About

Tissue Repair

Tissue Repair is a clinical stage biopharmaceutical company developing advanced wound healing products for chronic wounds and the aftercare of cosmetic procedures, with the potential for further development of related technologies.

  • About Tissue Repair
  • Our Focus
  • Technology
  • Commercial Blueprint

About

Tissue Repair

Overview

Our Focus


Commercial Blueprint

Overview

Tissue Repair has isolated a unique active ingredient that is designed for wound healing and which is delivered topically. The biologically active pharmaceutical ingredient (API) behaves like a decoy cell that simulates a yeast infection, resulting in the stimulation of the body’s own wound repair pathways. This unique active ingredient provides Tissue Repair with a platform with which to develop a number of products that have the potential to treat a broad range of conditions across the wound care and cosmetic procedure aftercare markets.

Tissue Repair is in the final stages of completing its Phase II program for its chronic wound product, TR-987, having completed the field activity and preliminary analysis of Phase IIB clinical trials in 2020. Tissue Repair is planning to commence pivotal Phase III trials for TR-987 in 2024, subject to FDA approval. Tissue Repair is also planning to launch its cosmeceutical product, TR Pro+, in the Australian market in 2022. TR Pro+ is a cosmeceutical post-procedure gel to be used following certain minimally invasive cosmetic procedures.

Company History

In 2012, the Company and its wholly owned US subsidiary, TR Therapeutics, Inc., were established to acquire the advanced wound care assets, intellectual property and technology of Novogen Research Pty Ltd and Glycotex, Inc. TR Therapeutics acquired these assets and has been responsible for conducting clinical research and trials in the USA since establishment.

Since founding Tissue Repair in 2012, a team of dedicated venture capital and scientific founders have been focused on obtaining further data and additional clinical evidence through undertaking a Phase IIB clinical trial program to confirm the early efficacy signals of the core technology. This Phase IIB clinical study was completed by Tissue Repair in November 2020, with data analysis finalised in March 2021. The Company is aiming to submit its end of study reports to the FDA in 2021. Additional work has since been undertaken on the analytical identification and manufacturing of its active ingredient candidate.

1989 The technology that now forms the basis of Tissue Repair’s product development program commences as a research project at the Department of Surgery, The University of Sydney, under the direction of Professor Graham Kelly
1990s Early pre-clinical, manufacturing, chemistry and control work undertaken at the University of Sydney and then at Novogen Limited (the company formed to commercialise the technology)
Early 2000s Phase I/II clinical trials completed in venous leg ulcer indications demonstrating a safety and efficacy signal Development of Glucoprime and Glucosol

  • GlucoprimeTM is a high molecular weight, micro-particulate glucan with a high degree of side branching. This compound is intended for trophic ulcer repair. GlucoprimeTM is the active ingredient in Tissue Repair’s lead product candidate, TR-987, for the treatment of venous ulcers
  • Glucocol is a low molecular weight, colloidal glucan with a lower degree of side-branching consistent with its higher solubility. This compound is intended to be used to accelerate healing of surgical incisions that are at risk of dehiscence, or wound breakdown. Glucocol is not currently being actively developed with the Company’s current focus on Glucoprime
2006 FDA IND (Investigational New Drug Application) lodged for approval to conduct human clinical trials
2006 – 2007 Phase IIA trial (n=66) dose finding study completed in venous leg ulcers demonstrating safety and a signal of efficacy across percent wound area reduction
2007 Glycotex S1 lodged on Nasdaq by Novogen Ltd to raise capital to conduct Phase II trials. Withdrawn by Novogen at the time, announcing intention to undertake further in-house development
2010 Preparatory work on the use of TR-987 for post cosmetic procedures. Animal studies and Phase IIA trials on the use of TR-987 post CO2 fractionated procedures demonstrating safety and efficacy
2012 Tissue Repair incorporated to acquire the advanced wound care assets, intellectual property and technology of Novogen and fund additional Phase IIB clinical trials
2012 – 2014 Tissue Repair Pty Ltd incorporated to acquire the advanced wound care assets, intellectual property and technology of Novogen and fund additional Phase IIB clinical trials
2016 Commencement of Phase IIB clinical trial program
consisting of double blind placebo controlled
trials in two separate indications:
Commencement of Phase IIB clinical trial program consisting of double blind placebo controlled trials in two separate indications:

  • Chronic Wounds: 82 patient phase double blind placebo controlled trials evaluating the use of TR-987 gel for non-healing venous leg ulcers vs a placebo gel on wound healing
  • Aesthetic Dermatology: 42 patient double blind placebo controlled trial evaluating the affects of TR-987 post CO2 fractionated laser on wound healing and skin quality
2019

Completion of 42 patient aesthetic dermatology Phase IIB trial providing evidence of safety and efficacy, with close to double the improvement in skin quality as measured by elastosis and wrinkling at day 28 for the TR-987 cohort over a placebo gel. An end of study report is anticipated to be filed with the FDA in 2021

2020 Completion of 82 venous leg ulcer patient trial demonstrating safety and a positive signal of efficiency on the FDA approved endpoint of incidence of complete closure. The study showed a clinically significant adjusted difference of approximately 20% in incidence of would closure following 12 weeks of treatment between the TR-987 group and a placebo group. An end of study report is anticipated to be filed with the FDA in 2021
2021

Raised $7.5m in May 2021 to progress to the next stage of business development (including preparations for the Ofter) and commence preparations required in advance of Phase III clinical trials

Partnered and executed and agreement with contract manufacturer on process development and manufacturing of API for Phase III clinical use and beyond

Preparations with a USA laboratory in the USA on further analytical characterisation work required prior to commencement of a Phase III trial

Commenced preliminary market research and business planning on a launch of TR Pro+

Overview

Tissue Repair’s core focus is on realising value from its Glucoprime technology through the regulatory approval of its chronic wound product, TR-987, to treat chronic wounds, with a secondary focus on its post-procedure cosmeceutical gel, TR Pro+. Tissue Repair’s aim is to commercialise TR Pro+ (same formulation as TR-987 under a different brand) in the medium term as a post-procedure gel for use following certain minimally invasive cosmetic procedures.

 

Strategic Focus Description Strategy
1 Chronic wound treatment (TR-987) Achieve FDA and TGA approval as a topical drug for use in venous leg ulcers
Obtain reimbursement approvals in the USA and Australia
Achieve Phase III approval targeting a 10-15% differential in incidence of complete healing

Apply for approval as a drug with the FDA and TGA based on the data package assembled by Tissue Repair
Seek reimbursement codes in the USA and Australia by proving compelling health economic outcomes

Launch direct sales model; employ internal sales reps and sell to health care professionals (targeting hospitals, specialist wound clinics and other relevant specialist clinics)

Potentially explore distribution partnership opportunities following Phase III

2 Post-procedure cosmeceutical (TR Pro+) Commercialise first product as a next generation post-procedure topical for minimally invasive cosmetic procedures Launch in Australia to test and refine go-to-market strategy ahead of expanding to other international markets

Potentially explore distribution partnerships with dermatology and cosmetic companies

Employ internal sales representatives targeting cosmetic surgeries, clinics and potentially beauticians

3 Additional products and indications Invest in the research and development of additional products and build clinical evidence for a broader range of indications

Other potential applications of Glucoprime technology could include the treatment of burns, an over-the-counter / pharmacy wound product, new bandage and scaffold products impregnated with Tissue Repair’s API, veterinary products, etc.

Overview of the Technology

Tissue Repair has isolated a unique immunogenic active ingredient, referred to as Glucoprime, which aims to activate the body’s own macrophages and stimulate an immune response that leads to accelerated wound healing.

 

TR-987 is the drug candidate incorporating Glucoprime that has been designed to activate immune cells which act to defend the body against pathogenic microorganisms. Using the principle of biologic pattern recognition, the TR-987 gel utilises a highly purified insoluble biological polysaccharide (β-glucan) “skeleton” of a yeast cell (composed of micro-particulate, insoluble glucan polymers) that is used as a decoy to attract macrophages to the wound site.

Macrophages are critical cells in the healing process, producing a range of cytokines and growth factors that initiate various components of the healing cascade, and ensuring that the process proceeds in a co-ordinated and integrated manner.

Although the evolutionary purpose of these mechanisms is to defend against a pathogenic threat, they may also be leveraged as powerful stimuli for tissue repair and regeneration, leading to enhanced wound healing.

The repair process within a dermal wound involves a complex set of biological responses that progressively results in the removal of damaged tissue, angiogenesis (formation of new blood vessels), fibrosis (thickening or scarring of the tissue) and epithelialisation (creating a new barrier between wound and environment). Under normal circumstances this complex interplay between many different biological responses involving a variety of tissue types occurs in a well-coordinated manner, ending in a remodelling process that results in minimal scar formation and a return to a fully functioning dermis.

In fresh wounds in healthy individuals, the influx of macrophages into the wound space can normally be expected to occur in a timely manner and at levels that will ensure that the repair process proceeds without interruption to a normal completion.

There are, however, other types of wounds where the local environment is averse to macrophages and discourages their presence and activity. Those wounds typically have delayed healing, are refractory therapy, and are inclined to remain chronic and harden the soft tissue, sometimes never healing over the life of the individual. Examples of such wounds include pressure (decubitus) ulcers, venous ulcers and diabetic ulcers.

Tissue Repair’s unique technology seeks to trigger the healing process and offers the potential for accelerated healing.  This in turn may provide superior cosmetic outcomes for wounds that would ordinarily heal, as well as the potential to re-initiate healing and lower treatment costs for chronic wounds that are failing to heal.

The way in which TR-987 works to achieve immune stimulation is supported by independent research on the active ingredient and this complements the abundance of published literature that describes the mode of action of β-glucans in general.  Prior to this research, molecules similar to Glucoprime were thought to be too inflammatory and potentially deleterious to wound healing.

A key component of the Glucoprime technology is understanding the structure of its unique molecules and their interaction with target cells in the wound. Tissue Repair has developed significant expertise with respect to identifying, analysing, characterising and producing the optimal forms of these molecules, which are highly purified and sterile, for use in wound healing.

 

GLYC-101 (TR-987) Active Pharmaceutical Ingredient (API) particles.

GLYC-101 (TR-987) API particles in human macrophage culture, partially inside cytoplasm of macrophages post
phagocytosis.

Clinical Benefits of the Technology

The unique mechanism of action of TR-987 is designed to activate macrophages and seeks to offer important clinical benefits to patients undergoing treatment for acute or chronic wounds including:

  • Accelerating wound healing
  • Restarting healing and closure for wounds which have stalled and become chronic
  • Aiming to lower cost of hospitalisation and medical treatment
  • Improving cosmetic outcomes
  • Enhancing patient quality of life
How the Technology Works

Glucoprime is TR-987’s active pharmaceutical ingredient (or API) and is based on mimicking a microbial threat (i.e. yeast infection) that triggers pattern recognition receptors (Dectin-1 and TRL2 Receptors) on the surface of macrophage cells in proximity to the wound.

By engaging with these receptors, Glucoprime is able to stimulate the body’s immune system, leading to initiation of tissue regeneration, wound healing, collagen production and improved cosmetic outcomes.  Specifically, Glucoprime works by activating the NF-КB pathway in macrophages leading to the synthesis and release of multiple cytokines including TNF-α (Roy et al, 2011) .

Tissue regeneration and wound healing requires both an inflammatory phase and an anti-inflammatory phase. Macrophages normally respond to clues in the wound and upon activation produce growth factors that work to generate new tissue, collagen and elastin. As this process proceeds, the role of macrophages becomes less important and an anti-inflammatory / healing phase begins.

In chronic wounds, the activity of macrophages is impaired.  An independent study by Ohio State University’s Comprehensive Wound Center (Roy et al, 2011) showed that when applied topically to a wound, TR-987 was able to activate macrophages which led to wound closure indicating that the inflammation initiated by TR-987 was indeed transitory.

TR-987’s active ingredient, Glucoprime, is a macro group of molecules isolated via a sophisticated, multistep process and is expected to be cost effective in its final configuration as a finished product.

S. Roy et al., Wound Repair Regen. 2011 May; 19(3):411-419

 

Macrophages play a key role in wounds:
  • engulfing and digesting cellular debris and pathogens
  • stimulating other immune cells (eg: neutrophils, mast cells,
  • Macrophages need to be activated by stimulating receptors in the cells wall to trigger expression of genes that enable phagocytosis,
    protein synthesis and cytokine release
  • Fungal cell walls are powerful stimulators of macrophages
  • B-glucan is found naturally in the cell walls of fungi
  • The immune system has learned to respond to these as threats
  • B-glucans activate macrophages by binding to the Dectin-1 receptor and promote an immune response
  • TR-987 is a non-infective insoluble, B-glucan containing product isolated from yeast cells
  • TR-987 is designed to activate macrophages without the toxic side effects seen with infections of living fungi
  • In laboratory and clinical studies TR-987 has been shown to promote wound healing by activating the genes in macrophages
  • Cytokines are released which attract helper cells like fibroblasts, monocytes and additional macrophages which assist in wound repair
  • Macrophage plays a key role in re-modelling by releasing growth factors that aid in tissue repair and angiogenesis
Platform Technology

In the longer term, pending approval by the respective regulatory agencies, Tissue Repair’s technology could have the potential to develop a family of products that promote and accelerate wound healing and tissue repair across a range of medical and surgical applications.

Value Proposition

The table below sets out several benefits of Tissue Repair’s technology over existing active wound care products:

 

Evidence of efficacy and robust clinical data in chronic wounds to Phase IIB
  • No drug or biologic appears to have been approved in chronic wounds since REGRANEX Gel was approved in 1997, as such, a drug label is highly prized driving reimbursement through high quality clinical data
  • Clinically significant wound healing (including on key FDA accepted endpoints) demonstrated in clinical trials (TR-987 has been tested on 244 patients across two indications in Phase I, IIA and IIB trials, the majority being randomised, double-blind and placebo-controlled)
  • Validated multifaceted mechanism of action seeks to generate one of the highest immune responses when compared to any drug currently available for wound healing
  • Independent scientific validation of the family of molecules to which Glucoprime belongs have demonstrated strong immunogenic properties and enhanced wound healing in animals, humans and in in vivo studies
Aiming to prove superior in-use outcomes to current therapies 
  • Existing therapies can be expensive. Many active wound care products (biologics) are harvested from human placental tissue, which is the treatment of choice for chronic wounds in the USA (although approved as wound coverings, many are considered to have regenerative properties)
  • However, human placental tissue has clinical limitations due to high cost and limited sizes. Tissue Repair aims to provide a superior in-use alternative to these therapies, without reliance on harvesting human tissue and with the ease of a topical gel in contrast to a complicated patch
Evidenced patient safety
  • TR-987 has been tested across different indications on 244 patients across two indications with no significant adverse events attributable to the drug product
  • Limited evidence of negative effects of inflammation, despite the underlying pro-inflammatory API
  • No evidence of higher infection rates attributable to the drug product
  • TR-987 has a robust safety profile across its clinical program to date
Ease of use as a topical gel
  • Administered topically directly onto the wound following a procedure – no complicated bandages or patches
  • Can be used in combination with standard of care products, including compression bandaging
  • Capable of being administered by a nurse / caregiver or in the home directly by the patient
Strong stability and long shelf life
  • TR-987 has stability testing which suggests a five-year shelf life at room temperature, no refrigeration or freezing required
  • This contrasts with some biologics, which can come with ultra-cold storage requirements creating supply chain and storage complexities
Intellectual property (IP)
  • If approved as a drug by the FDA, TR-987 may be eligible for 5 years of regulatory exclusivity in the USA from the date of marketing approval and 10 years in Europe
  • Recently lodged composition patent on Tissue Repair’s unique active ingredient, Glucoprime, which, if granted, provides a potential 21 years of protection from the date on which the provision patent application was filed
Platform technology
  • Tissue Repair’s unique active ingredient which stimulates an immune response could potentially be used across a variety of applications and the technology provides a platform for the development of a number of different products across indications such as diabetic ulcers, pressure ulcers, surgical wounds, burns (incl. sunburn) and veterinary applications
  • A multi-step extraction process and batch record is on file with the FDA
  • The Company has recently appointed a contract manufacturing organisation to replicate and produce API for the Phase III clinical trial program and for further commercial use
About Tissue Repair
Overview

Tissue Repair has isolated a unique active ingredient that is designed for wound healing and which is delivered topically. The biologically active pharmaceutical ingredient (API) behaves like a decoy cell that simulates a yeast infection, resulting in the stimulation of the body’s own wound repair pathways. This unique active ingredient provides Tissue Repair with a platform with which to develop a number of products that have the potential to treat a broad range of conditions across the wound care and cosmetic procedure aftercare markets.

Tissue Repair is in the final stages of completing its Phase II program for its chronic wound product, TR-987, having completed the field activity and preliminary analysis of Phase IIB clinical trials in 2020. Tissue Repair is planning to commence pivotal Phase III trials for TR-987 in 2024, subject to FDA approval. Tissue Repair is also planning to launch its cosmeceutical product, TR Pro+, in the Australian market in 2022. TR Pro+ is a cosmeceutical post-procedure gel to be used following certain minimally invasive cosmetic procedures.

Company History

In 2012, the Company and its wholly owned US subsidiary, TR Therapeutics, Inc., were established to acquire the advanced wound care assets, intellectual property and technology of Novogen Research Pty Ltd and Glycotex, Inc. TR Therapeutics acquired these assets and has been responsible for conducting clinical research and trials in the USA since establishment.

Since founding Tissue Repair in 2012, a team of dedicated venture capital and scientific founders have been focused on obtaining further data and additional clinical evidence through undertaking a Phase IIB clinical trial program to confirm the early efficacy signals of the core technology. This Phase IIB clinical study was completed by Tissue Repair in November 2020, with data analysis finalised in March 2021. The Company is aiming to submit its end of study reports to the FDA in 2021. Additional work has since been undertaken on the analytical identification and manufacturing of its active ingredient candidate.

1989 The technology that now forms the basis of Tissue Repair’s product development program commences as a research project at the Department of Surgery, The University of Sydney, under the direction of Professor Graham Kelly
1990s Early pre-clinical, manufacturing, chemistry and control work undertaken at the University of Sydney and then at Novogen Limited (the company formed to commercialise the technology)
Early 2000s Phase I/II clinical trials completed in venous leg ulcer indications demonstrating a safety and efficacy signal Development of Glucoprime and Glucosol

  • GlucoprimeTM is a high molecular weight, micro-particulate glucan with a high degree of side branching. This compound is intended for trophic ulcer repair. GlucoprimeTM is the active ingredient in Tissue Repair’s lead product candidate, TR-987, for the treatment of venous ulcers
  • Glucocol is a low molecular weight, colloidal glucan with a lower degree of side-branching consistent with its higher solubility. This compound is intended to be used to accelerate healing of surgical incisions that are at risk of dehiscence, or wound breakdown. Glucocol is not currently being actively developed with the Company’s current focus on Glucoprime
2006 FDA IND (Investigational New Drug Application) lodged for approval to conduct human clinical trials
2006 – 2007 Phase IIA trial (n=66) dose finding study completed in venous leg ulcers demonstrating safety and a signal of efficacy across percent wound area reduction
2007 Glycotex S1 lodged on Nasdaq by Novogen Ltd to raise capital to conduct Phase II trials. Withdrawn by Novogen at the time, announcing intention to undertake further in-house development
2010 Preparatory work on the use of TR-987 for post cosmetic procedures. Animal studies and Phase IIA trials on the use of TR-987 post CO2 fractionated procedures demonstrating safety and efficacy
2012 Tissue Repair incorporated to acquire the advanced wound care assets, intellectual property and technology of Novogen and fund additional Phase IIB clinical trials
2012 – 2014 Tissue Repair Pty Ltd incorporated to acquire the advanced wound care assets, intellectual property and technology of Novogen and fund additional Phase IIB clinical trials
2016 Commencement of Phase IIB clinical trial program
consisting of double blind placebo controlled
trials in two separate indications:
Commencement of Phase IIB clinical trial program consisting of double blind placebo controlled trials in two separate indications:

  • Chronic Wounds: 82 patient phase double blind placebo controlled trials evaluating the use of TR-987 gel for non-healing venous leg ulcers vs a placebo gel on wound healing
  • Aesthetic Dermatology: 42 patient double blind placebo controlled trial evaluating the affects of TR-987 post CO2 fractionated laser on wound healing and skin quality
2019

Completion of 42 patient aesthetic dermatology Phase IIB trial providing evidence of safety and efficacy, with close to double the improvement in skin quality as measured by elastosis and wrinkling at day 28 for the TR-987 cohort over a placebo gel. An end of study report is anticipated to be filed with the FDA in 2021

2020 Completion of 82 venous leg ulcer patient trial demonstrating safety and a positive signal of efficiency on the FDA approved endpoint of incidence of complete closure. The study showed a clinically significant adjusted difference of approximately 20% in incidence of would closure following 12 weeks of treatment between the TR-987 group and a placebo group. An end of study report is anticipated to be filed with the FDA in 2021
2021

Raised $7.5m in May 2021 to progress to the next stage of business development (including preparations for the Ofter) and commence preparations required in advance of Phase III clinical trials

Partnered and executed and agreement with contract manufacturer on process development and manufacturing of API for Phase III clinical use and beyond

Preparations with a USA laboratory in the USA on further analytical characterisation work required prior to commencement of a Phase III trial

Commenced preliminary market research and business planning on a launch of TR Pro+

Our Focus
Overview

Tissue Repair’s core focus is on realising value from its Glucoprime technology through the regulatory approval of its chronic wound product, TR-987, to treat chronic wounds, with a secondary focus on its post-procedure cosmeceutical gel, TR Pro+. Tissue Repair’s aim is to commercialise TR Pro+ (same formulation as TR-987 under a different brand) in the medium term as a post-procedure gel for use following certain minimally invasive cosmetic procedures.

 

Strategic Focus Description Strategy
1 Chronic wound treatment (TR-987) Achieve FDA and TGA approval as a topical drug for use in venous leg ulcers
Obtain reimbursement approvals in the USA and Australia
Achieve Phase III approval targeting a 10-15% differential in incidence of complete healing

Apply for approval as a drug with the FDA and TGA based on the data package assembled by Tissue Repair
Seek reimbursement codes in the USA and Australia by proving compelling health economic outcomes

Launch direct sales model; employ internal sales reps and sell to health care professionals (targeting hospitals, specialist wound clinics and other relevant specialist clinics)

Potentially explore distribution partnership opportunities following Phase III

2 Post-procedure cosmeceutical (TR Pro+) Commercialise first product as a next generation post-procedure topical for minimally invasive cosmetic procedures Launch in Australia to test and refine go-to-market strategy ahead of expanding to other international markets

Potentially explore distribution partnerships with dermatology and cosmetic companies

Employ internal sales representatives targeting cosmetic surgeries, clinics and potentially beauticians

3 Additional products and indications Invest in the research and development of additional products and build clinical evidence for a broader range of indications

Other potential applications of Glucoprime technology could include the treatment of burns, an over-the-counter / pharmacy wound product, new bandage and scaffold products impregnated with Tissue Repair’s API, veterinary products, etc.

Technology
Overview of the Technology

Tissue Repair has isolated a unique immunogenic active ingredient, referred to as Glucoprime, which aims to activate the body’s own macrophages and stimulate an immune response that leads to accelerated wound healing.

 

TR-987 is the drug candidate incorporating Glucoprime that has been designed to activate immune cells which act to defend the body against pathogenic microorganisms. Using the principle of biologic pattern recognition, the TR-987 gel utilises a highly purified insoluble biological polysaccharide (β-glucan) “skeleton” of a yeast cell (composed of micro-particulate, insoluble glucan polymers) that is used as a decoy to attract macrophages to the wound site.

Macrophages are critical cells in the healing process, producing a range of cytokines and growth factors that initiate various components of the healing cascade, and ensuring that the process proceeds in a co-ordinated and integrated manner.

Although the evolutionary purpose of these mechanisms is to defend against a pathogenic threat, they may also be leveraged as powerful stimuli for tissue repair and regeneration, leading to enhanced wound healing.

The repair process within a dermal wound involves a complex set of biological responses that progressively results in the removal of damaged tissue, angiogenesis (formation of new blood vessels), fibrosis (thickening or scarring of the tissue) and epithelialisation (creating a new barrier between wound and environment). Under normal circumstances this complex interplay between many different biological responses involving a variety of tissue types occurs in a well-coordinated manner, ending in a remodelling process that results in minimal scar formation and a return to a fully functioning dermis.

In fresh wounds in healthy individuals, the influx of macrophages into the wound space can normally be expected to occur in a timely manner and at levels that will ensure that the repair process proceeds without interruption to a normal completion.

There are, however, other types of wounds where the local environment is averse to macrophages and discourages their presence and activity. Those wounds typically have delayed healing, are refractory therapy, and are inclined to remain chronic and harden the soft tissue, sometimes never healing over the life of the individual. Examples of such wounds include pressure (decubitus) ulcers, venous ulcers and diabetic ulcers.

Tissue Repair’s unique technology seeks to trigger the healing process and offers the potential for accelerated healing.  This in turn may provide superior cosmetic outcomes for wounds that would ordinarily heal, as well as the potential to re-initiate healing and lower treatment costs for chronic wounds that are failing to heal.

The way in which TR-987 works to achieve immune stimulation is supported by independent research on the active ingredient and this complements the abundance of published literature that describes the mode of action of β-glucans in general.  Prior to this research, molecules similar to Glucoprime were thought to be too inflammatory and potentially deleterious to wound healing.

A key component of the Glucoprime technology is understanding the structure of its unique molecules and their interaction with target cells in the wound. Tissue Repair has developed significant expertise with respect to identifying, analysing, characterising and producing the optimal forms of these molecules, which are highly purified and sterile, for use in wound healing.

 

GLYC-101 (TR-987) Active Pharmaceutical Ingredient (API) particles.

GLYC-101 (TR-987) API particles in human macrophage culture, partially inside cytoplasm of macrophages post
phagocytosis.

Clinical Benefits of the Technology

The unique mechanism of action of TR-987 is designed to activate macrophages and seeks to offer important clinical benefits to patients undergoing treatment for acute or chronic wounds including:

  • Accelerating wound healing
  • Restarting healing and closure for wounds which have stalled and become chronic
  • Aiming to lower cost of hospitalisation and medical treatment
  • Improving cosmetic outcomes
  • Enhancing patient quality of life
How the Technology Works

Glucoprime is TR-987’s active pharmaceutical ingredient (or API) and is based on mimicking a microbial threat (i.e. yeast infection) that triggers pattern recognition receptors (Dectin-1 and TRL2 Receptors) on the surface of macrophage cells in proximity to the wound.

By engaging with these receptors, Glucoprime is able to stimulate the body’s immune system, leading to initiation of tissue regeneration, wound healing, collagen production and improved cosmetic outcomes.  Specifically, Glucoprime works by activating the NF-КB pathway in macrophages leading to the synthesis and release of multiple cytokines including TNF-α (Roy et al, 2011) .

Tissue regeneration and wound healing requires both an inflammatory phase and an anti-inflammatory phase. Macrophages normally respond to clues in the wound and upon activation produce growth factors that work to generate new tissue, collagen and elastin. As this process proceeds, the role of macrophages becomes less important and an anti-inflammatory / healing phase begins.

In chronic wounds, the activity of macrophages is impaired.  An independent study by Ohio State University’s Comprehensive Wound Center (Roy et al, 2011) showed that when applied topically to a wound, TR-987 was able to activate macrophages which led to wound closure indicating that the inflammation initiated by TR-987 was indeed transitory.

TR-987’s active ingredient, Glucoprime, is a macro group of molecules isolated via a sophisticated, multistep process and is expected to be cost effective in its final configuration as a finished product.

S. Roy et al., Wound Repair Regen. 2011 May; 19(3):411-419

 

Macrophages play a key role in wounds:
  • engulfing and digesting cellular debris and pathogens
  • stimulating other immune cells (eg: neutrophils, mast cells,
  • Macrophages need to be activated by stimulating receptors in the cells wall to trigger expression of genes that enable phagocytosis,
    protein synthesis and cytokine release
  • Fungal cell walls are powerful stimulators of macrophages
  • B-glucan is found naturally in the cell walls of fungi
  • The immune system has learned to respond to these as threats
  • B-glucans activate macrophages by binding to the Dectin-1 receptor and promote an immune response
  • TR-987 is a non-infective insoluble, B-glucan containing product isolated from yeast cells
  • TR-987 is designed to activate macrophages without the toxic side effects seen with infections of living fungi
  • In laboratory and clinical studies TR-987 has been shown to promote wound healing by activating the genes in macrophages
  • Cytokines are released which attract helper cells like fibroblasts, monocytes and additional macrophages which assist in wound repair
  • Macrophage plays a key role in re-modelling by releasing growth factors that aid in tissue repair and angiogenesis
Commercial Blueprint
Platform Technology

In the longer term, pending approval by the respective regulatory agencies, Tissue Repair’s technology could have the potential to develop a family of products that promote and accelerate wound healing and tissue repair across a range of medical and surgical applications.

Value Proposition

The table below sets out several benefits of Tissue Repair’s technology over existing active wound care products:

 

Evidence of efficacy and robust clinical data in chronic wounds to Phase IIB
  • No drug or biologic appears to have been approved in chronic wounds since REGRANEX Gel was approved in 1997, as such, a drug label is highly prized driving reimbursement through high quality clinical data
  • Clinically significant wound healing (including on key FDA accepted endpoints) demonstrated in clinical trials (TR-987 has been tested on 244 patients across two indications in Phase I, IIA and IIB trials, the majority being randomised, double-blind and placebo-controlled)
  • Validated multifaceted mechanism of action seeks to generate one of the highest immune responses when compared to any drug currently available for wound healing
  • Independent scientific validation of the family of molecules to which Glucoprime belongs have demonstrated strong immunogenic properties and enhanced wound healing in animals, humans and in in vivo studies
Aiming to prove superior in-use outcomes to current therapies 
  • Existing therapies can be expensive. Many active wound care products (biologics) are harvested from human placental tissue, which is the treatment of choice for chronic wounds in the USA (although approved as wound coverings, many are considered to have regenerative properties)
  • However, human placental tissue has clinical limitations due to high cost and limited sizes. Tissue Repair aims to provide a superior in-use alternative to these therapies, without reliance on harvesting human tissue and with the ease of a topical gel in contrast to a complicated patch
Evidenced patient safety
  • TR-987 has been tested across different indications on 244 patients across two indications with no significant adverse events attributable to the drug product
  • Limited evidence of negative effects of inflammation, despite the underlying pro-inflammatory API
  • No evidence of higher infection rates attributable to the drug product
  • TR-987 has a robust safety profile across its clinical program to date
Ease of use as a topical gel
  • Administered topically directly onto the wound following a procedure – no complicated bandages or patches
  • Can be used in combination with standard of care products, including compression bandaging
  • Capable of being administered by a nurse / caregiver or in the home directly by the patient
Strong stability and long shelf life
  • TR-987 has stability testing which suggests a five-year shelf life at room temperature, no refrigeration or freezing required
  • This contrasts with some biologics, which can come with ultra-cold storage requirements creating supply chain and storage complexities
Intellectual property (IP)
  • If approved as a drug by the FDA, TR-987 may be eligible for 5 years of regulatory exclusivity in the USA from the date of marketing approval and 10 years in Europe
  • Recently lodged composition patent on Tissue Repair’s unique active ingredient, Glucoprime, which, if granted, provides a potential 21 years of protection from the date on which the provision patent application was filed
Platform technology
  • Tissue Repair’s unique active ingredient which stimulates an immune response could potentially be used across a variety of applications and the technology provides a platform for the development of a number of different products across indications such as diabetic ulcers, pressure ulcers, surgical wounds, burns (incl. sunburn) and veterinary applications
  • A multi-step extraction process and batch record is on file with the FDA
  • The Company has recently appointed a contract manufacturing organisation to replicate and produce API for the Phase III clinical trial program and for further commercial use
Resources