Dipeptidyl peptidase IV inhibition for the treatment of type 2 diabetes: potential importance of selectivity over dipeptidyl peptidases 8 and 9

Diabetes. 2005 Oct;54(10):2988-94. doi: 10.2337/diabetes.54.10.2988.

Abstract

Dipeptidyl peptidase (DPP)-IV inhibitors are a new approach to the treatment of type 2 diabetes. DPP-IV is a member of a family of serine peptidases that includes quiescent cell proline dipeptidase (QPP), DPP8, and DPP9; DPP-IV is a key regulator of incretin hormones, but the functions of other family members are unknown. To determine the importance of selective DPP-IV inhibition for the treatment of diabetes, we tested selective inhibitors of DPP-IV, DPP8/DPP9, or QPP in 2-week rat toxicity studies and in acute dog tolerability studies. In rats, the DPP8/9 inhibitor produced alopecia, thrombocytopenia, reticulocytopenia, enlarged spleen, multiorgan histopathological changes, and mortality. In dogs, the DPP8/9 inhibitor produced gastrointestinal toxicity. The QPP inhibitor produced reticulocytopenia in rats only, and no toxicities were noted in either species for the selective DPP-IV inhibitor. The DPP8/9 inhibitor was also shown to attenuate T-cell activation in human in vitro models; a selective DPP-IV inhibitor was inactive in these assays. Moreover, we found DPP-IV inhibitors that were previously reported to be active in models of immune function to be more potent inhibitors of DPP8/9. These results suggest that assessment of selectivity of potential clinical candidates may be important to an optimal safety profile for this new class of antihyperglycemic agents.

Publication types

  • Comparative Study

MeSH terms

  • Animals
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Dipeptidases / antagonists & inhibitors*
  • Dipeptidyl Peptidase 4* / genetics
  • Dipeptidyl Peptidase 4* / physiology
  • Dipeptidyl-Peptidases and Tripeptidyl-Peptidases / antagonists & inhibitors*
  • Dogs
  • Female
  • Humans
  • Hypoglycemic Agents* / therapeutic use
  • Hypoglycemic Agents* / toxicity
  • Isoleucine / analogs & derivatives
  • Isoleucine / chemistry
  • Isoleucine / therapeutic use
  • Isoleucine / toxicity
  • Isomerism
  • Male
  • Mice
  • Mice, Inbred C57BL
  • Mice, Knockout
  • Protease Inhibitors / therapeutic use*
  • Protease Inhibitors / toxicity
  • Rats
  • Recombinant Proteins / antagonists & inhibitors
  • Thiazoles / chemistry
  • Thiazoles / therapeutic use
  • Thiazoles / toxicity

Substances

  • Hypoglycemic Agents
  • Protease Inhibitors
  • Recombinant Proteins
  • Thiazoles
  • isoleucyl-thiazolidide
  • Isoleucine
  • Dipeptidases
  • DPP9 protein, human
  • Dipeptidyl-Peptidases and Tripeptidyl-Peptidases
  • dipeptidyl peptidase II
  • DPP8 protein, human
  • Dipeptidyl Peptidase 4