Press Release

FibroGen Reports Advances in Targeting Hypoxia-Inducible Factor (HIF)
for Drug Development
HIF activation shows promise as new therapeutic approach to treating
acute renal failure and sickle cell disease
South San Francisco, Calif., - March 25, 2004 - FibroGen, Inc., today
announced research supporting the use of the Company's proprietary
Hypoxia-Inducible Factor (HIF) activation technology for the potential
treatment of serious diseases, such as acute renal failure and sickle
cell disease. FibroGen scientists will present results of preclinical HIF
research at the Keystone Symposium on Biology of Hypoxia, March
25th - 30th in Steamboat Springs, Colorado.
HIF is a transcription factor that exists in all cells and plays a
key role in activating the expression of genes that control the body's
critical defense mechanisms against low levels of oxygen, or hypoxia.
Hypoxia is a central component in many serious diseases including kidney
disease, anemia, heart disease, and stroke.
"FibroGen's research shows that targeting HIF for drug discovery and
development is a promising new approach to the treatment of several
diseases marked by hypoxia," said David Liu, Ph.D., Vice President
of Research at FibroGen. "We are presenting studies that demonstrate
pharmacological activation of HIF in a selective manner could prove
beneficial in treating acute renal failure and sickle cell disease,
two areas of serious unmet medical need."
Research suggests that activation of HIF leads to mobilization of critical
elements of biology that protect cells and tissues from the harmful
effects of oxygen deprivation. For example, in the short-term, HIF induces
cytoprotective factors, such as heme oxygenase and adrenomedullin, and
promotes changes in glucose metabolism that help conserve energy levels
within cells when the oxygen supply is interrupted. Longer-term effects
of HIF activation include changes in vascular biology that promote the
formation of blood vessels and an increase in the production of new
oxygen-carrying red blood cells (erythropoiesis).
FibroGen has developed small molecules that activate HIF through the
inhibition of HIF-prolyl hydroxylases (HIF-PHs), enzymes that target HIF
for degradation. Using different HIF-PH inhibitors, FibroGen has found
that desired components of the protective HIF biology can be regulated
in a separate and reproducible fashion, yielding unique pharmacodynamic
profiles that could provide therapeutic benefit in several diseases
and medical conditions. The Company is exploring application of its
HIF platform across multiple therapeutic target areas including acute
renal failure, sickle cell disease, anemia, obesity, diabetes, and
neuroprotection.
HIF Activation in Acute Renal Failure
Acute renal failure (ARF) is a sudden decline in kidney function that
often occurs in critically ill patients. Reports have indicated that
5 - 25% of hospitalized patients will develop ARF, and, depending
on severity of renal decline and co-morbid conditions, mortality can
reach 80%. The optimal target for therapeutic intervention in ARF has
not been identified thus far, and so pharmacological management of ARF
remains elusive. FibroGen will present laboratory findings demonstrating
that HIF activation is an important new approach to preventing or
treating renal damage through the stimulation of a multifactorial
response comprised of several important protective proteins. Using a
model of ischemic reperfusion injury to simulate acute renal failure,
FibroGen has demonstrated that administration of HIF-PH inhibitors leads
to improvement in, or preservation of, kidney function. The observed
renoprotective effects of HIF activation may be linked to the induction
of cytoprotective factors, including: heme oxygenase, which plays a role
in the metabolism of excess heme that would otherwise cause oxidative
injury; Glut-1, a critical glucose transporter that enables continued
energy generation in hypoxic environments; and adrenomedullin, a potent
vasodilating peptide that regulates cardiac and renal function.
HIF Activation in Sickle Cell Disease
Sickle cell disease (SCD), an inherited blood disorder affecting
millions of people worldwide, is caused by a mutation in adult
hemoglobin. Hemoglobin is an iron-rich molecule that carries oxygen
within red blood cells. In SCD, the mutated hemoglobin forms rigid,
rod-like polymers that cause mature red blood cells to take on an
abnormal crescent (sickle) shape. Sickled red blood cells obstruct
blood flow and are fragile and prone to bursting, leading to anemia
and painful ischemic crises. It has been recognized for decades that a
means to mitigate the pathophysiology of SCD is to substitute the mutant
adult hemoglobin with fetal hemoglobin, which is normally not present
during adulthood. Hydroxyurea, the current standard of care for SCD, is
believed to work by this mechanism; however, the use of hydroxyurea is
hindered by dose-limiting toxicity and the fact that many SCD patients
respond poorly or not at all.
FibroGen's preclinical research indicates that HIF activation could
provide multiple avenues of therapeutic benefit in SCD by inducing
protective biological mechanisms that address improperly formed hemoglobin
and acute ischemic events and acute pain. Using HIF-PH inhibitors,
FibroGen has demonstrated that HIF activation leads to an increase in
fetal hemoglobin that is additive to the hemoglobin-inducing effects
of hydroxyurea. Production of anti-ischemic proteins that ameliorate
vasoconstriction and oxidative stress, such as adrenomedullin and heme
oxygenase, respectively, and thus the severity of painful ischemic crises,
are under evaluation in experimental models and will be evaluated in
early clinical studies.
About FibroGen
FibroGen, Inc., is a privately held biotechnology company focused on
the discovery, development, and commercialization of therapeutics,
recombinant human collagens, and recombinant gelatins to address unmet
needs in the medical, pharmaceutical, and consumer markets. FibroGen's
therapeutic target areas include fibrosis, anemia, and ischemia.
For more information about FibroGen, Inc., please visit
www.fibrogen.com.
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Contact:
Laura Hansen (investors/media), 650-866-7223