The Bruton tyrosine kinase inhibitor PCI-32765 blocks B-cell activation and is efficacious in models of autoimmune disease and B-cell malignancy
Open accessAbstract
Activation of the B-cell antigen receptor (BCR) signaling pathway contributes to the initiation and maintenance of B-cell malignancies and autoimmune diseases. The Bruton tyrosine kinase (Btk) is specifically required for BCR signaling as demonstrated by human and mouse mutations that disrupt Btk function and prevent B-cell maturation at steps that require a functional BCR pathway. Herein we describe a selective and irreversible Btk inhibitor, PCI-32765, that is currently under clinical development in patients with B-cell non-Hodgkin lymphoma. We have used this inhibitor to investigate the biologic effects of Btk inhibition on mature B-cell function and the progression of B cell-associated diseases in vivo. PCI-32765 blocked BCR signaling in human peripheral B cells at concentrations that did not affect T cell receptor signaling. In mice with collagen-induced arthritis, orally administered PCI-32765 reduced the level of circulating autoantibodies and completely suppressed disease. PCI-32765 also inhibited autoantibody production and the development of kidney disease in the MRL-Fas(lpr) lupus model. Occupancy of the Btk active site by PCI-32765 was monitored in vitro and in vivo using a fluorescent affinity probe for Btk. Active site occupancy of Btk was tightly correlated with the blockade of BCR signaling and in vivo efficacy. Finally, PCI-32765 induced objective clinical responses in dogs with spontaneous B-cell non-Hodgkin lymphoma. These findings support Btk inhibition as a therapeutic approach for the treatment of human diseases associated with activation of the BCR pathway.
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Mutations have not been observed in other kinases containing C481, including ITK and BLK, in patients with acquired resistance.
“mutations have not been observed in these other targets, findings that suggest that BTK is its critical target.”
From Resistance Mechanisms for the Bruton's Tyrosine Kinase Inhibitor Ibrutinib (2014) · cites this paper as [7]
The Discussion reports that BTK inhibition correlated with efficacy in a mouse arthritis model, consistent with BTK being a relevant target in vivo. It does not report acquired-resistance mutations in patients or establish that mutations were absent from ITK, BLK, or other targets. It also says a role for other cysteine-containing kinases cannot be ruled out. (LLM, conf=0.80)
Experimental — accuracy not yet measuredIbrutinib inhibits other similar kinases that contain C481, including ITK and BLK.
“Although ibrutinib inhibits other similar kinases that contain C481, including ITK and BLK,7,22”
From Resistance Mechanisms for the Bruton's Tyrosine Kinase Inhibitor Ibrutinib (2014) · cites this paper as [7]
The Discussion (page unavailable) says PCI-32765 binds BTK at Cys-481 and that inhibition of other cysteine-containing kinases, including BLK, cannot be ruled out. It does not establish BLK inhibition or identify ITK as a kinase inhibited by PCI-32765, so the claim is stronger and more specific than this paper supports. (LLM, conf=0.86)
Experimental — accuracy not yet measuredAt relapse, none of the six patients had mutations in other kinases containing a cysteine residue homologous to C481 in BTK that are irreversibly inhibited by ibrutinib.
“At relapse, none of the patients had mutations in other kinases containing a cysteine residue homologous to C481 in BTK that are irreversibly inhibited by ibrutinib”
From Resistance Mechanisms for the Bruton's Tyrosine Kinase Inhibitor Ibrutinib (2014) · cites this paper as [7]
The Results and Discussion describe PCI-32765 binding to BTK at Cys-481 and note that a small subset of other kinases has a homologous cysteine. Neither section reports sequencing patients at relapse or whether any had mutations in those kinases; searches for relapse and patient mutations found no such result in our copy. (LLM, conf=0.76)
Experimental — accuracy not yet measured
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- Authors
- Honigberg, L. A., Smith, A. M., Sirisawad, M., Verner, E., Loury, D., Chang, B., Li, S., Pan, Z., Thamm, D. H., Miller, R. A., & Buggy, J. J.
- Affiliations
- Pharmacyclics (United States) (US)
- Exelixis (United States) (US)
- Peking University (CN)
- Colorado State University (US)
- Venue
- Proceedings of the National Academy of Sciences
- Publisher
- National Academy of Sciences
- Published
- 2010-07-06
- Volume
- 107
- Issue
- 29
- Pages
- 13075-13080
- ISSN
- 0027-8424 (ISSN-L)
- 1091-6490
- PMC
- PMC2919935
- OpenAlex
- W2163690533
- Cited by
- 1,561
- References
- 1
- Citations by year
- 2026: 52 · 2025: 83 · 2024: 79 · 2023: 98 · 2022: 94 · 2021: 137 · 2020: 109 · 2019: 116 · 2018: 118 · 2017: 125 · 2016: 116 · 2015: 142 · 2014: 103 · 2013: 87 · 2012: 70
- FWCI
- 26.54
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Proceedings of the National Academy of Sciences (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Immunology and Microbiology › Immunology › T-cell and B-cell Immunology
- Health Sciences › Medicine › Pathology and Forensic Medicine › Lymphoma Diagnosis and Treatment
- Health Sciences › Medicine › Genetics › Chronic Lymphocytic Leukemia Research
- Keywords
- Bruton's tyrosine kinase, B cell receptor signaling, B cell activation, autoimmune disease, collagen-induced arthritis, autoantibodies, kidney disease, B-cell non-Hodgkin lymphoma, irreversible kinase inhibitors, dogs
- MeSH terms
- Agammaglobulinaemia Tyrosine Kinase, Adenine, Administration, Oral, Animals, Arthritis, Experimental, Autoantibodies, Autoimmune Diseases, B-Lymphocytes, Benzofurans, Disease Models, Animal, Dogs, Humans, Lymphocyte Activation, Piperidines, Protein-Tyrosine Kinases, Pyrazoles, Pyrimidines, Receptors, Antigen, B-Cell, Signal Transduction, Lymphoma, B-Cell, Treatment Outcome, Protein Kinase Inhibitors, Mice
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