Systemic Mastocytosis

-- Achieved $128.2 million in AYVAKIT net product revenues in the third quarter 2024 -- -- Raising AYVAKIT net product revenue guidance to $475 million to $480 million for 2024 -- -- On track to initiate the registration-enabling HARBOR Part 2 study of elenestinib in ISM by year end -- CAMBRIDGE, Mass., Oct. 30, 2024 /PRNewswire/ -- Blueprint Medicines Corporation (Nasdaq: BPMC) today reported financial results, provided a business update for the third quarter ended Sept 30, 2024, and provided updated financial guidance. "With another strong quarter of AYVAKIT revenue performance, our year-to-date results provide the foundation to drive significant growth and long-term shareholder value creation in 2025 and beyond. AYVAKIT's sales momentum has given us the confidence to raise our revenue expectations again this year, estimating that we will end the year between $475 million and $480 million dollars. Ending our first full year of launch at nearly half a billion dollars in revenue positions AYVAKIT to be one of the most successful rare disease launches to-date," said Kate Haviland, Chief Executive Officer of Blueprint Medicines. "AYVAKIT has demonstrated tangible benefits to patients globally, with long-term data further reinforcing the clinically meaningful benefits and well-tolerated profile of a disease-modifying treatment. AYVAKIT's strong revenue ramp coupled with disciplined investment in our most compelling product opportunities, places Blueprint Medicines in a position to realize the significant decline in cash burn this year, while maintaining our focus on long-term growth and value creation." Third Quarter 2024 Highlights and Recent Progress Mast cell disorders Achieved AYVAKIT net product revenues of $128.2 million for third quarter of 2024, including $113.1 million in the US and $15.1 million ex-US, representing 136 percent growth year-over-year. Advanced the Phase 1 single ascending dose/multiple ascending dose healthy volunteer study of BLU-808, a highly selective and potent investigational oral wild-type KIT inhibitor, with best-in-class potential for chronic urticaria and other mast cell disorders. Data from the healthy volunteer study, including safety, pharmacokinetic and pharmacodynamic markers, are anticipated in early 2025. Presented data at the American College of Allergy, Asthma and Immunology (ACAAI) conference demonstrating the efficacy of AYVAKIT in patients with moderate and severe indolent SM (ISM) at baseline, and showing the significant disease burden of SM, highlighting the urgency to diagnose and treat. Read the presentations here. Hosting scientific seminar on mast cell franchise development with leading allergy and asthma expert Dr. Paul O'Byrne on Thursday, November 14, 2024. 2024 Financial Guidance Blueprint Medicines now anticipates approximately $475 million to $480 million in global AYVAKIT net product revenues in 2024, an increase from the previous range of $435 million to $450 million. This updated guidance is based on continued growth in patients on therapy, continued favorability in compliance and other performance factors, and stronger than expected performance outside of the U.S. The company continues to expect that full-year operating expenses and cash burn will decline in 2024 as compared to 2023, and that its existing cash, cash equivalents and investments, together with anticipated product revenues, will enable the company to maintain a durable capital position to achieve a self-sustainable financial profile. Key Upcoming Milestones The company plans to achieve the following remaining milestones by the end of 2024: Mast cell disorders Initiate registration-enabling Part 2 of the HARBOR trial of elenestinib in ISM by the end of this year. Cell cycle inhibition Continue strategic business development discussions. Complete Phase 1 combination dose escalation for BLU-222 by end of year to inform registration plans. Third Quarter 2024 Results Revenues: Revenues were $128.2 million for the third quarter of 2024 generated from the net product sales of AYVAKIT/AYVAKYT. Revenues were $56.6 million in the third quarter of 2023, including $54.2 million of net product revenues from sales of AYVAKIT/AYVAKYT and $2.4 million in collaboration, license and other revenues. Cost of Sales: Cost of sales was $1.9 million for the third quarter of 2024, as compared to $2.8 million for the third quarter of 2023. The decrease was primarily due to lower sales to our collaboration partner in greater China. R&D Expenses: Research and development expenses were $85.3 million for the third quarter of 2024, as compared to $110.3 million for the third quarter of 2023. This decrease was primarily due to operational efficiency across our portfolio as we execute across our top priority programs and the timing of manufacturing of clinical trial materials. Research and development expenses included $12.6 million in stock-based compensation expenses for the third quarter of 2024. SG&A Expenses: Selling, general and administrative expenses were $89.9 million for the third quarter of 2024, as compared to $70.7 million for the third quarter of 2023. This increase was primarily due to an increase in activities supporting the commercialization of AYVAKIT/AYVAKYT. Selling, general, and administrative expenses included $15.7 million in stock-based compensation expenses for the third quarter of 2024. Net Loss: Net loss was $56.3 million for the third quarter of 2024, as compared to a net loss of $133.7 million for the third quarter of 2023 . Cash Position: As of September 30, 2024, cash, cash equivalents and investments were $882.4 million, as compared to $767.2 million as of December 31, 2023. Blueprint Medicines' cash and investments provide a durable capital position which, together with anticipated product revenues, the company believes will enable it to reach a self-sustainable financial profile . Conference Call Information Blueprint Medicines will host a live conference call and webcast at 8:00 a.m. ET today to discuss third quarter 2024 financial results and recent business activities. The conference call may be accessed by dialing 833-470-1428 (domestic) or 404-975-4839 (international) and referring conference ID 387547. A webcast of the call will also be available under "Events and Presentations" in the Investors & Media section of the Blueprint Medicines website at . The archived webcast will be available on Blueprint Medicines' website approximately two hours after the conference call and will be available for 30 days following the call. Upcoming Investor Conferences Blueprint Medicines will participate in three upcoming investor conferences: Guggenheim Inaugural Healthcare Innovation Conference on Tuesday, November 12, 2024 at 3:30 p.m. ET. Stifel 2024 Healthcare Conference on Monday, November 18, 2024 at 10:20 a.m. ET. Jefferies London Healthcare Conference on Thursday, November 21, 2024 at 12:00 noon GMT. Scientific Webinar Series Blueprint Medicines will host the second event in its scientific seminar series, focused on mast cell diseases, on Thursday, November 14th at 10:00 a.m. ET. A live webcast of the above presentations and any related slides will be available under "Events and Presentations" in the Investors & Media section of the Blueprint Medicines website at . A replay of the webcasts will be archived on the Blueprint Medicines website following the events. About Blueprint Medicines Blueprint Medicines is a global, fully integrated biopharmaceutical company that invents life-changing medicines. We seek to alleviate human suffering by solving important medical problems in two core focus areas: allergy/inflammation and oncology/hematology. Our approach begins by targeting the root causes of disease, using deep scientific knowledge in our core focus areas and drug discovery expertise across multiple therapeutic modalities. We have a track record of success with two approved medicines, including AYVAKIT®/AYVAKYT® (avapritinib) which we are bringing to patients with systemic mastocytosis (SM) in the U.S. and Europe. Leveraging our established research, development, and commercial capability and infrastructure, we now aim to significantly scale our impact by advancing a broad pipeline of programs ranging from early science to advanced clinical trials in mast cell diseases including SM and chronic urticaria, breast cancer and other solid tumors. For more information, visit and follow us on X (formerly Twitter; @BlueprintMeds) and LinkedIn. Cautionary Note Regarding Forward-Looking Statements This press release contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995, as amended, including, without limitation, statements regarding plans, strategies, timelines and expectations for Blueprint Medicines' operations, including its expectations regarding growth and net product revenue in 2024; statements regarding its current or future approved drugs and drug candidates and operations, including plans to initiate registration-enabling Part 2 of the HARBOR trial of elenestinib in ISM in 2024, complete Phase 1 combination dose escalation for BLU-222 to inform registration plans and continue strategic business development discussions by the end of 2024, and present healthy volunteer data from its Phase 1 trial for BLU-808 in early 2025; expectations related to the markets for current or future approved drugs and drug candidates, including expectations regarding the size or scale of patient opportunities that future approved drugs and drug candidates could address; the potential benefits of any of its current or future approved drugs or drug candidates in treating patients; statements related to liquidity and capital position, including expectations that its cash, cash equivalents and investments will provide a durable capital position which, together with anticipated product revenues, will enable Blueprint Medicines to reach a self-sustainable financial profile; and its financial performance, strategy, goals and anticipated milestones, business plans and focus, including expectations regarding its revenue ramp and continued decline in operating expenses and cash burn. The words "aim," "may," "will," "could," "would," "should," "expect," "plan," "anticipate," "intend," "believe," "estimate," "predict," "project," "potential," "continue," "target" and similar expressions are intended to identify forward-looking statements, although not all forward-looking statements contain these identifying words. Any forward-looking statements in this press release are based on management's current expectations and beliefs and are subject to a number of risks, uncertainties and important factors that may cause actual events or results to differ materially from those expressed or implied by any forward-looking statements contained in this press release, including, without limitation: the risk that the marketing and sale of AYVAKIT/ AYVAKYT or any future approved drugs may be unsuccessful or less successful than anticipated, or that AYVAKIT/ AYVAKYT may not gain market acceptance by physicians, patients, third-party payors and others in the medical community; the risk that the market opportunities for AYVAKIT/ AYVAKYT or Blueprint Medicines' drug candidates are smaller than we estimate or that any approval we obtain may be based on a narrower definition of the patient population that we anticipate; the risk of delay of any current or planned clinical trials or the development of Blueprint Medicines' current or future drug candidates; risks related to Blueprint Medicines' ability to successfully demonstrate the safety and efficacy of its drug candidates and gain approval of its drug candidates on a timely basis, if at all; preclinical and clinical results for Blueprint Medicines' drug candidates may not support further development of such drug candidates either as monotherapies or in combination with other agents or may impact the anticipated timing of data or regulatory submissions; the timing of the initiation of clinical trials and trial cohorts at clinical trial sites and patient enrollment rates may be delayed or slower than anticipated; actions of regulatory agencies may affect its approved drugs or its current or future drug candidates, including affecting the initiation, timing and progress of clinical trials; risks related to Blueprint Medicines' ability to obtain, maintain and enforce patent and other intellectual property protection for its products and current or future drug candidates it is developing; the success of Blueprint Medicines' current and future collaborations, financing arrangements, partnerships or licensing and other arrangements; risks related to its liquidity and financial position, including the risk that Blueprint Medicines may be unable to generate sufficient future product revenues to achieve and maintain a self-sustainable financial profile; and the accuracy of its estimates of revenues, expenses and capital requirements. These and other risks and uncertainties are described in greater detail in the section entitled "Risk Factors" in Blueprint Medicines' filings with the Securities and Exchange Commission (SEC), including Blueprint Medicines' most recent Annual Report on Form 10-K, as supplemented by its most recent Quarterly Report on Form 10-Q and any other filings that Blueprint Medicines has made or may make with the SEC in the future. Any forward-looking statements contained in this press release represent Blueprint Medicines' views only as of the date hereof and should not be relied upon as representing its views as of any subsequent date. Except as required by law, Blueprint Medicines explicitly disclaims any obligation to update any forward-looking statements. Trademarks Blueprint Medicines, AYVAKIT, AYVAKYT and associated logos are trademarks of Blueprint Medicines Corporation. SOURCE Blueprint Medicines Corporation WANT YOUR COMPANY'S NEWS FEATURED ON PRNEWSWIRE.COM? 440k+ Newsrooms & Influencers 9k+ Digital Media Outlets 270k+ Journalists Opted In GET STARTED

点击上方“蓝字”关注我们吧！ 呼吸道合胞病毒（RSV）是儿童急性呼吸道感染的主要病因之一，暴露于包括香烟烟雾、颗粒物、苯、臭氧（O3）、一氧化碳（CO）或二氧化氮（NO2）在内的空气污染则可能增加RSV发病率和严重程度。世界卫生组织（WHO）已公布六种最重要的空气污染物清单，包括颗粒物≤直径10μm的颗粒物（PM10）、直径在0.1至2.5μm之间的颗粒物（PM2.5）、NO2、O3、二氧化硫（SO2）和CO。 目前关于RSV和空气污染的确切病理机制数据较少，主要结论集中在宿主抗病毒能力下降、促进病毒进入和病毒载量增加、病毒从主要感染细胞释放增加、炎症反应延长和/或加重（可能导致组织病理改变，粘液分泌增强和气道高反应（AHR）），其中最重要的共同机制之一似乎由氧化应激所介导。 N-乙酰半胱氨酸（NAC）作为一种具有抗氧化和抗炎特性的粘液溶解药物，已广泛应用于慢性阻塞性肺疾病（COPD）、支气管扩张症、特发性肺纤维化等临床研究中。一篇发布在《International Journal of Molecular Sciences》（IF=4.9）的系统综述回顾现有文献以确定NAC在治疗RSV感染和空气污染中的分子作用机制[1]。 研究设计 研究者对Scopus、PubMed（Medline）和Cochrane数据库进行了系统的文献检索，检索数据库中1998年至2023年9月7日期间所有分析NAC在RSV感染或空气污染中的分子作用机制的原始研究。共检索出167项研究，去重后，根据摘要和标题排除了122项研究，阅读全文最后筛选出28项原始研究纳入系统综述。 研究结果 NAC可减少病毒进入 空气污染主要通过两种机制促进病毒进入： (1)损伤保护屏障（由于现有屏障受损或存在额外的运输通道）； (2)病毒吸附增加（由于细胞表面的变化促进病毒粘附，或RSV获得特殊毒力，从而促进其粘附到细胞表面或进入），但暂未发现关于RSV毒力增加的信息（图1）。 ①NAC可改善上皮屏障通透性 Smallcombe等人在人支气管上皮细胞和小鼠模型中证明，TiO2-NP通过破坏顶端连接复合物（AJC）和重塑细胞内细胞骨架肌动蛋白对AJC的锚定以增强RSV诱导的上皮屏障瓦解，使上皮变得“渗漏”，从而增强病毒感染。通过评估病毒降低滴度，NAC治疗减少了AJC分解，改善了上皮通透性，降低了RSV感染程度。 氧化应激在其中扮演着不容忽视的作用，研究发现共暴露于RSV和TiO2-NP后细胞内活性氧（ROS）水平迅速增加，并保持高水平长达36小时；Wen等人的研究证实暴露于TiO2-NP后过氧化氢酶（CAT）活性增加，ROS上调，许多细胞间隙和内皮层通透性增加，内皮钙黏蛋白（VE-cadherin）表达降低，而NAC的使用逆转了氧化应激和间隙的形成，表明其在氧化应激中发挥关键作用。 ②NAC可抑制血清细胞间粘附分子1（ICAM-1）表达 ICAM-1是一种存在于多种细胞表面的糖蛋白，包括上皮细胞和内皮细胞、淋巴细胞和单核细胞，RSV感染诱导人内皮细胞上ICAM-1表达呈时间和剂量依赖性过度增加。 Mata等研究表明，在RSV培养的原代正常人支气管上皮细胞（NHBEC）中，使用NAC预处理可消除ICAM-1表达增加现象；Modestou等人发现香烟烟雾提取物抑制干扰素-γ（IFN-γ）诱导的人器官支气管上皮细胞（hTBE）中ICAM-1的表达，但NAC和谷胱甘肽单乙基酯（GSH-MEE）能够减轻这种抑制作用。 除ICAM-1外，空气污染还可能诱导其他表面分子表达：TiO2-NP诱导内皮细胞中ICAM-1、血管细胞间黏附分子1（VCAM-1）、血小板内皮细胞黏附分子（PECAM-1）和选择素（E和P）的表达，以及它们在单核细胞上的配体包括早期[E-选择素配体（sLex）和P-选择素配体（PSGL-1）]和晚期粘附分子[ICAM-1配体（LFA-1）、VCAM-1配体（VLA-4）和PECAM-1配体（αVβ3）]的受体表达，而NAC可抑制表面受体的表达。 ③NAC可阻断表皮生长因子受体（EGFR）磷酸化 RSV进入细胞的另一种机制涉及EGFR的磷酸化和激活以及与EGFR相关信号因子的级联反应（PI3K、PKC、Cdc42、PAK1和N-Wasp）。RSV与细胞表面结合即激活EGFR的磷酸化及其下游信号级联，通过微胞饮作用引起肌动蛋白重排和内吞。NAC可阻断人支气管上皮细胞（HBECS）中EGFR的磷酸化，从而阻止病毒的内吞作用并减少感染。 NAC可抑制病毒载量增加 病毒载量增加可能源于宿主抗病毒反应降低、感染开始后RSV释放加速（通过促进从主要感染细胞释放）或由于RSV获得异常毒力（图2）。 ①NAC可恢复抗病毒反应 人T细胞和自然杀伤（NK）细胞具有产生IFN-γ的能力，IFN-γ与其受体结合，并通过磷酸化Stat1导致Janus激酶/信号转导和转录激活因子（JAK/STAT）通路激活，二聚磷酸化的Stat1随后易位到细胞核并激活抗病毒基因。香烟烟雾提取物（CSE）抑制Stat1的磷酸化，并抑制IFN-γ介导的RSV mRNA和RSV蛋白表达降低，而使用NAC或GSH-MEE可恢复IFN-γ的抗病毒作用。 ②NAC可抑制病毒释放 在暴露于CSE和RSV的hTBE细胞中观察到较高的病毒载量似乎与香烟烟雾可能阻止RSV诱导的caspase激活有关。在受CSE和RSV侵袭的细胞中，坏死比凋亡更明显，这导致病毒从感染细胞中释放出来，而不是凋亡。 一系列实验表明，使用NAC和醛脱氢酶能够部分逆转上皮细胞从凋亡到坏死的转变，这表明ROS和丙烯醛在这一复杂系统中发挥了重要作用。细胞模型显示，无香烟烟雾暴露的RSV也会产生ROS，并激活蛋白激酶/哺乳动物雷帕霉素靶点（AMPK-MTOR）信号通路，从而诱导自噬，促进病毒感染。敲除自噬基因（如beclin1）或用AMPK抑制剂（化合物C）或NAC治疗能够抑制RSV复制，但化合物C仅能阻断自噬依赖性RSV复制，NAC则具有抑制自噬依赖性和自噬非依赖性途径的能力。 Zhou等人的研究将细胞凋亡标志物的评估与临床角度相结合，在126例老年慢性阻塞性肺疾病（COPD）患者中采用口服NAC、吸入硫酸特布他林和两者联合三种治疗方法。所有治疗方案均可降低Fas受体/凋亡抗原1（Fas/APO-1）和可溶性Fas（sFas）水平，改善氧化还原状态，即ROS降低、氧化应激指标丙二醛（MDA）降低，并伴有超氧化物歧化酶（SOD）和谷胱甘肽过氧化物酶（GSH-PX）升高，且两药合用效果最佳。 NAC可减轻过度的宿主反应 ①NAC可减轻过度的促炎反应 A． NAC可减少促炎趋化因子和细胞因子的产生 许多促炎趋化因子和细胞因子被认为与RSV感染和空气污染共同暴露后的强烈的免疫反应有关，具有广泛数据支持的包括白细胞介素-6（IL-6）、白细胞介素-8（IL-8）、白细胞介素-17（IL-17）、肿瘤坏死因子（TNF-α）、单核细胞趋化蛋白-1（MCP-1）的作用，以及在激活后调节的正常T细胞表达和分泌（RANTES）（图3）。 Lei Chi等人的研究证实了NAC的抗炎作用：NAC处理后细胞上清液中mRNA表达和细胞因子浓度（TNF-α、IL-6、IL-1β和IL-18）均显著降低；Mata等人的研究也表明NAC抑制IL-6、IL-8和TNF-α的表达；在苯并[a]芘引起的急性肺损伤小鼠模型中，NAC预处理能够减轻炎症反应，降低TNF-α、IL-6、MCP-1、MIP-2（巨噬细胞炎症蛋白2，Cxcl2）基因的表达。 B．NAC可降低NF-κB刺激作用 Carpenter证明了NAC抑制RSV诱导的趋化因子表达的方式与TNF-α不同，提示氧化还原敏感的NF-κB通路参与了IL-8、MCP-1和RANTES的诱导。 当HBEC（BEAS-2B）、正常人支气管上皮（NHBE）和COPD人支气管上皮（DHBE）细胞暴露于PM2.5后，NF-κB靶细胞因子的结合活性和分泌均表现出剂量依赖性增加。长时间暴露于PM2.5会导致核因子-红细胞2p45相关因子2（NRF2）信号通路部分失活，破坏线粒体氧化还原稳态。NRF2/Kelch样环氧氯丙烷相关蛋白1（KEAP-1）是抗氧化反应的关键调节因子，KEAP1释放NRF2导致其蛋白体降解，从而刺激包括血红素加氧酶1（HO1）基因在内的NRF2靶基因产生抗氧化作用。 Mata等人的研究描述了NAC作用诱导的抗氧化机制：感染RSV后第15天HO1表达下降，NAC预处理后HO1表达不仅恢复且升高。由于NRF2本身表现出复杂的时变反应，RSV感染后，总抗氧化状态（TAS）即细胞对氧化事件的反应能力下降，使用1mM NAC预处理恢复，使用10mM NAC预处理后增加。此外，NAC能够抑制NF-κB向细胞核的易位以及p38/丝裂原活化蛋白激酶（MAPK）的磷酸化以调节NRF2的表达。 IL-8和RANTES的产生均受柴油尾气颗粒诱导，p38/MAPK磷酸化在HBECs中起关键作用，NAC预处理不仅降低了p38 MAPK磷酸化酪氨酸和苏氨酸的数量，也因此降低了IL-8和RANTES的浓度。MAPK信号通路包括三个信号通路：细胞外信号相关激酶（ERK）、Jun氨基末端激酶（JNK）和p38，它们将信号从细胞膜传递到细胞核，Wang等人使用细胞（HBECs）和动物（小鼠）模型进行的一项研究表明，在暴露于颗粒物之前使用NAC预处理可阻断ERK、JNK和p38的磷酸化。 C．NAC可阻止或减少氧化应激 氧化应激在RSV和空气污染的相互作用中起着至关重要的作用，NAC可有效阻止或减少氧化应激的危害。RSV感染HBECs模型（BEAS-2B）显示，RSV诱导ROS和MDA的产生，SOD活性和细胞内还原型谷胱甘肽/氧化型谷胱甘肽（GSH/GSSG）比值。NAC处理可抑制ROS和MDA的产生，提高SOD活性和GSH/GSSG比值，从而减弱RSV感染的病理效应。柴油尾气暴露的体外模型表明，NAC具有恢复细胞内GSH/GSSG比值、抵消脂质和蛋白质氧化、抑制氧化应激诱导的HO-1表达的能力。 在人体和动物模型中，颗粒物均可诱导ROS以剂量和时间依赖的方式产生，而NAC预处理能够阻断ROS的产生；缺氧-再氧化应激通过增加ROS的产生对人上皮细胞造成损伤，NAC可有效缓解该现象；此外，RSV感染会增加热休克70kDa蛋白6（HSPA6），而NAC可有效阻断HSPA6 mRNA和蛋白表达。 D．NAC可减轻病原相关分子模式（PAMP）激活带来的影响 toll样受体（TLRs）是膜结合的模式识别受体（PRRs），TLR3、TLR7、TLR8和TLR9识别特定的病毒基因组成分，并在病毒诱导的信号转导中发挥关键作用。Wang等人的研究证实了人肺上皮A549细胞中TLR3的激活与氧化应激之间存在相关性。 RSV感染细胞羟基自由基（·OH）和一氧化氮（NO）浓度升高，SOD总活性降低，NAC预处理可降低这些影响，并且·OH和NO水平均与RSV感染持续时间呈时间依赖性；在mRNA表达方面，RSV感染后TLR3和NF-κB上调，干扰素调节因子-3（IRF3）和超氧化物歧化酶1（SOD1）基因下调，NAC预处理可逆转mRNA和蛋白的表达模式，提示氧化应激可能在TLR3激活和炎症反应增强中起调节作用。 ②NAC可抑制过度的粘液分泌 RSV感染和空气污染（如香烟烟雾）可能增加粘液分泌，MUC5AC作为一种形成凝胶的粘蛋白，是人类粘液的主要成分之一，Mata等人的研究表明，NAC能够抑制粘蛋白基因MUC5AC的释放。 ③NAC可改善肺部结构异常 在慢性鼻窦炎或COPD等病理条件下，杯状细胞化生和MUC5AC表达增加，而香烟烟雾增强了病理反应，这主要是由EGFR通路介导的。Mata等人研究发现，感染RSV的NHBECs的纤毛阳性和β管蛋白阳性细胞数量下降，并伴有轴突基底体超微结构异常，而NAC能够以剂量依赖的方式抑制上调，恢复上皮功能；Lei Chi等人的研究也表明，在人HBECs（BEAS-2B细胞）中，NAC处理抑制了EGFR的磷酸化和MUC5AC的激活。 大鼠肺支气管肺泡灌洗（BAL）表现为高浓度环境颗粒引起的多形核白细胞内流，并伴有细支气管血管增厚、细支气管炎症和肺水肿等组织病理改变，NAC预处理逆转了多形核白细胞内流，动物无组织学变化。此外，NAC预处理可逆转小鼠肺部颗粒物诱导的PM沉积周围炎症细胞浸润，减少支气管肺泡灌洗液（BALF）中中性粒细胞和巨噬细胞数量，提高肺损伤评分。 ④NAC可减轻肺气肿 Cai等研究显示NAC可减轻吸烟致COPD大鼠晚期肺气肿，NAC处理大鼠的平均线性截距（MLI）和破坏指数（DI）均较低。重要的是，NAC降低了肺泡间隔细胞的凋亡指数（AI），逆转了血管内皮生长因子（VEGF）及其受体蛋白（VEGFR2）表达的下降，AI与VEGF水平呈负相关。苯并[a]芘引起的小鼠组织病理学改变包括气道壁增厚，MLI减少，DI增加，经NAC预处理后均有缓解，肺病理总评分均有改善。 另一种小鼠模型研究了臭氧诱导的COPD，并比较了NAC的预防和治疗作用，结果显示，暴露前给予NAC能够减少BAL和气道平滑肌（ASM）肿块中的巨噬细胞数量，而治疗性给药能够减少ASM肿块和凋亡细胞数量，但肺气肿不可逆。肺气肿的机制复杂，与基质金属蛋白酶（MMP）尤其是MMP-9和MMP-12相关，在颗粒物暴露模型中，NAC预处理后HBECs和BALF中MMP-9的表达和水平均降低。 ⑤NAC可减轻DNA损伤和衰老 氧化应激诱导DNA损伤，并可能引发细胞衰老（增殖停止），这已在RSV感染中得到证实。RSV感染后，ROS产生增加，DNA损伤和增殖阻滞标志物表达增加，而NAC可显著减少受损细胞核的数量，但其保护作用仅对新生DNA损伤灶有效，对先前存在的DNA损伤灶几乎无效。 各种空气污染物包括颗粒物（PM2.5、PM10）、NO或香烟烟雾对衰老和细胞衰老也有类似的影响，而氧化应激则是最合理的相互作用机制。Kang等人研究证实NAC预处理可逆转空气污染物对ROS生成和DNA断裂的影响，在防止DNA损伤和细胞衰老方面发挥保护作用。 NAC可降低气道高反应（AHR） 混合暴露于RSV和空气污染可导致RANTES、MCP-1和NGF水平升高，白血病抑制因子（LIF）水平降低，从而导致AHR，而上述研究证明了NAC在RSV暴露和空气污染暴露（分别为柴油排放和苯并芘）模型中降低RANTES和MCP-1水平的有效性，这可能进一步导致AHR降低或消失。 · 总结 · 本综述确定了NAC用于减轻RSV感染和空气污染影响的潜在分子机制，包括阻断病毒进入、降低病毒载量和过度的宿主反应（炎症反应增强、粘液分泌增加、AHR、DNA损伤和/或细胞衰老）等。未来应开展进一步研究以调查RSV感染期间NAC的作用，并重点关注NAC在最重要的六种空气污染物中发挥的分子机制。 参考文献 [1]Wrotek A, Badyda A, Jackowska T. Molecular Mechanisms of N-Acetylcysteine in RSV Infections and Air Pollution-Induced Alterations: A Scoping Review. Int J Mol Sci. 2024，25(11):6051.  提示：本材料仅供医疗卫生专业人士进行医学科学交流，不用于推广目的。

Preclinical data highlight company’s fourth discovery stage program, a novel potent and selective KRAS(ON) inhibitor Updated preclinical data from CGT6297, Cogent’s H1047R mutant-selective PI3Kα inhibitor demonstrates robust inhibition of downstream signaling and efficacy WALTHAM, Mass. and BOULDER, Colo., Oct. 23, 2024 (GLOBE NEWSWIRE) -- Cogent Biosciences, Inc. (Nasdaq: COGT), a biotechnology company focused on developing precision therapies for genetically defined diseases, today announced the addition of a potent and selective KRAS inhibitor to its pipeline. Preclinical data from this program as well as its newly announced H1047R mutant-selective PI3Kα clinical candidate will be presented in two poster presentations at the 2024 EORTC-NCI-AACR International Symposium on Molecular Targets and Cancer Therapeutics taking place in Barcelona, Spain October 23-25, 2024. “Our Research team continues to make amazing progress, and we are excited to announce our third clinical candidate and fourth preclinical program today,” said Andrew Robbins, Cogent’s President and Chief Executive Officer. “Building upon earlier data presentations and recent advancements in the field, our first poster describes the properties of CGT6297, which we believe has the potential to emerge as a best-in-class H1047R mutant-selective PI3Kα inhibitor. Separately, for the first time, we outline our progress toward developing a potential best-in-class KRAS(ON) inhibitor, which in addition to its mechanistic attributes, has pharmacological properties differentiated from existing compounds in the class. Each of these programs align with our long-term strategy of creating and developing best-in-class molecules with the potential to have a broad impact on patients with genetically defined diseases.” Poster DetailsThe posters can be accessed in the ‘Posters and Publications’ page of Cogent’s website. Title: Identification of a Pan KRAS(On) Inhibitor with Selectivity Over KRAS over H/NRAS and pM Activity Across Prevalent KRAS MutationsSession Date and Time: Wednesday, October 23, 2024 – 12.00 - 19.00 CESTLocation: Exhibition Hall, Centre de convencions internacional Barcelona (CCIB), Barcelona, SpainPoster Number: PB108Abstract Number: 120 Mutations in KRAS are among the most prevalent mutations found in cancer, occurring most often in colorectal cancer, non-small cell lung cancer and pancreatic cancer. The poster presented today describes Cogent’s internally-developed pan KRAS(ON) inhibitor with selectivity over HRAS and NRAS and picomolar (pM) activity across KRAS mutations without the potential liabilities of molecules in the class. Following oral administration, CGT6737 demonstrated robust PK/PD and tumor growth inhibition with 90% PD inhibition in mouse xenograft models. Lead optimization of CGT6737 is ongoing. Title: Preclinical Characterization of a Novel PI3Kα H1047R Mutant Selective Inhibitor Session Date and Time: Wednesday, October 23, 2024 – 12.00 - 19.00 CESTLocation: Exhibition Hall, Centre de convencions internacional Barcelona (CCIB) Barcelona, SpainPoster Number: PB133Abstract Number: 145 Cogent is also developing a potential best-in-class, wild-type-sparing, PI3Kα inhibitor that provides coverage for the H1047R mutation, which affects >55,000 cancer patients each year. The phosphoinositide 3-kinase (PI3K) pathway is a key cell cycle regulating pathway that has an established role in tumor growth and development. The approved agents for these patients often lead to dose limitations, resulting from activity against wild-type PI3Kα. The poster presented today highlights Cogent’s clinical candidate CGT6297, a potent allosteric inhibitor of PI3K, with 25-fold selectivity over PI3Kα WT. CGT6297 has high oral bioavailability and low clearance across species, providing robust inhibition of downstream signaling and efficacy in animal models. Importantly, when compared to a clinically relevant dose of a currently approved therapy in a mouse tumor model, CGT6297 demonstrated superior efficacy with no increase in insulin. IND-enabling studies are expected to be initiated in 2025. Upcoming Investor ConferenceCogent will participate in the following upcoming investor conference: Guggenheim Healthcare Innovation Conference - November 12, 2024 at 10:30 a.m. ET. A live webcast of the fireside discussion will be available in the Investors & Media section of Cogent’s website at investors.cogentbio.com/events. A replay of the event will be archived on Cogent’s website for up to 30 days. About Cogent Biosciences, Inc.  Cogent Biosciences is a biotechnology company focused on developing precision therapies for genetically defined diseases. The most advanced clinical program, bezuclastinib, is a selective tyrosine kinase inhibitor that is designed to potently inhibit the KIT D816V mutation as well as other mutations in KIT exon 17. KIT D816V is responsible for driving systemic mastocytosis, a serious disease caused by unchecked proliferation of mast cells. Exon 17 mutations are also found in patients with advanced gastrointestinal stromal tumors (GIST), a type of cancer with strong dependence on oncogenic KIT signaling. In addition to bezuclastinib, the Cogent Research Team is developing a portfolio of novel targeted therapies to help patients fighting serious, genetically driven diseases initially targeting mutations in FGFR2, ErbB2, PI3Kα and KRAS. Cogent Biosciences is based in Waltham, MA and Boulder, CO. Visit our website for more information at www.cogentbio.com. Follow Cogent Biosciences on social media: X (formerly known as Twitter) and LinkedIn. Information that may be important to investors will be routinely posted on our website and X.  Forward Looking StatementsThis press release contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995, including, but not limited to, statements regarding the potential for CGT6297 to be a best-in-class H1047R mutant-selective PI3Kα inhibitor, the expectation that the company will initiate IND-enabling studies for CGT6297 in 2025, and the potential for the company’s KRAS program to produce a best-in-class KRAS(ON) inhibitor with pharmacological properties differentiated from existing compounds in the class and without the potential liabilities of molecules in the class. The use of words such as, but not limited to, "anticipate," "believe," "continue," "could," "estimate," "expect," "intend," "may," "might," "plan," "potential," "predict," "project," "should," "target," "will," or "would" and similar words expressions are intended to identify forward-looking statements. Forward-looking statements are neither historical facts nor assurances of future performance. Instead, they are based on our current beliefs, expectations and assumptions regarding the future of our business, future plans and strategies, our clinical results, the rate of enrollment in our clinical trials and other future conditions. New risks and uncertainties may emerge from time to time, and it is not possible to predict all risks and uncertainties. No representations or warranties (expressed or implied) are made about the accuracy of any such forward-looking statements. We may not actually achieve the forecasts or milestones disclosed in our forward-looking statements, and you should not place undue reliance on our forward-looking statements. Such forward-looking statements are subject to a number of material risks and uncertainties including but not limited to those set forth under the caption "Risk Factors" in Cogent's most recent Quarterly Report on Form 10-Q filed with the SEC. Any forward-looking statement speaks only as of the date on which it was made. Neither we, nor our affiliates, advisors or representatives, undertake any obligation to publicly update or revise any forward-looking statement, whether as result of new information, future events or otherwise, except as required by law. These forward-looking statements should not be relied upon as representing our views as of any date subsequent to the date hereof. Contact:Christi WaarichSenior Director, Investor Relationschristi.waarich@cogentbio.com617-830-1653