Key result
Oral BLVRB inhibitor BCT1028 increases platelet mass index ~57% vs vehicle in murine models.
Why the study?
BLVRB was implicated in a redox-regulated mechanism of thrombopoiesis distinct from the TPO/c-MPL axis, motivating the development of selective BLVRB inhibitors as a novel platelet-enhancing strategy.
Does BCT1028 improve platelet recovery in murine models of stress thrombopoiesis?
Does BCT1028 improve platelet recovery in murine models of stress thrombopoiesis?
Absolute Event Rate: 214.8% vs 137.1%
p-value: p=<0.0001
A novel orally bioavailable small molecule BLVRB inhibitor, BCT1028, promotes megakaryocytopoiesis and enhances platelet recovery in murine models of stress thrombopoiesis, offering a potential alternative to TPO receptor agonists.
Hypothesis-generating for BLVRB inhibition in stress thrombopoiesis; human trials needed before clinical consideration.
Biliverdin IXβ reductase (BLVRB) is an NADPH-dependent enzyme previously implicated in a redox-regulated mechanism of thrombopoiesis distinct from the thrombopoietin (TPO)/c-MPL axis. Here, we apply computational modeling to inform molecule design, followed by de novo syntheses and screening of unique small molecules retaining the capacity for selective BLVRB inhibition as a novel platelet-enhancing strategy. Two distinct classes of molecules are identified, and NMR spectroscopy and co-crystallization studies confirm binding modes within the BLVRB active site and ring stacking between the nicotinamide moiety of the NADP+ cofactor. A diazabicyclo derivative displaying minimal off-target promiscuity and excellent bioavailability characteristics promotes megakaryocyte speciation in biphenotypic (erythro/megakaryocyte) cellular models and synergizes with TPO-dependent megakaryocyte formation in hematopoietic stem cells. Upon oral delivery into mice, this inhibitor expands platelet recovery in stress thrombopoietic models with no adverse effects. In this work, we identify and validate a cellular redox inhibitor retaining the potential to selectively promote megakaryocytopoiesis and enhance stress-associated platelet formation in vivo distinct from TPO receptor agonists. The heme degradation enzyme biliverdin IXβ reductase (BLVRB) is implicated in a redox-regulated thrombopoietic pathway. Here, the authors validate BLVRB as a cellular target by generating an orally-available small molecule inhibitor that retains platelet-enhancing functions that are mechanistically distinct from thrombopoietin receptor-targeted mimetics.
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Nesbitt et al. (2025) studied Stress thrombopoiesis. BCT1028 vs. PBS/PEG 400 vehicle was evaluated on Platelet mass index (PMI) AUC (p=<0.0001). Oral delivery of the BLVRB inhibitor BCT1028 significantly enhanced platelet mass index compared to vehicle (AUC 214.8 vs 137.1, p<0.0001) in murine models of stress thrombopoiesis.
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