# Development of the New Synthetic Triterpenoid CDDO-2P-Im for Chemoprevention of the ARDS of COVID-19

> **NIH NIH R43** · TRITERPENOID THERAPEUTICS, INC. · 2020 · $249,799

## Abstract

PROJECT ABSTRACT
COVID-19 infection is associated with substantial mortality in patients with clinical co-morbidities, including
smoking, advanced age and diabetes mellitus. In these patients, COVID-19 infection leads to a
hyperinflammatory state producing vascular leak, interstitial edema, hyaline membrane formation and ARDS.
COVID-19 patients requiring ICU admission have high circulating levels of IL-6, GM-CSF, MCP and MIP1 (CCL2)
cytokines compared to those with uncomplicated illnesses. This hyper-inflammation syndrome, (aka “cytokine
storm”) is a prodromal feature of ARDS and multi-organ failure. Bronchoalveolar fluids (BALF) from patients with
severe COVID-19 are enriched in CCL2, one of the most potent chemokines driving the recruitment of monocytes
into the lung. Of note, cytokine storm is also associated with extensive lung damage in SARS-CoV and MERS-
CoV infections, suggesting that innate hyper-inflammation is common to respiratory zoonoses. There is no
effective treatment currently available that may be deployed as an intervention to either prevent or ameliorate
the cytokine storm of COVID-19. To address this need, our research team is actively engaged in the preclinical
development of an optimized lead agent (CDDO-2P-Im, or ‘2P-Im’), a highly potent synthetic triterpenoid that is
the most advanced among a class of small molecules recognized as effective modifiers of the host inflammatory
response. Our data show that 2P-Im broadly inhibits expression of cytokine networks and pathways underlying
hyper-inflammation. In particular, 2P-Im and its related derivatives are potent suppressors of macrophage
activation, suppressing the production of MIP1 (CCL2) by human macrophages at picomolar concentrations. 2P-
Im is an innovative new drug, with a mechanism of action not shared by any other drug currently under
investigation for in use in treating COVID-19. We envision 2P-Im will be provided to patients as an oral agent
deployed to prevent macrophage activation syndrome and disrupt progression to the ARDS of COVID-19
disease in high-risk populations. 2P-Im also has potential for use in the outpatient setting as a chemopreventive
regimen to reduce risk in first responders, residents living in group settings, and other high-risk groups exposed
to COVID-19. Preliminary data demonstrate potent cytoprotective effects in assays of efficacy against Influenza
virus A H1N1 and Influenza virus A H3N2. Through partnership between Triterpenoid Therapeutics (TTX) and
the Texas Biomedical Research Institute, we will pursue full-scale, IND-enabling efficacy studies in established
mouse models of COVID-19. Specifically, we will define the capacity of 2P-Im to prevent the cytopathic effects
of SARS-CoV-2 in established, validated in vitro models of COVID-19 (Aim 1); and demonstrate the in vivo
efficacy of 2P-Im against SARS-CoV-2 induced inflammation and capacity to promote survival in the established
K18-hACE2 mouse model of COVID-19 (Aim 2). The proposed pl...

## Key facts

- **NIH application ID:** 10202843
- **Project number:** 3R43CA243842-01S1
- **Recipient organization:** TRITERPENOID THERAPEUTICS, INC.
- **Principal Investigator:** Michael B Sporn
- **Activity code:** R43 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $249,799
- **Award type:** 3
- **Project period:** 2020-09-01 → 2022-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10202843

## Citation

> US National Institutes of Health, RePORTER application 10202843, Development of the New Synthetic Triterpenoid CDDO-2P-Im for Chemoprevention of the ARDS of COVID-19 (3R43CA243842-01S1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10202843. Licensed CC0.

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