Program Number TO021 – 50th ERA-EDTA Congress – May 21, 2013 1

Oral treatment with a novel first-in-classanti-fibrotic compound PBI-4050 reduces

hepatic steatosis and improves kidneyfunction in the diabetic db/db mouse model.

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Presented by: Dr. Lyne Gagnon

AASLD ConferenceWashington

November 2-4, 2013

Disclosure: ProMetic BioSciences Inc.

Additional Information

Also including the results on the effect ofPBI-4050 in CCl4-induced liver fibrosis

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Program Number TO021 – 50th ERA-EDTA Congress – May 21, 2013

PBI-4050 preclinical data in two liver fibrosis models

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NASH-fibrosis model

CCl4-induced steatohepatitis(Slides 17-27)

Chronic modelUni-nephrectomized diabetic (db/db) mouse model(Slides 4-16)

Chronic model: Uni-nephrectomized diabetic (db/db) mouse model

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Program Number TO021 – 50th ERA-EDTA Congress – May 21, 2013

PBI-4050 reduces serum glucose to the C57BL/6 and sham level

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Serum glucose measured on 5-hour starved mice

Program Number TO021 – 50th ERA-EDTA Congress – May 21, 2013

Treatment with PBI-4050 increases glucose metabolism in oral glucose tolerance test at day 112

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Serum glucose measured on 16-hour starved mice

Program Number TO021 – 50th ERA-EDTA Congress – May 21, 2013

PBI-4050 reduces liver steatosis

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3.0

2.5

2.0

1.5

1.0

0.5

0

Liv

er

Ste

ato

sis

Db/db Db/db + PBI-4050

p = 0.04

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PBI-4050 reduces liver steatosis

C57BL/6 Db/db Db/db + PBI-4050

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Program Number TO021 – 50th ERA-EDTA Congress – May 21, 2013

PBI-4050 reduces fibrotic markers expression in liver

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Program Number TO021 – 50th ERA-EDTA Congress – May 21, 2013

Treatment with PBI-4050 reduces kidney hyperfiltration in db/db mice at day 97

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Program Number TO021 – 50th ERA-EDTA Congress – May 21, 2013

Treatment with PBI-4050 reduces proteinuria

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Program Number TO021 – 50th ERA-EDTA Congress – May 21, 2013

Treatment with PBI-4050 increases urinary creatinine excretion

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Program Number TO021 – 50th ERA-EDTA Congress – May 21, 2013

PBI-4050 reduces kidney mesangium lesions

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Program Number TO021 – 50th ERA-EDTA Congress – May 21, 2013

PBI-4050 reduces fibrotic markers expression in kidney

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PBI-4050 reduces lipid peroxidation in kidney

Conclusions: PBI-4050 offers the potential as a novel therapy for hepatic steatosis in DKD

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In liverReduces steatosisReduces fibrotic markers (TGF-, collagen 1, MMP-2 and TIMP-1 mRNA expression)

In kidneyReduces kidney hyperfiltration, proteinuria, albuminuriaIncreases urinary creatinine excretionReduces histological lesions in the mesangiumReduces fibrotic markers expression (IL-6, collagen 1, TIMP-1 and MMP-2 mRNA expression)Reduces oxidative stress (lipid peroxidation)

PBI-4050 has now enter into clinical program.

Program Number TO021 – 50th ERA-EDTA Congress – May 21, 2013 17

NASH-Fibrosis Model

CCl4-induced steatohepatitis

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CCl4-induced liver fibrosis: Effect of PBI-4050

Study design

Day 1: Oral administration of vehicle or PBI-4050 (day 1 to day 59)

IP injection of 2ml/kg of CCl4 10% in olive oil, twice a week for 8, 12 or 16 weeks

Day 59: Euthanasiaand analysis

C57BL6/J male

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Program Number TO021 – 50th ERA-EDTA Congress – May 21, 2013

Day 59: Evidence of pre-fibrosis

The effect of PBI-4050 was studied on the pre-fibrosis/ fibrosis development in CCl4-induced hepatic fibrosis.

Fibrosis was estimated with the measurement of hydroxyproline which is a direct measure of collagen (marker of fibrosis) in the liver (next slide). PBI-4050 reduces liver fibrosis.

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Program Number TO021 – 50th ERA-EDTA Congress – May 21, 2013

PBI-4050 significantly reduces hepatic concentration of hydroxyproline

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P = 0.007

Program Number TO021 – 50th ERA-EDTA Congress – May 21, 2013

PBI-4050 significantly reduces the histology activity index (HAI)-Knodell score

Intoxication with CCl4 results in hepatocyte damage, necrosis, inflammation, and fibrosis, which spreads to link the vascular structures that feed into and drain the hepatic sinusoid (the portal tract and central vein radicle, respectively), and over 8-30 weeks results in the development of fibrosis to hepatocellular carcinoma.

Knodell score is the combined scores for necrosis, inflammation and fibrosis. Histology activity index (HAI) evaluates:

1) Periportal +/- bridging necrosis (bridging between portal-portal and portal-central linkage);

2) Intralobular degeneration (acidophil bodies, ballooning, focal necrosis-scattered foci of hepatocellular necrosis) and focal necrosis;

3) Portal inflammation, and

4) fibrosis (fibrous portal expansion, or bridging fibrosis (portal-portal or portal-central linkage or cirrhosis (loss of normal hepatic lobular architecture with fibrous septae separating and surrounding nodules)).

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Program Number TO021 – 50th ERA-EDTA Congress – May 21, 2013

PBI-4050 significantly reduces the histology activity index (HAI)-Knodell score

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p= 0.008

Program Number TO021 – 50th ERA-EDTA Congress – May 21, 2013

PBI-4050 significantly reduces the collagen score in liver (Masson’sTrichrome staining)

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p = 0.03

Program Number TO021 – 50th ERA-EDTA Congress – May 21, 2013

PBI-4050 significantly reduces collagene deposition in CCl4-induced liver fibrosis (Masson’s trichrome stain)

The Masson’s trichrome stain the cytoplasm, keratin, muscle fibers and intracellular fibers in red colour; nuclei in black colour and collagen (fibrous tissue) in blue color.

All control mice revealed a normal distribution of collagen.

Extensive collagen deposition and bridging fibrosis were evident in CCl4-treated animals.

Significant reduction of collagen deposition and bridging formation between portal-portal or portal-central was observed in PBI-4050 treated animals.

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25

Control

Control

CCL4)

CCL4

CCL4 + PBI-4050 (200 mg/kg)

CCL4 + PBI-4050 (200 mg/kg)

PBI-4050 significantly reduces histological lesions in CCl4-induced liver fibrosis (Masson’s Trichrome)

Program Number TO021 – 50th ERA-EDTA Congress – May 21, 2013

PBI-4050 significantly reduces histological lesions in CCl4-induced liver fibrosis (Hematoxylin-Eosin stain)

The hematoxylin eosin stains the cytoplasm in red colour; nuclei with blue colour and show the steatosis and lymphocyte infiltration in stained tissue.

A moderate steatosis and a severe inflammation are observed as compared to control (non-CCl4) mice. Treatment with PBI-4050 reduces inflammatory infiltration in hepatic lobes.

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27

Control

Control

CCL4)

CCL4

CCL4 + PBI-4050 (200 mg/kg)

CCL4 + PBI-4050 (200 mg/kg)

PBI-4050 significantly reduces histological lesions in CCl4-induced liver fibrosis (Hematoxyline-Eosin)

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Acknowledgements

BiologyDr. Brigitte Grouix

Lilianne GeertsFrançois Sarra-Bournet

Kathy HinceAndré Doucet

Mikaël TremblayAlexandra FeltonDr. Martin Leduc

Liette Gervais

ChemistryDr. Christopher Penney

Dr. Boulos ZacharieDr. Shaun Abbott

Jean-Simon Duceppe

Frank CesariLyne Marcil

Pierre Laurin