease economic burdens, free
patients from discomfort, and improve quality of life. The investigative team, comprising experts from
pharmaceutical, biomedical, chemical, and clinical fields, is highly qualified to conduct the proposed studies.
Our long-term goal is to translate this formulation from bench to bedside and develop an effective therapy,
which would transform the current treatment modalities for PAH.
Project Summary/Abstract Page 6
