Parent Drug and Metabolites Tested Separately
Researchers investigated whether mitiperstat and metabolites M7, M9, M10 and M12 activate human T cells in vitro. The irreversible myeloperoxidase (MPO) inhibitor, described as being in clinical development, had been associated with delayed maculopapular rash.
A healthy-donor dendritic-cell/T-cell co-culture assay assessed de novo responses. The team characterized 29 predominantly CD4+ clones specific to mitiperstat and 47 CD4+ or CD8+ clones responsive to its metabolites. Tritiated-thymidine incorporation measured proliferation, while enzyme-linked immunospot (ELISpot) measured IFN-γ, IL-5, IL-13 and granzyme B. Proliferation was dose-dependent, with heterogeneous secretion profiles.
Mechanism and Compound Specificity
Major histocompatibility complex (MHC) class II or class I blockade attenuated CD4+ or CD8+ activation, respectively. Despite mitiperstat’s irreversible target pharmacology, nearly all responsive clones could be activated with the compound present alongside fixed antigen-presenting cells, supporting direct pharmacological interactions. One clone instead responded to drug-pulsed antigen-presenting cells.
Clones were highly specific to their cognate compounds, with no observed cross-reactivity. The results support testing the parent and individual metabolites when examining this candidate’s immune reactivity. The authors propose these assays as a framework for comparing T-cell responses to future MPO-targeting therapies.