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Title:
CNP COMPOUNDS
Document Type and Number:
WIPO Patent Application WO/2024/094747
Kind Code:
A1
Abstract:
This application relates to new C-type natriuretic peptide (CNP) compounds, pharmaceutical compositions comprising these compounds, and these compounds for use as medicaments.

Inventors:
RASMUSSEN JAKOB (DK)
KODAL ANNE (DK)
WILBS JONAS (DK)
POULSEN CHRISTIAN (DK)
FRIEBOES KILIAN (DK)
TORNØE CHRISTIAN (DK)
MADSEN PETER
Application Number:
PCT/EP2023/080459
Publication Date:
May 10, 2024
Filing Date:
November 01, 2023
Export Citation:
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Assignee:
NOVO NORDISK AS (DK)
International Classes:
C07K14/58; A61K38/22; A61K47/59
Domestic Patent References:
WO2021252931A22021-12-16
WO2021252910A22021-12-16
WO2013058833A12013-04-25
WO2018175534A12018-09-27
WO2010102886A12010-09-16
Foreign References:
US20100331256A12010-12-30
CA3153730A12021-03-25
US20200017567A12020-01-16
CA3184145A12021-12-16
US20180207239A12018-07-26
US5352770A1994-10-04
US6034231A2000-03-07
US8636965B22014-01-28
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Claims:
CLAIMS

1. A CNP compound comprising a CNP peptide and a modifying group wherein the net charge of the compound at physiological pH is 0 or negative, wherein the CNP peptide comprises an amino acid sequence according to Formula I:

AA01 - AAO2-AAO3-AAO4-AAO5-AAO6-AAO7-AAO8-AAO9-AAI 0-AA11 -AAi 2-AA13-AA14-

AA15-AA16-AA17-AA18-AA19-AA20-AA21 -AA22-AA23-AA24-AA25-AA26-AA27-AA28-AA29-

AA30-AA31-AA32-AA33-AA34-AA35-AA36-AA37 wherein

AA01 is Gin or absent,

AA02 is Glu or absent,

AA03 is His or absent,

AA04 is Pro or absent,

AAos is Asn or Gin or Glu or absent,

AAoe is Ala or absent,

AA07 is Arg or His or Ala or absent,

AAos is Lys or Ser or His or absent,

AA09 is Tyr or Glu or absent,

AA10 is Lys or Glu or Gin or His or absent,

AA11 is Gly,

AA12 is Ala,

AA13 is Gin or Asn or Glu,

AA14 is Lys or His or Glu,

AA15 is Lys or Ser or Glu or Thr or His,

AA16 is Gly,

AA17 is Leu or Gly or Ser or Vai,

AA18 is Ser or His,

AA19 is Gin or Ser or Lys or His,

AA20 is Gly,

AA21 is Cys,

AA22 is Phe,

AA23 is Gly,

AA24 is Leu, AA25 is Pro or Lys,

AA26 is Leu,

AA27 is Asp or Glu,

AA28 is Arg,

AA29 is lie,

AA30 is Gly,

AA31 is Ser,

AA32 is Leu or Nle or Met,

AA33 is Ser,

AA34 is Gly,

AA35 is Leu,

AA36 is Gly, and

AA37 is Cys; wherein the modifying group comprises Chem. A, Chem. B and Chem. C; wherein Chem. A is selected from the group consisting of:

(Chem. A1), and

(Chem. A2) wherein p is an integer in the range of 14-20, and where * denotes an amide bond connecting Chem. A and Chem. B; and wherein Chem. B is selected from the group consisting of:

(Chem. B1) and

(Chem. B2) wherein q is an integer in the range of 1-8, wherein * denotes an amide bond connecting Chem. A- and Chem. B-, wherein ** denotes an amide bond connecting Chem. B- and Chem. C-; and wherein Chem. C is selected from the group consisting of: (Chem C4), wherein r is an integer in the range of 0-4, wherein s is an integer in the range of 0-3, wherein t is an integer in the range of 0-1 , wherein u is an integer in the range of 0-3, wherein ** denotes an amide bond connecting Chem. B- and Chem. C-, wherein *** denotes an amide bond connecting Chem. C- and the N-terminal alphaamine on the CNP peptide.

2. The CNP compound according to claim 1 , wherein AA13 of the CNP peptide is Gin; AA19 is Gin or Ser; AA25 is Pro; and AA32 is Leu.

3. The CNP compound according to claim 1, wherein AAs of the CNP peptide is Gin; AA13 is Gin; AA19 is Gin or Ser; AA25 is Pro; and AA32 is Leu.

4. The CNP compound according to claim 1, wherein the CNP peptide comprises one of the following amino acid sequences:

YKGANKKGLSKGCFGLKLDRIGSXSGLGC SEQ ID NO: 6

NARKYKGANKSGLSSGCFGLKLDRIGSXSGLGC SEQ ID NO: 7

GANKKGLSKGCFGLKLDRIGSXSGLGC SEQ ID NO: 8

GAQKKGLSKGCFGLKLDRIGSXSGLGC SEQ ID NO: 9

YEGAQKKGLSKGCFGLKLDRIGSLSGLGC SEQ ID NO: 10

EEGAQKKGLSKGCFGLKLDRIGSLSGLGC SEQ ID NO: 11

YEGAQEKGLSKGCFGLKLDRIGSLSGLGC SEQ ID NO: 12

YEGAQKKGLSSGCFGLKLDRIGSLSGLGC SEQ ID NO: 13

YEGAQKKGLSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 14

YEGAQEKGLSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 15

YEGAQKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 16

YEGAQEKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 17

EKGAQEKGLSKGCFGLKLDRIGSLSGLGC SEQ ID NO: 18

EKGAQEKGLSSGCFGLKLDRIGSLSGLGC SEQ ID NO: 19

EQGAQEKGLSKGCFGLKLDRIGSLSGLGC SEQ ID NO: 20

YKGAQEKGLSKGCFGLKLDRIGSLSGLGC SEQ ID NO: 21

YKGAQKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 22

EHGAQEKGLSKGCFGLKLDRIGSLSGLGC SEQ ID NO: 23

YHGAQEKGLSKGCFGLKLDRIGSLSGLGC SEQ ID NO: 24

YHGAQEKGLSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 25

YHGAQKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 26 YHGAQEKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 27 YEGAEKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 28 EGAQEKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 29 EGAQKEGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 30 YEGAQKEGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 31 YHGAQKTGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 32 YHGAQKTGVSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 33 YHGAQHTGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 34 YKGAQHTGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 35 EHGAQKKGLSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 36 EHGAQKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 37 EHGAQKKGVSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 38 EHGAQKTGVSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 39 YHGAQHHGLSKGCFGLKLERIGSLSGLGC SEQ ID NO: 40 YKGAQHHGLSQGCFGLKLERIGSLSGLGC SEQ ID NO: 41 YEGAQKKGLSSGCFGLPLERIGSLSGLGC SEQ ID NO: 42 EGAQKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 43 YKGAQHHGLSQGCFGLKLDRIGSLSGLGC SEQ ID NO: 44 YKGAQHHGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 45 YHGAQHHGLSKGCFGLKLDRIGSLSGLGC SEQ ID NO: 46 YHGAQHHGLSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 47 GAQKKGLSHGCFGLPLDRIGSLSGLGC SEQ ID NO: 48 GAQKKGLHSGCFGLPLDRIGSLSGLGC SEQ ID NO: 49

ARKYHGAQHTGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 50 ARKYHGAQHTGVSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 51 ARKYHGAQKTGVSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 52 ARKEHGAQKTGVSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 53 ARKEHGAQHTGVSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 54 YEGAQKKGGSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 55 QEHPQARSYEGAQKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 57 QEHPEARSYEGAQKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 58 QEHPQAHKYHGAQHHGSSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 59 QEHPQAHKYKGAQKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 60 QEHPQAHKYHGAQKHGSSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 61 ARKYEGAQKKGLSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 63 ARKYKGAQKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 64 QEHPQARKYKGAQKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 67 QEHPQARKYEGAQKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 68 YEGAQKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 69 QEHPQARKYEGAQKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 70 QEHPQAAKYEGAQKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 71 QEHPQARHYKGAQKKGSSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 72 QEHPQAHKYKGAQKKGGSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 73 QEHPQARKYKGAQKKGLSKGCFGLKLDRIGSLSGLGC SEQ ID NO: 74 QEHPQARKYKGAQKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 75 QEHPQARKYKGAQKKGGSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 76 ARKYKGAQKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 77 ARKYHGAQHTGVSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 78 ARKYKGAQKTGVSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 79 ARKYHGAQKKGVSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 80 ARKYHGAQKTGVSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 81 ARKYKGAQKTGVSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 82 YHGAQKTGVSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 83 ARKYHGAQKSGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 84 YEGAQKKGGSHGCFGLPLDRIGSLSGLGC SEQ ID NO: 85 ARKYEGAQHKGGSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 86 YHGAQKKGGSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 87 YKGAQKKGGSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 88 YKGAQKKGVSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 89 YHGAQKKGVSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 90 QEHPQARKYEGAQKKGLSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 91 ARKYHGAQKKGVSSGCFGLPLERIGSLSGLGC SEQ ID NO: 92 ARKYKGAQKKGLSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 96 YHGAQKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 97 ARKYKGAQKKGLSQGCFGLKLDRIGSLSGLGC SEQ ID NO: 98 ARKYKGANKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 99

ARKYKGAQKKGLSQGCFGLPLDRIGSMSGLGC SEQ ID NO: 100

QEHPQARKYKGAQKKGLSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 101

ARKYKGAQKKGLSQGCFGLPLERIGSLSGLGC SEQ ID NO: 102

YKGAQKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 103

QEHPQARKYKGAQKKGLSSGCFGLPLERIGSLSGLGC SEQ ID NO: 104

YKGAQKKGGSQGCFGLPLERIGSLSGLGC SEQ ID NO: 108

YKGAQKKGLSQGCFGLPLERIGSLSGLGC SEQ ID NO: 109

GAQKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 112

GAQKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 113

GAQKKGGSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 114

GAQKKGGSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 115

GAQKKGLSQGCFGLKLDRIGSLSGLGC SEQ ID NO: 116

GAQKKGLSSGCFGLKLDRIGSLSGLGC SEQ ID NO: 117

GAQKKGGSQGCFGLKLDRIGSLSGLGC SEQ ID NO: 118

GAQKKGGSSGCFGLKLDRIGSLSGLGC SEQ ID NO: 119

GANKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 120

GANKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 121

GANKKGGSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 122

GANKKGGSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 123

GAQKKGLSQGCFGLPLDRIGSMSGLGC SEQ ID NO: 124

GAQKKGLSSGCFGLPLDRIGSMSGLGC SEQ ID NO: 125

GAQKKGGSQGCFGLPLDRIGSMSGLGC SEQ ID NO: 126 GAQKKGGSSGCFGLPLDRIGSMSGLGC SEQ ID NO: 127

GAQKKGLSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 128

GAQKKGGSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 129

GAQKKGLSQGCFGLPLERIGSLSGLGC SEQ ID NO: 130

GAQKKGLSSGCFGLPLERIGSLSGLGC SEQ ID NO: 131

GANKKGLSQGCFGLPLDRIGSMSGLGC SEQ ID NO: 132

GANKKGLSSGCFGLPLDRIGSMSGLGC SEQ ID NO: 133

GANKKGLSQGCFGLPLERIGSMSGLGC SEQ ID NO: 134

GANKKGLSSGCFGLPLERIGSMSGLGC SEQ ID NO: 135

GAQKKGSSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 136

GAQKKGSSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 137

GAQKKGSSQGCFGLKLDRIGSLSGLGC SEQ ID NO: 138

GAQKKGSSSGCFGLKLDRIGSLSGLGC SEQ ID NO: 139

GANKKGSSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 140

GANKKGSSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 141

GAQKKGSSQGCFGLPLDRIGSMSGLGC SEQ ID NO: 142

GAQKKGSSSGCFGLPLDRIGSMSGLGC SEQ ID NO: 143

GAQKKGSSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 144

YKGAQKKGGSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 145

YKGAQKKGLSQGCFGLKLDRIGSLSGLGC SEQ ID NO: 146

YKGAQKKGLSSGCFGLKLDRIGSLSGLGC SEQ ID NO: 147

YKGAQKKGGSQGCFGLKLDRIGSLSGLGC SEQ ID NO: 148

YKGAQKKGGSSGCFGLKLDRIGSLSGLGC SEQ ID NO: 149

YKGANKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 150

YKGANKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 151

YKGANKKGGSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 152

YKGANKKGGSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 153

YKGAQKKGLSQGCFGLPLDRIGSMSGLGC SEQ ID NO: 154

YKGAQKKGLSSGCFGLPLDRIGSMSGLGC SEQ ID NO: 155

YKGAQKKGGSQGCFGLPLDRIGSMSGLGC SEQ ID NO: 156

YKGAQKKGGSSGCFGLPLDRIGSMSGLGC SEQ ID NO: 157

YKGAQKKGLSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 158

YKGAQKKGGSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 159

YKGAQKKGLSQGCFGLPLERIGSLSGLGC SEQ ID NO: 160

YKGAQKKGLSSGCFGLPLERIGSLSGLGC SEQ ID NO: 161

YKGANKKGLSQGCFGLPLDRIGSMSGLGC SEQ ID NO: 162

YKGANKKGLSSGCFGLPLDRIGSMSGLGC SEQ ID NO: 163

YKGANKKGLSQGCFGLPLERIGSMSGLGC SEQ ID NO: 164

YKGANKKGLSSGCFGLPLERIGSMSGLGC SEQ ID NO: 165

YKGAQKKGSSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 166

YKGAQKKGSSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 167

YKGAQKKGSSQGCFGLKLDRIGSLSGLGC SEQ ID NO: 168

YKGAQKKGSSSGCFGLKLDRIGSLSGLGC SEQ ID NO: 169

YKGANKKGSSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 170 YKGANKKGSSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 171 YKGAQKKGSSQGCFGLPLDRIGSMSGLGC SEQ ID NO: 172 YKGAQKKGSSSGCFGLPLDRIGSMSGLGC SEQ ID NO: 173 YKGAQKKGSSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 174 ARKYKGAQKKGGSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 175 ARKYKGAQKKGGSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 176 ARKYKGAQKKGLSSGCFGLKLDRIGSLSGLGC SEQ ID NO: 177 ARKYKGAQKKGGSQGCFGLKLDRIGSLSGLGC SEQ ID NO: 178 ARKYKGAQKKGGSSGCFGLKLDRIGSLSGLGC SEQ ID NO: 179 ARKYKGANKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 180 ARKYKGANKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 181 ARKYKGANKKGGSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 182 ARKYKGANKKGGSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 183 ARKYKGAQKKGLSQGCFGLPLDRIGSMSGLGC SEQ ID NO: 184 ARKYKGAQKKGLSSGCFGLPLDRIGSMSGLGC SEQ ID NO: 185 ARKYKGAQKKGGSQGCFGLPLDRIGSMSGLGC SEQ ID NO: 186 ARKYKGAQKKGGSSGCFGLPLDRIGSMSGLGC SEQ ID NO: 187 ARKYKGAQKKGGSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 188 ARKYKGAQKKGLSQGCFGLPLERIGSLSGLGC SEQ ID NO: 189 ARKYKGAQKKGLSSGCFGLPLERIGSLSGLGC SEQ ID NO: 190 ARKYKGANKKGLSQGCFGLPLDRIGSMSGLGC SEQ ID NO: 191 ARKYKGANKKGLSSGCFGLPLDRIGSMSGLGC SEQ ID NO: 192 ARKYKGANKKGLSQGCFGLPLERIGSMSGLGC SEQ ID NO: 193 ARKYKGANKKGLSSGCFGLPLERIGSMSGLGC SEQ ID NO: 194 ARKYKGAQKKGSSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 195 ARKYKGAQKKGSSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 196 ARKYKGAQKKGSSQGCFGLKLDRIGSLSGLGC SEQ ID NO: 197 ARKYKGAQKKGSSSGCFGLKLDRIGSLSGLGC SEQ ID NO: 198 ARKYKGANKKGSSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 199 ARKYKGANKKGSSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 200 ARKYKGAQKKGSSQGCFGLPLDRIGSMSGLGC SEQ ID NO: 201 ARKYKGAQKKGSSSGCFGLPLDRIGSMSGLGC SEQ ID NO: 202 ARKYKGAQKKGSSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 203 GAQKKGSSQGCFGLPLERIGSLSGLGC SEQ ID NO: 232

5. The CNP compound according to claim 1, wherein the CNP peptide has any one of the following amino acid sequences:

YKGANKKGLSKGCFGLKLDRIGSXSGLGC SEQ ID NO: 6

NARKYKGANKSGLSSGCFGLKLDRIGSXSGLGC SEQ ID NO: 7

GANKKGLSKGCFGLKLDRIGSXSGLGC SEQ ID NO: 8

GAQKKGLSKGCFGLKLDRIGSXSGLGC SEQ ID NO: 9

YEGAQKKGLSKGCFGLKLDRIGSLSGLGC SEQ ID NO: 10

EEGAQKKGLSKGCFGLKLDRIGSLSGLGC SEQ ID NO: 1 1 YEGAQEKGLSKGCFGLKLDRIGSLSGLGC SEQ ID NO: 12 YEGAQKKGLSSGCFGLKLDRIGSLSGLGC SEQ ID NO: 13 YEGAQKKGLSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 14 YEGAQEKGLSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 15 YEGAQKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 16 YEGAQEKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 17 EKGAQEKGLSKGCFGLKLDRIGSLSGLGC SEQ ID NO: 18 EKGAQEKGLSSGCFGLKLDRIGSLSGLGC SEQ ID NO: 19 EQGAQEKGLSKGCFGLKLDRIGSLSGLGC SEQ ID NO: 20 YKGAQEKGLSKGCFGLKLDRIGSLSGLGC SEQ ID NO: 21 YKGAQKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 22 EHGAQEKGLSKGCFGLKLDRIGSLSGLGC SEQ ID NO: 23 YHGAQEKGLSKGCFGLKLDRIGSLSGLGC SEQ ID NO: 24 YHGAQEKGLSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 25 YHGAQKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 26 YHGAQEKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 27 YEGAEKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 28 EGAQEKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 29 EGAQKEGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 30 YEGAQKEGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 31 YHGAQKTGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 32 YHGAQKTGVSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 33 YHGAQHTGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 34 YKGAQHTGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 35 EHGAQKKGLSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 36 EHGAQKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 37 EHGAQKKGVSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 38 EHGAQKTGVSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 39 YHGAQHHGLSKGCFGLKLERIGSLSGLGC SEQ ID NO: 40 YKGAQHHGLSQGCFGLKLERIGSLSGLGC SEQ ID NO: 41 YEGAQKKGLSSGCFGLPLERIGSLSGLGC SEQ ID NO: 42 EGAQKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 43 YKGAQHHGLSQGCFGLKLDRIGSLSGLGC SEQ ID NO: 44 YKGAQHHGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 45 YHGAQHHGLSKGCFGLKLDRIGSLSGLGC SEQ ID NO: 46 YHGAQHHGLSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 47 GAQKKGLSHGCFGLPLDRIGSLSGLGC SEQ ID NO: 48 GAQKKGLHSGCFGLPLDRIGSLSGLGC SEQ ID NO: 49 ARKYHGAQHTGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 50 ARKYHGAQHTGVSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 51 ARKYHGAQKTGVSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 52 ARKEHGAQKTGVSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 53 ARKEHGAQHTGVSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 54 YEGAQKKGGSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 55 QEHPQARSYEGAQKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 57

QEHPEARSYEGAQKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 58

QEHPQAHKYHGAQHHGSSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 59

QEHPQAHKYKGAQKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 60

QEHPQAHKYHGAQKHGSSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 61

ARKYEGAQKKGLSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 63

ARKYKGAQKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 64

QEHPQARKYKGAQKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 67

QEHPQARKYEGAQKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 68

YEGAQKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 69

QEHPQARKYEGAQKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 70

QEHPQAAKYEGAQKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 71

QEHPQARHYKGAQKKGSSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 72

QEHPQAHKYKGAQKKGGSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 73

QEHPQARKYKGAQKKGLSKGCFGLKLDRIGSLSGLGC SEQ ID NO: 74

QEHPQARKYKGAQKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 75

QEHPQARKYKGAQKKGGSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 76

ARKYKGAQKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 77

ARKYHGAQHTGVSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 78

ARKYKGAQKTGVSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 79

ARKYHGAQKKGVSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 80

ARKYHGAQKTGVSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 81

ARKYKGAQKTGVSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 82

YHGAQKTGVSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 83

ARKYHGAQKSGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 84

YEGAQKKGGSHGCFGLPLDRIGSLSGLGC SEQ ID NO: 85

ARKYEGAQHKGGSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 86

YHGAQKKGGSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 87

YKGAQKKGGSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 88

YKGAQKKGVSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 89

YHGAQKKGVSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 90

QEHPQARKYEGAQKKGLSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 91

ARKYHGAQKKGVSSGCFGLPLERIGSLSGLGC SEQ ID NO: 92

ARKYKGAQKKGLSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 96

YHGAQKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 97

ARKYKGAQKKGLSQGCFGLKLDRIGSLSGLGC SEQ ID NO: 98

ARKYKGANKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 99

ARKYKGAQKKGLSQGCFGLPLDRIGSMSGLGC SEQ ID NO: 100

QEHPQARKYKGAQKKGLSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 101

ARKYKGAQKKGLSQGCFGLPLERIGSLSGLGC SEQ ID NO: 102

YKGAQKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 103

QEHPQARKYKGAQKKGLSSGCFGLPLERIGSLSGLGC SEQ ID NO: 104

YKGAQKKGGSQGCFGLPLERIGSLSGLGC SEQ ID NO: 108

YKGAQKKGLSQGCFGLPLERIGSLSGLGC SEQ ID NO: 109 GAQKKGLSQGCFGLPLDRIGSLSGLGC SEQID NO: 112 GAQKKGLSSGCFGLPLDRIGSLSGLGC SEQID NO: 113 GAQKKGGSQGCFGLPLDRIGSLSGLGC SEQID NO: 114 GAQKKGGSSGCFGLPLDRIGSLSGLGC SEQID NO: 115 GAQKKGLSQGCFGLKLDRIGSLSGLGC SEQID NO: 116 GAQKKGLSSGCFGLKLDRIGSLSGLGC SEQID NO: 117 GAQKKGGSQGCFGLKLDRIGSLSGLGC SEQID NO: 118 GAQKKGGSSGCFGLKLDRIGSLSGLGC SEQID NO: 119 GANKKGLSQGCFGLPLDRIGSLSGLGC SEQID NO: 120 GANKKGLSSGCFGLPLDRIGSLSGLGC SEQID NO: 121 GANKKGGSQGCFGLPLDRIGSLSGLGC SEQID NO: 122 GANKKGGSSGCFGLPLDRIGSLSGLGC SEQID NO: 123 GAQKKGLSQGCFGLPLDRIGSMSGLGC SEQID NO: 124 GAQKKGLSSGCFGLPLDRIGSMSGLGC SEQID NO: 125

GAQKKGGSQGCFGLPLDRIGSMSGLGC SEQID NO: 126 GAQKKGGSSGCFGLPLDRIGSMSGLGC SEQID NO: 127 GAQKKGLSKGCFGLPLDRIGSLSGLGC SEQID NO: 128 GAQKKGGSKGCFGLPLDRIGSLSGLGC SEQID NO: 129 GAQKKGLSQGCFGLPLERIGSLSGLGC SEQID NO: 130 GAQKKGLSSGCFGLPLERIGSLSGLGC SEQID NO: 131 GANKKGLSQGCFGLPLDRIGSMSGLGC SEQID NO: 132 GANKKGLSSGCFGLPLDRIGSMSGLGC SEQID NO: 133 GANKKGLSQGCFGLPLERIGSMSGLGC SEQID NO: 134 GANKKGLSSGCFGLPLERIGSMSGLGC SEQID NO: 135 GAQKKGSSQGCFGLPLDRIGSLSGLGC SEQID NO: 136 GAQKKGSSSGCFGLPLDRIGSLSGLGC SEQID NO: 137 GAQKKGSSQGCFGLKLDRIGSLSGLGC SEQID NO: 138 GAQKKGSSSGCFGLKLDRIGSLSGLGC SEQID NO: 139 GANKKGSSQGCFGLPLDRIGSLSGLGC SEQID NO: 140 GANKKGSSSGCFGLPLDRIGSLSGLGC SEQID NO: 141

GAQKKGSSQGCFGLPLDRIGSMSGLGC SEQID NO: 142 GAQKKGSSSGCFGLPLDRIGSMSGLGC SEQID NO: 143 GAQKKGSSKGCFGLPLDRIGSLSGLGC SEQID NO: 144 YKGAQKKGGSSGCFGLPLDRIGSLSGLGC SEQID NO: 145 YKGAQKKGLSQGCFGLKLDRIGSLSGLGC SEQID NO: 146 YKGAQKKGLSSGCFGLKLDRIGSLSGLGC SEQID NO: 147 YKGAQKKGGSQGCFGLKLDRIGSLSGLGC SEQID NO: 148 YKGAQKKGGSSGCFGLKLDRIGSLSGLGC SEQID NO: 149 YKGANKKGLSQGCFGLPLDRIGSLSGLGC SEQID NO: 150 YKGANKKGLSSGCFGLPLDRIGSLSGLGC SEQID NO: 151 YKGANKKGGSQGCFGLPLDRIGSLSGLGC SEQID NO: 152 YKGANKKGGSSGCFGLPLDRIGSLSGLGC SEQID NO: 153 YKGAQKKGLSQGCFGLPLDRIGSMSGLGC SEQID NO: 154 YKGAQKKGLSSGCFGLPLDRIGSMSGLGC SEQID NO: 155 YKGAQKKGGSQGCFGLPLDRIGSMSGLGC SEQ ID NO 156 YKGAQKKGGSSGCFGLPLDRIGSMSGLGC SEQ ID NO 157 YKGAQKKGLSKGCFGLPLDRIGSLSGLGC SEQ ID NO 158 YKGAQKKGGSKGCFGLPLDRIGSLSGLGC SEQ ID NO 159 YKGAQKKGLSQGCFGLPLERIGSLSGLGC SEQ ID NO 160 YKGAQKKGLSSGCFGLPLERIGSLSGLGC SEQ ID NO 161 YKGANKKGLSQGCFGLPLDRIGSMSGLGC SEQ ID NO 162 YKGANKKGLSSGCFGLPLDRIGSMSGLGC SEQ ID NO 163 YKGANKKGLSQGCFGLPLERIGSMSGLGC SEQ ID NO 164 YKGANKKGLSSGCFGLPLERIGSMSGLGC SEQ ID NO 165 YKGAQKKGSSQGCFGLPLDRIGSLSGLGC SEQ ID NO 166 YKGAQKKGSSSGCFGLPLDRIGSLSGLGC SEQ ID NO 167 YKGAQKKGSSQGCFGLKLDRIGSLSGLGC SEQ ID NO 168 YKGAQKKGSSSGCFGLKLDRIGSLSGLGC SEQ ID NO 169 YKGANKKGSSQGCFGLPLDRIGSLSGLGC SEQ ID NO 170 YKGANKKGSSSGCFGLPLDRIGSLSGLGC SEQ ID NO 171 YKGAQKKGSSQGCFGLPLDRIGSMSGLGC SEQ ID NO 172 YKGAQKKGSSSGCFGLPLDRIGSMSGLGC SEQ ID NO 173 YKGAQKKGSSKGCFGLPLDRIGSLSGLGC SEQ ID NO 174 ARKYKGAQKKGGSQGCFGLPLDRIGSLSGLGC SEQ ID NO 175 ARKYKGAQKKGGSSGCFGLPLDRIGSLSGLGC SEQ ID NO 176 ARKYKGAQKKGLSSGCFGLKLDRIGSLSGLGC SEQ ID NO 177 ARKYKGAQKKGGSQGCFGLKLDRIGSLSGLGC SEQ ID NO 178 ARKYKGAQKKGGSSGCFGLKLDRIGSLSGLGC SEQ ID NO 179 ARKYKGANKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO 180 ARKYKGANKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO 181 ARKYKGANKKGGSQGCFGLPLDRIGSLSGLGC SEQ ID NO 182 ARKYKGANKKGGSSGCFGLPLDRIGSLSGLGC SEQ ID NO 183 ARKYKGAQKKGLSQGCFGLPLDRIGSMSGLGC SEQ ID NO 184 ARKYKGAQKKGLSSGCFGLPLDRIGSMSGLGC SEQ ID NO 185 ARKYKGAQKKGGSQGCFGLPLDRIGSMSGLGC SEQ ID NO 186 ARKYKGAQKKGGSSGCFGLPLDRIGSMSGLGC SEQ ID NO 187 ARKYKGAQKKGGSKGCFGLPLDRIGSLSGLGC SEQ ID NO 188 ARKYKGAQKKGLSQGCFGLPLERIGSLSGLGC SEQ ID NO 189 ARKYKGAQKKGLSSGCFGLPLERIGSLSGLGC SEQ ID NO 190 ARKYKGANKKGLSQGCFGLPLDRIGSMSGLGC SEQ ID NO 191 ARKYKGANKKGLSSGCFGLPLDRIGSMSGLGC SEQ ID NO 192 ARKYKGANKKGLSQGCFGLPLERIGSMSGLGC SEQ ID NO 193 ARKYKGANKKGLSSGCFGLPLERIGSMSGLGC SEQ ID NO 194 ARKYKGAQKKGSSQGCFGLPLDRIGSLSGLGC SEQ ID NO 195 ARKYKGAQKKGSSSGCFGLPLDRIGSLSGLGC SEQ ID NO 196 ARKYKGAQKKGSSQGCFGLKLDRIGSLSGLGC SEQ ID NO 197 ARKYKGAQKKGSSSGCFGLKLDRIGSLSGLGC SEQ ID NO 198 ARKYKGANKKGSSQGCFGLPLDRIGSLSGLGC SEQ ID NO 199 ARKYKGANKKGSSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 200 ARKYKGAQKKGSSQGCFGLPLDRIGSMSGLGC SEQ ID NO: 201 ARKYKGAQKKGSSSGCFGLPLDRIGSMSGLGC SEQ ID NO: 202 ARKYKGAQKKGSSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 203 QEHPQARKYKGAQKKGGSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 204 QEHPQARKYKGAQKKGLSQGCFGLKLDRIGSLSGLGC SEQ ID NO: 205 QEHPQARKYKGAQKKGLSSGCFGLKLDRIGSLSGLGC SEQ ID NO: 206 QEHPQARKYKGAQKKGGSQGCFGLKLDRIGSLSGLGC SEQ ID NO: 207 QEHPQARKYKGAQKKGGSSGCFGLKLDRIGSLSGLGC SEQ ID NO: 208 QEHPNARKYKGANKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 209 QEHPNARKYKGANKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 210 QEHPNARKYKGANKKGGSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 211 QEHPNARKYKGANKKGGSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 212 QEHPQARKYKGAQKKGLSQGCFGLPLDRIGSMSGLGC SEQ ID NO: 213 QEHPQARKYKGAQKKGLSSGCFGLPLDRIGSMSGLGC SEQ ID NO: 214 QEHPQARKYKGAQKKGGSQGCFGLPLDRIGSMSGLGC SEQ ID NO: 215 QEHPQARKYKGAQKKGGSSGCFGLPLDRIGSMSGLGC SEQ ID NO: 216 QEHPQARKYKGAQKKGGSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 217 QEHPQARKYKGAQKKGLSQGCFGLPLERIGSLSGLGC SEQ ID NO: 218 QEHPNARKYKGANKKGLSQGCFGLPLDRIGSMSGLGC SEQ ID NO: 219 QEHPNARKYKGANKKGLSSGCFGLPLDRIGSMSGLGC SEQ ID NO: 220 QEHPNARKYKGANKKGLSQGCFGLPLERIGSMSGLGC SEQ ID NO: 221 QEHPNARKYKGANKKGLSSGCFGLPLERIGSMSGLGC SEQ ID NO: 222 QEHPQARKYKGAQKKGSSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 223 QEHPQARKYKGAQKKGSSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 224 QEHPQARKYKGAQKKGSSQGCFGLKLDRIGSLSGLGC SEQ ID NO: 225 QEHPQARKYKGAQKKGSSSGCFGLKLDRIGSLSGLGC SEQ ID NO: 226 QEHPNARKYKGANKKGSSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 227 QEHPNARKYKGANKKGSSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 228 QEHPQARKYKGAQKKGSSQGCFGLPLDRIGSMSGLGC SEQ ID NO: 229 QEHPQARKYKGAQKKGSSSGCFGLPLDRIGSMSGLGC SEQ ID NO: 230 QEHPQARKYKGAQKKGSSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 231 GAQKKGSSQGCFGLPLERIGSLSGLGC SEQ ID NO: 232

6. The CNP compound according to claim 1, wherein the CNP peptide has any one of the following amino acid sequences:

GAQKKGSSQGCFGLPLDRIGSLSGLGC (SEQ ID NO: 136), ARKYKGAQKKGLSQGCFGLPLDRIGSLSGLGC (SEQ ID NO: 77),

YKGAQKKGGSQGCFGLPLDRIGSLSGLGC (SEQ ID NO: 88), YKGAQKKGLSQGCFGLPLDRIGSLSGLGC (SEQ ID NO: 103), QEHPQARKYKGAQKKGLSSGCFGLPLDRIGSLSGLGC (SEQ ID NO: 67), and QEHPQARKYKGAQKKGLSSGCFGLPLERIGSLSGLGC (SEQ ID NO: 104). 7. The CNP compound according to claim 1, wherein the CNP peptide has the following amino acid sequence:

QEHPQARKYKGAQKKGLSSGCFGLPLDRIGSLSGLGC (SEQ ID NO: 67).

8. The CNP compound according to any one of the preceding claims, wherein Chem. B of the modifying group has a q of 1-5.

9. The CNP compound according to any one of the preceding claims, wherein the modifying group is selected from the following: Chem. E, Chem. F, Chem. G, Chem. H, Chem. I, and Chem. J (in which the dotted line defines the attachment through an amide bond to the N-terminal alpha-amine of the CNP peptide)

(Chem. F)

(Chem. J).

10. A CNP compound according to Formula II:

(Formula II). 11. A CNP compound according to any one of Formula II, III, IV, V, VI, and VII:

(Formula IV)

(Formula VII). 12. A CNP compound comprising a CNP peptide and a modifying group, wherein the compound is any one of the compounds disclosed in Table 1: Table 1 : Summary of compounds Chem. 6-148

13. A pharmaceutical composition comprising a compound according to any one of claims 1-12, and one or more pharmaceutically acceptable excipients. 14. The compound according to any one of claims 1-12, or a composition according to claim 13, for use in the treatment or prevention of cardio-renal-metabolic diseases including heart failure, and growth disorders including achondroplasia.

15. A method of treating or preventing heart failure, comprising administering to a patient in need thereof an effective amount of the compound according to any one of the claims 1-12, optionally in combination with one or more additional therapeutically active compounds.

Description:
TITLE: CNP COMPOUNDS

TECHNICAL FIELD OF INVENTION

This invention relates to new C-type natriuretic peptide (CNP) compounds, pharmaceutical compositions comprising these compounds, and these compounds for use as medicaments.

BACKGROUND OF INVENTION

The natriuretic peptides are a family of three structurally related hormones that play distinctive roles within the cardiovascular system. Atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) are expressed in the heart and released in response to a volume- induced stretch of the atria and ventricles, respectively. Their physiological effects include regulation of cardiac structure, blood pressure and blood volume.

C-type natriuretic peptide (CNP) is highly expressed in endothelial cells where it is constitutively released. Other cells within the cardiovascular system, including cardiomyocytes and fibroblasts, also produce CNP, albeit to a lesser extent. CNP has direct effects on inflammation, fibrosis, cardiac contractility, endothelial function, angiogenesis and blood pressure.

There are three known receptors for natriuretic peptides. Natriuretic peptide receptor-1 (NPR1) is a particulate guanylyl cyclase that catalyses the synthesis of cGMP upon binding by ANP or BNP. NPR1 is expressed in kidney, lung, adipose, adrenal, brain, heart, testis, and vascular smooth muscle tissue. NPR2, which is expressed in bone, brain, fibroblasts, heart, kidney, liver, lung, uterine, and vascular smooth muscle tissue, is homologous to NPR1 but is selectively activated by CNP. In contrast, NPR3 only contains a 37-residue intracellular domain and lacks guanylyl cyclase activity. It controls local natriuretic peptide concentrations via receptor-mediated internalization and degradation, but there is accumulating evidence for a signalling function of NPR3. All three natriuretic peptides bind to NPR3 with high affinity and this receptor is the most widely and abundantly expressed of the three receptors. There is also a very high degree of conservation of all three receptors and in line with CNP, NPR2 is the most highly conserved.

Clinical and preclinical data have demonstrated an essential role of CNP and its two receptors for cardio-renal-metabolic function, and there is also accumulating data supporting that targeting of this system holds therapeutic potential in a broad range of cardiovascular, renal, and metabolic diseases (Int. J. Mol. Sci. 2019, 20, 2281 ; Cardiovasc. Res. 2022, 118, 2085-2102; Cardiovasc. Res. 2022 Aug 25;cvac125)”. Similarly, human genetics, as well as preclinical and clinical data, supports NPR2 and CNP as regulators of bone growth, with therapeutic potential in a broad range of short stature indications that relates to NPR2 and CNP (Lancet, 396:684; J Pharmacol Exp Ther, 370:459; Hisado-Oliva (2018) Genet Med, 20:91, as well as to FGFR3-related skeletal dysplasia (Sabir and Cole Orphanet Journal of Rare Diseases (2019) 14:300; Krakow and Rimoin, Genetics in medicine (2010) 12:6, Decker et al. Human Molecular Genetics (2011), 20:8) and RASopathies (Adv Cancer Res. 153:305). Currently, two CNP compounds are in clinical development for achondroplasia which is a type of Dwarfism (BMN111(Vosoritide) and TransCon CNP). The Mayo clinic has previously explored a CNP compound designed to activate both NPR2 and NPR1 in heart failure (J Am Coll Cardiol. 2008 July 1; 52(1): 60-68).

The clearance of CNP in human plasma is very rapid, with a calculated half-life of minutes. Given this short half-life, it would be beneficial to develop new long acting CNP compounds which can be administered less frequently, while retaining an acceptable clinical profile.

A range of different approaches have been used for modifying the structure of CNP in order to provide a longer acting profile. WO 2013/058833 discloses fusion peptides of CNP and Fc domains. WO 2018/175534 discloses fatty acid modified NPR1 agonists.

SUMMARY OF INVENTION

The invention provides CNP compounds with improved pharmaceutical properties. In one aspect, the present invention provides a CNP compound comprising a CNP peptide and a modifying group wherein the net charge of the compound at physiological pH is 0 or negative, wherein the CNP peptide comprises an amino acid sequence according to Formula I:

AA01 - AAO2-AAO3-AAO4-AAO5-AAO6-AAO7-AAO8-AAO9-AAI 0-AA11 -AAi 2-AA13-AA14- AA15-AA16-AA17-AA18-AA19-AA20-AA21 -AA22-AA23-AA24-AA25-AA26-AA27-AA28-AA29- AA30-AA31-AA32-AA33-AA34-AA35-AA36-AA37 wherein

AA01 is Gin or absent, AA02 is Glu or absent, AA03 is His or absent, AA04 is Pro or absent, AAos is Asn or Gin or Glu or absent, AAoe is Ala or absent,

AA07 is Arg or His or Ala or absent,

AAos is Lys or Ser or His or absent,

AA09 is Tyr or Glu or absent

AA10 is Lys or Glu or Gin or His or absent,

AA11 is Gly,

AA12 is Ala,

AA13 is Gin or Asn or Glu,

AA14 is Lys or His or Glu,

AA15 is Lys Ser or Glu or Thr or His,

AA is Gly,

AA17 is Leu or Gly or Ser or Vai,

AA is Ser or His

AA19 is Gin or Ser or Lys or His,

AA20 is Gly,

AA21 is Cys,

AA22 is Phe,

AA23 is Gly,

AA24 is Leu,

AA25 is Pro or Lys,

AA26 is Leu,

AA27 is Asp or Glu,

AA28 is Arg,

AA29 is lie,

AA30 is Gly,

AA31 is Ser,

AA32 is Leu or Nle or Met,

AA33 is Ser,

AA34 is Gly,

AA35 is Leu,

AA36 is Gly, and

AA37 is Cys; wherein the modifying group comprises Chem. A, Chem. B and Chem. C; wherein Chem. A is selected from the group consisting of:

(Chem. A1), and

(Chem. A2), wherein p is an integer in the range of 14-20, and where * denotes an amide bond connecting Chem. A and Chem. B; and wherein Chem. B is selected from the group consisting of:

(Chem. B2) wherein q is an integer in the range of 1-8, wherein * denotes an amide bond connecting Chem. A- and Chem. B-, wherein ** denotes an amide bond connecting Chem. B- and Chem. C-; and wherein Chem. C is selected from the group consisting of:

(Chem. C1),

(Chem. C3) wherein r is an integer in the range of 0-4, wherein s is an integer in the range of 0-3, wherein t is an integer in the range of 0-1 , wherein ** denotes an amide bond connecting Chem. B- and Chem. C-, wherein *** denotes an amide bond connecting Chem. C- and the N-terminal alpha-amine on the CNP peptide.

In one embodiment, the present invention provides a CNP compound, wherein the CNP peptide has any one of the following amino acid sequences:

GAQKKGSSQGCFGLPLDRIGSLSGLGC (SEQ ID NO: 136), ARKYKGAQKKGLSQGCFGLPLDRIGSLSGLGC (SEQ ID NO: 77), YKGAQKKGGSQGCFGLPLDRIGSLSGLGC (SEQ ID NO: 88), YKGAQKKGLSQGCFGLPLDRIGSLSGLGC (SEQ ID NO: 103), QEHPQARKYKGAQKKGLSSGCFGLPLDRIGSLSGLGC (SEQ ID NO: 67), and QEHPQARKYKGAQKKGLSSGCFGLPLERIGSLSGLGC (SEQ ID NO: 104). In another aspect, the present invention provides a pharmaceutical composition comprising a compound according to the invention, and one or more pharmaceutically acceptable excipients.

The present invention also in one aspect provides, the use of the compounds of the invention as medicaments for treating or preventing of cardio-renal-metabolic diseases including heart failure, and achondroplasia.

The short half-life of approximately two minutes of wt CNP makes CNP unsuitable for pharmaceutical use. In the present invention, the half-life of CNP is extended by fatty acid acylation which facilitates albumin binding. However, the combination of the net positively charged CNP peptide (at physiological pH) with a fatty acid albumin binder modification (where the CNP compound is overall positively charged) leads to significant injection site reactions upon subcutaneous injection as well as low bioavailability. This is surprising since a net positively charged CNP peptide without a fatty acid albumin binder attached shows no observable injection site reactions. To solve these problems, amino acid substitutions have been introduced into the CNP peptide and negative charges have been introduced into the modifying group (comprising the fatty acid). The combination of these modifications results in a compound of overall net negative charge at physiological pH which shows good subcutaneous bioavailability and none to mild subcutaneous injection site reactions.

Surprisingly, the addition of negative charges also reduces the in vitro and in vivo potency of the CNP compounds, in a manner such that higher net negative charge generally correlates with lower in vivo potency. To retain sufficient potency of the CNP compounds, only a low number of net negative charges where introduced. However, a low number of net negative charges reduces solubility and biophysical stability of the CNP compounds when formulated for subcutaneous administration at a physiologically relevant pH. The present disclosure strikes a balance with respect to these parameters and, surprisingly, provides CNP compounds with sufficient potency, and also sufficient solubility and biophysical stability for liquid formulation.

Further, wt CNP does not show desired chemical stability in liquid formulation needed for convenient pharmaceutical administration. In the present invention, selected amino acid substitutions of the wt CNP sequence are introduced to facilitate chemical stability in formulation.

The present disclosure provides CNP compounds with extended half-life and good tolerability for subcutaneous administration while retaining sufficient in vivo potency for therapeutic use and high chemical and biophysical stability in liquid formulation.

The invention may also solve further problems that will be apparent from the disclosure of the exemplary embodiments.

DESCRIPTION OF DRAWING

Fig. 1 shows the pharmacodynamic response (cGMP) after i.v. administration of Compound ID 0776 to rats as described in example 11.

Fig. 2 shows the pharmacodynamic response (cGMP) after i.v. administration of Compound ID 0312 to rats as described in example 11. Fig. 3 shows the pharmacodynamic response (cGMP) after i.v. administration of Compound ID 1225 to rats as described in example 11.

Fig. 4 shows the pharmacodynamic response (cGMP) after i.v. administration of Compound ID 1233 to rats as described in example 11.

Fig. 5 shows the pharmacodynamic response (cGMP) after i.v. administration of Compound ID 1227 to rats as described in example 11.

Fig. 6 shows the pharmacodynamic response (cGMP) after i.v. administration of Compound ID 1241 to rats as described in example 11.

Fig. 7 shows the pharmacodynamic response (cGMP) after i.v. administration of Compound ID 1351 to rats as described in example 11.

Fig. 8 shows the pharmacodynamic response (cGMP) after i.v. administration of Compound ID 1354 to rats as described in example 11.

Fig. 9 shows the pharmacodynamic response (cGMP) after i.v. administration of Compound ID 1356 to rats as described in example 11.

Fig. 10 shows the pharmacodynamic response (cGMP) after i.v. administration of Compound ID 1375 to rats as described in example 11.

Fig. 11 shows the pharmacodynamic response (cGMP) after i.v. administration of Compound ID 1376 to rats as described in example 11.

Fig. 12 shows the pharmacodynamic response (cGMP) after i.v. administration of Compound ID 1377 to rats as described in example 11.

Fig. 13 shows the pharmacodynamic response (cGMP) after i.v. administration of Compound ID 1352 to rats as described in example 11.

Fig. 14 shows the pharmacodynamic response (cGMP) after i.v. administration of Compound ID 1379 to rats as described in example 11.

Fig. 15 shows the pharmacodynamic response (cGMP) after i.v. administration of Compound ID 1434 to rats as described in example 11.

Fig. 16 shows the pharmacodynamic response (cGMP) after i.v. administration of Compound ID 9384 to rats as described in example 11.

Fig. 17 shows the pharmacodynamic response (cGMP) after i.v. administration of Compound ID 9407 to rats as described in example 11.

Fig. 18 shows the pharmacodynamic response (cGMP) after i.v. administration of Compound ID 1420 to rats as described in example 11.

Fig. 19 shows the pharmacodynamic response (cGMP) after i.v. administration of Compound ID 1378 to rats as described in example 11. Fig. 20 shows the pharmacodynamic response (cGMP) after i.v. administration of Compound ID 1381 to rats as described in example 11.

Fig. 21 shows the pharmacodynamic response (cGMP) after i.v. administration of Compound ID 1386 to rats as described in example 11.

Fig. 22 shows the pharmacodynamic response (cGMP) after i.v. administration of Compound ID 1389 to rats as described in example 11.

Fig. 23 shows the pharmacodynamic response (cGMP) after i.v. administration of Compound ID 1392 to rats as described in example 11.

Fig. 24 shows the pharmacodynamic response (cGMP) after i.v. administration of Compound ID 1426 to rats as described in example 11.

Fig. 25 shows the pharmacodynamic response (cGMP) after i.v. administration of Compound ID 9435 to rats as described in example 11.

Fig. 26 shows the pharmacodynamic response (cGMP) after i.v. administration of Compound ID 1235 to rats as described in example 11.

Fig. 27 shows the pharmacodynamic response (cGMP) after i.v. administration of Compound ID 9482 to rats as described in example 11.

Fig. 28 shows the pharmacodynamic response (cGMP) after i.v. administration of Compound ID 0312 to Gottingen minipigs as described in example 12.

Fig. 29 shows the pharmacodynamic response (cGMP) after i.v. administration of Compound ID 0776 to Gottingen minipigs as described in example 12.

Fig. 30 shows the pharmacodynamic response (cGMP) after i.v. administration of Compound ID 9384 to Gottingen minipigs as described in example 12.

Fig. 31 shows the pharmacodynamic response (cGMP) after i.v. administration of Compound ID 9407 to Gottingen minipigs as described in example 12.

Fig. 32 shows the pharmacodynamic response (cGMP) after i.v. administration of Compound ID 9435 to Gottingen minipigs as described in example 12.

Fig. 33 shows the pharmacodynamic response (cGMP) after i.v. administration of Compound ID 9480 to Gottingen minipigs as described in example 12.

Fig. 34 shows the pharmacodynamic response (cGMP) after i.v. administration of Compound ID 9482 to Gottingen minipigs as described in example 12.

Fig. 35 shows the pharmacodynamic response (cGMP) after i.v. administration of Compound ID 9483 to Gottingen minipigs as described in example 12.

Fig. 36 shows the pharmacodynamic response (cGMP) after s.c. administration of Compound ID 0312 to Gottingen minipigs as described in example 12. Fig. 37 shows the pharmacodynamic response (cGMP) after s.c. administration of Compound ID 0776 to Gottingen minipigs as described in example 12.

Fig. 38 shows the pharmacodynamic response (cGMP) after s.c. administration of Compound ID 9384 to Gottingen minipigs as described in example 12.

Fig. 39 shows the pharmacodynamic response (cGMP) after s.c. administration of Compound ID 9407 to Gottingen minipigs as described in example 12.

Fig. 40 shows the pharmacodynamic response (cGMP) after s.c. administration of Compound ID 9435 to Gottingen minipigs as described in example 12.

Fig. 41 shows the pharmacodynamic response (cGMP) after s.c. administration of Compound ID 9480 to Gottingen minipigs as described in example 12.

Fig. 42 shows the pharmacodynamic response (cGMP) after s.c. administration of Compound ID 9482 to Gottingen minipigs as described in example 12.

Fig. 43 shows the pharmacodynamic response (cGMP) after s.c. administration of Compound ID 9483 to Gottingen minipigs as described in example 12.

Fig. 44 shows the pharmacodynamic response (cGMP) after i.v. administration of Compound ID 0312 to Domestic LYD pigs as described in example 12.

Fig. 45 shows the pharmacodynamic response (cGMP) after i.v. administration of Compound ID 0776 to Domestic LYD pigs as described in example 12.

Fig. 46 shows the pharmacodynamic response (cGMP) after i.v. administration of Compound ID 1225 to Domestic LYD pigs as described in example 12.

Fig. 47 shows the pharmacodynamic response (cGMP) after i.v. administration of Compound ID 1227 to Domestic LYD pigs as described in example 12.

Fig. 48 shows the pharmacodynamic response (cGMP) after i.v. administration of Compound ID 1235 to Domestic LYD pigs as described in example 12.

DETAILED DESCRIPTION

The present invention provides CNP compounds with improved pharmaceutical properties. The present invention also provides pharmaceutical compositions and the use of the compounds and compositions of the present invention as medicaments for treating disease.

C-tvpe natriuretic peptide

C-type natriuretic peptide (CNP) (GenBank Accession No. NP 077720) is a small, single chain peptide in a family of peptides (ANP, BNP, CNP) having a 17-amino acid residue disulfide ring structure and have important roles in multiple biological processes. CNP interacts with natriuretic peptide receptor 2 (NPR2, NPR-B, GC-B) to stimulate the generation of cyclic-guanosine monophosphate (cGMP). CNP is expressed more widely, including in the central nervous system, reproductive tract, bone and endothelium of blood vessels. The clearance of CNP in human plasma is rapid, with a half-life of minutes.

Natural CNP gene and polypeptide have been previously described. U.S. Patent No. 5,352,770 discloses isolated and purified CNP-22 from porcine brain identical in sequence to human CNP (human wild-type CNP-22: GLSKGCFGLKLDRIGSMSGLGC (SEQ ID NO: 01)). U.S. Patent No. 6,034,231 discloses the human gene and polypeptide of pre-pro-CNP (126 amino acids) and the human CNP-53 gene and peptide. Human wild-type CNP-37 has the sequence QEHPNARKYKGANKKGLSKGCFGLKLDRIGSMSGLGC (SEQ ID NO: 02).

CNP compound

In one aspect, the present invention provides a CNP compound comprising a CNP peptide and a modifying group wherein the net charge of the compound at physiological pH is 0 or negative.

The CNP compounds as described herein, have been engineered to achieve a compound of overall neutral or net negative charge. This was achieved with introduction of amino acid substitutions of the CNP peptide, and with the introduction of negative charges into the modifying group. It is not trivial to reduce the charge of the CNP compound and still retain biological activity of the CNP compound towards the NPR2 receptor.

The term “net charge”, as used herein, refers to the sum of all negative and positive charges on the CNP compound at a given pH, where the charges are defined solely by the acid dissociation constant of each ionizable group in the CNP compound.

In one embodiment, the net charge of the CNP compound at physiological pH is negative determined as described in Example 4.

In one embodiment, the net charge of the CNP compound at physiological pH is 0 to -4, determined as described in Example 4.

The term "physiological pH", as used herein, refers to a pH in the range of 7.35 to 7.45 inclusive, more typically averaging 7.4.

In one aspect, the CNP compounds, described herein, have an intramolecular disulfide bridge (disulfide bond between two cysteine residues), resulting in a cyclic structure.

The term “CNP peptide” as used herein refers to a peptide being 37 to 22 amino acids long comprising the CNP-22 amino acid sequence (SEQ ID NO: 01), and amino acid sequences thereof including one or more amino acid modifications (e.g. one or more amino acid substitutions, additions, and/or deletions). The term “CNP peptide” as used herein also encompasses CNP variants.

The term “CNP variant”, as used herein, refers to a CNP peptide, which is an amino acid variant of the CNP-37 sequence (SEQ ID NO:02). In other words, a CNP variant is a CNP peptide including one or more amino acid modifications, i.e. at least one amino acid has been changed compared to SEQ ID NO: 02. These modifications may represent, independently, one or more amino acid substitutions, additions, and/or deletions.

A CNP variant may be described by reference to the number of the amino acid residue which is changed (i.e. the corresponding position in the CNP-37 sequence (SEQ ID NQ:02)), and the change (e.g. the identity of the amino acid residue in variant at the given position.). That is, numerical references to specific amino acid residues of the CNP peptide, if not stated otherwise, refer to the CNP-37 sequence (SEQ ID NO:2) (i.e., residue 1 is Glutamine (Q1), and residue 37 is Cysteine (C37). The following is a non-limiting example of suitable variant nomenclature: the des1-4, 5Q, 13Q, 32Nle CNP variant designates a CNP peptide sequence which, when compared to CNP-37, has the following amino acid changes: deletion of the amino acid residues in positions 1-4, as well as substitutions of asparagine (N) at position 5 with Glutamine (Q), of asparagine (N) at position 13 with Glutamine (Q), of Methionine (M) at position 32 with Norleucine.

The term "amino acid" refers to any amino acid, naturally occurring (including the 20 standard amino acids which are encoded by the standard genetic code in humans) or not naturally occurring. Amino acid residues may be identified by their full name, their one-letter code, and/or their three-letter code as is usual in the art. These three ways are fully equivalent. The term “non-coded amino acids” refers to all amino acids which aren’t among the 20 standard amino acids encoded by the standard genetic code in humans. Non-coded amino acids may exist in nature or be purely synthetic. Non-limiting examples of non-coded amino acids are D-isomers of the coded amino acids, and glycine residues with a side chain attached to the nitrogen atom rather than the alpha-carbon atom. D-isomers of coded amino acids may be referred to as (i) “D-“ followed by the full name, followed by the one-letter code, or followed by the three-letter code of the amino acid, or as (ii) the lower case one-letter code of the amino acid. Further abbreviations for non-coded amino acids used in this application are presented below. Abbreviation Name of the residue Chemical structure

Nle (X) L-Norleucine

(Chem. D)

In an aspect of the invention, the CNP peptide, comprises an amino acid sequence according to Formula I:

AA0I-AA02-AA03-AA04-AA05-AA06-AA07-AA08-AA09-AA10-AA11-AA 12-AA13-AA14-AA15- AA16-AA17-AA18-AA19-AA20-AA21-AA22-AA23-AA24-AA25-AA26-AA27- AA28-AA29-AA30-AA31-AA32- AA33-AA34-AA35-AA36-AA37 wherein

AA01 is Gin or absent,

AA02 is Glu or absent,

AA03 is His or absent,

AA04 is Pro or absent,

AA05 is Asn or Gin or Glu or absent,

AAoe is Ala or absent,

AA07 is Arg or His or Ala or absent,

AAos is Lys or Ser or His or absent,

AA09 is Tyr or Glu or absent

AA10 is Lys or Glu or Gin or His or absent,

AA11 is Gly,

AA12 is Ala,

AA13 is Gin or Asn or Glu,

AA14 is Lys or His or Glu,

AA15 is Lys Ser or Glu or Thr or His,

AA16 is Gly,

AA17 is Leu or Gly or Ser or Vai,

AA18 is Ser or His

AA19 is Gin or Ser or Lys or His,

AA20 is Gly, AA21 is Cys, AA22 is Phe, AA23 is Gly, AA24 is Leu, AA25 is Pro or Lys, AA 2 6 is Leu, AA27 is Asp or Glu, AA 2 8 is Arg, AA29 is lie, AA30 is Gly, AA31 is Ser, AA32 is Leu or Nle or Met, AA33 is Ser, AA34 is Gly, AA35 is Leu, AA36 is Gly, and AA37 is Cys. In certain embodiments of the invention, amino acid substitutions of the CNP peptide are introduced in order to reduce the positive charges of the CNP peptide. For example Lys25 (AA25) is substituted to Pro and Lys19 (AA19) is substituted to Gin or Ser to remove positive charge.

In certain embodiments of the invention, AA13 of the CNP peptide is Gin; AA19 is Gin or Ser; AA25 is Pro; and AA32 is Leu.

In certain embodiments of the invention, AAs of the CNP peptide is Gin; AA13 is Gin; AA19 is Gin or Ser; AA25 is Pro; and AA32 is Leu.

In certain embodiments of the invention, the CNP peptide has any one of the following amino acid sequences:

GAQKKGSSQGCFGLPLDRIGSLSGLGC (SEQ ID NO: 136), ARKYKGAQKKGLSQGCFGLPLDRIGSLSGLGC (SEQ ID NO: 77), YKGAQKKGGSQGCFGLPLDRIGSLSGLGC (SEQ ID NO: 88), YKGAQKKGLSQGCFGLPLDRIGSLSGLGC (SEQ ID NO: 103), QEHPQARKYKGAQKKGLSSGCFGLPLDRIGSLSGLGC (SEQ ID NO: 67), and QEHPQARKYKGAQKKGLSSGCFGLPLERIGSLSGLGC (SEQ ID NO: 104). Modifying group

In one aspect of the invention, the CNP compound comprises a modifying group covalently attached to an amino acid residue of the CNP peptide.

In one aspect of the invention, the modifying group is capable of forming non- covalent associations with albumin and thereby promoting the circulation of the CNP compound in the blood stream, this having the effect of protracting plasma exposure and extending plasma half-life of the CNP compound compared to plasma half-life of CNP-22 (SEQ ID NO: 01) and CNP-37 (SEQ ID NO: 02). The modifying group having the effect of extending and protracting the time of action of the CNP compound, thus, may also be referred to as a protracting group.

In some embodiments of the invention, the modifying group is covalently attached to the N-terminal amino acid of the CNP peptide.

In some embodiments of the invention, the modifying group is covalently attached to the N-terminal alpha-amine of the CNP peptide.

In an aspect of the invention, the modifying group comprises Chem. A, Chem. B and Chem. C; wherein Chem. A is selected from the group consisting of:

(Chem. A1), and

(Chem. A2) wherein p is an integer in the range of 14-20, and where * denotes an amide bond connecting Chem. A, and Chem. B; and wherein Chem. B is selected from the group consisting of:

(Chem. B1) and

(Chem. B2) wherein q is an integer in the range of 1-8, wherein * denotes an amide bond connecting Chem. A- and Chem. B-, wherein ** denotes an amide bond connecting Chem. B- and Chem. C-; and

Wherein Chem. C is selected from the group consisting of: (Chem C4), wherein r is an integer in the range of 0-4, wherein s is an integer in the range of 0-3, wherein t is an integer in the range of 0-1 , wherein u is an integer in the range of 0-3, wherein ** denotes an amide bond connecting Chem. B- and Chem. C-, wherein *** denotes an amide bond connecting Chem. C- and the N-terminal alphaamine on the CNP peptide. Abbreviations for modifying group elements used in this application are presented below:

In some embodiments of the invention, the modifying group is selected from the following non-limiting examples: Chem. E, Chem. F, Chem. G, Chem. H, Chem. I, and Chem. J (in which the dotted line defines the attachment through an amide bond to the CNP peptide).

(Chem. E)

10 (Chem. I)

(Chem. J)

The modifying group of the invention may exist in different stereo-isomeric forms having the same molecular formula and sequence of bonded atoms, but differing only in the three-dimensional orientation of their atoms in space. The stereoisomerism of the exemplified modifying groups of the invention is indicated in the experimental section, in the names as well as the structures, using standard nomenclature. Unless otherwise stated the invention relates to all stereoisomeric forms of the claimed modifying groups.

Functional properties

In some aspects of the invention, the CNP compounds have desirable biophysical properties. The CNP compounds exhibit extended in vivo half-life. Also, the CNP compounds of the invention have biological activity. Further, the compounds of the invention have desirable stability. Furthermore, the compounds of the invention have desirable solubility. Furthermore, the compounds of the invention can be dosed subcutaneously without eliciting an undesirable level of local tissue reaction like necrosis.

Biological activity

In one aspect of the invention, the compounds have biological activity in vitro, which may be determined as their ability to activate the NPR2 receptor in vitro in a cell line expressing the NPR2 receptor which may be determined as their ability to increase the production and concentration of cGMP, representing receptor activation downstream of NPR2, in the cell. Biological activity in vitro may be determined e.g. as described in Example 2.

In one aspect of the invention, the compounds have biological activity in vivo, which may be determined as their ability to increase the concentration of cGMP in plasma after i.v. or s.c. administration in either rats or Gottingen minipigs or domestic LYD pigs. The rat is one example of a suitable animal model, and the activity may be determined in such rats in vivo, as described in Example 11.

The Gottingen minipigs or domestic LYD pigs is other examples of a suitable animal models, and the activity may be determined in such pigs in vivo, as described in Example 12.

Plasma half-life

In one aspect of the invention, the CNP compounds have a protracted plasma exposure and have an extended in vivo plasma half-life relative to native CNP, which can be determined in a suitable pharmacokinetic in vivo study. Extended plasma exposure may be determined as plasma half-life (T%) after i.v. or s.c. administration to animals such as rats, Gottingen minipigs or domestic LYD pigs.

In some embodiments of the invention, the CNP compounds have a plasma half-life after i.v. administration to rat of at least 4 hours, more preferably at least 8 hours, or most preferably at least 10 hours, determined as described in Example 11.

In some embodiments of the invention, the CNP compounds have an in vivo plasma half-life after i.v. or s.c. administration to Gottingen minipigs of at least 10 hours, more preferably at least 40 hours, or most preferably at least 60 hours, determined as described in Example 12.

In one aspect of the invention, the compounds have suitable bioavailability after subcutaneous injection. Bioavailability (F%) may be determined as is known in the art in any suitable animal model.

The Gottingen minipigs or domestic LYD pigs are examples of a suitable animal models, and the bioavailability may be determined in such Gottingen minipigs or domestic LYD pigs in vivo, as described in Example 12.

In some embodiments of the invention, the CNP compounds have a bioavailability after s.c. administration to Gottingen minipigs of at least 40%, 50%, 60% or 70%.

In one aspect of the invention the compounds have suitable physical and chemical stability. Lack of physical or chemical stability could lead to changes in the compound structure leading to formation of chemical degradation products potentially having a reduced biological activity, decreased solubility, and/or increased immunogenic effect as compared to the intact compound. The physical stability can be evaluated by measuring the propensity for fibril formation, for example using a ThT assay as described in Example 6.

The chemical stability can be evaluated by measuring the amount of chemical degradation products (like isomers, isoAsp and hydrolysis products) at various time-points after exposure to different conditions like elevated temperature, e.g. as described in Example 8.

Stability could also be evaluated by looking into the molecules ability to form covalent dimers and multimers - referred to as HMWP, e.g. as described in Example 7.

According to a functional aspect of the invention, the CNP compounds have desirable solubility. Low solubility of CNP may significantly hamper its pharmaceutical formulation properties and therapeutic use, so developing a CNP compound with high solubility in relevant formulations would improve the therapeutic utility.

As described herein, solubility is measured as described in Example 5.

In certain embodiments, the CNP compounds of the invention have a solubility of at least at least 2000 pM, 3000 pM, or 4000 pM solubility at either pH 4 or pH 6.5.

Pharmaceutical compositions

In one aspect the invention concerns a pharmaceutical composition comprising a compound according to the invention, and pharmaceutically acceptable excipients. The compositions are suited for parenteral administration.

In one embodiment the compound is present in the formulation at a concentration of from about 0.1 mg/ml to about 50 mg/ml. In another aspect, the compound is present in the formulation at a concentration of from about 10 mg/ml to about 30 mg/ml.

In another embodiment, the formulation has a pH from 3.0 to 8.0. In another embodiment, the formulation has a pH from 3.5 to 5.5. In a further embodiment, the formulation has a pH from 6.0 to 7.0 Pharmaceutical compositions containing a compound according to the present invention may be prepared by conventional techniques, e.g. as described in Remington’s Pharmaceutical Sciences, 1985 or in Remington: The Science and Practice of Pharmacy, 19 th edition, 1995.

The formulation may further comprise a buffer system, preservative(s), isotonicity agent(s), chelating agent(s), stabilizers and/or surfactants. The use of such excipients in pharmaceutical compositions is well-known to the skilled person. For convenience reference is made to Remington: The Science and Practice of Pharmacy, 19 th edition, 1995. In one embodiment the pharmaceutical formulation is an aqueous formulation, i.e. formulation comprising water. Such formulation is typically a solution or a suspension. In a further embodiment of the invention the pharmaceutical formulation is an aqueous solution. The term “aqueous formulation” is defined as a formulation comprising at least 50 %w/w water. Likewise, the term “aqueous solution” is defined as a solution comprising at least 50 %w/w water, and the term “aqueous suspension” is defined as a suspension comprising at least 50 %w/w water.

In another embodiment the pharmaceutical formulation is a freeze-dried formulation, whereto the physician or the patient adds solvents and/or diluents prior to use. In another embodiment the pharmaceutical formulation is a dried formulation (e.g. freeze-dried or spray- dried) ready for use without any prior dissolution. By “dried form” is intended the liquid pharmaceutical composition or formulation is dried either by freeze drying (i.e., lyophilization; see, for example, Williams and Polli (1984) J. Parenteral Sci. Technol. 38:48-59), spray drying (see Masters (1991) in Spray-Drying Handbook (5 th ed; Longman Scientific and Technical, Essez, U.K.), pp. 491-676; Broadhead et al. (1992) Drug Devel. Ind. Pharm. 18:1169-1206; and Mumenthaler et al. (1994) Pharm. Res. 11:12-20), or air drying (Carpenter and Crowe (1988) Cryobiology 25:459-470; and Roser (1991) Biopharm. 4:47- 53).

In a further embodiment of the invention the buffer(s) are selected from the group consisting of acetate, carbonate, citrate, glycylglycine, histidine, glycine, lysine, arginine, dihydrogen phosphate, hydrogen phosphate, phosphate, and tris(hydroxymethyl)- aminomethan, bicine, tricine, malic acid, lactic acid, succinate, maleic acid, fumaric acid, tartaric acid, aspartic acid or mixtures thereof. Each one of these specific buffers constitutes an alternative embodiment of the invention.

In another embodiment of the invention the formulation further comprises a pharmaceutically acceptable preservative. In a further embodiment of the invention the formulation further comprises an isotonic agent, e.g. propylene glycol, mannitol or glycerol. In a further embodiment of the invention the formulation further comprises a chelating agent.

In another embodiment of the invention the formulation further comprises a stabilizer. The use of a stabilizer in pharmaceutical compositions is well-known to the skilled person. For convenience reference is made to Remington: The Science and Practice of Pharmacy, 19 th edition, 1995.

The pharmaceutical compositions of the invention may further comprise an amount of an amino acid base sufficient to decrease aggregate formation by the peptide during storage of the composition. By “amino acid base” is intended an amino acid or a combination of amino acids, where any given amino acid is present either in its free base form or in its salt form. Where a combination of amino acids is used, all of the amino acids may be present in their free base forms, all may be present in their salt forms, or some may be present in their free base forms while others are present in their salt forms. In one embodiment, amino acids used in preparing the compositions of the invention are those carrying a charged side chain, such as arginine, lysine, aspartic acid, and glutamic acid. Any stereoisomer (i.e., L, D, or a mixture thereof) of a particular amino acid (e.g. methionine, histidine, imidazole, arginine, lysine, isoleucine, aspartic acid, tryptophan, threonine and mixtures thereof) or combinations of these stereoisomers, may be present in the pharmaceutical compositions of the invention so long as the particular amino acid is present either in its free base form or its salt form. In one embodiment the L-stereoisomer is used. Compositions of the invention may also be formulated with derivatives of these amino acids. Suitable arginine derivatives include, for example, aminoguanidine, ornithine and N-monoethyl L-arginine, suitable methionine derivatives include ethionine and buthionine and suitable cysteine derivatives include S- methyl-L cysteine. As with the other amino acids, the amino acid derivatives are incorporated into the compositions in either their free base form or their salt form. In another embodiment of the invention the amino acids or amino acid derivatives thereof are used in a concentration, which is sufficient to prevent or delay aggregation of the protein.

In another embodiment of the invention the formulation further comprises a surfactant. In another embodiment of the invention the formulation further comprises protease inhibitors. The use of a protease inhibitor is particular useful in pharmaceutical compositions comprising zymogens of proteases in order to inhibit autocatalysis.

It is possible that other ingredients may be present in the pharmaceutical formulation of the present invention. Such additional ingredients may include wetting agents, emulsifiers, antioxidants, bulking agents, tonicity modifiers, chelating agents, metal ions, oleaginous vehicles, proteins (e.g., human serum albumin, gelatine or proteins) and a zwitterion (e.g., an amino acid such as betaine, taurine, arginine, glycine, lysine and histidine). Such additional ingredients, of course, should not adversely affect the overall stability of the pharmaceutical formulation of the present invention.

Pharmaceutical compositions according to the present invention may be administered to a patient in need of such treatment at several sites, for example, at topical sites, for example, skin and mucosal sites, at sites which bypass absorption, for example, administration in an artery, in a vein, in the heart, and at sites which involve absorption, for example, administration in the skin, under the skin, in a muscle or in the abdomen. Administration of pharmaceutical compositions according to the invention may be through several routes of administration, for example, lingual, sublingual, buccal, in the mouth, oral, in the stomach and intestine, nasal, pulmonary, for example, through the bronchioles and alveoli or a combination thereof, epidermal, dermal, transdermal, vaginal, rectal, ocular, for examples through the conjunctiva, uretal, and parenteral to patients in need of such a treatment.

Compositions of the current invention may be administered in several dosage forms, for example, as solutions, suspensions, emulsions, microemulsions, multiple emulsion, foams, salves, pastes, plasters, ointments, tablets, coated tablets, rinses, capsules, for example, hard gelatine capsules and soft gelatine capsules, suppositories, rectal capsules, drops, gels, sprays, powder, aerosols, inhalants, eye drops, ophthalmic ointments, ophthalmic rinses, vaginal pessaries, vaginal rings, vaginal ointments, injection solution, in situ transforming solutions, for example in situ gelling, in situ setting, in situ precipitating, in situ crystallization, infusion solution, and implants.

Compositions of the invention may further be compounded in, or attached to, for example through covalent, hydrophobic and electrostatic interactions, a drug carrier, drug delivery system and advanced drug delivery system in order to further enhance stability of the compound thereof increase bioavailability, increase solubility, decrease adverse effects, achieve chronotherapy well known to those skilled in the art, and increase patient compliance or any combination thereof.

Compositions of the current invention are useful in the formulation of solids, semisolids, powder and solutions for pulmonary administration of the CNP compound of the current invention, using, for example a metered dose inhaler, dry powder inhaler and a nebulizer, all being devices well known to those skilled in the art.

Compositions of the current invention are useful in the formulation of controlled, sustained, protracting, retarded, and slow-release drug delivery systems.

Parenteral administration may be performed by subcutaneous, intramuscular, intraperitoneal or intravenous injection by means of a syringe, optionally a pen-like syringe. Alternatively, parenteral administration can be performed by means of an infusion pump. A further option is a composition which may be a solution or suspension for the administration of the CNP compound of the current invention in the form of a nasal or pulmonal spray. As a still further option, the pharmaceutical compositions containing the peptide of the invention can also be adapted to transdermal administration, e.g. by needle-free injection or from a patch, optionally an iontophoretic patch, or transmucosal, e.g. buccal, administration. The CNP compound of the current invention can be administered via the pulmonary route in a vehicle, as a solution, suspension or dry powder using any of known types of devices suitable for pulmonary drug delivery. Examples of these comprise of, but are not limited to, the three general types of aerosol-generating for pulmonary drug delivery, and may include jet or ultrasonic nebulizers, metered-dose inhalers, or dry powder inhalers (cf. Yu J, Chien YW. Pulmonary drug delivery: Physiologic and mechanistic aspects. Crit Rev Ther Drug Carr Sys 14(4) (1997) 395-453).

In one embodiment of the invention the pharmaceutical formulation comprising the compound of the invention is stable for more than 6 weeks of usage and for more than 3 years of storage. In another embodiment of the invention the pharmaceutical formulation comprising the compound of the invention is stable for more than 2 weeks of usage and for more than two years of storage.

In one aspect a process for preparing a pharmaceutical composition comprising the compound according to the invention comprises mixing a compound according to the invention with at least one pharmaceutically acceptable excipient.

Medical indications

The present invention also relates to a compound for use as a medicament.

The term “treatment”, as used herein, refers to the medical treatment of any human subject in need thereof. The timing and purpose of said treatment may vary from one individual to another, according to the status of the subject’s health. Said treatment may be prophylactic, palliative, symptomatic and/or curative.

In one aspect, the compound of the invention may be used for treatment of cardiorenal-metabolic diseases. Cardio-renal-metabolic diseases, include, but are not restricted to, the group consisting of hypertension, arteriosclerosis, atherosclerosis, restenosis, acute myocardial infarction, pulmonary hypertension, acute decompensated heart failure, congestive heart failure, cardiac edema, renal edema, hepatic edema*, acute renal insufficiency, chronic renal insufficiency, insulin resistance, and type 2 diabetes.

In one embodiment, the compound of the invention is used for treatment of congestive heart failure.

In one embodiment, the compound of the invention is used for treatment of acute decompensated heart failure.

In one aspect, the compound of the invention may be used for treatment of growth disorders including short stature that may relate to FGFR3-related skeletal dysplasia, and related comorbidities. In some embodiments, the compound of the invention may be used in the treatment of a disease selected from the group consisting of achondroplasia, hypochondroplasia, thanatophoric dysplasia type 1 and type 2, SHOX deficiency, Noonan syndrome, Costello , LEOPARD syndrome, idiopathic short stature, autosomal dominant short stature, growth hormone deficiency, hypophosphatemic rickets, CNP deficiency, Aggrecan deficiency, Heterozygous NPR2 mutation, osteoarthritis, craniosynostosis, (e.g., Muenke syndrome, Crouzon syndrome, Apert syndrome, Jackson- Weiss syndrome, Pfeiffer syndrome, or Crouzonodermoskeletal syndrome), Lacrimo-Auriculo-Dento-Digital syndrome (LADD), Osteoglophonic dysplasia, and SADDAN (severe achondroplasia developmental delay acanthosis nigricans).

In some embodiments, the compound of the invention may be used in the treatment of a disease selected from the group consisting of osteogenesis imperfecta, achondrogenesis, chondrodysplasia punctata, homozygous achondroplasia, rhizomelic type of chondrodysplasia punctata, spondyloepiphyseal dysplasia congenita, congenital short femur, Langer-type mesomelic dysplasia, Neurofibromatosis, Legius syndrome and neurofibromatosis type 1.

In some embodiments, the compound of the invention may be used in the treatment of phenotypes related to growth disorders including short stature that may relate to FGFR3- related skeletal dysplasia, selected from the group consisting of growth retardation, skull deformities, orthodontic defects, cervical cord compression, spinal stenosis, pain in relation to skeletal dysplasia, hydrocephalus, hearing loss due to chronic otitis, cardiovascular disease, neurological disease, and obesity.

Unless otherwise indicated in the specification, terms presented in singular form also may include the plural situation.

List of Embodiments

The invention is further described by the following non-limiting embodiments:

Embodiment 1 : a CNP compound comprising a CNP peptide and a modifying group wherein the net charge of the compound at physiological pH is 0 or negative, wherein the CNP peptide comprises an amino acid sequence according to Formula I:

AA01 - AAO2-AAO3-AAO4-AAO5-AAO6-AAO7-AAO8-AAO9-AAI 0-AA11 -AAi 2-AA13-AA14-

AA15-AA16-AA17-AA18-AA19-AA20-AA21 -AA22-AA23-AA24-AA25-AA26-AA27-AA28-AA29-

AA30-AA31-AA32-AA33-AA34-AA35-AA36-AA37 wherein AAoi is Gin or absent,

AA02 is Glu or absent,

AA03 is His or absent,

AA04 is Pro or absent,

AAos is Asn or Gin or Glu or absent,

AAoe is Ala or absent,

AA07 is Arg or His or Ala or absent,

AAos is Lys or Ser or His or absent,

AA09 is Tyr or Glu or absent

AA10 is Lys or Glu or Gin or His or absent,

AA11 is Gly,

AA12 is Ala,

AA13 is Gin or Asn or Glu,

AA14 is Lys or His or Glu,

AA15 is Lys Ser or Glu or Thr or His,

AA is Gly,

AA17 is Leu or Gly or Ser or Vai,

AA is Ser or His

AA19 is Gin or Ser or Lys or His,

AA20 is Gly,

AA21 is Cys,

AA22 is Phe,

AA23 is Gly,

AA24 is Leu,

AA25 is Pro or Lys,

AA26 is Leu,

AA27 is Asp or Glu,

AA28 is Arg,

AA29 is lie,

AA30 is Gly,

AA31 is Ser,

AA32 is Leu or Nle or Met, AA33 is Ser,

AA34 is Gly,

AA35 is Leu,

AA36 is Gly, and

AA37 is Cys; wherein the modifying group comprises Chem. A, Chem. B and Chem. C; wherein Chem. A is selected from the group consisting of:

(Chem. A1), and

(Chem. A2) herein p is an integer in the range of 14-20, and where * denotes an amide bond connecting Chem. A and Chem. B; and wherein Chem. B is selected from the group consisting of: Chem. B1 and Chem. B2

(Chem. B2) wherein q is an integer in the range of 1-8, wherein * denotes an amide bond connecting Chem. A- and Chem. B-, wherein ** denotes an amide bond connecting Chem. B- and Chem. C-; and

Wherein Chem. C is selected from the group consisting of:

(Chem. 03) wherein r is an integer in the range of 0-4, wherein s is an integer in the range of 0-3, wherein t is an integer in the range of 0-1 , wherein

** denotes an amide bond connecting Chem. B- and Chem. C-, wherein *** denotes an amide bond connecting Chem. C- and the N-terminal alphaamine on the CNP peptide.

Embodiment 2: the CNP compound according to embodiment 1 , wherein AA13 of the CNP peptide is Gin; AA19 is Gin or Ser; AA25 is Pro; and AA32 is Leu.

Embodiment 3: the CNP compound according to embodiment 1 , wherein AAs of the CNP peptide is Gin; AA13 is Gin; AA19 is Gin or Ser; AA25 is Pro; and AA32 is Leu.

Embodiment 4: the CNP compound according to embodiment 1 , wherein the CNP peptide comprises one of the following amino acid sequences: YKGANKKGLSKGCFGLKLDRIGSXSGLGC SEQ ID NO: 6

NARKYKGANKSGLSSGCFGLKLDRIGSXSGLGC SEQ ID NO: 7

GANKKGLSKGCFGLKLDRIGSXSGLGC SEQ ID NO: 8

GAQKKGLSKGCFGLKLDRIGSXSGLGC SEQ ID NO: 9

YEGAQKKGLSKGCFGLKLDRIGSLSGLGC SEQ ID NO: 10

EEGAQKKGLSKGCFGLKLDRIGSLSGLGC SEQ ID NO: 11

YEGAQEKGLSKGCFGLKLDRIGSLSGLGC SEQ ID NO: 12

YEGAQKKGLSSGCFGLKLDRIGSLSGLGC SEQ ID NO: 13

YEGAQKKGLSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 14

YEGAQEKGLSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 15

YEGAQKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 16

YEGAQEKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 17

EKGAQEKGLSKGCFGLKLDRIGSLSGLGC SEQ ID NO: 18

EKGAQEKGLSSGCFGLKLDRIGSLSGLGC SEQ ID NO: 19

EQGAQEKGLSKGCFGLKLDRIGSLSGLGC SEQ ID NO: 20

YKGAQEKGLSKGCFGLKLDRIGSLSGLGC SEQ ID NO: 21

YKGAQKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 22

EHGAQEKGLSKGCFGLKLDRIGSLSGLGC SEQ ID NO: 23

YHGAQEKGLSKGCFGLKLDRIGSLSGLGC SEQ ID NO: 24

YHGAQEKGLSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 25

YHGAQKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 26

YHGAQEKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 27

YEGAEKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 28

EGAQEKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 29

EGAQKEGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 30

YEGAQKEGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 31

YHGAQKTGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 32

YHGAQKTGVSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 33

YHGAQHTGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 34

YKGAQHTGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 35

EHGAQKKGLSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 36

EHGAQKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 37

EHGAQKKGVSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 38

EHGAQKTGVSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 39

YHGAQHHGLSKGCFGLKLERIGSLSGLGC SEQ ID NO: 40

YKGAQHHGLSQGCFGLKLERIGSLSGLGC SEQ ID NO: 41

YEGAQKKGLSSGCFGLPLERIGSLSGLGC SEQ ID NO: 42

EGAQKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 43

YKGAQHHGLSQGCFGLKLDRIGSLSGLGC SEQ ID NO: 44

YKGAQHHGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 45

YHGAQHHGLSKGCFGLKLDRIGSLSGLGC SEQ ID NO: 46

YHGAQHHGLSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 47

GAQKKGLSHGCFGLPLDRIGSLSGLGC SEQ ID NO: 48

GAQKKGLHSGCFGLPLDRIGSLSGLGC SEQ ID NO: 49 ARKYHGAQHTGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 50 ARKYHGAQHTGVSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 51 ARKYHGAQKTGVSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 52 ARKEHGAQKTGVSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 53 ARKEHGAQHTGVSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 54 YEGAQKKGGSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 55 QEHPQARSYEGAQKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 57 QEHPEARSYEGAQKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 58 QEHPQAHKYHGAQHHGSSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 59 QEHPQAHKYKGAQKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 60 QEHPQAHKYHGAQKHGSSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 61 ARKYEGAQKKGLSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 63 ARKYKGAQKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 64 QEHPQARKYKGAQKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 67 QEHPQARKYEGAQKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 68 YEGAQKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 69 QEHPQARKYEGAQKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 70 QEHPQAAKYEGAQKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 71 QEHPQARHYKGAQKKGSSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 72 QEHPQAHKYKGAQKKGGSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 73 QEHPQARKYKGAQKKGLSKGCFGLKLDRIGSLSGLGC SEQ ID NO: 74 QEHPQARKYKGAQKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 75 QEHPQARKYKGAQKKGGSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 76 ARKYKGAQKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 77 ARKYHGAQHTGVSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 78 ARKYKGAQKTGVSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 79 ARKYHGAQKKGVSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 80 ARKYHGAQKTGVSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 81 ARKYKGAQKTGVSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 82 YHGAQKTGVSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 83 ARKYHGAQKSGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 84 YEGAQKKGGSHGCFGLPLDRIGSLSGLGC SEQ ID NO: 85 ARKYEGAQHKGGSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 86 YHGAQKKGGSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 87 YKGAQKKGGSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 88 YKGAQKKGVSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 89 YHGAQKKGVSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 90 QEHPQARKYEGAQKKGLSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 91 ARKYHGAQKKGVSSGCFGLPLERIGSLSGLGC SEQ ID NO: 92 ARKYKGAQKKGLSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 96 YHGAQKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 97 ARKYKGAQKKGLSQGCFGLKLDRIGSLSGLGC SEQ ID NO: 98 ARKYKGANKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 99 ARKYKGAQKKGLSQGCFGLPLDRIGSMSGLGC SEQ ID NO: 100 QEHPQARKYKGAQKKGLSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 101 ARKYKGAQKKGLSQGCFGLPLERIGSLSGLGC SEQ ID NO: 102 YKGAQKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 103 QEHPQARKYKGAQKKGLSSGCFGLPLERIGSLSGLGC SEQ ID NO: 104 YKGAQKKGGSQGCFGLPLERIGSLSGLGC SEQ ID NO: 108 YKGAQKKGLSQGCFGLPLERIGSLSGLGC SEQ ID NO: 109 GAQKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 112 GAQKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 113 GAQKKGGSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 114 GAQKKGGSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 115 GAQKKGLSQGCFGLKLDRIGSLSGLGC SEQ ID NO: 116 GAQKKGLSSGCFGLKLDRIGSLSGLGC SEQ ID NO: 117 GAQKKGGSQGCFGLKLDRIGSLSGLGC SEQ ID NO: 118 GAQKKGGSSGCFGLKLDRIGSLSGLGC SEQ ID NO: 119 GANKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 120 GANKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 121 GANKKGGSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 122 GANKKGGSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 123 GAQKKGLSQGCFGLPLDRIGSMSGLGC SEQ ID NO: 124 GAQKKGLSSGCFGLPLDRIGSMSGLGC SEQ ID NO: 125 GAQKKGGSQGCFGLPLDRIGSMSGLGC SEQ ID NO: 126 GAQKKGGSSGCFGLPLDRIGSMSGLGC SEQ ID NO: 127 GAQKKGLSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 128 GAQKKGGSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 129 GAQKKGLSQGCFGLPLERIGSLSGLGC SEQ ID NO: 130 GAQKKGLSSGCFGLPLERIGSLSGLGC SEQ ID NO: 131 GANKKGLSQGCFGLPLDRIGSMSGLGC SEQ ID NO: 132 GANKKGLSSGCFGLPLDRIGSMSGLGC SEQ ID NO: 133 GANKKGLSQGCFGLPLERIGSMSGLGC SEQ ID NO: 134 GANKKGLSSGCFGLPLERIGSMSGLGC SEQ ID NO: 135 GAQKKGSSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 136 GAQKKGSSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 137 GAQKKGSSQGCFGLKLDRIGSLSGLGC SEQ ID NO: 138 GAQKKGSSSGCFGLKLDRIGSLSGLGC SEQ ID NO: 139 GANKKGSSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 140 GANKKGSSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 141 GAQKKGSSQGCFGLPLDRIGSMSGLGC SEQ ID NO: 142 GAQKKGSSSGCFGLPLDRIGSMSGLGC SEQ ID NO: 143 GAQKKGSSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 144 YKGAQKKGGSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 145 YKGAQKKGLSQGCFGLKLDRIGSLSGLGC SEQ ID NO: 146 YKGAQKKGLSSGCFGLKLDRIGSLSGLGC SEQ ID NO: 147 YKGAQKKGGSQGCFGLKLDRIGSLSGLGC SEQ ID NO: 148 YKGAQKKGGSSGCFGLKLDRIGSLSGLGC SEQ ID NO: 149 YKGANKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 150 YKGANKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 151 YKGANKKGGSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 152 YKGANKKGGSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 153 YKGAQKKGLSQGCFGLPLDRIGSMSGLGC SEQ ID NO: 154 YKGAQKKGLSSGCFGLPLDRIGSMSGLGC SEQ ID NO: 155 YKGAQKKGGSQGCFGLPLDRIGSMSGLGC SEQ ID NO: 156 YKGAQKKGGSSGCFGLPLDRIGSMSGLGC SEQ ID NO: 157 YKGAQKKGLSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 158 YKGAQKKGGSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 159 YKGAQKKGLSQGCFGLPLERIGSLSGLGC SEQ ID NO: 160 YKGAQKKGLSSGCFGLPLERIGSLSGLGC SEQ ID NO: 161 YKGANKKGLSQGCFGLPLDRIGSMSGLGC SEQ ID NO: 162 YKGANKKGLSSGCFGLPLDRIGSMSGLGC SEQ ID NO: 163 YKGANKKGLSQGCFGLPLERIGSMSGLGC SEQ ID NO: 164 YKGANKKGLSSGCFGLPLERIGSMSGLGC SEQ ID NO: 165 YKGAQKKGSSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 166 YKGAQKKGSSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 167 YKGAQKKGSSQGCFGLKLDRIGSLSGLGC SEQ ID NO: 168 YKGAQKKGSSSGCFGLKLDRIGSLSGLGC SEQ ID NO: 169 YKGANKKGSSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 170 YKGANKKGSSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 171

YKGAQKKGSSQGCFGLPLDRIGSMSGLGC SEQ ID NO: 172 YKGAQKKGSSSGCFGLPLDRIGSMSGLGC SEQ ID NO: 173 YKGAQKKGSSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 174 ARKYKGAQKKGGSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 175 ARKYKGAQKKGGSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 176 ARKYKGAQKKGLSSGCFGLKLDRIGSLSGLGC SEQ ID NO: 177 ARKYKGAQKKGGSQGCFGLKLDRIGSLSGLGC SEQ ID NO: 178 ARKYKGAQKKGGSSGCFGLKLDRIGSLSGLGC SEQ ID NO: 179 ARKYKGANKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 180 ARKYKGANKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 181 ARKYKGANKKGGSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 182 ARKYKGANKKGGSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 183 ARKYKGAQKKGLSQGCFGLPLDRIGSMSGLGC SEQ ID NO: 184 ARKYKGAQKKGLSSGCFGLPLDRIGSMSGLGC SEQ ID NO: 185 ARKYKGAQKKGGSQGCFGLPLDRIGSMSGLGC SEQ ID NO: 186 ARKYKGAQKKGGSSGCFGLPLDRIGSMSGLGC SEQ ID NO: 187 ARKYKGAQKKGGSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 188 ARKYKGAQKKGLSQGCFGLPLERIGSLSGLGC SEQ ID NO: 189 ARKYKGAQKKGLSSGCFGLPLERIGSLSGLGC SEQ ID NO: 190 ARKYKGANKKGLSQGCFGLPLDRIGSMSGLGC SEQ ID NO: 191 ARKYKGANKKGLSSGCFGLPLDRIGSMSGLGC SEQ ID NO: 192 ARKYKGANKKGLSQGCFGLPLERIGSMSGLGC SEQ ID NO: 193 ARKYKGANKKGLSSGCFGLPLERIGSMSGLGC SEQ ID NO: 194

ARKYKGAQKKGSSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 195

ARKYKGAQKKGSSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 196

ARKYKGAQKKGSSQGCFGLKLDRIGSLSGLGC SEQ ID NO: 197

ARKYKGAQKKGSSSGCFGLKLDRIGSLSGLGC SEQ ID NO: 198

ARKYKGANKKGSSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 199

ARKYKGANKKGSSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 200

ARKYKGAQKKGSSQGCFGLPLDRIGSMSGLGC SEQ ID NO: 201

ARKYKGAQKKGSSSGCFGLPLDRIGSMSGLGC SEQ ID NO: 202

ARKYKGAQKKGSSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 203

GAQKKGSSQGCFGLPLERIGSLSGLGC SEQ ID NO: 232

Embodiment 5: the CNP compound according to embodiment 1, wherein the CNP peptide has any one of the following amino acid sequences:

YKGANKKGLSKGCFGLKLDRIGSXSGLGC SEQ ID NO: 6

NARKYKGANKSGLSSGCFGLKLDRIGSXSGLGC SEQ ID NO: 7

GANKKGLSKGCFGLKLDRIGSXSGLGC SEQ ID NO: 8

GAQKKGLSKGCFGLKLDRIGSXSGLGC SEQ ID NO: 9

YEGAQKKGLSKGCFGLKLDRIGSLSGLGC SEQ ID NO: 10

EEGAQKKGLSKGCFGLKLDRIGSLSGLGC SEQ ID NO: 11

YEGAQEKGLSKGCFGLKLDRIGSLSGLGC SEQ ID NO: 12

YEGAQKKGLSSGCFGLKLDRIGSLSGLGC SEQ ID NO: 13

YEGAQKKGLSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 14

YEGAQEKGLSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 15

YEGAQKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 16

YEGAQEKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 17

EKGAQEKGLSKGCFGLKLDRIGSLSGLGC SEQ ID NO: 18

EKGAQEKGLSSGCFGLKLDRIGSLSGLGC SEQ ID NO: 19

EQGAQEKGLSKGCFGLKLDRIGSLSGLGC SEQ ID NO: 20

YKGAQEKGLSKGCFGLKLDRIGSLSGLGC SEQ ID NO: 21

YKGAQKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 22

EHGAQEKGLSKGCFGLKLDRIGSLSGLGC SEQ ID NO: 23

YHGAQEKGLSKGCFGLKLDRIGSLSGLGC SEQ ID NO: 24

YHGAQEKGLSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 25

YHGAQKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 26

YHGAQEKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 27

YEGAEKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 28

EGAQEKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 29

EGAQKEGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 30

YEGAQKEGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 31

YHGAQKTGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 32

YHGAQKTGVSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 33

YHGAQHTGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 34 YKGAQHTGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 35 EHGAQKKGLSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 36 EHGAQKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 37 EHGAQKKGVSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 38 EHGAQKTGVSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 39 YHGAQHHGLSKGCFGLKLERIGSLSGLGC SEQ ID NO: 40 YKGAQHHGLSQGCFGLKLERIGSLSGLGC SEQ ID NO: 41 YEGAQKKGLSSGCFGLPLERIGSLSGLGC SEQ ID NO: 42 EGAQKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 43 YKGAQHHGLSQGCFGLKLDRIGSLSGLGC SEQ ID NO: 44 YKGAQHHGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 45 YHGAQHHGLSKGCFGLKLDRIGSLSGLGC SEQ ID NO: 46 YHGAQHHGLSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 47 GAQKKGLSHGCFGLPLDRIGSLSGLGC SEQ ID NO: 48 GAQKKGLHSGCFGLPLDRIGSLSGLGC SEQ ID NO: 49 ARKYHGAQHTGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 50 ARKYHGAQHTGVSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 51 ARKYHGAQKTGVSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 52 ARKEHGAQKTGVSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 53 ARKEHGAQHTGVSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 54 YEGAQKKGGSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 55 QEHPQARSYEGAQKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 57 QEHPEARSYEGAQKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 58 QEHPQAHKYHGAQHHGSSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 59 QEHPQAHKYKGAQKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 60 QEHPQAHKYHGAQKHGSSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 61 ARKYEGAQKKGLSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 63 ARKYKGAQKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 64 QEHPQARKYKGAQKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 67 QEHPQARKYEGAQKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 68 YEGAQKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 69 QEHPQARKYEGAQKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 70 QEHPQAAKYEGAQKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 71 QEHPQARHYKGAQKKGSSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 72 QEHPQAHKYKGAQKKGGSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 73 QEHPQARKYKGAQKKGLSKGCFGLKLDRIGSLSGLGC SEQ ID NO: 74 QEHPQARKYKGAQKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 75 QEHPQARKYKGAQKKGGSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 76

ARKYKGAQKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 77 ARKYHGAQHTGVSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 78 ARKYKGAQKTGVSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 79 ARKYHGAQKKGVSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 80 ARKYHGAQKTGVSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 81 ARKYKGAQKTGVSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 82 YHGAQKTGVSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 83 ARKYHGAQKSGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 84 YEGAQKKGGSHGCFGLPLDRIGSLSGLGC SEQ ID NO: 85 ARKYEGAQHKGGSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 86 YHGAQKKGGSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 87 YKGAQKKGGSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 88 YKGAQKKGVSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 89 YHGAQKKGVSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 90 QEHPQARKYEGAQKKGLSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 91 ARKYHGAQKKGVSSGCFGLPLERIGSLSGLGC SEQ ID NO: 92 YHGAQKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 97 ARKYKGAQKKGLSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 96 ARKYKGAQKKGLSQGCFGLKLDRIGSLSGLGC SEQ ID NO: 98 ARKYKGANKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 99 ARKYKGAQKKGLSQGCFGLPLDRIGSMSGLGC SEQ ID NO: 100 QEHPQARKYKGAQKKGLSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 101 ARKYKGAQKKGLSQGCFGLPLERIGSLSGLGC SEQ ID NO: 102 YKGAQKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 103 QEHPQARKYKGAQKKGLSSGCFGLPLERIGSLSGLGC SEQ ID NO: 104 YKGAQKKGGSQGCFGLPLERIGSLSGLGC SEQ ID NO: 108 YKGAQKKGLSQGCFGLPLERIGSLSGLGC SEQ ID NO: 109 GAQKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 112 GAQKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 113 GAQKKGGSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 114 GAQKKGGSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 115 GAQKKGLSQGCFGLKLDRIGSLSGLGC SEQ ID NO: 116 GAQKKGLSSGCFGLKLDRIGSLSGLGC SEQ ID NO: 117 GAQKKGGSQGCFGLKLDRIGSLSGLGC SEQ ID NO: 118 GAQKKGGSSGCFGLKLDRIGSLSGLGC SEQ ID NO: 119 GANKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 120 GANKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 121 GANKKGGSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 122 GANKKGGSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 123 GAQKKGLSQGCFGLPLDRIGSMSGLGC SEQ ID NO: 124 GAQKKGLSSGCFGLPLDRIGSMSGLGC SEQ ID NO: 125 GAQKKGGSQGCFGLPLDRIGSMSGLGC SEQ ID NO: 126 GAQKKGGSSGCFGLPLDRIGSMSGLGC SEQ ID NO: 127 GAQKKGLSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 128 GAQKKGGSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 129 GAQKKGLSQGCFGLPLERIGSLSGLGC SEQ ID NO: 130 GAQKKGLSSGCFGLPLERIGSLSGLGC SEQ ID NO: 131 GANKKGLSQGCFGLPLDRIGSMSGLGC SEQ ID NO: 132 GANKKGLSSGCFGLPLDRIGSMSGLGC SEQ ID NO: 133 GANKKGLSQGCFGLPLERIGSMSGLGC SEQ ID NO: 134 GANKKGLSSGCFGLPLERIGSMSGLGC SEQ ID NO: 135

GAQKKGSSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 136

GAQKKGSSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 137

GAQKKGSSQGCFGLKLDRIGSLSGLGC SEQ ID NO: 138

GAQKKGSSSGCFGLKLDRIGSLSGLGC SEQ ID NO: 139

GANKKGSSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 140

GANKKGSSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 141

GAQKKGSSQGCFGLPLDRIGSMSGLGC SEQ ID NO: 142

GAQKKGSSSGCFGLPLDRIGSMSGLGC SEQ ID NO: 143

GAQKKGSSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 144

YKGAQKKGGSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 145

YKGAQKKGLSQGCFGLKLDRIGSLSGLGC SEQ ID NO: 146

YKGAQKKGLSSGCFGLKLDRIGSLSGLGC SEQ ID NO: 147

YKGAQKKGGSQGCFGLKLDRIGSLSGLGC SEQ ID NO: 148

YKGAQKKGGSSGCFGLKLDRIGSLSGLGC SEQ ID NO: 149

YKGANKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 150

YKGANKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 151

YKGANKKGGSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 152

YKGANKKGGSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 153

YKGAQKKGLSQGCFGLPLDRIGSMSGLGC SEQ ID NO: 154

YKGAQKKGLSSGCFGLPLDRIGSMSGLGC SEQ ID NO: 155

YKGAQKKGGSQGCFGLPLDRIGSMSGLGC SEQ ID NO: 156

YKGAQKKGGSSGCFGLPLDRIGSMSGLGC SEQ ID NO: 157

YKGAQKKGLSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 158

YKGAQKKGGSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 159

YKGAQKKGLSQGCFGLPLERIGSLSGLGC SEQ ID NO: 160

YKGAQKKGLSSGCFGLPLERIGSLSGLGC SEQ ID NO: 161

YKGANKKGLSQGCFGLPLDRIGSMSGLGC SEQ ID NO: 162

YKGANKKGLSSGCFGLPLDRIGSMSGLGC SEQ ID NO: 163

YKGANKKGLSQGCFGLPLERIGSMSGLGC SEQ ID NO: 164

YKGANKKGLSSGCFGLPLERIGSMSGLGC SEQ ID NO: 165

YKGAQKKGSSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 166

YKGAQKKGSSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 167

YKGAQKKGSSQGCFGLKLDRIGSLSGLGC SEQ ID NO: 168

YKGAQKKGSSSGCFGLKLDRIGSLSGLGC SEQ ID NO: 169

YKGANKKGSSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 170

YKGANKKGSSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 171

YKGAQKKGSSQGCFGLPLDRIGSMSGLGC SEQ ID NO: 172

YKGAQKKGSSSGCFGLPLDRIGSMSGLGC SEQ ID NO: 173

YKGAQKKGSSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 174

ARKYKGAQKKGGSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 175

ARKYKGAQKKGGSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 176

ARKYKGAQKKGLSSGCFGLKLDRIGSLSGLGC SEQ ID NO: 177

ARKYKGAQKKGGSQGCFGLKLDRIGSLSGLGC SEQ ID NO: 178 ARKYKGAQKKGGSSGCFGLKLDRIGSLSGLGC SEQ ID NO: 179 ARKYKGANKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 180 ARKYKGANKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 181 ARKYKGANKKGGSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 182 ARKYKGANKKGGSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 183 ARKYKGAQKKGLSQGCFGLPLDRIGSMSGLGC SEQ ID NO: 184 ARKYKGAQKKGLSSGCFGLPLDRIGSMSGLGC SEQ ID NO: 185 ARKYKGAQKKGGSQGCFGLPLDRIGSMSGLGC SEQ ID NO: 186 ARKYKGAQKKGGSSGCFGLPLDRIGSMSGLGC SEQ ID NO: 187 ARKYKGAQKKGGSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 188 ARKYKGAQKKGLSQGCFGLPLERIGSLSGLGC SEQ ID NO: 189 ARKYKGAQKKGLSSGCFGLPLERIGSLSGLGC SEQ ID NO: 190 ARKYKGANKKGLSQGCFGLPLDRIGSMSGLGC SEQ ID NO: 191 ARKYKGANKKGLSSGCFGLPLDRIGSMSGLGC SEQ ID NO: 192 ARKYKGANKKGLSQGCFGLPLERIGSMSGLGC SEQ ID NO: 193 ARKYKGANKKGLSSGCFGLPLERIGSMSGLGC SEQ ID NO: 194 ARKYKGAQKKGSSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 195 ARKYKGAQKKGSSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 196 ARKYKGAQKKGSSQGCFGLKLDRIGSLSGLGC SEQ ID NO: 197 ARKYKGAQKKGSSSGCFGLKLDRIGSLSGLGC SEQ ID NO: 198 ARKYKGANKKGSSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 199 ARKYKGANKKGSSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 200 ARKYKGAQKKGSSQGCFGLPLDRIGSMSGLGC SEQ ID NO: 201 ARKYKGAQKKGSSSGCFGLPLDRIGSMSGLGC SEQ ID NO: 202

ARKYKGAQKKGSSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 203 QEHPQARKYKGAQKKGGSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 204 QEHPQARKYKGAQKKGLSQGCFGLKLDRIGSLSGLGC SEQ ID NO: 205 QEHPQARKYKGAQKKGLSSGCFGLKLDRIGSLSGLGC SEQ ID NO: 206 QEHPQARKYKGAQKKGGSQGCFGLKLDRIGSLSGLGC SEQ ID NO: 207 QEHPQARKYKGAQKKGGSSGCFGLKLDRIGSLSGLGC SEQ ID NO: 208 QEHPNARKYKGANKKGLSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 209 QEHPNARKYKGANKKGLSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 210 QEHPNARKYKGANKKGGSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 211 QEHPNARKYKGANKKGGSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 212 QEHPQARKYKGAQKKGLSQGCFGLPLDRIGSMSGLGC SEQ ID NO: 213 QEHPQARKYKGAQKKGLSSGCFGLPLDRIGSMSGLGC SEQ ID NO: 214 QEHPQARKYKGAQKKGGSQGCFGLPLDRIGSMSGLGC SEQ ID NO: 215 QEHPQARKYKGAQKKGGSSGCFGLPLDRIGSMSGLGC SEQ ID NO: 216 QEHPQARKYKGAQKKGGSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 217 QEHPQARKYKGAQKKGLSQGCFGLPLERIGSLSGLGC SEQ ID NO: 218 QEHPNARKYKGANKKGLSQGCFGLPLDRIGSMSGLGC SEQ ID NO: 219 QEHPNARKYKGANKKGLSSGCFGLPLDRIGSMSGLGC SEQ ID NO: 220 QEHPNARKYKGANKKGLSQGCFGLPLERIGSMSGLGC SEQ ID NO: 221 QEHPNARKYKGANKKGLSSGCFGLPLERIGSMSGLGC SEQ ID NO: 222 QEHPQARKYKGAQKKGSSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 223

QEHPQARKYKGAQKKGSSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 224

QEHPQARKYKGAQKKGSSQGCFGLKLDRIGSLSGLGC SEQ ID NO: 225

QEHPQARKYKGAQKKGSSSGCFGLKLDRIGSLSGLGC SEQ ID NO: 226

QEHPNARKYKGANKKGSSQGCFGLPLDRIGSLSGLGC SEQ ID NO: 227

QEHPNARKYKGANKKGSSSGCFGLPLDRIGSLSGLGC SEQ ID NO: 228

QEHPQARKYKGAQKKGSSQGCFGLPLDRIGSMSGLGC SEQ ID NO: 229

QEHPQARKYKGAQKKGSSSGCFGLPLDRIGSMSGLGC SEQ ID NO: 230

QEHPQARKYKGAQKKGSSKGCFGLPLDRIGSLSGLGC SEQ ID NO: 231

GAQKKGSSQGCFGLPLERIGSLSGLGC SEQ ID NO: 232

Embodiment s: the CNP compound according to embodiment 1 , wherein the CNP peptide has any one of the following amino acid sequences:

GAQKKGSSQGCFGLPLDRIGSLSGLGC (SEQ ID NO: 136), ARKYKGAQKKGLSQGCFGLPLDRIGSLSGLGC (SEQ ID NO: 77), YKGAQKKGGSQGCFGLPLDRIGSLSGLGC (SEQ ID NO: 88), YKGAQKKGLSQGCFGLPLDRIGSLSGLGC (SEQ ID NO: 103), QEHPQARKYKGAQKKGLSSGCFGLPLDRIGSLSGLGC (SEQ ID NO: 67), and QEHPQARKYKGAQKKGLSSGCFGLPLERIGSLSGLGC (SEQ ID NO: 104).

Embodiment 7: the CNP compound according to embodiment 1 , wherein the CNP peptide has the following amino acid sequence:

QEHPQARKYKGAQKKGLSSGCFGLPLDRIGSLSGLGC (SEQ ID NO: 67).

Embodiment 8: the CNP compound according to any one of the preceding embodiments, wherein the modifying group is covalently attached to the N-terminal alphaamine of the CNP peptide.

Embodiment 9: the CNP compound according to any one of the preceding embodiments, wherein Chem. A of the modifying group has a p of 16.

Embodiment 10: the CNP compound according to embodiments 1-8, wherein Chem. A of the modifying group is Chem. A2

(Chem. A2) wherein p is 16.

Embodiment 11: the CNP compound according to any one of the preceding embodiments, wherein Chem. B of the modifying group has a q of 1-5.

Embodiment 12: the CNP compound according to any one of the preceding embodiments, wherein the modifying group is selected from the following non-limiting examples Chem. E, Chem. F, Chem. G, Chem. H, Chem. I, and Chem. J (in which the dotted line defines the attachment through an amide bond to the CNP peptide)

(Chem. G)

(Chem. J).

Embodiment 13: the CNP compound according to any one of the preceding embodiments, wherein the modifying group is Chem. I.

Embodiment 14: a CNP compound comprising a CNP peptide and a modifying group comprising a Chem. A, a Chem. B and a Chem. C, wherein the compound is according to any one of the compounds disclosed in Table 1 (see below). Embodiment 15: a CNP compound comprising a CNP peptide and a modifying group wherein the compound is according to any one of the compounds disclosed in Table 1a.

Table 1a:

CNP peptide - with

Compound sequence modifications SEQ ID Modifying group vis-a-vis CNP37 ID NO gGlu-2xOEG- des1-10, 13Q, 17S, 19Q,

9384 C18d IxGQAP 25P, 32L 62 des1-5, 13Q, 19Q, 25P,

9407 C18d 5xgGlu-4xOEG 32 L 77 des1-8, 13Q, 17G, 19Q,

9435 C18d 2xgGlu-4xOEG 25P, 32L 88 des1-8, 13Q, 19Q, 25P,

9480 C18d 3xgGlu-4xOEG 32 L 103

9482 C18d 5xgGlu 5Q, 13Q, 19S, 25P, 32L 67 5Q, 13Q, 19S, 25P, 27E,

9483 C18d 4xgGlu 32 L 104

Embodiment 16: a CNP compound comprising a CNP peptide and a modifying group, wherein the CNP peptide has the following amino acid sequence,

QEHPQARKYKGAQKKGLSSGCFGLPLDRIGSLSGLGC (SEQ ID NO: 67), and wherein the modifying group is Chem. I.

Embodiment 17: a CNP compound according to Formula II:

(Formula II).

Embodiment 18: a CNP compound according to any one of Formula II, III, IV, V, VI, and VII:

(Formula IV)

(Formula VI)

(Formula VII)

Embodiment 19: the compound according to any one of the embodiments 1-18 wherein the net charge of the CNP compound at physiological pH is 0 to -4, determined as described in Example 4.

Embodiment 20: the compound according to any one of the embodiments 1-18 wherein the compound has a in vivo half-life after s.c. administration to Gottingen minipigs of at least 10 hours, determined as described in Example 12.

Embodiment 21: the compound according to any one of the embodiments 1-18 wherein the compound has a in vivo half-life after s.c. administration to Gottingen minipigs of at least 20 hours, determined as described in Example 12.

Embodiment 22: the compound according to any one of the embodiments 1-18 wherein the compound has a in vivo half-life after s.c. administration to Gottingen minipigs of at least 30 hours, determined as described in Example 12. Embodiment 23: the compound according to any one of the embodiments 1-18 wherein the compound has a in vivo half-life after s.c. administration to Gottingen minipigs of at least 40 hours, determined as described in Example 12.

Embodiment 24: the compound according to any one of the embodiments 1-18 wherein the compound has a in vivo half-life after s.c. administration to Gottingen minipigs of at least 50 hours, determined as described in Example 12.

Embodiment 25: the compound according to any one of the embodiments 1-18 wherein the compound has a bioavailability after s.c. administration to Gottingen minipigs of at least 40%, determined as described in Example 12.

Embodiment 26: the compound according to any one of the embodiments 1-18 wherein the compound has a bioavailability after s.c. administration to Gottingen minipigs of at least 50%, determined as described in Example 12.

Embodiment 27: the compound according to any one of the embodiments 1-18 wherein the compound has a bioavailability after s.c. administration to Gottingen minipigs of at least 60%, determined as described in Example 12.

Embodiment 28: the compound according to any one of the embodiments 1-18 wherein the compound has a bioavailability after s.c. administration to Gottingen minipigs of at least 70%, determined as described in Example 12.

Embodiment 29: the compound according to any one of the embodiments 1-18 wherein the compound has a solubility of at least at least 2000 pM at either pH 4 or pH 6.5 measured as described in Example 5.

Embodiment 30: the compound according to any one of the embodiments 1-18 wherein the compound has a solubility of at least at least 3000 pM at either pH 4 or pH 6.5 measured as described in Example 5. Embodiment 31: the compound according to any one of the embodiments 1-18 wherein the compound has a solubility of at least at least 4000 pM at either pH 4 or pH 6.5 measured as described in Example 5.

Embodiment 32: the compound according to any one of the embodiments 1-31 wherein the compound comprises an intramolecular disulfide bridge resulting in a cyclic structure.

Embodiment 33: a pharmaceutical composition comprising a compound according to any one of embodiments 1-32, and one or more pharmaceutically acceptable excipients.

Embodiment 34: the compound according to any one of the embodiments 1-32, or a composition according to embodiment 33, for the use in the treatment or prevention of cardio-renal-metabolic diseases.

Embodiment 35: the compound according to any one of the embodiments 1-32, or a composition according to embodiment 33, for the use in the treatment or prevention of cardio-renal-metabolic diseases, including the group consisting of hypertension, arteriosclerosis, atherosclerosis, restenosis, acute myocardial infarction, pulmonary hypertension, acute decompensated heart failure, congestive heart failure, cardiac edema, renal edema, hepatic edema*, acute renal insufficiency, chronic renal insufficiency, insulin resistance, and type 2 diabetes.

Embodiment 36: the compound according to any one of the embodiments 1-32, or a composition according to embodiment 33, for the use in the treatment or prevention of congestive heart failure.

Embodiment 37: the compound according to any one of the embodiments 1-32, or a composition according to embodiment 33, for the use in the treatment or prevention of decompensated heart failure.

Embodiment 38: the compound according to any one of the embodiments 1-32, or a composition according to embodiment 33, for the use in the treatment or prevention of growth disorders including short stature that may relate to FGFR3-related skeletal dysplasia, and related comorbidities. Embodiment 39: the compound according to any one of the embodiments 1-32, or a composition according to embodiment 33, for the use in the treatment or prevention of achondroplasia, hypochondroplasia, thanatophoric dysplasia type 1 and type 2, SHOX deficiency, Noonan syndrome, Costello , LEOPARD syndrome, idiopathic short stature, autosomal dominant short stature, growth hormone deficiency, hypophosphatemic rickets, CNP deficiency, Aggrecan deficiency, Heterozygous NPR2 mutation, osteoarthritis, craniosynostosis, (e.g., Muenke syndrome, Crouzon syndrome, Apert syndrome, Jackson- Weiss syndrome, Pfeiffer syndrome, or Crouzonodermoskeletal syndrome), Lacrimo- Auriculo-Dento-Digital syndrome (LADD), Osteoglophonic dysplasia, and SADDAN (severe achondroplasia developmental delay acanthosis nigricans).

Embodiment 40: the compound according to any one of the embodiments 1-32, or a composition according to embodiment 33, for the use in the treatment or prevention of osteogenesis imperfecta, achondrogenesis, chondrodysplasia punctata, homozygous achondroplasia, rhizomelic type of chondrodysplasia punctata, spondyloepiphyseal dysplasia congenita, congenital short femur, Langer-type mesomelic dysplasia, Neurofibromatosis, Legius syndrome and neurofibromatosis type 1.

Embodiment 41 : the compound according to any one of the embodiments 1-32, or a composition according to embodiment 33, for the use in the treatment or prevention of phenotypes related to growth disorders including short stature that may relate to FGFR3- related skeletal dysplasia, selected from the group consisting of growth retardation, skull deformities, orthodontic defects, cervical cord compression, spinal stenosis, pain in relation to skeletal dysplasia, hydrocephalus, hearing loss due to chronic otitis, cardiovascular disease, neurological disease, and obesity.

Embodiment 42: a method of treating or preventing cardio-renal-metabolic diseases, comprising administering to a patient in need thereof an effective amount of the compound according to any one of the embodiments 1-32, or a composition according to embodiment 33.

Embodiment 43: a method of treating or preventing cardio-renal-metabolic diseases, including the group consisting of hypertension, arteriosclerosis, atherosclerosis, restenosis, acute myocardial infarction, pulmonary hypertension, acute decompensated heart failure, congestive heart failure, cardiac edema, renal edema, hepatic edema*, acute renal insufficiency, chronic renal insufficiency, insulin resistance, and type 2 diabetes, comprising administering to a patient in need thereof an effective amount of the compound according to any one of the embodiments 1-32, or a composition according to embodiment 33.

Embodiment 44: a method of treating or preventing growth disorders including short stature that may relate to FGFR3-related skeletal dysplasia, and related comorbidities, comprising administering to a patient in need thereof an effective amount of the compound according to any one of the embodiments 1-32, or a composition according to embodiment 33.

Embodiment 45: a method of treating or preventing achondroplasia, hypochondroplasia, thanatophoric dysplasia type 1 and type 2, SHOX deficiency, Noonan syndrome, Costello , LEOPARD syndrome, idiopathic short stature, autosomal dominant short stature, growth hormone deficiency, hypophosphatemic rickets, CNP deficiency, Aggrecan deficiency, Heterozygous NPR2 mutation, osteoarthritis, craniosynostosis, (e.g., Muenke syndrome, Crouzon syndrome, Apert syndrome, Jackson- Weiss syndrome, Pfeiffer syndrome, or Crouzonodermoskeletal syndrome), Lacrimo-Auriculo-Dento-Digital syndrome (LADD), Osteoglophonic dysplasia, and SADDAN (severe achondroplasia developmental delay acanthosis nigricans), comprising administering to a patient in need thereof an effective amount of the compound according to any one of the embodiments 1-32, or a composition according to embodiment 33.

Embodiment 46: a method of treating or preventing osteogenesis imperfecta, achondrogenesis, chondrodysplasia punctata, homozygous achondroplasia, rhizomelic type of chondrodysplasia punctata, spondyloepiphyseal dysplasia congenita, congenital short femur, Langer-type mesomelic dysplasia, Neurofibromatosis, Legius syndrome and neurofibromatosis type 1, comprising administering to a patient in need thereof an effective amount of the compound according to any one of the embodiments 1-32, or a composition according to embodiment 33.

Embodiment 47: a method of treating or preventing phenotypes related to growth disorders including short stature that may relate to FGFR3-related skeletal dysplasia, selected from the group consisting of growth retardation, skull deformities, orthodontic defects, cervical cord compression, spinal stenosis, pain in relation to skeletal dysplasia, hydrocephalus, hearing loss due to chronic otitis, cardiovascular disease, neurological disease, and obesity, comprising administering to a patient in need thereof an effective amount of the compound according to any one of the embodiments 1-32, or a composition according to embodiment 33.

EXAMPLES

Materials and Methods

List of Abbreviations

2-CITrt 2-Chlorotrityl resin

Aldrithiol-4 4,4'-Dipyridyl disulfide

AUC Area under the curve

BEH Ethylene Bridged Hybrid

Boc tert-Butyloxycarbonyl

C18d Octadecanedioic acid

C20d Eicosanedioic acid

CAD Charged aerosol detector cGMP Cyclic guanosine monophosphate

CL Clearance

CSH Charged Surface Hybrid

DCM Dichloromethane

DgGlu □-configuration gamma-glutamoyl

DIC N,N'-Diisopropylcarbodiimide

DMEM Dulbecco’s Modified Eagle Medium

DMF Dimethylformamide

DMSO Dimethyl sulfoxide

DTT Dithiothreitol

EDTA Ethylenediaminetetraacetic acid

ESI Electrospray ionisation

F% Bioavailability

Fd Faraday

Fmoc Fluorenylmethyloxycarbonyl

FPLC Fast protein liquid chromatography gGlu Gamma-glutamoyl HEPES 2-[4-(2-Hydroxyethyl)piperazin-1 -yl]ethane-1 -sulfonic acid

HFIP Hexafluoro-2-propanol

HMWP High molecular weight protein

HSA Human serum albumin i.v. Intravenous

I PA Isopropanol

LCMS Liquid chromatography-mass spectrometry

LLOQ Lower limit of quantitation

LYD Landrace, Yorkshire & Duroc

MeCN Acetonitrile

MMPX 8-Methoxymethyl-3-isobutyl 1 -methylxanthine

MS Mass spectrometry

NAD No abnormalities detected

NCA Non-compartmental analysis n.d. not detected

Nle (X) Norleucine

NMP N-Methyl-2-pyrrolidone

OEG Oligoethylene glycol

Oxyma Pure Ethyl cyanohydroxyiminoacetate

Pbf 2,2,4,6,7-pentamethyldihydrobenzofuran-5-sulfonyl

PBS Phosphate buffered saline

PD Pharmacodynamics

PDA Photodiode-array detection

PK Pharmacokinetics

QC Quality control

RP Reversed phase

RPM Rounds per minute s.c. Subcutaneous

SEC Size-exclusion chromatography

SIL Stable isotope labelled

SPPS Solid-phase peptide synthesis

T 1 / 2 Half-life tBu tert-Butyl

Tetrazol e-C 18 17-(2H-T etrazol-5-yl)heptadecanoic acid TF Time-of-flight TFA Trifluoroacetic acid

ThT Thioflavin T

TIPS Triisopropyl silane

Tris 2-Amino-2-(hydroxymethyl)propane-1,3-diol

Trt T rityl

TUV Tunable UV

LIPLC Ultra-performance liquid chromatography

UV Ultraviolet

General Methods of

Method A - Solid-i

Peptides can be synthesized by solid-phase peptide synthesis which is well known in the art, below is described methods used to synthesize the exemplified compounds of the present invention.

Synthesis of compounds was performed on a SymphonyX Solid Phase Peptide Synthesizer (GYROS Protein Technologies AB, Tucson, AZ).

Typically synthesis was performed using 450 pmol resin, but syntheses using 150 or 300 pmol resin were also used. In a typical synthesis, the resin was washed in DMF. After washing with DMF, the resin was incubated with Fmoc-protected amino acid (5 eq., 0.3 M in 0.3 M Oxyma Pure in DMF, 7.5 mL), DIG (5 eq., 0.75 M in DMF, 3.0 mL), and collidine (5 eq., 0.75 M in DMF, 3.0 mL) for 30 min. Additional DIG (5 eq., 0.75 M in DMF, 3.0 mL) was then added and the resin incubated for 90 min. After each coupling, the resin was capped by treatment with acetic anhydride (1 M, 7.5 mL) and collidine (0.75 M, 3.0 mL) in DMF for 20 min. Fatty acids were coupled using fatty acid mono-tert-butyl ester (5 eq., 0.3 M in 0.3 M Oxyma Pure, 7.5 mL), DIG (5 eq., 0.75 M in DMF, 3.0 mL), and collidine (5 eq., 0.75 M in DMF, 3.0 mL) for 6 h.

The Fmoc-protected amino acids used were the standard recommended: Fmoc-Ala-OH, Fmoc-Arg(Pbf)-OH, Fmoc-Asn(Trt)-OH, Fmoc-Asp(OtBu)-OH, Fmoc-Cys(Trt)- OH, Fmoc-Gln(Trt)-OH, Fmoc-Glu(OtBu)-OH, Fmoc-Gly-OH, Fmoc-His(Trt)-OH, Fmoc-lle- OH, Fmoc-Leu-OH, Fmoc-Lys(Boc)-OH, Fmoc-Met-OH, Fmoc-Phe-OH, Fmoc-Pro-OH, Fmoc-Ser(tBu)-OH, Fmoc-Thr(tBu)-OH, Fmoc-Trp(Boc)-OH, Fmoc-Tyr(tBu)-OH, Fmoc-Val- OH and Fmoc-Nle-OH, supplied from e.g. Anaspec, Bachem, Iris Biotech or NovabioChem. Where nothing else is specified the naturally occurring L-form of the amino acids were used. In cases where a serine or a threonine is present in the peptide, pseudoproline di-peptides may be used (see also W.R. Sampson et al., J. Pept. Sci. 1999, 5, 403-409).

For peptides acylated at any position during SPPS the following suitably protected building blocks such as, but not limited to, Fmoc-8-amino-3,6-dioxaoctanoic acid and Boc- Glu(Fmoc)-OH were supplied from e.g. Anaspec, Bachem, Iris Biotech, or Novabiochem.

Octadecanedioic acid mono-tert-butyl-ester and eicosanedioic acid mono-tert-butyl ester was prepared as is known in the art, e.g. as described in WO 2010102886 A1.

17-(2H-tetrazol-5-yl)heptadecanoic acid (Tetrazole-C18) was incorporated by coupling the protected building block (S)-4-(17-(1 H-tetrazol-5-yl)heptadecanamido)-5-(tert- butoxy)-5-oxopentanoic acid which was synthesized according to the following procedure: 5- Chloro-1-((dimethylamino)(dimethyliminio)methyl)-1 H-benzo[d][1 ,2,3]triazole 3-oxide tetrafluoroborate (TCTLI, 5.87 g, 16.5 mmol) and N-methylmorpholine (NMM, 8.00 mL, 72.8 mmol) were sequentially added to a stirred suspension of 17-(1H-tetrazol-5-yl)heptadecanoic acid (5.10 g, 15.0 mmol) in dry DMF (70 mL). The mixture was stirred at room temperature for 30 minutes. H-L-Glu-OtBu (L-glutamic acid 1 -tert-butyl ester, 4.58 g, 22.5 mmol) was added in one portion. The suspension turned into yellow solution in 5 minutes. It was allowed to stand at room temperature for 4 hours and then poured into an ice cooled stirred solution of hydrochloric acid (35%, 20 mL) in water (1 L). The crude product was filtered off and washed with water (3 x 100 mL) and shortly dried on a glass sintered frit by suction and redissolved in DMF (70 mL). This solution was poured into water (1 L), the resulting suspension stirred for 5 minutes and the solid was filtered off, washed with water (3 x 100 mL) and dried in vacuo. Crude product was dissolved in ethyl acetate (400 mL) and filtered through a silica gel (Silicagel 60, 0.040-0.063 mm) column (100 g) and the column was washed by ethyl acetate (600 mL). Ethyl acetate was removed in vacuo. Solid residue was boiled in 1 ,2-dichloroethane (200 mL) with vigorous stirring for 5 minutes, then the emulsion was allowed to cool to room temperature in 5 minutes and allowed to crystallize at the same temperature overnight. The waxy crystals were filtered off and washed by 1 ,2- dichloromethane (50 mL) and n-heptane (100 mL) and dried on air. This purification step was repeated one more time. Finally the compound was dissolved in 1 ,4-dioxane (50 mL) and freeze dried to afford (S)-4-(17-(1 H-tetrazol-5-yl)heptadecanamido)-5-(tert-butoxy)-5- oxopentanoic acid as off-white powder.

For peptides featuring a C-terminal cysteine the resin was a pre-loaded H-Cys(Trt)- 2-CITrt (e.g. from Bachem or Novabiochem). Method B - Peptide cleavage from the resin.

After synthesis the resin was washed with DCM, and the peptide cleaved from the resin by a 2-3 hours treatment with TFA/TIPS/water/DTT (e.g. in the ratios 90:5:2.5:2.5 or 92.5:2.5:2.5:5) followed by precipitation with diethyl ether. The precipitate was centrifuged and washed several times with diethyl ether.

Method C - Disulfide bridge formation

Native CNP contains a disulfide bridge which, if reduced, abolishes binding to the NPR2 receptor. Methods for disulfide bridge formation for synthetic peptides are well known in the art, below is described three methods used to prepare the exemplified compounds of the present invention.

Folding using Aldrithiol-4

The crude precipitated peptide from a 150 pmol synthesis was dissolved in 10 ml DMSO, followed by addition of water to 700 mL and additional addition of 100 mL MeCN. Finally, 2 mL of 0.5M NaOAc buffer pH 5.0 was added to the peptide solution. The pH was adjusted with 1M NaOH to pH 5-6.5 until the solution was clear. The amount of peptide in solution was guantified using CAD and a fresh stock solution of Aldrithiol-4 (2 mg/ml in MeOH) was prepared. 1.0 eguiv of Aldrithiol-4 in MeOH compared to peptide content was added over 5-10 min. under vigorous stirring. The solution was stirred for 10 min and additional 0.5 or 1.0 eguiv of Aldrithiol-4 stock solution added. The reaction was guenched with 2 mL TFA once complete as determined by LCMS. The peptide was purified by RP- HPLC as described below.

The crude peptide precipitate from a 450 pmol synthesis was dissolved in MeCN/water 1 :1 (50 mL), and added to a 500 mM Tris-HCI pH 8.0 buffer (1 L) and diluted with water (1.4 L) and DMSO (600 mL). The solution was left with gentle stirring for 16-24 h at RT. The reaction was guenched by addition of 5.0 eguiv. of iodoacetamide (50 mM in water), then acidified after 10 min with TFA to pH 2 and diluted to 5 L with water. The peptide was purified by RP-HPLC as described below.

Folding using cysteine/cystine or cysteamine/cystamine redox buffer

The crude peptide precipitate from a 150 pmol synthesis was dissolved in DMSO

(20 mL) and added to a buffer of 50 mM Tris-HCI, 3 mM cysteine, 0.3 mM cystine pH 8.2 (800 mL) or a buffer of 50 mM Tris-HCI, 3 mM cysteamine, 0.3 mM cystamine pH 8.2. The solution was left with gentle stirring for 16-24 h at RT. The reaction was quenched by addition of 3 mL TFA, diluted with 100 mL MeCN and purified by RP-HPLC as described below.

Method D - Purification

Methods of peptide purification are well known in the art, below is described two methods used to purify the exemplified compounds of the present invention.

Reverse phase preparative HPLC using acidic eluents

Crude folded peptides were purified by preparative reverse phase HPLC on a Waters Delta Prep 4000 or a Gilson Model 322 H2 system fitted with a C18 column, e.g. a Waters Xbridge Prep C18 OBD, 5 pm, 250 x 50 mm or a Phenomenex Gemini Axia NX C18, 5 pm, 250 x 30 mm. The peptide was eluted from the column using a linear gradient of eluents A (0.1% TFA in water) and B (0.1% TFA in acetonitrile), e.g. from 27-42% eluent B over 30 min at a constant flowrate of 25 mL/min (030 mm column) or from 30-40% eluent B over 10 min at 120 mL/min (050 mm column). The peptide fractions with acceptable purity were collected, pooled and lyophilised to yield the peptide TFA salt as a colourless powder.

Reverse phase preparative HPLC using near neutral eluents

If further purification was required the lyophilised peptide TFA salt was purified on a similar preparative HPLC system in a neutral or near-neutral pH eluent, e.g. eluent A: 100 mM NaOAc pH 6.5, 5% MeCN; eluent B: MeCN. The peptide was eluted from the column using a linear gradient of eluents A and B, e.g. from 25-55% eluent B over 30 min at a constant flowrate of 60 mL/min (050 mm column). The peptide fractions with acceptable purity were collected, pooled and desalted using either of the methods described below.

Method E -

In some instances, it was desirable to change the counter ion to sodium to ease formulation at pH 6.5. Methods for exchanging peptide counter ions are well known in the art, below is described a method used to change counter ion for some of the exemplified compounds of the present invention. Size exclusion desalting

The counter-ion was exchanged by solubilising the peptide TFA salt in 400 mM NaOAc pH 6.5 and 20% MeCN at 2-3 mg/mL. The dissolved peptide was then desalted on an Akta Purifer FPLC system using a HiPrep 26/10 desalting column. The column was preequilibrated with 20% MeCN and the peptide was injected and eluted over 1.5 CV of isocratic 20% MeCN at 6 mL/min. The peptide was collected, quantified by CAD analysis and lyophilised to yield the peptide sodium salt as a colourless powder.

General Methods of Detection and Characterisation:

In order to confirm the identity, to measure the purity and to quantify the amount of a prepared synthetic peptide, the peptide is characterised using methods such as LCMS and reverse-phase LIPLC that are well known in the art. Below is described methods used to characterise the exemplified compounds of the present invention.

Method F - Analytical chromatography methods

The prepared CNP compounds were characterised by RP-UPLC and LCMS and the amount prepared quantified by RP-UPLC/CAD.

LCMS34

LCMS was performed on a setup consisting of a Waters ACQUITY UPLC system and a Xevo G2-XS QTOF mass spectrometer. The system was fitted with a Waters ACQUITY UPLC BEH C18 Column, 1.7 pm, 2.1 mm x 50 mm, column temperature 60 °C. UV-detection was at 214 nm. MS ionisation mode was ESI+.

Eluent A: 0.1% formic acid in water; eluent B: 0.1% formic acid in acetonitrile. The analysis was performed by injecting an appropriate volume of the sample (preferably 1-10 pL ) onto the column which was eluted with a linear gradient of eluents A and B from 5-95% eluent B over 4.0 min at a constant flowrate of 0.4 mL/min.

RP-UPLC107:

Alternatively, LCMS was performed on a setup consisting of a Waters ACQUITY UPLC system and a Waters QDA mass detector. The system was fitted with a Waters ACQUITY UPLC BEH C18 Column, 1.7 pm, 2.1 mm x 50 mm, column temperature 40 °C. UV-detection was at 214 nm.

Eluent A: 0.05% TFA in water; eluent B: 0.05% TFA in acetonitrile. The analysis was performed by injecting an appropriate volume of the sample (preferably 1-10 pL) onto the column which was eluted with a linear gradient of eluents A and B from 5-60% eluent B over

1.6 min at a constant flowrate of 0.9 mL/min.

RP-UPLC02:

RP-UPLC02 was performed on a Waters ACQUITY LIPLC system with a TUV or PDA detector. The system was fitted with a Waters ACQUITY UPLC BEH C18 column, 1.7 pm, 2.1 mm x 150 mm, column temperature 40 °C. UV-detection was at 214 nm. Eluent A: 0.05% TFA in water; eluent B: 0.05% TFA in acetonitrile.

The analysis was performed by injecting an appropriate volume of the sample (preferably 1- 10 pL ) onto the column which was eluted with a linear gradient of eluents A and B from 5- 95% eluent B over 16.0 min at a constant flowrate of 0.4 mL/min.

RP-UPLC61 :

RP-UPLC61 was performed on a Waters ACQUITY UPLC system with a TUV or PDA detector. The system was fitted with a Waters ACQUITY UPLC BEH Shield C18 column, 1.7 pm, 2.1 mm x 150 mm, column temperature 60 °C. UV-detection was at 214 nm. Eluent A: 20 mM Na2SO4, 2 mM Na2HPO4, 2 mM NaH2PO4 in water/MeCN 9:1 , pH 7.2; eluent B: MeCN/water 7:3. The analysis was performed by injecting an appropriate volume of the sample (preferably 1-10 pL) onto the column which was eluted with a linear gradient of eluents A and B from 5-20% B over 3 min, then 20-80% B over 17 min, then 80-90% B over 1 min at a constant flowrate of 0.4 mL/min.

CAD was performed on a Thermo Scientific Vanquish UPLC system with a UV-DAD and CAD (Charged Aerosol Detector). The system was fitted with a Waters ACQUITY UPLC CSH C18 column, 1.7 pm, 2.1 mm x 50 mm, column temperature 40 °C. UV-detection was at 214 nm. Eluent A: 0.1% v/v TFA in water; eluent B: 0.1% v/v TFA in MeCN. The analysis was performed by injecting an appropriate volume of the sample onto the column which was eluted with a linear gradient of eluents A and B from 0-95% B over 4 min at a constant flowrate of 0.45 mL/min. Calibration was performed using a standard curve generated by injecting an external standard of Insulin Aspart, 3.55 mg/mL.

Method G - of CNP com formulations for in vivo

Formulations for in vivo studies were prepared according to the principles outlined below. Procedure: The formulations used for the in-vivo studies were prepared by dissolving the lyophilized peptide in formulation buffers with compositions identical to the final formulations (final formulation composition are specified in Example 9 to Example 15). The following final formulation compositions have been used: pH 4.0: 5 mM sodium acetate, 250 mM glycerol, pH 4.0 pH 4.0: 5 mM sodium acetate, 240 mM propylene glycol, pH 4.0 pH 4.0: 5 mM sodium acetate, 250 mM glycerol, 0.007% polysorbate 20, pH 4.0 pH 6.0: 20 mM sodium phosphate, 223 mM propylene glycol, pH 6.0 pH 6.5: 8 mM sodium phosphate, 250 mM glycerol, pH 6.5 pH 7.4: 8 mM sodium phosphate, 250 mM glycerol, pH 7.4 pH 7.4: 8 mM sodium phosphate, 250 mM glycerol, 0.007% polysorbate 20, pH 7.4 pH 7.5: 8 mM sodium phosphate, 250 mM glycerol, pH 7.5 pH 5.5: 1.33 mM citric acid monohydrate; 3.67 mM citrate, trisodium; 52 mg/ml trehalose; 15 mg/ml D-mannose; 0.73 mg/ml L-methionine; 0.05 mg/ml polysorbate 80, pH 5.5

The formulation procedure was for practical reasons slightly different for pH 6.5 formulations compared to formulations of other pH targets.

Formulations at pH 6.5: The lyophilized peptide was dissolved in a pH 7.4 buffer (8 mM sodium phosphate, 250 mM glycerol, pH 7.4) to a nominal concentration of 20-50% above the target peptide concentration and pH was adjusted to pH 6.5 using 0.2N NaOH, or 0.2N HCI. The actual peptide concentration was determined using CAD (Method F, CAD02) and a volume of a pH 6.5 buffer (8 mM sodium phosphate, 250 mM glycerol, pH 6.5) was added to reach a nominal concentration corresponding to the target peptide concentration and pH was adjusted to pH 6.5 using 0.2N NaOH, or 0.2N HCI. The actual peptide concentration was determined using CAD (Method F, CAD02). The formulation was sterile filtered (0.22pm), the final peptide concentration was determined using CAD (Method F, CAD02) and the formulation was filled into sterile containers.

Formulations at pH 4.0, pH 6.0, pH 7.4 and pH 7.5: The lyophilized peptide was dissolved in a formulation buffer with a composition corresponding to the composition of the final formulation (specified in Example 9 to Example 15) to a nominal concentration of 20- 50% above the target peptide concentration and pH was adjusted to target using 0.2 N NaOH, or 0.2 N HCI. The actual peptide concentration was determined using CAD (Method F, CAD02) and a volume of the same formulation buffer was added to reach a nominal concentration corresponding to the target peptide concentration and pH was adjusted to target using 0.2 N NaOH, or 0.2 N HCI. The actual peptide concentration was determined using CAD (Method F, CAD02). The formulation was sterile filtered (0.22pm), the final peptide concentration was determined using CAD (Method F, CAD02) and the formulation was filled into sterile containers.

Example 1 - Synthesis of CNP compounds

CNP compounds were synthesized and characterized according to the general methods of preparation described above. The exemplified CNP compounds and their constituents are summarised in Table 1. The protractor and linker elements, of Table 1, together form up the modifying group of the CNP compounds.

Table 1 : Summary of exemplified compounds Chem. 1-148

Chem. Compound Protractor Linker (Chem B- SEQ No. ID (Chem A) C) CNP37 sequence modifications ID

1 0065 des1-15 (CNP22) 1

2 1510 (CNP37) 2

3 0312 C18d gGlu-2xOEG des1-4, 5Q, 13Q, 32Nle 3

4 0776 C18d gGlu-2xOEG des1-5, 13Q, 27E, 32L 4

5 1235 C18d gGlu-2xOEG des1-8, 9E, 10H, 13Q, 32L 5

6 0262 C18d 6xgGlu des1-8, 32Nle 6

7 0296 C18d 6xgGlu des1-4, 15S, 19S, 32Nle 7

8 0313 C18d 5xgGlu des1-10, 32Nle 8

9 0334 C18d 5xgGlu des1-10, 13Q, 32Nle 9

10 1221 C18d gGlu-2xOEG des1-8, 10E, 13Q, 32L 10

11 1222 C18d gGlu-2xOEG des1-8, 9E, 10E, 13Q, 32L 11

12 1223 C18d gGlu-2xOEG des1-8, 10E, 13Q, 14E, 32L 12

13 1224 C18d gGlu-2xOEG des1-8, 10E, 13Q, 19S, 32L 13

14 1225 C18d gGlu-2xOEG des1-8, 10E, 13Q, 25P, 32L 14

15 1226 C18d gGlu-2xOEG des1-8, 10E, 13Q, 14E, 25P, 32L 15

16 1227 C18d gGlu-2xOEG des1-8, 10E, 13Q, 19S, 25P, 32L 16 des1-8, 10E, 13Q, 14E, 19S, 25P,

17 1228 C18d gGlu-2xOEG 32L 17

18 1229 C18d gGlu-2xOEG des1-8, 9E, 13Q, 14E, 32L 18

19 1230 C18d gGlu-2xOEG des1-8, 9E, 13Q, 14E, 19S, 32L 19

20 1231 C18d gGlu-2xOEG des1-8, 9E, 10Q, 13Q, 14E, 32L 20

21 1232 C18d gGlu-2xOEG des1-8, 13Q, 14E, 32L 21

22 1233 C18d gGlu-2xOEG des1-8, 13Q, 19S, 25P, 32L 22

23 1236 C18d gGlu-2xOEG des1-8, 9E, 10H, 13Q, 14E, 32L 23

24 1237 C18d gGlu-2xOEG des1-8, 10H, 13Q, 14E, 32L 24 1240 C18d gGlu-2xOEG des1-8, 10H, 13Q, 14E, 25P, 32L 25

1241 C18d gGlu-2xOEG des1-8, 10H, 13Q, 19S, 25P, 32L 26 des1-8, 10H, 13Q, 14E, 19S, 25P,

1242 C18d gGlu-2xOEG 32L 27

1274 C18d gGlu-2xOEG des1-8, 10E, 13E, 19Q, 25P, 32L 28 des1-9, 10E, 13Q, 14E, 19S, 25P,

1287 C18d gGlu-2xOEG 32L 29 des1-9, 10E, 13Q, 15E, 19S, 25P,

1288 C18d gGlu-2xOEG 32L 30 des1-8, 10E, 13Q, 15E, 19S, 25P,

1289 C18d gGlu-2xOEG 32L 31

1290 C18d 2xgGlu-2xOEG des1-8, 10E, 13Q, 19S, 25P, 32L 16 des1-8, 10H, 13Q, 15T, 19S, 25P,

1302 C18d gGlu-2xOEG 32L 32 des1-8, 10H, 13Q, 15T, 17V, 19S,

1303 C18d gGlu-2xOEG 25P, 32L 33 des1-8, 10H, 13Q, 14H, 15T, 19S,

1304 C18d gGlu-2xOEG 25P, 32L 34 des1-8, 13Q, 14H, 15T, 19S, 25P,

1305 C18d gGlu-2xOEG 32L 35

1309 C18d gGlu-2xOEG des1-8, 9E, 10H, 13Q, 25P, 32L 36 des1-8, 9E, 10H, 13Q, 19S, 25P,

1310 C18d gGlu-2xOEG 32L 37 des1-8, 9E, 10H, 13Q, 17V, 19S,

1311 C18d gGlu-2xOEG 25P, 32L 38 des1-8, 9E, 10H, 13Q, 15T, 17V,

1312 C18d gGlu-2xOEG 19S, 25P, 32L 39 des1-8, 10H, 13Q, 14H, 15H, 27E,

1322 C18d gGlu-2xOEG 32L 40 des1-8, 10H, 13Q, 14H, 15H, 27E,

1323 C18d 2xgGlu-2xOEG 32L 40 des1-8, 13Q, 14H, 15H, 19Q, 27E,

1324 C18d 2xgGlu-2xOEG 32L 41 des1-8, 10E, 13Q, 19S, 25P, 27E,

1338 C18d gGlu-2xOEG 32L 42

1339 C18d gGlu-2xOEG des1-9, 10E, 13Q, 19S, 25P, 32L 43

1340 C18d gGlu-2xOEG des1-8, 13Q, 14H, 15H, 19Q, 32L 44 des1-8, 13Q, 14H, 15H, 19Q, 25P,

1341 C18d gGlu-2xOEG 32L 45

1345 C18d gGlu-2xOEG des1-8, 10H, 13Q, 14H, 15H, 32L 46 des1-8, 10H, 13Q, 14H, 15H, 25P,

1346 C18d gGlu-2xOEG 32L 47

1347 C18d gGlu-2xOEG des1-10, 13Q, 19H, 25P, 32L 48

1348 C18d gGlu-2xOEG des1-10, 13Q, 18H, 19S, 25P, 32L 49 des1-5, 10H, 13Q, 14H, 15T, 19S,

1350 C18d gGlu-2xOEG 25P, 32L 50 des1-5, 10H, 13Q, 14H, 15T, 17V,

1351 C18d gGlu-2xOEG 19S, 25P, 32L 51 des1-8, 10H, 13Q, 15T, 17V, 19S,

1352 C18d gGlu-3xOEG 25P, 32L 33

1353 C18d gGlu-3xOEG des1-8, 9E, 10H, 13Q, 25P, 32L 36 des1-5, 10H, 13Q, 15T, 17V, 19S,

1354 C18d 2xgGlu-2xOEG 25P, 32L 52

1355 C18d gGlu-3xOEG des1-8, 13Q, 19S, 25P, 32L 22 1356 C18d 2xgGlu-3xOEG des1-8, 13Q, 19S, 25P, 32L 22 1357 C18d 2xgGlu-3xOEG des1-8, 9E, 10H, 13Q, 32L 5 des1-5, 9E, 10H, 13Q, 15T, 17V, 1359 C18d gGlu-2xOEG 19S, 25P, 32L 53 des1-5, 9E, 10H, 13Q, 14H, 15T, 1360 C18d gGlu-2xOEG 17V, 19S, 25P, 32L 54 1375 C18d gGlu-4xOEG des1-8, 10E, 13Q, 25P, 32L 14 1376 C20d gGlu-2xOEG des1-8, 10E, 13Q, 25P, 32L 14 1377 C18d gGlu-2xOEG des1-8, 10E, 13Q, 17G, 25P, 32L 55 gGlu-2xOEG- 1378 C18d GGG des1-8, 10E, 13Q, 19S, 25P, 32L 56 1379 C18d gGlu-2xOEG 5Q, 8S, 10E, 13Q, 19S, 25P, 32L 57 1380 C18d gGlu-2xOEG 5E, 8S, 10E, 13Q, 19S, 25P, 32L 58

5Q, 7H, 10H, 13Q, 14H, 15H, 1381 C18d gGlu-2xOEG 17S, 19Q, 25P, 32L 59 1382 C18d 3xgGlu-2xOEG 5Q, 7H, 13Q, 19Q, 25P, 32L 60

5Q, 7H, 10H, 13Q, 15H, 17S, 1383 C18d 2xgGlu-2xOEG 19Q, 25P, 32L 61 gGlu-2xOEG- des1 -10, 13Q, 17S, 19Q, 25P, 9384 C18d GQAP 32L 62 1385 C18d 4xgGlu des1-5, 10E, 13Q, 25P, 32L 63 1386 C18d 4xgGlu des1-5, 13Q, 19S, 25P, 32L 64 1387 C18d 4xgGlu-GGG des1-8, 13Q, 19S, 25P, 32L 65 1388 C18d 4xgGlu-GGG des1-8, 13Q, 25P, 32L 66 1389 C18d 4xgGlu 5Q, 13Q, 19S, 25P, 32L 67 1390 C18d 4xgGlu 5Q, 10E, 13Q, 19S, 25P, 32L 68 1391 C18d gGlu-4xOEG des1-8, 10E, 13Q, 17G, 25P, 32L 55 1392 C18d gGlu-4xOEG des1-8, 10E, 13Q, 19S, 25P, 32L 16 1393 C18d gGlu-4xOEG des1-8, 10E, 13Q, 19Q, 25P, 32L 69 1394 C18d gGlu-2xOEG 5Q, 10E, 13Q, 19Q, 25P, 32L 70 1395 C18d gGlu-2xOEG 5Q, 7A, 10E, 13Q, 19Q, 25P, 32L 71 1396 C18d 2xgGlu-2xOEG 5Q, 10E, 13Q, 19Q, 25P, 32L 70 1398 C18d 4xgGlu-2xOEG 5Q, 8H, 13Q, 17S, 19Q, 25P, 32L 72 1399 C20d 4xgGlu-2xOEG 5Q, 8H, 13Q, 17S, 19Q, 25P, 32L 72 1400 C18d 4xgGlu-2xOEG 5Q, 7H, 13Q, 17G, 19Q, 25P, 32L 73 1401 C18d 8xgGlu-2xOEG 5Q, 13Q, 32L 74 1402 C18d 6xgGlu-2xOEG 5Q, 13Q, 19Q, 25P, 32L 75 1403 C18d 6xgGlu-2xOEG 5Q, 13Q, 17G, 19Q, 25P, 32L 76 1404 C18d 6xgGlu-4xOEG 5Q, 13Q, 19Q, 25P, 32L 75 1405 C20d 6xgGlu-2xOEG 5Q, 13Q, 19Q, 25P, 32L 75 1406 C18d 5xgGlu-4xOEG 5Q, 13Q, 19Q, 25P, 32L 75 9407 C18d 5xgGlu-4xOEG des1-5, 13Q, 19Q, 25P, 32L 77 des1-5, 10H, 13Q, 14H, 15T, 17V, 1419 C18d 2xgGlu-2xOEG 19S, 25P, 32L 51 des1-5, 10H, 13Q, 14H, 15T, 17V, 1420 C18d 3xgGlu-2xOEG 25P, 32L 78 des1-5, 13Q, 15T, 17V, 19S, 25P, 1421 C18d 3xgGlu-2xOEG 32L 79 des1-5, 10H, 13Q, 17V, 19S, 25P,

1422 C18d 3xgGlu-2xOEG 32L 80 des1-5, 10H, 13Q, 15T, 17V, 25P,

1423 C18d 3xgGlu-2xOEG 32L 81

1424 C18d 4xgGlu-2xOEG des1-5, 13Q, 15T, 17V, 25P, 32L 82 des1-8, 10H, 13Q, 15T, 17V, 25P,

1425 C18d 2xgGlu-4xOEG 32L 83

Tetrazo I e- des1-5, 10H, 13Q, 15S, 19Q, 25P,

1426 C18 2xgGlu-2xOEG 32L 84 des1-8, 10E, 13Q, 17G, 19H, 25P,

1431 C18d gGlu-4xOEG 32L 85 des1-5, 10E, 13Q, 14H, 17G,

1432 C18d 2xgGlu-4xOEG 19Q, 25P, 32L 86 des1-8, 10H, 13Q, 17G, 19Q,

1434 C18d 2xgGlu-4xOEG 25P, 32L 87

9435 C18d 2xgGlu-4xOEG des1-8, 13Q, 17G, 19Q, 25P, 32L 88

1436 C18d 2xgGlu-4xOEG des1-8, 13Q, 17V, 19Q, 25P, 32L 89 des1-8, 10H, 13Q, 17V, 19Q, 25P,

1437 C18d 2xgGlu-4xOEG 32L 90

1448 C18d 4xgGlu 5Q, 10E, 13Q, 25P, 32L 91 des1-5, 10H, 13Q, 14H, 15T, 17V,

1449 C18d 3xgGlu-2xOEG 19S, 25P, 32L 51 des1-5, 10H, 13Q, 15T, 17V, 19S,

1450 C18d 3xgGlu-2xOEG 25P, 32L 52 des1-5, 10H, 13Q, 17V, 19S, 25P,

1451 C18d 3xgGlu-2xOEG 27E, 32L 92

1452 C18d 5xgGlu-3xOEG des1-5, 13Q, 19Q, 25P, 32L 77

1453 C18d 5xgGlu-2xOEG des1-5, 13Q, 19Q, 25P, 32L 77

1454 C18d 4xgGlu-4xOEG des1-5, 13Q, 19Q, 25P, 32L 77

1455 C18d 4xgGlu-3xOEG des1-5, 13Q, 19Q, 25P, 32L 77

1456 C18d 4xgGlu-2xOEG des1-5, 13Q, 19Q, 25P, 32L 77 gGlu-2xOEG-

1457 C18d 3xGQAP des1-10, 13Q, 19Q, 25P, 32L 93 gGlu-2xOEG- des1-10, 13Q, 17S, 19Q, 25P,

1458 C18d 2xGQAP 32L 94 4xgGlu-2xOEG-

1459 C18d GQAP des1-5, 13Q, 17S, 19Q, 25P, 32L 95

1460 C18d 6xgGlu-2xOEG des1-5, 13Q, 25P, 32L 96

1461 C18d 2xgGlu-4xOEG des1-8, 10H, 13Q, 19Q, 25P, 32L 97

1462 C18d 5xgGlu-4xOEG des1-5, 13Q, 25P, 32L 96

1463 C18d 5xgGlu-4xOEG des1-5, 13Q, 19Q, 32L 98

1464 C18d 5xgGlu-4xOEG des1-5, 19Q, 25P, 32L 99

1465 C18d 5xgGlu-4xOEG des1-5, 13Q, 19Q, 25P 100

1470 C18d 5xgGlu-2xOEG des1-5, 13Q, 25P, 32L 96

1471 C18d 5xgGlu-2xOEG 5Q, 13Q, 19Q, 25P, 32L 75

1472 C18d 4xgGlu-2xOEG 5Q, 13Q, 19Q, 25P, 32L 75

1473 C18d 4xgGlu-2xOEG 5Q, 13Q, 19S, 25P, 32L 67

1474 C18d 5xgGlu-2xOEG 5Q, 13Q, 25P, 32L 101

1475 C18d 5xGlu-4xOEG des1-5, 13Q, 19Q, 25P, 32L 77 4x(Glu-Gly)-Glu-

1476 C18d 2xOEG des1-5, 13Q, 19Q, 25P, 32L 77 133 1477 C18d 5xgGlu-4xOEG des1 -5, 13Q, 19Q, 25P, 27E, 32L 102

134 1478 C18d 2xgGlu-4xOEG des1-8, 13Q, 19Q, 25P, 32L 103

135 9480 C18d 3xgGlu-4xOEG des1-8, 13Q, 19Q, 25P, 32L 103

136 1481 C18d 3xGlu-4xOEG des1-8, 13Q, 19Q, 25P, 32L 103

137 9482 C18d 5xgGlu 5Q, 13Q, 19S, 25P, 32L 67

138 9483 C18d 4xgGlu 5Q, 13Q, 19S, 25P, 27E, 32L 104 gGlu-2xOEG-

139 1484 C18d GQAP des1-10, 13Q, 19Q, 25P, 32L 105 gGlu-2xOEG- des1 -10, 13Q, 17S, 19Q, 25P,

140 1486 C18d GQAP 27E, 32L 106 gGlu-2xOEG-

141 1487 C18d 3xGQAP des1-10, 13Q, 19Q, 25P, 32L 107

142 1488 C18d gGlu-3xGQAP des1-10, 13Q, 19Q, 25P, 32L 107 des1-8, 13Q, 17G, 19Q, 25P, 27E,

143 1489 C18d 2xgGlu-4xOEG 32L 108

144 1493 C18d 2xgGlu-4xOEG des1-8, 13Q, 19Q, 25P, 27E, 32L 109

Glu-2xOEG- des1-10, 13Q, 17S, 19Q, 25P,

145 1511 C18d GQAP 32L 62

146 1512 C18d 2xGlu-4xOEG des1 -8, 13Q, 17G, 19Q, 25P, 32L 88

147 1513 C18d 5xGlu 5Q, 13Q, 19S, 25P, 32L 110

148 1514 C18d 4xGlu 5Q, 13Q, 19S, 25P, 27E, 32L 111 des1-5, 6a, 7r, 8k, 9y, 10k, 12a, 13q, 14k, 15k, 171, 18s, 19k, 21c, 22f, 24I, 25k, 26I, 27e, 28r, 29i,

149 1265 C18d DgGlu-2xOEG 31s, 32I, 33s, 35I, 37c 233

150 0106 -2P, -1 G 234

151 0089 C18d gGlu-2xOEG des1-15 1 gGlu-2xOEG-

152 0230 C18d 5xGQAP des1-15 235

153 0231 C18d gGlu-8xOEG des1-15 1

Chem. 1 ; Compound ID 0065; SEQ ID NO: 1 hCNP22 Molecular weight: 2197.6008. LCMS34: m/3 calcd: 733.5336; m/3 found: 733.7000; m/4 calcd: 550.4002; m/4 found: 550.2800

Chem. 2; Compound ID 1510; SEQ ID NO: 2 hCNP37

Molecular weight: 3948.5589. UPLC107UPLC107: m/3 calcd: 1317.1863

Chem. 3; Compound ID 0312; SEQ ID NO: 3

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), des1-4, 5Q, 13Q, 32Nle]-hCNP37

Molecular weight: 4182.9477. LCMS34LCMS34: m/3 calcd: 1395.3159; m/3 found: 1395.1200; m/4 calcd: 1046.7369; m/4 found: 1046.600

Chem. 4; Compound ID 0776; SEQ ID NO: 4

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), des1-5, 13Q, 27E, 32L]-hCNP37

Molecular weight: 4068.8451. LCMS34LCMS34: m/3 calcd: 1357.2817; m/3 found: 1357.2694; m/4 calcd: 1018.2113; m/4 found: 1018.2089

Chem. 5; Compound ID 1235; SEQ ID NO: 5

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), des1-8, 9E, 10H, 13Q, 32L]-hCNP37

Molecular weight: 3674.2904. UPLC107: m/3 calcd: 1225.7635; m/3 found: 1225.5700

Chem. 6; Compound ID 0262; SEQ ID NO: 6

[N-terminal([(4S)-4-carboxy-4-[[(4S)-4-carboxy-4-[[(4S)-4 -carboxy-4-[[(4S)-4-carboxy-4-

[[(4S)-4-carboxy-4-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]buta noyl]amino]butanoyl]amino

]butanoyl]amino]butanoyl]), des1-8, 32Nle]-hCNP37

Molecular weight: 4040.6131. LCMS34LCMS34: m/3 calcd: 1347.8710; m/3 found: 1347.7200; m/4 calcd: 1011.1533; m/4 found: 1010.7900

Chem. 7; Compound ID 0296; SEQ ID NO: 7

[N-terminal([(4S)-4-carboxy-4-[[(4S)-4-carboxy-4-[[(4S)-4 -carboxy-4-[[(4S)-4-carboxy-4-

[[(4S)-4-carboxy-4-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]buta noyl]amino]butanoyl]amino

]butanoyl]amino]butanoyl]), des1-4, 15S, 19S, 32Nle]-hCNP37

Molecular weight: 4427.9616. LCMS34LCMS34: m/3 calcd: 1476.9872; m/3 found: 1476.9200; m/4 calcd: 1107.9904; m/4 found: 1108.1700 Chem. 8; Compound ID 0313; SEQ ID NO: 8

[N-terminal([(4S)-4-carboxy-4-[[(4S)-4-carboxy-4-[[(4S)-4 -carboxy-4-[[(4S)-4-carboxy-4-

[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]buta noyl]amino]butanoyl]amino

Jbutanoyl]), des1-10, 32Nle]-hCNP37

Molecular weight: 3620.1536. LCMS34: m/3 calcd: 1207.7179; m/3 found: 1207.6400; m/4 calcd: 906.0384; m/4 found: 905.9900

Chem. 9; Compound ID 0334; SEQ ID NO: 9

[N-terminal([(4S)-4-carboxy-4-[[(4S)-4-carboxy-4-[[(4S)-4 -carboxy-4-[[(4S)-4-carboxy-4-

[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]buta noyl]amino]butanoyl]amino

Jbutanoyl]), des1-10, 13Q, 32Nle]-hCNP37

Molecular weight: 3634.1801. LCMS34: m/3 calcd: 1212.3934; m/3 found: 1212.3100; m/4 calcd: 909.5450; m/4 found: 909.2400

Chem. 10; Compound ID 1221; SEQ ID NO: 10

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), des1-8, 10E, 13Q, 32L]-hCNP37

Molecular weight: 3700.3243. UPLC107: m/3 calcd: 1234.4414; m/3 found: 1234.2700

Chem. 11; Compound ID 1222; SEQ ID NO: 11 [N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), des1-8, 9E, 10E, 13Q, 32L]-hCNP37

Molecular weight: 3666.2651. LCMS34: m/3 calcd: 1223.0884; m/3 found: 1222.9000; ;

Chem. 12; Compound ID 1223; SEQ ID NO: 12

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), des1-8, 10E, 13Q, 14E, 32L]-hCNP37

Molecular weight: 3701.266. LCMS34: m/3 calcd: 1234.7553; m/3 found: 1234.5800; ; Chem. 13; Compound ID 1224; SEQ ID NO: 13

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), des1-8, 10E, 13Q, 19S, 32L]-hCNP37

Molecular weight: 3669.2672. UPLC107: m/3 calcd: 1224.0891; m/3 found: 1223.9400

Chem. 15; Compound ID 1226; SEQ ID NO: 15

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), des1-8, 10E, 13Q, 14E, 25P, 32L]-hCNP37

Molecular weight: 3629.114. LCMS34: m/3 calcd: 1210.7047; m/3 found: 1210.5790; m/4 calcd: 908.2785; m/4 found: 908.1400

Chem. 18; Compound ID 1229; SEQ ID NO: 18

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), des1-8, 9E, 13Q, 14E, 32L]-hCNP37

Molecular weight: 3666.2651. UPLC107: m/3 calcd: 1223.0884; m/3 found: 1222.9300

Chem. 19; Compound ID 1230; SEQ ID NO: 19

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), des1-8, 9E, 13Q, 14E, 19S, 32L]-hCNP37

Molecular weight: 3625.1701. UPLC107: m/3 calcd: 1209.3900; m/3 found: 1209.2800

Chem. 20; Compound ID 1231; SEQ ID NO: 20

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), des1-8, 9E, 10Q, 13Q, 14E, 32L]-hCNP37

Molecular weight: 3627.2306. UPLC107: m/3 calcd: 1210.0769; m/3 found: 1209.9600 Chem. 23; Compound ID 1236; SEQ ID NO: 23

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), des1-8, 9E, 10H, 13Q, 14E, 32L]-hCNP37

Molecular weight: 3675.2321. LCMS34: m/3 calcd: 1226.0774; m/3 found: 1225.8900; ;

Chem. 24; Compound ID 1237; SEQ ID NO: 24

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), des1-8, 10H, 13Q, 14E, 32L]-hCNP37

Molecular weight: 3709.2913. UPLC107: m/3 calcd: 1237.4304; m/3 found: 1237.3400 Chem. 25; Compound ID 1240; SEQ ID NO: 25

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), des1-8, 10H, 13Q, 14E, 25P, 32L]-hCNP37

Molecular weight: 3637.1393. UPLC107: m/3 calcd: 1213.3798; m/3 found: 1213.2100 Chem. 28; Compound ID 1274; SEQ ID NO: 28

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), des1-8, 10E, 13E, 19Q, 25P, 32L]-hCNP37

Molecular weight: 3465.9407. LCMS34: m/3 calcd: 1156.3136; m/3 found: 1156.5100; m/4 calcd: 867.4852; m/4 found: 867.3800

Chem. 30; Compound ID 1288; SEQ ID NO: 30

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), des1-9, 10E, 13Q, 15E, 19S, 25P, 32L]-hCNP37

Molecular weight: 3465.9407. LCMS34: m/3 calcd: 1156.3136; m/3 found: 1155.8400; m/4 calcd: 867.4852; m/4 found: 867.3800

Chem. 31; Compound ID 1289; SEQ ID NO: 31

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), des1-8, 10E, 13Q, 15E, 19S, 25P, 32L]-hCNP37

Molecular weight: 3629.114. LCMS34: m/3 calcd: 1210.7047; m/3 found: 1210.5500; m/4 calcd: 908.2785; m/4 found: 908.1600

Chem. 32; Compound ID 1290; SEQ ID NO: 16

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-[[(4S)- 4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]etho xy]ethoxy]acetyl]amino]eth oxy]ethoxy]acetyl]), des1-8, 10E, 13Q, 19S, 25P, 32L]-hCNP37

Molecular weight: 3757.2862. LCMS34: m/3 calcd: 1253.4287; m/3 found: 1253.5700; m/4 calcd: 940.3216; m/4 found: 940.1700

Chem. 33; Compound ID 1302; SEQ ID NO: 32

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), des1-8, 10H, 13Q, 15T, 19S, 25P, 32L]-hCNP37

Molecular weight: 3609.1292. LCMS34: m/3 calcd: 1204.0431; m/3 found: 1203.7523; m/4 calcd: 903.2823; m/4 found: 903.3355

Chem. 34; Compound ID 1303; SEQ ID NO: 33

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), des1-8, 10H, 13Q, 15T, 17V, 19S, 25P, 32L]-hCNP37

Molecular weight: 3595.1026. LCMS34: m/3 calcd: 1199.3675; m/3 found: 1199.3210; m/4 calcd: 899.7757; m/4 found: 899.7320

Chem. 35; Compound ID 1304; SEQ ID NO: 34

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), des1-8, 10H, 13Q, 14H, 15T, 19S, 25P, 32L]-hCNP37

Molecular weight: 3618.0962. LCMS34: m/3 calcd: 1207.0321; m/3 found: 1206.7366; m/4 calcd: 905.5241; m/4 found: 905.5760

Chem. 36; Compound ID 1305; SEQ ID NO: 35

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), des1-8, 13Q, 14H, 15T, 19S, 25P, 32L]-hCNP37

Molecular weight: 3609.1292. LCMS34: m/3 calcd: 1204.0431; m/3 found: 1204.0040; m/4 calcd: 903.2823; m/4 found: 903.2470

Chem. 37; Compound ID 1309; SEQ ID NO: 36

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), des1-8, 9E, 10H, 13Q, 25P, 32L]-hCNP37

Molecular weight: 3643.2333. LCMS34: m/3 calcd: 1215.4111; m/3 found: 1215.4546; m/4 calcd: 911.8083; m/4 found: 911.8567

Chem. 38; Compound ID 1310; SEQ ID NO: 37

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), des1-8, 9E, 10H, 13Q, 19S, 25P, 32L]-hCNP37

Molecular weight: 3602.1383. LCMS34: m/3 calcd: 1201.7128; m/3 found: 1201.7507; m/4 calcd: 901.5346; m/4 found: 901.5770

Chem. 39; Compound ID 1311; SEQ ID NO: 38

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), des1-8, 9E, 10H, 13Q, 17V, 19S, 25P, 32L]-hCNP37

Molecular weight: 3588.1117. LCMS34: m/3 calcd: 1197.0372; m/3 found: 1197.0725; m/4 calcd: 898.0279; m/4 found: 898.0776

Chem. 40; Compound ID 1312; SEQ ID NO: 39

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), des1-8, 9E, 10H, 13Q, 15T, 17V, 19S, 25P, 32L]-hCNP37

Molecular weight: 3561.0433. LCMS34: m/3 calcd: 1188.0144; m/3 found: 1187.9800; m/4 calcd: 891.2608; m/4 found: 891.2320

Chem. 41; Compound ID 1322; SEQ ID NO: 40

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), des1-8, 10H, 13Q, 14H, 15H, 27E, 32L]-hCNP37

Molecular weight: 3740.3102. LCMS34: m/3 calcd: 1247.7701; m/3 found: 1247.6970; m/4 calcd: 936.0776; m/4 found: 936.0280

Chem. 42; Compound ID 1323; SEQ ID NO: 40

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-[[(4S)- 4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]etho xy]ethoxy]acetyl]amino]eth oxy]ethoxy]acetyl]), des1-8, 10H, 13Q, 14H, 15H, 27E, 32L]-hCNP37

Molecular weight: 3869.4242. LCMS34: m/3 calcd: 1290.8081; m/3 found: 1290.7130; m/4 calcd: 968.3561; m/4 found: 968.2840

Chem. 43; Compound ID 1324; SEQ ID NO: 41

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-[[(4S)- 4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]etho xy]ethoxy]acetyl]amino]eth oxy]ethoxy]acetyl]), des1-8, 13Q, 14H, 15H, 19Q, 27E, 32L]-hCNP37

Molecular weight: 3860.4141. LCMS34: m/3 calcd: 1287.8047; m/3 found: 1287.7150; m/4 calcd: 966.1035; m/4 found: 966.0310

Chem. 44; Compound ID 1338; SEQ ID NO: 42

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), des1-8, 10E, 13Q, 19S, 25P, 27E, 32L]-hCNP37

Molecular weight: 3642.1988. LCMS34: m/3 calcd: 1215.0663; m/3 found: 1214.9827; m/4 calcd: 911.5497; m/4 found: 911.2273

Chem. 45; Compound ID 1339; SEQ ID NO: 43 [N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), des1-9, 10E, 13Q, 19S, 25P, 32L]-hCNP37

Molecular weight: 3464.999. LCMS34: m/3 calcd: 1155.9997; m/3 found: 1155.9600; m/4 calcd: 867.2498; m/4 found: 866.9667

Chem. 46; Compound ID 1340; SEQ ID NO: 44

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), des1-8, 13Q, 14H, 15H, 19Q, 32L]-hCNP37

Molecular weight: 3717.2736. LCMS34: m/3 calcd: 1240.0912; m/3 found: 1240.0320; m/4 calcd: 930.3184; m/4 found: 930.2630

Chem. 47; Compound ID 1341; SEQ ID NO: 45

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), des1-8, 13Q, 14H, 15H, 19Q, 25P, 32L]-hCNP37

Molecular weight: 3686.2165. LCMS34: m/3 calcd: 1229.7388; m/3 found: 1229.6760; m/4 calcd: 922.5541; m/4 found: 922.5020 Chem. 48; Compound ID 1345; SEQ ID NO: 46

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), des1-8, 10H, 13Q, 14H, 15H, 32L]-hCNP37

Molecular weight: 3726.2836. LCMS34: m/3 calcd: 1243.0945; m/3 found: 1243.0310; m/4 calcd: 932.5709; m/4 found: 932.5240

Chem. 49; Compound ID 1346; SEQ ID NO: 47

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), des1-8, 10H, 13Q, 14H, 15H, 25P, 32L]-hCNP37

Molecular weight: 3695.2265. LCMS34: m/3 calcd: 1232.7422; m/3 found: 1232.6930; m/4 calcd: 924.8066; m/4 found: 924.7340

Chem. 50; Compound ID 1347; SEQ ID NO: 48

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), des1-10, 13Q, 19H, 25P, 32L]-hCNP37

Molecular weight: 3385.947. LCMS34: m/3 calcd: 1129.6490; m/3 found: 1129.2775; m/4 calcd: 847.4868; m/4 found: 847.2063

Chem. 51 ; Compound ID 1348; SEQ ID NO: 49

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), des1-10, 13Q, 18H, 19S, 25P, 32L]-hCNP37

Molecular weight: 3385.947. LCMS34: m/3 calcd: 1129.6490; m/3 found: 1129.2775; m/4 calcd: 847.4868; m/4 found: 847.4684

Chem. 52; Compound ID 1350; SEQ ID NO: 50

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), des1-5, 10H, 13Q, 14H, 15T, 19S, 25P, 32L]-hCNP37

Molecular weight: 3973.532. LCMS34: m/3 calcd: 1325.5107; m/3 found: 1325.3463; m/4 calcd: 994.3830; m/4 found: 994.2843

Chem. 53; Compound ID 1351 ; SEQ ID NO: 51 [N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), des1-5, 10H, 13Q, 14H, 15T, 17V, 19S, 25P, 32L]-hCNP37

Molecular weight: 3959.5054. LCMS34: m/3 calcd: 1320.8351; m/3 found: 1320.6271 ; m/4 calcd: 990.8764; m/4 found: 990.7383

Chem. 54; Compound ID 1352; SEQ ID NO: 33

[N-terminal([2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy -4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]amino]ethoxy]ethoxy]acetyl]), des1-8, 10H, 13Q, 15T, 17V, 19S, 25P, 32L]-hCNP37

Molecular weight: 3740.259. LCMS34: m/3 calcd: 1247.7530; m/3 found: 1247.3048; m/4 calcd: 936.0648; m/4 found: 935.9911

Chem. 55; Compound ID 1353; SEQ ID NO: 36

[N-terminal([2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy -4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]amino]ethoxy]ethoxy]acetyl]), des1-8, 9E, 10H, 13Q, 25P, 32L]-hCNP37

Molecular weight: 3788.3897. LCMS34: m/3 calcd: 1263.7966; m/3 found: 1263.6780; m/4 calcd: 948.0974; m/4 found: 947.7735

Chem. 56; Compound ID 1354; SEQ ID NO: 52 [N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-[[(4S)-4-c arboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]etho xy]ethoxy]acetyl]amino]eth oxy]ethoxy]acetyl]), des1-5, 10H, 13Q, 15T, 17V, 19S, 25P, 32L]-hCNP37

Molecular weight: 4079.6524. LCMS34: m/3 calcd: 1360.8841; m/3 found: 1360.7530; m/4 calcd: 1020.9131 ; m/4 found: 1020.8160

Chem. 57; Compound ID 1355; SEQ ID NO: 22

[N-terminal([2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy -4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]amino]ethoxy]ethoxy]acetyl]), des1-8, 13Q, 19S, 25P, 32L]-hCNP37

Molecular weight: 3772.387. LCMS34: m/3 calcd: 1258.4623; m/3 found: 1258.3439; m/4 calcd: 944.0968; m/4 found: 944.0223

Chem. 58; Compound ID 1356; SEQ ID NO: 22

[N-terminal([2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy -4-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]etho xy]ethoxy]acetyl]amino]eth oxy]ethoxy]acetyl]amino]ethoxy]ethoxy]acetyl]), des1-8, 13Q, 19S, 25P, 32L]-hCNP37

Molecular weight: 3901.501. LCMS34: m/3 calcd: 1301.5003; m/3 found: 1301.3470; m/4 calcd: 976.3753; m/4 found: 976.2725

Chem. 59; Compound ID 1357; SEQ ID NO: 5 [N-terminal([2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4- [[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]etho xy]ethoxy]acetyl]amino]eth oxy]ethoxy]acetyl]amino]ethoxy]ethoxy]acetyl]), des1-8, 9E, 10H, 13Q, 32L]-hCNP37

Molecular weight: 3948.5608. LCMS34: m/3 calcd: 1317.1869; m/3 found: 1317.0300; m/4 calcd: 988.1402; m/4 found: 988.0348

Chem. 60; Compound ID 1359; SEQ ID NO: 53

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), des1-5, 9E, 10H, 13Q, 15T, 17V, 19S, 25P, 32L]-hCNP37

Molecular weight: 3916.4792. LCMS34: m/3 calcd: 1306.4931; m/3 found: 1306.0170; m/4 calcd: 980.1198; m/4 found: 979.7797

Chem. 61; Compound ID 1360; SEQ ID NO: 54

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), des1-5, 9E, 10H, 13Q, 14H, 15T, 17V, 19S, 25P, 32L]-hCNP37

Molecular weight: 3925.4462. LCMS34: m/3 calcd: 1309.4821; m/3 found: 1309.3323; m/4 calcd: 982.3616; m/4 found: 982.2667

Chem. 62; Compound ID 1375; SEQ ID NO: 14 [N-terminal([2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[(4S)-4- carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]amino]ethoxy]ethoxy]acetyl]amino]ethoxy]ethoxy]acetyl]), des1-8, 10E, 13Q, 25P, 32L]-

Molecular weight: 3959.5801. LCMS34: m/3 calcd: 1320.8600; m/3 found: 1320.7200; m/4 calcd: 990.8950; m/4 found: 990.5400

Chem. 63; Compound ID 1376; SEQ ID NO: 14

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(19- carboxynonadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acetyl ]amino]ethoxy]ethoxy]acety

Molecular weight: 3697.3204. LCMS34: m/3 calcd: 1233.4401; m/3 found: 1233.3500; m/4 calcd: 925.3301; m/4 found: 925.2600

Chem. 64; Compound ID 1377; SEQ ID NO: 55

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), des1-8, 10E, 13Q, 17G, 25P, 32L]-hCNP37

Molecular weight: 3613.1609. LCMS34: m/3 calcd: 1205.3870; m/3 found: 1205.3100; m/4 calcd: 904.2902; m/4 found: 903.9800

Chem. 65; Compound ID 1378; SEQ ID NO: 56 [N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), des1-5, 6G, 7G, 8G, 10E, 13Q, 19S, 25P, 32L]-hCNP37

Molecular weight: 3799.3262. LCMS34: m/3 calcd: 1267.4421; m/3 found: 1267.3470; m/4 calcd: 950.8316; m/4 found: 950.7240

Chem. 66; Compound ID 1379; SEQ ID NO: 57

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), 5Q, 8S, 10E, 13Q, 19S, 25P, 32L]-hCNP37

Molecular weight: 4562.14. LCMS34: m/3 calcd: 1521.7133; m/3 found: 1521.3220; m/4 calcd: 1141.5350; m/4 found: 1141.2370

Chem. 67; Compound ID 1380; SEQ ID NO: 58

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), 5E, 8S, 10E, 13Q, 19S, 25P, 32L]-hCNP37

Molecular weight: 4563.1248. LCMS34: m/3 calcd: 1522.0416; m/3 found: 1521.8490; m/4 calcd: 1141.7812; m/4 found: 1141.6240

Chem. 68; Compound ID 1381; SEQ ID NO: 59

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), 5Q, 7H, 10H, 13Q, 14H, 15H, 17S, 19Q, 25P, 32L]-hCNP37

Molecular weight: 4625.1195. LCMS34: m/3 calcd: 1542.7065; m/3 found: 1542.3070; m/4 calcd: 1157.2799; m/4 found: 1156.9700

Chem. 69; Compound ID 1382; SEQ ID NO: 60

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-[[(4S)- 4-carboxy-4-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]buta noyl]amino]ethoxy]ethoxy] acetyl]amino]ethoxy]ethoxy]acetyl]), 5Q, 7H, 13Q, 19Q, 25P, 32L]-hCNP37

Molecular weight: 4882.5268. LCMS34: m/3 calcd: 1628.5089; m/3 found: 1628.2280; m/4 calcd: 1221.6317; m/4 found: 1221.2810

Chem. 70; Compound ID 1383; SEQ ID NO: 61

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-[[(4S)- 4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]etho xy]ethoxy]acetyl]amino]eth oxy]ethoxy]acetyl]), 5Q, 7H, 10H, 13Q, 15H, 17S, 19Q, 25P, 32L]-hCNP37

Molecular weight: 4745.2665. LCMS34: m/3 calcd: 1582.7555; m/3 found: 1582.5080; m/4 calcd: 1187.3166; m/4 found: 1186.9970

Chem. 71; Compound ID 9384; SEQ ID NO: 62

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), des1-6, 7G, 8Q, 9A, 10P, 13Q, 17S, 19Q, 25P, 32L]-hCNP37

Molecular weight: 3704.2302. LCMS34: m/3 calcd: 1235.7434; m/3 found: 1235.5400; m/4 calcd: 927.0576; m/4 found: 926.9010

Chem. 72; Compound ID 1385; SEQ ID NO: 63

[N-terminal([(4S)-4-carboxy-4-[[(4S)-4-carboxy-4-[[(4S)-4 -carboxy-4-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]buta noyl]amino]butanoyl]), des1-5, 10E, 13Q, 25P, 32L]-hCNP37

Molecular weight: 4121.7322. LCMS34: m/3 calcd: 1374.9107; m/3 found: 1374.6120; m/4 calcd: 1031.4331 ; m/4 found: 1031.2130

Chem. 73; Compound ID 1386; SEQ ID NO: 64

[N-terminal([(4S)-4-carboxy-4-[[(4S)-4-carboxy-4-[[(4S)-4 -carboxy-4-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]buta noyl]amino]butanoyl]), des1-5, 13Q, 19S, 25P, 32L]-hCNP37

Molecular weight: 4079.6955. LCMS34: m/3 calcd: 1360.8985; m/3 found: 1360.7680; m/4 calcd: 1020.9239; m/4 found: 1020.8160 Chem. 74; Compound ID 1387; SEQ ID NO: 65

[N-terminal([(4S)-4-carboxy-4-[[(4S)-4-carboxy-4-[[(4S)-4 -carboxy-4-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]buta noyl]amino]butanoyl]), des1-5, 6G, 7G, 8G, 13Q, 19S, 25P, 32L]-hCNP37

Molecular weight: 3895.4136. LCMS34: m/3 calcd: 1299.4712; m/3 found: 1299.3300; m/4 calcd: 974.8534; m/4 found: 974.7500

Chem. 75; Compound ID 1388; SEQ ID NO: 66

[N-terminal([(4S)-4-carboxy-4-[[(4S)-4-carboxy-4-[[(4S)-4 -carboxy-4-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]buta noyl]amino]butanoyl]), des1-5, 6G, 7G, 8G, 13Q, 25P, 32L]-hCNP37

Molecular weight: 3936.5086. LCMS34: m/3 calcd: 1313.1695; m/3 found: 1313.0250; m/4 calcd: 985.1272; m/4 found: 985.2870

Chem. 76; Compound ID 1389; SEQ ID NO: 67

[N-terminal([(4S)-4-carboxy-4-[[(4S)-4-carboxy-4-[[(4S)-4 -carboxy-4-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]buta noyl]amino]butanoyl]), 5Q, 13Q, 19S, 25P, 32L]-hCNP37

Molecular weight: 3903.4738. LCMS34: m/3 calcd: 1302.1579; m/3 found: 1302.0100; m/4 calcd: 976.8685; m/4 found: 976.5200

Chem. 79; Compound ID 1392; SEQ ID NO: 16

[N-terminal([2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[(4S) -4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]amino]ethoxy]ethoxy]acetyl]amino]ethoxy]ethoxy]acetyl]), des1-8, 10E, 13Q, 19S, 25P,

Molecular weight: 3959.5371. LCMS34: m/3 calcd: 1320.8457; m/3 found: 1321.0300; m/4 calcd: 990.8843; m/4 found: 990.7800

Chem. 81; Compound ID 1394; SEQ ID NO: 70

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), 5Q, 10E, 13Q, 19Q, 25P, 32L]-hCNP37

Molecular weight: 4644.2869. LCMS34: m/3 calcd: 1549.0956; m/3 found: 1548.7900; m/4 calcd: 1162.0717; m/4 found: 1161.8500

Chem. 82; Compound ID 1395; SEQ ID NO: 71

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), 5Q, 7A, 10E, 13Q, 19Q, 25P, 32L]-hCNP37

Molecular weight: 4559.1791. LCMS34: m/3 calcd: 1520.7264; m/3 found: 1520.4600; m/4 calcd: 1140.7948; m/4 found: 1140.600

Chem. 83; Compound ID 1396; SEQ ID NO: 70

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-[[(4S)- 4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]etho xy]ethoxy]acetyl]amino]eth oxy]ethoxy]acetyl]), 5Q, 10E, 13Q, 19Q, 25P, 32L]-hCNP37

Molecular weight: 4773.4009. LCMS34: m/3 calcd: 1592.1336; m/3 found: 1592.1600; m/4 calcd: 1194.3502; m/4 found: 1194.3700

Chem. 84; Compound ID 1398; SEQ ID NO: 72

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-[[(4S)- 4-carboxy-4-[[(4S)-4-carboxy-4-[[(4S)-

4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]buta noyl]amino]butanoyl]amino ]ethoxy]ethoxy]acetyl]amino]ethoxy]ethoxy]acetyl]), 5Q, 8H, 13Q, 17S, 19Q, 25P, 32L]- hCNP37

Molecular weight: 5013.5738. LCMS34: m/3 calcd: 1672.1913; m/3 found: 1672.1528; m/4 calcd: 1254.3935; m/4 found: 1254.1224

Chem. 85; Compound ID 1399; SEQ ID NO: 72

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-[[(4S)- 4-carboxy-4-[[(4S)-4-carboxy-4-[[(4S)-

4-carboxy-4-(19- carboxynonadecanoylamino)butanoyl]amino]butanoyl]amino]butan oyl]amino]butanoyl]amino] ethoxy]ethoxy]acetyl]amino]ethoxy]ethoxy]acetyl]), 5Q, 8H, 13Q, 17S, 19Q, 25P, 32L]- hCNP37

Chem. 86; Compound ID 1400; SEQ ID NO: 73

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-[[(4S)- 4-carboxy-4-[[(4S)-4-carboxy-4-[[(4S)-

4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]buta noyl]amino]butanoyl]amino ]ethoxy]ethoxy]acetyl]amino]ethoxy]ethoxy]acetyl]), 5Q, 7H, 13Q, 17G, 19Q, 25P, 32L]- hCNP37

Molecular weight: 4955.5344. LCMS34: m/3 calcd: 1652.8448; m/3 found: 1652.8279; m/4 calcd: 1239.8836; m/4 found: 1239.8716

Chem. 87; Compound ID 1401; SEQ ID NO: 74

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-[[(4S)- 4-carboxy-4-[[(4S)-4-carboxy-4-[[(4S)-

4-carboxy-4-[[(4S)-4-carboxy-4-[[(4S)-4-carboxy-4-[[(4S)- 4-carboxy-4-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]buta noyl]amino]butanoyl]amino ]butanoyl]amino]butanoyl]amino]butanoyl]amino]butanoyl]amino ]ethoxy]ethoxy]acetyl]amino] ethoxy]ethoxy]acetyl]), 5Q, 13Q, 32L]-hCNP37

Molecular weight: 5578.2432. LCMS34: m/3 calcd: 1860.4144; m/3 found: 1860.2654; m/4 calcd: 1395.5608; m/4 found: 1395.4623

Chem. 88; Compound ID 1402; SEQ ID NO: 75 [N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-[[(4S)-4-c arboxy-4-[[(4S)-4-carboxy-4-[[(4S)-

4-carboxy-4-[[(4S)-4-carboxy-4-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]buta noyl]amino]butanoyl]amino ]butanoyl]amino]butanoyl]amino]ethoxy]ethoxy]acetyl]amino]et hoxy]ethoxy]acetyl]), 5Q, 13Q,

Molecular weight: 5288.9151. LCMS34: m/3 calcd: 1763.9717; m/3 found: 1763.8729; m/4 calcd: 1323.2288; m/4 found: 1323.1718

Chem. 89; Compound ID 1403; SEQ ID NO: 76

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-[[(4S)- 4-carboxy-4-[[(4S)-4-carboxy-4-[[(4S)-

4-carboxy-4-[[(4S)-4-carboxy-4-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]buta noyl]amino]butanoyl]amino ]butanoyl]amino]butanoyl]amino]ethoxy]ethoxy]acetyl]amino]et hoxy]ethoxy]acetyl]), 5Q, 13Q,

Molecular weight: 5232.8088. LCMS34: m/3 calcd: 1745.2696; m/3 found: 1744.8611 ; m/4 calcd: 1309.2022; m/4 found: 1309.1547

Chem. 90; Compound ID 1404; SEQ ID NO: 75

[N-terminal([2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[(4S) -4-carboxy-4-[[(4S)-4-carboxy-4-[[(4S)-4- carboxy-4-[[(4S)-4-carboxy-4-[[(4S)-4-carboxy-4-[[(4S)-4-car boxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]buta noyl]amino]butanoyl]amino

]butanoyl]amino]butanoyl]amino]ethoxy]ethoxy]acetyl]amino ]ethoxy]ethoxy]acetyl]amino]etho xy]ethoxy]acetyl]amino]ethoxy]ethoxy]acetyl]), 5Q, 13Q, 19Q, 25P, 32L]-hCNP37

Molecular weight: 5579.228. LCMS34: m/3 calcd: 1860.7427; m/3 found: 1860.6008; m/4 calcd: 1395.8070; m/4 found: 1395.7069

Chem. 91; Compound ID 1405; SEQ ID NO: 75

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-[[(4S)- 4-carboxy-4-[[(4S)-4-carboxy-4-[[(4S)-

4-carboxy-4-[[(4S)-4-carboxy-4-[[(4S)-4-carboxy-4-(19- carboxynonadecanoylamino)butanoyl]amino]butanoyl]amino]butan oyl]amino]butanoyl]amino] butanoyl]amino]butanoyl]amino]ethoxy]ethoxy]acetyl]amino]eth oxy]ethoxy]acetyl]), 5Q, 13Q,

Molecular weight: 5316.9683. LCMS34: m/3 calcd: 1773.3228; m/3 found: 1773.2192; m/4 calcd: 1330.2421 ; m/4 found: 1330.1785

Chem. 92; Compound ID 1406; SEQ ID NO: 75

[N-terminal([2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[(4S) -4-carboxy-4-[[(4S)-4-carboxy-4-[[(4S)-4- carboxy-4-[[(4S)-4-carboxy-4-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]buta noyl]amino]butanoyl]amino

]butanoyl]amino]ethoxy]ethoxy]acetyl]amino]ethoxy]ethoxy] acetyl]amino]ethoxy]ethoxy]acetyl

]amino]ethoxy]ethoxy]acetyl]), 5Q, 13Q, 19Q, 25P, 32L]-hCNP37

Molecular weight: 5450.114. LCMS34: m/3 calcd: 1817.7047; m/3 found: 1817.5808; m/4 calcd: 1363.5285; m/4 found: 1363.4484 Chem. 93; Compound ID 9407; SEQ ID NO: 77

[N-terminal([2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[(4S) -4-carboxy-4-[[(4S)-4-carboxy-4-[[(4S)-4- carboxy-4-[[(4S)-4-carboxy-4-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]buta noyl]amino]butanoyl]amino

]butanoyl]amino]ethoxy]ethoxy]acetyl]amino]ethoxy]ethoxy] acetyl]amino]ethoxy]ethoxy]acetyl ]amino]ethoxy]ethoxy]acetyl]), des1-5, 13Q, 19Q, 25P, 32L]-hCNP37

Molecular weight: 4830.4871. LCMS34: m/3 calcd: 1611.1624; m/3 found: 1610.8330; m/4 calcd: 1208.6218; m/4 found: 1208.3823 Chem. 94; Compound ID 1419; SEQ ID NO: 51

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-[[(4S)- 4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]etho xy]ethoxy]acetyl]amino]eth oxy]ethoxy]acetyl]), des1-5, 10H, 13Q, 14H, 15T, 17V, 19S, 25P, 32L]-hCNP37

Molecular weight: 4088.6194. LCMS34: m/3 calcd: 1363.8731; m/3 found: 1363.6902; m/4 calcd: 1023.1549; m/4 found: 1023.0371

Chem. 95; Compound ID 1420; SEQ ID NO: 78

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-[[(4S)- 4-carboxy-4-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]buta noyl]amino]ethoxy]ethoxy] acetyl]amino]ethoxy]ethoxy]acetyl]), des1-5, 10H, 13Q, 14H, 15T, 17V, 25P, 32L]-hCNP37

Molecular weight: 4258.8284. LCMS34: m/3 calcd: 1420.6095; m/3 found: 1420.3875; m/4 calcd: 1065.7071 ; m/4 found: 1065.5448

Chem. 96; Compound ID 1421; SEQ ID NO: 79

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-[[(4S)- 4-carboxy-4-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]buta noyl]amino]ethoxy]ethoxy] acetyl]amino]ethoxy]ethoxy]acetyl]), des1-5, 13Q, 15T, 17V, 19S, 25P, 32L]-hCNP37

Molecular weight: 4199.7994. LCMS34: m/3 calcd: 1400.9331; m/3 found: 1400.7268; m/4 calcd: 1050.9499; m/4 found: 1050.8062

Chem. 97; Compound ID 1422; SEQ ID NO: 80

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-[[(4S)- 4-carboxy-4-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]buta noyl]amino]ethoxy]ethoxy] acetyl]amino]ethoxy]ethoxy]acetyl]), des1-5, 10H, 13Q, 17V, 19S, 25P, 32L]-hCNP37

Molecular weight: 4235.8348. LCMS34: m/3 calcd: 1412.9449; m/3 found: 1412.7313; m/4 calcd: 1059.9587; m/4 found: 1059.8075

Chem. 98; Compound ID 1423; SEQ ID NO: 81

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-[[(4S)- 4-carboxy-4-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]buta noyl]amino]ethoxy]ethoxy] acetyl]amino]ethoxy]ethoxy]acetyl]), des1-5, 10H, 13Q, 15T, 17V, 25P, 32L]-hCNP37

Molecular weight: 4249.8614. LCMS34: m/3 calcd: 1417.6205; m/3 found: 1417.3965; m/4 calcd: 1063.4654; m/4 found: 1063.3148

Chem. 99; Compound ID 1424; SEQ ID NO: 82

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-[[(4S)- 4-carboxy-4-[[(4S)-4-carboxy-4-[[(4S)-

4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]buta noyl]amino]butanoyl]amino ]ethoxy]ethoxy]acetyl]amino]ethoxy]ethoxy]acetyl]), des1-5, 13Q, 15T, 17V, 25P, 32L]- hCNP37

Molecular weight: 4370.0084. LCMS34: m/3 calcd: 1457.6695; m/3 found: 1457.4309; m/4 calcd: 1093.5021 ; m/4 found: 1093.5833

Chem. 100; Compound ID 1425; SEQ ID NO: 83

[N-terminal([2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[(4S) -4-carboxy-4-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]etho xy]ethoxy]acetyl]amino]eth oxy]ethoxy]acetyl]amino]ethoxy]ethoxy]acetyl]amino]ethoxy]et hoxy]acetyl]), des1-8, 10H,

Molecular weight: 3912.4408. LCMS34: m/3 calcd: 1305.1469; m/3 found: 1304.9080; m/4 calcd: 979.1102; m/4 found: 978.9250

Chem. 103; Compound ID 1432; SEQ ID NO: 86

[N-terminal([2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[(4S) -4-carboxy-4-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]etho xy]ethoxy]acetyl]amino]eth oxy]ethoxy]acetyl]amino]ethoxy]ethoxy]acetyl]amino]ethoxy]et hoxy]acetyl]), des1-5, 10E, 13Q, 14H, 17G, 19Q, 25P, 32L]-hCNP37

Molecular weight: 4396.9476. LCMS34: m/3 calcd: 1466.6492; m/3 found: 1466.3500; m/4 calcd: 1100.2369; m/4 found: 1100.0354

Chem. 104; Compound ID 1434; SEQ ID NO: 87

[N-terminal([2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[(4S) -4-carboxy-4-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]etho xy]ethoxy]acetyl]amino]eth oxy]ethoxy]acetyl]amino]ethoxy]ethoxy]acetyl]amino]ethoxy]et hoxy]acetyl]), des1-8, 10H,

Molecular weight: 4040.57. LCMS34: m/3 calcd: 1347.8567; m/3 found: 1347.9714; m/4 calcd: 1011.1425; m/4 found: 1011.2499

Chem. 105; Compound ID 9435; SEQ ID NO: 88

[N-terminal([2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[(4S) -4-carboxy-4-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]etho xy]ethoxy]acetyl]amino]eth oxy]ethoxy]acetyl]amino]ethoxy]ethoxy]acetyl]amino]ethoxy]et hoxy]acetyl]), des1-8, 13Q,

Molecular weight: 4031.603. LCMS34: m/3 calcd: 1344.8677; m/3 found: 1344.7600; m/4 calcd: 1008.9008; m/4 found: 1008.8210

Chem. 106; Compound ID 1436; SEQ ID NO: 89

[N-terminal([2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[(4S) -4-carboxy-4-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]etho xy]ethoxy]acetyl]amino]eth oxy]ethoxy]acetyl]amino]ethoxy]ethoxy]acetyl]amino]ethoxy]et hoxy]acetyl]), des1-8, 13Q, 17V, 19Q, 25P, 32L]-hCNP37

Molecular weight: 4073.6828. LCMS34: m/3 calcd: 1358.8943; m/3 found: 1358.6617; m/4 calcd: 1019.4207; m/4 found: 1019.2703

Chem. 107; Compound ID 1437; SEQ ID NO: 90

[N-terminal([2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[(4S) -4-carboxy-4-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]etho xy]ethoxy]acetyl]amino]eth oxy]ethoxy]acetyl]amino]ethoxy]ethoxy]acetyl]amino]ethoxy]et hoxy]acetyl]), des1-8, 10H,

Molecular weight: 4082.6498. LCMS34: m/3 calcd: 1361.8833; m/3 found: 1361.7580; m/4 calcd: 1021.6625; m/4 found: 1021.5750

Chem. 108; Compound ID 1448; SEQ ID NO: 91

[N-terminal([(4S)-4-carboxy-4-[[(4S)-4-carboxy-4-[[(4S)-4 -carboxy-4-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]buta noyl]amino]butanoyl]), 5Q,

Molecular weight: 4741.359. LCMS34: m/3 calcd: 1581.4530; m/3 found: 1581.2060; m/4 calcd: 1186.3398; m/4 found: 1186.0240

Chem. 109; Compound ID 1449; SEQ ID NO: 51

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-[[(4S)- 4-carboxy-4-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]buta noyl]amino]ethoxy]ethoxy] acetyl]amino]ethoxy]ethoxy]acetyl]), des1-5, 10H, 13Q, 14H, 15T, 17V, 19S, 25P, 32L]- hCNP37

Molecular weight: 4217.7334. LCMS34: m/3 calcd: 1406.9111; m/3 found: 9407.0500; m/4 calcd: 1055.4334; m/4 found: 1055.300

Chem. 110; Compound ID 1450; SEQ ID NO: 52

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-[[(4S)- 4-carboxy-4-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]buta noyl]amino]ethoxy]ethoxy] acetyl]amino]ethoxy]ethoxy]acetyl]), des1-5, 10H, 13Q, 15T, 17V, 19S, 25P, 32L]-hCNP37

Molecular weight: 4208.7664. LCMS34: m/3 calcd: 1403.9221; m/3 found: 1403.7330; m/4 calcd: 1053.1916; m/4 found: 1053.0130

Chem. 111 ; Compound ID 1451 ; SEQ ID NO: 92

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-[[(4S)- 4-carboxy-4-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]buta noyl]amino]ethoxy]ethoxy] acetyl]amino]ethoxy]ethoxy]acetyl]), des1-5, 10H, 13Q, 17V, 19S, 25P, 27E, 32L]-hCNP37

Molecular weight: 4249.8614. LCMS34: m/3 calcd: 1417.6205; m/3 found: 1417.4290; m/4 calcd: 1063.4654; m/4 found: 1063.3310

Chem. 112; Compound ID 1452; SEQ ID NO: 77 [N-terminal([2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4- [[(4S)-4-carboxy-4-[[(4S)-4-carboxy-

4-[[(4S)-4-carboxy-4-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]buta noyl]amino]butanoyl]amino

]butanoyl]amino]ethoxy]ethoxy]acetyl]amino]ethoxy]ethoxy] acetyl]amino]ethoxy]ethoxy]acetyl

]), des1-5, 13Q, 19Q, 25P, 32L]-hCNP37

Molecular weight: 4685.3307. LCMS34: m/3 calcd: 1562.7769; m/3 found: 1562.3981 ; m/4 calcd: 1172.3327; m/4 found: 1172.3179

Chem. 113; Compound ID 1453; SEQ ID NO: 77

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-[[(4S)- 4-carboxy-4-[[(4S)-4-carboxy-4-[[(4S)-

4-carboxy-4-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]buta noyl]amino]butanoyl]amino ]butanoyl]amino]ethoxy]ethoxy]acetyl]amino]ethoxy]ethoxy]ace tyl]), des1-5, 13Q, 19Q, 25P, 32L]-hCNP37

Molecular weight: 4540.1743. LCMS34: m/3 calcd: 1514.3914; m/3 found: 1514.0494; m/4 calcd: 1136.0436; m/4 found: 1135.8064

Chem. 114; Compound ID 1454; SEQ ID NO: 77

[N-terminal([2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[(4S) -4-carboxy-4-[[(4S)-4-carboxy-4-[[(4S)-4- carboxy-4-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]buta noyl]amino]butanoyl]amino

]ethoxy]ethoxy]acetyl]amino]ethoxy]ethoxy]acetyl]amino]et hoxy]ethoxy]acetyl]amino]ethoxy]e thoxyjacetyl]), des1-5, 13Q, 19Q, 25P, 32L]-hCNP37

Molecular weight: 4701.3732. LCMS34: m/3 calcd: 1568.1244; m/3 found: 1567.7415; m/4 calcd: 1176.3433; m/4 found: 1176.0765

Chem. 115; Compound ID 1455; SEQ ID NO: 77

[N-terminal([2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy -4-[[(4S)-4-carboxy-4-[[(4S)-4-carboxy-

4-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]buta noyl]amino]butanoyl]amino ]ethoxy]ethoxy]acetyl]amino]ethoxy]ethoxy]acetyl]amino]ethox y]ethoxy]acetyl]), des1-5, 13Q, 19Q, 25P, 32L]-hCNP37

Molecular weight: 4556.2167. LCMS34: m/3 calcd: 1519.7389; m/3 found: 1519.3893; m/4 calcd: 1140.0542; m/4 found: 1139.8102

Chem. 116; Compound ID 1456; SEQ ID NO: 77

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-[[(4S)- 4-carboxy-4-[[(4S)-4-carboxy-4-[[(4S)-

4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]buta noyl]amino]butanoyl]amino

]ethoxy]ethoxy]acetyl]amino]ethoxy]ethoxy]acetyl]), des1-5, 13Q, 19Q, 25P, 32L]-hCNP37

Molecular weight: 4411.0603. LCMS34: m/3 calcd: 1471.3534; m/3 found: 1471.0409; m/4 calcd: 1103.7651 ; m/4 found: 1103.5541

Chem. 117; Compound ID 1457; SEQ ID NO: 93 [N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), -2G, -1Q, 2P, 3G, 4Q, 5A, 6P, 7G, 8Q, 9A, 10P, 13Q, 19Q, 25P, 32L]-hCNP37

Molecular weight: 4410.9775. LCMS34: m/3 calcd: 1471.3258; m/3 found: 1471.0251 ; m/4 calcd: 1103.7444; m/4 found: 1103.7853

Chem. 118; Compound ID 1458; SEQ ID NO: 94

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), des1-2, 3G, 4Q, 5A, 6P, 7G, 8Q, 9A, 10P, 13Q, 17S, 19Q, 25P, 32L]-hCNP37

Molecular weight: 4057.6038. LCMS34: m/3 calcd: 1353.5346; m/3 found: 1353.3113; m/4 calcd: 1015.4010; m/4 found: 1015.2496

Chem. 119; Compound ID 1459; SEQ ID NO: 95

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-[[(4S)- 4-carboxy-4-[[(4S)-4-carboxy-4-[[(4S)-

4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]buta noyl]amino]butanoyl]amino ]ethoxy]ethoxy]acetyl]amino]ethoxy]ethoxy]acetyl]), des1, 2G, 3Q, 4A, 5P, 13Q, 17S, 19Q, 25P, 32L]-hCNP37

Molecular weight: 4738.3536. LCMS34: m/3 calcd: 1580.4512; m/3 found: 1580.0658; m/4 calcd: 1185.5884; m/4 found: 1185.5701

Chem. 120; Compound ID 1460; SEQ ID NO: 96

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-[[(4S)- 4-carboxy-4-[[(4S)-4-carboxy-4-[[(4S)-

4-carboxy-4-[[(4S)-4-carboxy-4-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]buta noyl]amino]butanoyl]amino ]butanoyl]amino]butanoyl]amino]ethoxy]ethoxy]acetyl]amino]et hoxy]ethoxy]acetyl]), des1-5, 13Q, 25P, 32L]-hCNP37

Molecular weight: 4669.3313. LCMS34: m/3 calcd: 1557.4438; m/3 found: 1557.4031 ; m/4 calcd: 1168.3328; m/4 found: 1168.0756 Chem. 121 ; Compound ID 1461 ; SEQ ID NO: 97

[N-terminal([2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[(4S) -4-carboxy-4-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]etho xy]ethoxy]acetyl]amino]eth oxy]ethoxy]acetyl]amino]ethoxy]ethoxy]acetyl]amino]ethoxy]et hoxy]acetyl]), des1-8, 10H,

Molecular weight: 4096.6763. LCMS34: m/3 calcd: 1366.5588; m/3 found: 1366.3214; m/4 calcd: 1025.1691 ; m/4 found: 1025.0148

Chem. 122; Compound ID 1462; SEQ ID NO: 96 [N-terminal([2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[(4S)-4- carboxy-4-[[(4S)-4-carboxy-4-[[(4S)-4- carboxy-4-[[(4S)-4-carboxy-4-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]buta noyl]amino]butanoyl]amino ]butanoyl]amino]ethoxy]ethoxy]acetyl]amino]ethoxy]ethoxy]ace tyl]amino]ethoxy]ethoxy]acetyl ]amino]ethoxy]ethoxy]acetyl]), des1-5, 13Q, 25P, 32L]-hCNP37

Molecular weight: 4830.5302. LCMS34: m/3 calcd: 1611.1767; m/3 found: 1611.1900; m/4 calcd: 1208.6326; m/4 found: 1208.6500

Chem. 123; Compound ID 1463; SEQ ID NO: 98

[N-terminal([2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[(4S) -4-carboxy-4-[[(4S)-4-carboxy-4-[[(4S)-4- carboxy-4-[[(4S)-4-carboxy-4-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]buta noyl]amino]butanoyl]amino

]butanoyl]amino]ethoxy]ethoxy]acetyl]amino]ethoxy]ethoxy] acetyl]amino]ethoxy]ethoxy]acetyl

]amino]ethoxy]ethoxy]acetyl]), des1-5, 13Q, 19Q, 32L]-hCNP37

Molecular weight: 4861.5442. LCMS34: m/3 calcd: 1621.5147; m/3 found: 1621.1760; m/4 calcd: 1216.3861 ; m/4 found: 1216.1420

Chem. 124; Compound ID 1464; SEQ ID NO: 99

[N-terminal([2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[(4S) -4-carboxy-4-[[(4S)-4-carboxy-4-[[(4S)-4- carboxy-4-[[(4S)-4-carboxy-4-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]buta noyl]amino]butanoyl]amino

]butanoyl]amino]ethoxy]ethoxy]acetyl]amino]ethoxy]ethoxy] acetyl]amino]ethoxy]ethoxy]acetyl ]amino]ethoxy]ethoxy]acetyl]), des1-5, 19Q, 25P, 32L]-hCNP37

Molecular weight: 4816.4606. LCMS34: m/3 calcd: 1606.4869; m/3 found: 1606.1700; m/4 calcd: 1205.1152; m/4 found: 1204.8820

Chem. 125; Compound ID 1465; SEQ ID NO: 100

[N-terminal([2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[(4S) -4-carboxy-4-[[(4S)-4-carboxy-4-[[(4S)-4- carboxy-4-[[(4S)-4-carboxy-4-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]buta noyl]amino]butanoyl]amino

]butanoyl]amino]ethoxy]ethoxy]acetyl]amino]ethoxy]ethoxy] acetyl]amino]ethoxy]ethoxy]acetyl

]amino]ethoxy]ethoxy]acetyl]), des1-5, 13Q, 19Q, 25P]-hCNP37

Molecular weight: 4848.5256. LCMS34: m/3 calcd: 1617.1752; m/3 found: 1616.8130; m/4 calcd: 1213.1314; m/4 found: 1212.8620

Chem. 126; Compound ID 1470; SEQ ID NO: 96

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-[[(4S)- 4-carboxy-4-[[(4S)-4-carboxy-4-[[(4S)-

4-carboxy-4-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]buta noyl]amino]butanoyl]amino ]butanoyl]amino]ethoxy]ethoxy]acetyl]amino]ethoxy]ethoxy]ace tyl]), des1-5, 13Q, 25P, 32L]- hCNP37

Molecular weight: 4540.2173. LCMS34: m/3 calcd: 1514.4058; m/3 found: 1514.1500; m/4 calcd: 1136.0543; m/4 found: 1135.8500

Chem. 127; Compound ID 1471 ; SEQ ID NO: 75

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-[[(4S)- 4-carboxy-4-[[(4S)-4-carboxy-4-[[(4S)-

4-carboxy-4-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]buta noyl]amino]butanoyl]amino ]butanoyl]amino]ethoxy]ethoxy]acetyl]amino]ethoxy]ethoxy]ace tyl]), 5Q, 13Q, 19Q, 25P,

Molecular weight: 5159.8011. LCMS34: m/3 calcd: 1720.9337; m/3 found: 1720.8900; m/4 calcd: 1290.9503; m/4 found: 1290.9200

Chem. 128; Compound ID 1472; SEQ ID NO: 75

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-[[(4S)- 4-carboxy-4-[[(4S)-4-carboxy-4-[[(4S)-

4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]buta noyl]amino]butanoyl]amino

]ethoxy]ethoxy]acetyl]amino]ethoxy]ethoxy]acetyl]), 5Q, 13Q, 19Q, 25P, 32L]-hCNP37

Molecular weight: 5030.6872. LCMS34: m/3 calcd: 1677.8957; m/3 found: 1677.8700; m/4 calcd: 1258.6718; m/4 found: 1258.6600

Chem. 129; Compound ID 1473; SEQ ID NO: 67

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-[[(4S)- 4-carboxy-4-[[(4S)-4-carboxy-4-[[(4S)-

4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]buta noyl]amino]butanoyl]amino

]ethoxy]ethoxy]acetyl]amino]ethoxy]ethoxy]acetyl]), 5Q, 13Q, 19S, 25P, 32L]-hCNP37

Chem. 130; Compound ID 1474; SEQ ID NO: 101

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-[[(4S)- 4-carboxy-4-[[(4S)-4-carboxy-4-[[(4S)-

4-carboxy-4-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]buta noyl]amino]butanoyl]amino ]butanoyl]amino]ethoxy]ethoxy]acetyl]amino]ethoxy]ethoxy]ace tyl]), 5Q, 13Q, 25P, 32L]-

Molecular weight: 5159.8442. LCMS34: m/3 calcd: 1720.9481; m/3 found: 1720.8900; m/4 calcd: 1290.9611 ; m/4 found: 1290.9200

Chem. 131 ; Compound ID 1475; SEQ ID NO: 77

[N-terminal([2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[(2S) -4-carboxy-2-[[(2S)-4-carboxy-2-[[(2S)-4- carboxy-2-[[(2S)-4-carboxy-2-[[(2S)-4-carboxy-2-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]buta noyl]amino]butanoyl]amino

]butanoyl]amino]ethoxy]ethoxy]acetyl]amino]ethoxy]ethoxy] acetyl]amino]ethoxy]ethoxy]acetyl

]amino]ethoxy]ethoxy]acetyl]), des1-5, 13Q, 19Q, 25P, 32L]-hCNP37

Molecular weight: 4830.4871. LCMS34: m/3 calcd: 1611.1624; m/3 found: 1610.7510; m/4 calcd: 1208.6218; m/4 found: 1208.5814

Chem. 132; Compound ID 1476; SEQ ID NO: 77 [N-terminal([2-[2-[2-[[2-[2-[2-[[(2S)-4-carboxy-2-[[2-[[(2S) -4-carboxy-2-[[2-[[(2S)-4-carboxy-2-

[[2-[[(2S)-4-carboxy-2-[[2-[[(2S)-4-carboxy-2-(17- carboxyheptadecanoylamino)butanoyl]amino]acetyl]amino]butano yl]amino]acetyl]amino]buta noyl]amino]acetyl]amino]butanoyl]amino]acetyl]amino]butanoyl ]amino]ethoxy]ethoxy]acetyl]a mino]ethoxy]ethoxy]acetyl]), des1-5, 13Q, 19Q, 25P, 32L]-hCNP37

Molecular weight: 4768.3795. LCMS34: m/3 calcd: 1590.4598; m/3 found: 1590.4137; m/4 calcd: 1193.0949; m/4 found: 1193.0793

Chem. 133; Compound ID 1477; SEQ ID NO: 102

[N-terminal([2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[(4S) -4-carboxy-4-[[(4S)-4-carboxy-4-[[(4S)-4- carboxy-4-[[(4S)-4-carboxy-4-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]buta noyl]amino]butanoyl]amino

]butanoyl]amino]ethoxy]ethoxy]acetyl]amino]ethoxy]ethoxy] acetyl]amino]ethoxy]ethoxy]acetyl

]amino]ethoxy]ethoxy]acetyl]), des1-5, 13Q, 19Q, 25P, 27E, 32L]-hCNP37

Molecular weight: 4844.5137. LCMS34: m/3 calcd: 1615.8379; m/3 found: 1615.4194; m/4 calcd: 1212.1284; m/4 found: 1212.0844

Chem. 134; Compound ID 1478; SEQ ID NO: 103

[N-terminal([2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[(4S) -4-carboxy-4-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]etho xy]ethoxy]acetyl]amino]eth oxy]ethoxy]acetyl]amino]ethoxy]ethoxy]acetyl]amino]ethoxy]et hoxy]acetyl]), des1-8, 13Q, 19Q, 25P, 32L]-hCNP37

Molecular weight: 4087.7093. LCMS34: m/3 calcd: 1363.5698; m/3 found: 1363.3427; m/4 calcd: 1022.9273; m/4 found: 1022.7753

Chem. 135; Compound ID 9480; SEQ ID NO: 103

[N-terminal([2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[(4S) -4-carboxy-4-[[(4S)-4-carboxy-4-[[(4S)-4- carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]buta noyl]amino]ethoxy]ethoxy] acetyl]amino]ethoxy]ethoxy]acetyl]amino]ethoxy]ethoxy]acetyl ]amino]ethoxy]ethoxy]acetyl]),

Molecular weight: 4216.8233. LCMS34: m/3 calcd: 1406.6078; m/3 found: 1406.6766; m/4 calcd: 1055.2058; m/4 found: 1055.0295

Chem. 136; Compound ID 1481 ; SEQ ID NO: 103

[N-terminal([2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[(2S) -4-carboxy-2-[[(2S)-4-carboxy-2-[[(2S)-4- carboxy-2-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]buta noyl]amino]ethoxy]ethoxy] acetyl]amino]ethoxy]ethoxy]acetyl]amino]ethoxy]ethoxy]acetyl ]amino]ethoxy]ethoxy]acetyl]), des1-8, 13Q, 19Q, 25P, 32L]-hCNP37

Molecular weight: 4216.8233. LCMS34: m/3 calcd: 1406.6078; m/3 found: 1406.3542; m/4 calcd: 1055.2058; m/4 found: 1055.0295 Chem. 137; Compound ID 9482; SEQ ID NO: 67

[N-terminal([(4S)-4-carboxy-4-[[(4S)-4-carboxy-4-[[(4S)-4 -carboxy-4-[[(4S)-4-carboxy-4-

[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]buta noyl]amino]butanoyl]amino

Jbutanoyl]), 5Q, 13Q, 19S, 25P, 32L]-hCNP37

Molecular weight: 4828.4363. LCMS34: m/3 calcd: 1610.4788; m/3 found: 1610.4060; m/4 calcd: 1208.1091 ; m/4 found: 1207.8275 Chem. 138; Compound ID 9483; SEQ ID NO: 104

[N-terminal([(4S)-4-carboxy-4-[[(4S)-4-carboxy-4-[[(4S)-4 -carboxy-4-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]buta noyl]amino]butanoyl]), 5Q, Molecular weight: 4713.3489. LCMS34: m/3 calcd: 1572.1163; m/3 found: 1572.1500; m/4 calcd: 1179.3372; m/4 found: 1179.1200

Chem. 139; Compound ID 1484; SEQ ID NO: 105

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), des1-6, 7G, 8Q, 9A, 10P, 13Q, 19Q, 25P, 32L]-hCNP37

Molecular weight: 3730.3106. LCMS34: m/3 calcd: 1244.4369; m/3 found: 1244.7042; m/4 calcd: 933.5777; m/4 found: 933.5259

Chem. 140; Compound ID 1486; SEQ ID NO: 106

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), des1-6, 7G, 8Q, 9A, 10P, 13Q, 17S, 19Q, 25P, 27E, 32L]-hCNP37

Molecular weight: 3718.2568. LCMS34: m/3 calcd: 1240.4189; m/3 found: 1240.3220; m/4 calcd: 930.5642; m/4 found: 930.4920

Chem. 141 ; Compound ID 1487; SEQ ID NO: 107

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), -2G, -1Q, 2P, 3G, 4Q, 5A, 6P, 7G, 8Q, 9A, 10P, 13Q, 19Q, 25P, 32L]-hCNP37

Molecular weight: 4437.0578. LCMS34: m/3 calcd: 9480.0193; m/3 found: 1479.8291 ; m/4 calcd: 1110.2645; m/4 found: 1110.3766 Chem. 142; Compound ID 1488; SEQ ID NO: 107 [N-terminal([(4S)-4-carboxy-4-(17-carboxyheptadecanoylamino) butanoyl]), -2G, -1Q, 2P, 3G, 4Q, 5A, 6P, 7G, 8Q, 9A, 10P, 13Q, 19Q, 25P, 32L]-hCNP37

Molecular weight: 4146.7449. LCMS34: m/3 calcd: 1383.2483; m/3 found: 1383.4402; m/4 calcd: 1037.6862; m/4 found: 1037.5803

Chem. 143; Compound ID 1489; SEQ ID NO: 108

[N-terminal([2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[(4S) -4-carboxy-4-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]etho xy]ethoxy]acetyl]amino]eth oxy]ethoxy]acetyl]amino]ethoxy]ethoxy]acetyl]amino]ethoxy]et hoxy]acetyl]), des1-8, 13Q,

Molecular weight: 4045.6296. LCMS34: m/3 calcd: 1349.5432; m/3 found: 1349.3710; m/4 calcd: 1012.4074; m/4 found: 1012.2860

Chem. 144; Compound ID 1493; SEQ ID NO: 109

[N-terminal([2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[(4S) -4-carboxy-4-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]etho xy]ethoxy]acetyl]amino]eth oxy]ethoxy]acetyl]amino]ethoxy]ethoxy]acetyl]amino]ethoxy]et hoxy]acetyl]), des1-8, 13Q,

Molecular weight: 4101.7359. LCMS34: m/3 calcd: 1368.2453; m/3 found: 1368.0680; m/4 calcd: 1026.4340; m/4 found: 1026.3130

Chem. 145; Compound ID 1511 ; SEQ ID NO: 62 [N-terminal([2-[2-[2-[[2-[2-[2-[[(2S)-4-carboxy-2-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), des1-6, 7G, 8Q, 9A, 10P, 13Q, 17S, 19Q, 25P, 32L]-hCNP37

Molecular weight: 3704.2302. LCMS34: m/3 calcd: 1235.7434; m/3 found: 1235.6700; m/4 calcd: 927.0576; m/4 found: 927.0010

Chem. 146; Compound ID 1512; SEQ ID NO: 88

[N-terminal([2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[(2S) -4-carboxy-2-[[(2S)-4-carboxy-2-(17- carboxyheptadecanoylamino)butanoyl]amino]butanoyl]amino]etho xy]ethoxy]acetyl]amino]eth oxy]ethoxy]acetyl]amino]ethoxy]ethoxy]acetyl]amino]ethoxy]et hoxy]acetyl]), des1-8, 13Q,

Molecular weight: 4031.603. LCMS34: m/3 calcd: 1344.8677; m/3 found: 1344.7600; m/4 calcd: 1008.9008; m/4 found: 1008.8080

Chem. 147; Compound ID 1513; SEQ ID NO: 110 [N-terminal(17-carboxyheptadecanoyl), -5E, -4E, -3E, -2E, -1E, 5Q, 13Q, 19S, 25P, 32L]-

Molecular weight: 4828.4363. LCMS34: m/3 calcd: 1610.4788; m/3 found: 1610.2260; m/4 calcd: 1208.1091 ; m/4 found: 1207.9160 Chem. 148; Compound ID 1514; SEQ ID NO: 111 [N-terminal(17-carboxyheptadecanoyl), -4E, -3E, -2E, -1 E, 5Q, 13Q, 19S, 25P, 27E, 32L]-

Molecular weight: 4102.7254. LCMS34: m/3 calcd: 1368.5751 ; m/3 found: 1368.362; m/4 calcd: 1026.6814; m/4 found: 1026.529

Chem. 151 ; Compound ID 0089; SEQ ID NO: 1

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl])]-hCNP22

Molecular weight: 2913.4725. LCMS34: m/3 calcd: 972.1575; m/3 found: 971.844; m/4 calcd: 729.3681 ; m/4 found: 729.131

Chem. 152; Compound ID 0230; SEQ ID NO: 235

[N-terminal([2-[2-[2-[[2-[2-[2-[[(4S)-4-carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]), -5G, -4Q, -3A, -2P, -1G, 2A, 3P, 4G, 5Q, 7P, 8G, 9Q, 10A, 11 P, 12G, 13Q, 14A, 15P]-

Molecular weight: 4680.3406. LCMS34: m/3 calcd: 1561.11 ; m/3 found: 1560.773; m/4 calcd: 1171.0852; m/4 found: 1170.834

Chem. 153; Compound ID 0231 ; SEQ ID NO: 1

[N-terminal([2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[2-[2 -[2-[[2-[2-[2-[[2-[2-[2-[[2-[2-[2-[[(4S)-4- carboxy-4-(17- carboxyheptadecanoylamino)butanoyl]amino]ethoxy]ethoxy]acety l]amino]ethoxy]ethoxy]acet yl]amino]ethoxy]ethoxy]acetyl]amino]ethoxy]ethoxy]acetyl]ami no]ethoxy]ethoxy]acetyl]amino] ethoxy]ethoxy]acetyl]amino]ethoxy]ethoxy]acetyl]amino]ethoxy ]ethoxy]acetyl])]-hCNP22

Molecular weight: 3784.4112. LCMS34: m/3 calcd: 1262.4704; m/3 found: 1262.303; m/4 calcd: 947.1028; m/4 found: 946.995

To evaluate the in vitro activity of CNP22 (0065; Chem. 1) and CNP compounds of the invention, they were tested for their ability to induce production of cyclic guanosine monophosphate (cGMP) in reporter cells expressing the human natriuretic peptide receptor 2 (hNPR2).

Cell culture: To produce the reporter cell line, HEK293 (ATCC® CRL-1573™) cells were stably transfected with the pGloSensor-42F reporter plasmid (GloSensor cGMP reporter - luciferase, Promega) and an expression plasmid encoding the hNPR2 receptor. A single cell clone was isolated for the reporter cell line. When reporter cells are exposed to an hNPR2 activating compound, hNPR2 cause production of cGMP. GloSensor luciferase, produced from the pGloSensor-42F plasmid, binds cGMP and this binding induces a conformational shift of the GloSensor luciferase, activating the otherwise inactive enzyme. Active GloSensor luciferase is able to convert luciferin to oxyluciferin, a process that produces bioluminescence. Upon cell lysis and supply of luciferase substrate, luciferase activity can be quantified by detection of luminescence. Therefore, addition of an hNPR2 activating compound and subsequent addition of detection reagent to reporter cells causes generation of luminescence in a dose dependent manner. By testing a number of different concentrations of hNPR2 activating compound, a half maximal effective concentration (EC50) can be determined. This measure, also referred to as in vitro potency, is reported for all compounds tested. In all the in vitro activity experiments, CNP22 was used as a positive in-plate control for hNPR2 activation. To reduce inter-assay variation, we also report the potency of each compound relative to the potency of the CNP22 control on each plate.

Procedure: HEK293-hNPR2/GloSensor clone 35 cells were continuously cultured in selection medium (DMEM containing 10% FCS, 1% P/S, 200 pg/mL G418 and 100 pg/mL hygromycin). To perform the assay, cells were detached with TrypLE Express (Gibco #12604013), put through a 70 pm cell strainer, counted and seeded in 30 pL/well assay medium (DMEM without phenol red and with 1% P/S) at 10,000 cells/well in white 384-well plates (Perkin Elmer #6007680) overnight. The following day, test compounds were serial diluted in dilution medium (DMEM without phenol red containing 1% OVA (Sigma #A5505 lot 04M7001V), 0.01% Tween20 (Roche #33766700) and 1% P/S) and 10 pL/well of diluted test compounds were subsequently added to the cells. For each compound, ten different concentrations in the range 0.25 pM - 10 pM were tested. After 30 min of incubation at 37 °C and 5% CO2, 40 pL/well Bright-Glo detection reagent (Promega # E2650) was added. Immediately thereafter or after 15 min, luminescence was detected by an EnVision Multimode Plate Reader (PerkinElmer). To determine the in vitro potency or EC50 of each test compound, a four parameter logistic regression was done on the raw data for each test compound using the Python package SciPy optimize. The average EC50 values are listed as “hNPR2 0% HSA. [EC50 (nM)]” in Table 2. A relative potency was calculated by the following expression: EC50 (CNP22 in-plate control)/EC50 (test compound)*100, shown as “hNPR2 0% HSA. [EC50 % rel CNP]” in Table 2. A minimum of two replicates was measured for each test compound. The reported values are averages of the replicates and listed in Table 2.

Table 2 - In vitro human NPR2 potencies of CNP compounds:

These data demonstrate that the tested CNP compounds span a broad range of NPR2 in vitro activation levels and that negatively charged CNP compounds commonly show reduced in vitro NPR2 potency relative to positively charged CNP compounds. Example 3 - In vitro neprilysin stability of CNP-compounds

It has been reported that native CNP can be metabolised by neprilysin (neutral endopeptidase, NEP), which is a protease that is widely present in the body. Therefore, an in vitro neprilysin stability assay was set up to test the neprilysin mediated degradation of selected CNP compounds.

Procedure: In short, the assay buffer consisted of PBS-buffer (pH 7.4, ThermoFisher Scientific) with a final concentration of 0.005% v/v tween 20 (Sigma-Aldrich). Recombinant human neprilysin (rhNEP; R&D Systems) and the CNP compounds were dissolved in assay buffer. Native CNP22 (0065, Chem. 1) was included as positive control on each day of incubation. Initially, the CNP compound (the final concentration was 1000 nM) was preincubated in assay buffer for 10 min at 37 °C. The assay was started by adding either rhNEP (final concentration was 2 pg protein per mL) or assay buffer (adsorption experiment) and the incubation was conducted at 37 °C. The reaction was terminated at selected time points (0.5; 5; 15; 30; 60: 90 and 120 min) by adding one volume of incubation mixture to three volumes of ethanol (containing 1% v/v of formic acid). The mixture was centrifuged at 13000 rpm at 4 °C for 20 minutes. After centrifugation, one volume of supernatant was mixed with one volume of Milli-Q water.

Analysis by LCMS: The mixture was analysed by LCMS using an Acquity LIPLC Peptide CSH C18 analytical column from Waters (130A, 1.7pm, 1*50mm) operated at 60°C. A gradient elution was conducted with a Nexera LIHPLC system (Shimadzu) using mobile phase A (consisting of Milli-Q water with 0.1% formic acid) and mobile phase B (consisting of acetonitrile with 0.1% formic acid). The flow was 0.3 ml/min. A zenoTOF 7600 mass spectrometer (Sciex) was used as detector and operated in positive electrospray ionisation mode. Data was recorded in full scan mode (m/z 300-1700).

Calibration curves were prepared in assay buffer and treated as study samples. These samples were used for calculating the concentration of the relevant CNP compound in the in vitro samples. Quality control samples were included. For at least 75% of the standards and QCs, the deviation between nominal and calculated concentration was below 20%.

All incubations were conducted in duplicate. Data was reported as percent remaining at 90 min (based on calculated concentrations) compared to the average concentration in the 0.5-minute time point samples. An example of seven compounds and CNP22 (0065, Chem. 1) is shown in Table 3.

Table 3 - Percent remaining of CNP-compounds upon incubation with rhNEP for 90 minutes

These data demonstrate that the CNP compounds of the present invention are substantially stable in the presence of recombinant human neprilysin in comparison to CNP22 which is rapidly degraded.

Example 4 - Peptide net charge calculation

The charge of an ionizable group in a peptide at a given pH can be calculated using the Henderson-Hasselbalch equation using empirically determined acid dissociation constants (pKa) for each amino acid residue or modifying group as is well known in the art, for example as by the method described by B. Skoog and A. Wichman (Trends in Analytical Chemistry, 1986, vol. 5, pp. 82-83.) and L. Kozlowski (Biology Direct, 2016, 11 :55). This is shown for negatively charged amino acids or modifying groups in Equation 1 and for positively charged amino acids and modifying groups in Equation 2, in which pKn is the pKa of the negatively charged group and pKp is the pKa of the positively charged group and where pH in the equation is the pH of interest. The net charge of a peptide at a given pH is then the sum of the negative and positive charges of all the ionizable groups in the peptide.

Equation 1 :

Equation 2: For natural amino acid residues, tabulated pKa constants are used for free terminals and ionizable sites in side chains. pKa-values for modified amino acid and modifying groups were estimated by the ACD/Labs ver. 12 package and also shown in Table 4.

As an example, to calculate the net charge of compound 9482 at pH 7.4 the sum of negative charges carried by positions Cys37 (C-terminal acid), Asp27, Glu2, gGlu (1), gGlu (2), gGlu (3), gGlu (4), gGlu (5) and C18d fatty acid is minus 8.995 Fd when using the pKa values shown in Table 4. The sum of positive charges carried by positions Arg28, Lys15, Lys14, Lys10, Lys8, Arg7 and His3 is 6.162 Fd. The net charge is then the sum of the above which is minus 2.833. Calculated charge values for selected pH (pH 7.4 and pH 6.5) using the above principle for CNP compounds of the present invention are shown in Table 5.

Table 4 - pKa values for termini, sidechains of amino acids and modifying groups used when calculating pl and net charge of CNP compounds

Table 5 - Calculated values of net charge (Q) at pH 7.4 and net charge at 6.5 for CNP compounds

Example 5 - Solubility of CNP compounds

In order to assess the suitability of CNP compounds for a soluble liquid formulation, the solubility of CNP compounds in pharmaceutically relevant buffers were measured. Solubility at two different pH-levels (pH 4.0 and pH 6.5) was examined as pH is expected to affect solubility.

Preparation of pH 4.0 samples: The pH 4.0 samples of the CNP compounds were prepared by mixing freeze dried peptide with a pH 4.0 5 mM sodium acetate, 250 mM glycerol buffer at room temperature to a nominal concentration of at least 4000-5000 nmol/mL. The pH of the samples was measured and adjusted to pH 4.0 and the samples were allowed to equilibrate at room temperature until next day if not fully dissolved.

Preparation of pH 6.5 samples: The pH 6.5 samples of the CNP compounds were prepared by dissolving the freeze dried peptide in water. While stirring, a part of the peptide solution was transferred to a buffer consisting of 41 mM sodium phosphate and 118 mg/mL glycerol, pH 7.5-8.0, followed by addition of diluted sodium hydroxide followed by another part of the peptide solution and further addition of diluted sodium hydroxide. This procedure was repeated until all of the peptide solution had been added where a nominal concentration of at least 4000-5000 nmol/mL had been reached and the buffer composition was 8 mM sodium phosphate, 23 mg/mL glycerol. The pH of the samples was measured and adjusted to pH 6.5 and the samples were allowed to equilibrate at room temperature until next day if not fully dissolved.

Procedure: Samples at pH 4.0 were prepared as described above and the compound concentration in the supernatant was determined using CAD (Method F, CAD02). The compound concentration at pH 4.0 represents the solubility at pH 4.0 and the measured values are given in Table 6.

Table 6 - Solubility of CNP compounds formulated at pH 4.0 Samples at pH 6.5 were prepared as described above and peptide concentration in the supernatant was determined by CAD (Method F, CAD02). The peptide concentration at pH 6.5 represents the solubility at pH 6.5 and the measured values are given in Table 7.

Table 7 - Solubility of CNP compound formulations at pH 6.5

As a rule of thumb, only samples containing more than 4000 pM were subjected to further testing as described below.

These results demonstrate the CNP compounds of the present invention can be formulated in pharmaceutically relevant buffers at concentrations suitable for s.c. administration.

Example 6 - Thioflavin T (ThT) assay

The ThT assay was used to evaluate physical stability of the CNP compounds and their suitability for liquid formulation. Low physical stability of peptides may lead to amyloid fibril formation, which is observed as well-ordered, thread-like macromolecular structures in the sample eventually resulting in gel formation. This has traditionally been tested by visual inspection of the sample. However, that kind of measurement is very subjective and depending on the observer. Therefore, the application of a small molecule indicator probe is much more advantageous. Thioflavin T (ThT) is such a probe and has a distinct fluorescence signature when binding to fibrils [Naiki et al. (1989) Anal. Biochem. 177, 244-249; LeVine (1999) Methods. Enzymol. 09, 274-284],

Procedure: Thioflavin T was added to the supernatant samples from Example 5 (pH 4.0 and 6.5) using an aqueous ThT stock solution to a final concentration of about 1 pM in the samples. Sample aliquots of 150 pL were placed in a 96 well microtiter plate (Packard OptiPlateTM-96, white polystyrene). Usually, two to three replicas of each sample were applied to the plate. The plate was sealed and placed in a fluorescence plate reader (Fluoroskan Ascent FL) and incubated at 37 °C with orbital shaking (960 rpm; 1 mm amplitude). Fluorescence measurements were performed every 20 minutes using excitation through a 444 nm filter and measurement of emission through a 485 nm filter. Between each measurement, the plate was shaken and heated as described above and the assay was terminated after 45 hours. Fluorescence measurements for each microtiter plate well were plotted against time and the lag-time (time until an increase in ThT fluorescence was observed) was estimated.

To assess loss of dissolved peptide following 45h incubation, peptide recovery was measured as the ratio between total peak area after incubation vs. before incubation using the RP-UPLC method described below.

Measurement of LagTime and Peptide recovery % using RP-UPLC: RP-UPLC was conducted using an Acquity UPLC BEH C18 1.7 pm (2.1 x 30 mm) Waters column (Eluent A: 0.1 %v/v% TFA in water; Eluent B: 0.1 %v/v TFA in acetonitrile/water 4:1) with gradient elution (0 min: 95% A; 2 min: 20% A; 2.3 min: 20% A; 2.4 min: 95% A; 9 min: 95% A) in a flow rate of 0.9 mL/min and a column temperature of 30 °C. UV-detection at 215 nm was used to assess the total peptide area.

Samples at pH 4.0 were prepared as described in Example 5 and subjected to the ThT assay as described above. LagTime and Peptide recovery values are given in Table 8.

Table 8 - ThT assay lagtime and peptide recovery of CNP compounds at pH 4.0

Samples at pH 6.5 were prepared as described in Example 5 and subjected to the ThT assay as described above. LagTime and Peptide recovery values are given in Table 9. Table 9 - ThT assay lagtime and peptide recovery of CNP compounds at pH 6.5

In conclusion this experiment demonstrates that most CNP compounds of the invention can be formulated in pharmaceutically relevant buffers with low propensity towards fibril formation. Example 7 - Measurement of High-Molecular-Weight-Protein (HMWP)

In order to assess the propensity of CNP compounds to form covalent dimers or oligomers when formulated the High-Molecular-Weight-Protein content of CNP compound formulations at pH 4.0 and 6.5 were determined.

Procedure: The relative amount of covalent HMWP was assessed using SEC- LIPLC. SEC-UPLC was conducted using a Waters LIPLC Protein BEH SEC column, 125A, 4.6 x 150 mm, 1.7 pm, with isocratic elution (0.3 M NaCI, 10 mM NaH 2 PC>4 and 5 mM H3PO4, 50% (v/v) isopropanol, pH 2.4) with a flow rate of 0.3 mL/min, a column temperature at 50 °C with UV-detection at 215 nm. The total area of peaks eluting prior to the monomeric main peak was termed HMWP and given on a percentage scale relative to the total peptide peak area.

Results: HMWP Formation Following 2-Weeks Quiescent Incubation at 37 °C: Samples at pH 4.0 were prepared as described in Example 5 and the amount of HMWP was determined as described above. Samples were incubated for two weeks at 37 °C and the amount of HMWP was determined again. The increase in HMWP over two weeks incubation at 37 °C are reported in Table 10 (in case the incubation period deviated from two weeks the increase in HMWP was normalized to two weeks assuming a constant formation rate).

Table 10 - 2-Week HMWP formation at pH 4.0 (%) Samples at pH 6.5 were prepared as described in Example 5 and the amount of HMWP was determined as described above. Samples were incubated for two weeks at 37 °C and the amount of HMWP was determined again. The increase in HMWP over two weeks incubation at 37 °C are reported in Table 11 (in case the incubation period deviated from two weeks the increase in HMWP was normalized to two weeks assuming a constant formation rate).

Table 11 - 2-Week HMWP formation at pH 6.5 (%) In conclusion, this experiment demonstrates that CNP compounds of the invention can be formulated in pharmaceutically relevant buffers with low propensity towards HMWP formation.

Example 8 - Accelerated chemical stability of CNP compounds

In order to determine the chemical stability of CNP compounds in formulation, samples of CNP compounds in buffer were exposed to accelerated chemical degradation by heating. The stability of a given peptide was assessed by measuring recovery of intact peptide by quantification by RP-UPLC. To assess the chemical degradation pattern samples were also analysed by LC-MS.

Sample preparation: Samples for the 2 week study were prepared according to the principles described in Example 5.

Samples for the 6 week study were prepared by dissolving lyophilized peptide in buffer (8 mM phosphate, 250 mM glycerol, pH 7.4) to a nominal peptide concentration of 5000 nmol/ml followed by pH adjustment with 0.1N HCI to pH 6.5.

Incubation: For the 2 week study a time-zero (TZ) sample was pulled and stored at - 18 °C and the remaining volume was incubated at 37 °C. Samples were pulled and stored at -18 °C after 2 weeks of incubation. Frozen samples were thawed, diluted to about 200 nmol/mL and the extent of chemical degradation was determined using LCMS as described.

For the 6 week study a time-zero (TZ) sample was pulled and stored at -18 °C and the remaining volume was incubated at 37 °C. Samples were pulled on a weekly basis and stored at -18 °C until the last sampling time point at 6 weeks. Frozen samples were thawed, diluted to about 200 nmol/mL and the extent of chemical degradation was determined using RP-UPLC and LCMS as described.

Analysis of peptide recovery by RP-UPLC: The RP-UPLC method was performed on a Waters ACQUITY H-CLASS UPLC system fitted with a PDA detector. Separation was carried out on an ACQUITY UPLC BEH C8 Column (130A, 1.7 pm, 2.1 mm X 150 mm) operating at a column temperature of 50 °C with eluent A (19.59 mM NH4H2PO441.71 mM (NH 4 ) 2 HPO4, pH 6.5 and MeCN 9:1 v:v) and eluent B (80 % MeCN in water). UV-detection was carried out at 214 nm. The analysis was performed by injection of 3 pL of sample onto the column which was eluted with a 1-step linear gradient of eluents A and B from 27 to 30% B over 20 minutes followed by a wash at 95% B over 2 minutes followed by a re-equilibration phase for 7 minutes at a constant flow rate of 0.3 mL/min. This yielded an analysis time of 30 minutes per sample. The area of the peak corresponding to intact CNP compound was given on a percentage scale relative to the total peptide peak area. Analysis of chemical degradation patterns by LCMS: Samples were analysed on a VANQUISH UPLC from Thermo Scientific, using a Waters Acquity C18 reversed-phase column, 300A, 1.7 pM particles 1 mm x 150 mm. The compounds were separated by a linear gradient of solvent B from 5% to 55% over 48 minutes, using solvent A: water, 0.1% formic acid with 0.02% TFA and solvent B: acetonitrile, 0.1% formic acid with 0.02% TFA. Mass spectra were acquired by a Q Exactive Plus hybrid Quadrupole-Orbitrap mass spectrometer, BioPharma option (Thermo Scientific) interfaced with H-ESI II ion source. Data acquisitions were performed with a m/z 500 to 2000 scan range and a resolution of 30000.

The data list was aggregated into a summed table of the compounds. The table headers were defined as follows:

“Recovery": The compound peak (i.e. the main peak intensity at time zero possessing the compounds monoisotopic mass) recovery’s are normalized to the compound peak at a given time point; “Isomers”: as the summed intensity of peaks with isobaric masses to the main compound, which segregate in the RT dimension; “Loss of 18 amu”: i.e., the summed intensity of peaks with masses 18 amu lower than the CNP compound peak, which segregate in the RT dimension; Fragments: the summed intensity of peaks with a mass 50 amu lower than the compound peak and peaks with a mass 18 amu higher than the compound mass, which segregate in the RT dimension and develop over time and assumed to be derived from hydrolytic peptide backbone cleavage; and finally “Others”: contains the sum intensities of peaks with a 32 amu addition or dimers of the main peak, which develop over time.

Results: The results from LCMS analysis of a 2 week accelerated degradation study on several CNP compounds of the present invention are summarised in Table 12. The results from RP-UPLC and LCMS analysis of a 6 week accelerated degradation study on CNP compound 9482 (Chem. 137) is summarised in Table 13 and Table 14 respectively.

Table 12 - Recovery and chemical degradation pattern of CNP compounds after 2 weeks incubation at 37 °C:

Table 13 - RP-UPLC analysis of peptide recovery of CNP compound [94821 over 6 weeks:

Table 14 - LCMS analysis of recovery and chemical degradation pattern of CNP compound

9482 (Chem. 137) over 6 weeks:

These data show that a CNP compound according to the present invention display substantial chemical stability in formulation.

Example 9 - Local tolerance of CNP compounds in rats

The purpose of this study was to evaluate the local tissue reaction to subcutaneous injection of CNP compounds in rats.

Procedure: The CNP compounds were formulated according to the principles described in General Methods of Preparation - Method G. Each Sprague Dawley rat (male, 10-11 weeks of age at arrival, Janvier, France) was dosed s.c. with 250 or 350 uL of the same compound (formulation concentration of 1000 nmol/mL) 120 h prior to tissue collection resulting in a total of two injections for each animal (Table 15). Injection site (flank or neck) was alternated across animals within each group and time point.

Table 15 - Experimental timeline for local tolerance study in rats

Animals had access to tap water and food (Altromin 1324) ad libitum. Group size was n = 3 for vehicles and positive control, and n = 4 for test compounds. Vehicles and compounds were formulated in either 5 mM sodium acetate, 250 mM glycerol, pH 4.0 or 8 mM sodium phosphate, 250 mM glycerol, pH 7.4 as shown in Table 16.

The animals were anesthetized with isoflurane. Via an electric shaving machine, a squared area of fur (2 cm x 2 cm) was removed either from the rats’ neck or flank area). For dosing, a new injection needle (25G canula, 1 ml syringe) was placed in the middle of the square border closest to the animal’s head and the needle was inserted into the skin from the border towards the center of the square. Hence, the needle tip was located in the center of the square, the location was marked with a permanent pen and the formulation was inserted in the center of the square. On the day of tissue collection, the rats were deeply anaesthetized with isoflurane and euthanized by exsanguination. The injection sites were inspected and scored with regards to pathological lesions. The injection sites were evaluated, and any changes were noted (location, colour, shape and size), and sampled for histology preparation.

The injection sites were removed and fixed in 4% phosphate buffered neutral formaldehyde in sealed plastic containers.

Each injection site was subsequently cut into three sections 0.8 cm, 1.0 cm and 1.2 cm from the square border where the injection needle was placed, and, respectively, these sections represented the injection sites and the adjacent tissue. The tissue was processed, embedded in paraffin and cut in 2-4 pm thin sections, stained with the haematoxylin and eosin (H&E), and evaluated microscopically with a light microscope. Histopathological changes were graded on a 5-level scale (Minimal (Min), Mild (Mil), Moderate (Mod), Marked (Mar) and Severe (Sev)). The studies are summarised in Table 16.

Table 16 - Overview of compound, timepoint for sampling, and formulations

Results: The results from the local tolerance study are summarised in Table 17.

Table 17 - Severity and incidence of local subcutaneous reactions* 4 or 5 days after injection of different compounds in rats.

* Necrosis was used as a marker for local subcutaneous reactions; **NAD = No Abnormalities Detected

Conclusions: The positive net charge control 0776 showed moderate to marked local subcutaneous necrosis 5 days after subcutaneous injections in the rat. In comparison the compounds 1351 , 9384, 9407 and 1420 showed no or mild local subcutaneous necrosis 5 days after subcutaneous injections in the rat and were all assessed as acceptable for human subcutaneous administration. Example 10 - CNP local tolerance study in LYD pigs

The purpose of this study was to evaluate the local tissue reaction response to subcutaneous injection of CNP compounds in pigs.

Procedure: In domestic pigs, the injection site was subjected to histopathologic examination after subcutaneous dosing. Injections were placed mid-back between the shoulder and hip on both sides of the dorsal midline, and one or two days before injection sites of 2x2 cm were shaved and marked by permanent ink under light anaesthesia.

Each injection consisted of 100 or 200 pl formulation with a concentration of approx. 4400 pM. CNP compound formulations were prepared according to the principles in General Methods of Preparation - Method G, and were either A) 8 mM sodium phosphate, 250 mM glycerol, pH 6.5, B) 5 mM sodium acetate, 250 mM glycerol, pH 4.0 or C) 5 mM sodium acetate, 240 mM propylene glycol, pH 4.0 and physiological saline was included as negative control.

On Day 1 the pigs were lightly anaesthetised. An insulin pen (NovoPen 4) and insulin needle (NovoTwist 32G/5mm) were used for accurate deposition of the CNP formulations in the subcutaneous fat tissue with the needle perpendicular to the skin. On Day 5 (4 days post injection) or 6 (5 days post injection), the pigs were euthanised, and the injection sites were removed and fixed in 4% phosphate buffered neutral formaldehyde in sealed plastic containers. The tissue blocks were prefixed for 2-4 hours in 10% buffered formalin, cut into 2 mm thick slabs with a multi knife, examined for macroscopic changes and finally fixed overnight in cassettes. Two slabs of tissue were selected for light microscopic evaluation where the tissue reaction was maximal or alternatively in the central part of the injection site. Three to four 2-4 pm sections were cut from three levels at 100 pm distance, stained with haematoxylin and eosin (H&E) and evaluated in a light microscope. Histopathological changes were graded on a 5-level scale ((Minimal (Min), Mild (Mil), Moderate (Mod), Marked (Mar) and Severe (Sev)). The studies are summarised in Table 18.

Table 18 - Overview of compound, timepoint for sampling and formulations:

Results: The results are summarised in Table 19. * Necrosis was used as a marker for local subcutaneous reactions; **NAD: No Abnormalities Detected

Table 19 - Severity and incidence of local subcutaneous reactions 4 or 5 days after injection of different compounds in pigs:

In conclusion the positive net charge control compound 0776 showed moderate to marked local subcutaneous necrosis 5 days after subcutaneous injections in the pig, whereas the net positively charged CNP peptide 0106 without a fatty acid albumin binder attached shows no observable injection site reactions.

In comparison the compounds 9480 and 9482 showed no local subcutaneous necrosis 5 days after subcutaneous injections in the pig; compounds 9384 and compounds 9407 showed no to minimal local subcutaneous necrosis 5 days after subcutaneous injections in the pig; compounds 9435 and 1235 showed minimal to mild local subcutaneous necrosis 5 days after subcutaneous injections in the pig and compound 9483 showed no to moderate local subcutaneous necrosis 5 days after subcutaneous injections in the pig. The compounds 9384, 9407, 9435, 9480 and 9482 were all assessed as acceptable for human subcutaneous administration. Example 11 - PK/PD of CNP compounds after i.v. and s.c. administration to rats

In order to assess the i.v. and s.c. PK/PD profile of CNP compounds of the present invention, formulations of CNP compounds were administered to rats, blood samples taken and exposure and cGMP response measured. cGMP biomarker assay: The biological activity of CNP compounds in vivo was assessed by measuring cGMP in plasma samples by plasma protein precipitation followed by quantification with LC-MS/MS.

To evaluate the cyclic guanosine monophosphate (cGMP) biomarker response in biological samples, after administration of CNP compounds to study animals, a plasma protein precipitation procedure was applied, followed by liquid chromatography with tandem mass spectrometric (LC-MS/MS) analysis. In principle, the concentration of cGMP in study plasma samples, was determined using a standard curve prepared with a stable isotope labelled (SIL) surrogate analyte ( 13 C 15 Ns cGMP) as a reference. The surrogate analyte was spiked in pooled authentic blank matrix to cover an analytical range of 5 nM - 2000 nM. 8- Methoxymethyl-3-isobutyl 1 -methylxanthine (MMPX) was used as an internal standard. The plasma protein precipitation procedure was conducted using an organic solvent to precipitate the plasma protein, leaving a supernatant that contained the cGMP molecules which would then be analysed on the LC-MS/MS instrument.

To prepare the standard samples, frozen authentic blank plasma matrix was thawed and subsequently centrifuged for 5 min at 4000 RPM, at 4 °C. A stock solution of SIL-cGMP was used to prepare a standard of 2000 nM in blank plasma, which is then transferred to a 1 mL Eppendorf 96-well plate (Pat. 8,636,965). This was placed in a liquid handler (TECAN Fluent 78) to prepare standards and QCs (5, 10, 20, 50, 100, 200, 500, 1000, 2000 nM) by serial dilution in blank plasma in a 96-well microplate (Chimney Well 651201). Blank plasma samples were prepared in the same plate. Study samples were thawed by ventilation for 10 min at ambient temperature, shaken on a table shaker for 5 min at ambient temperature, and subsequently centrifuged for 5 min at 4000 RPM at 4 °C. The samples were then placed in the liquid handler to perform the plasma protein precipitation procedure. A volume of Standards, QCs, Zero, and study samples were precipitated with 4 volumes of acetonitrile (OPTIMA® LC/MS Grade) containing 30 nM of MMPX (Sigma #M2547). The samples were then shaken on a table shaker for 4 min at ambient temperature, and subsequently, centrifuged for 30 min, at 4000 RPM at 4 °C, whereafter the supernatant was transferred to a new 96-well microplate. The plates were subsequently evaporated using an Eppendorf concentrator plus™ for 60 min at 30 °C. Residues were reconstituted in a volume of 5% acetonitrile and 0.1 % formic acid (RATHBURN LC/MS Grade), shaken on a table shaker for 2 min at ambient temperature and centrifuged for 10 min at 4 °C. The prepared samples were then analysed on a LC-MS/MS instrument (Sciex ExionLC™ coupled to a Sciex 6500+ Triple quadrupole). Gradient elution was applied on the reverse-phase LC, using 0.1% formic acid as mobile phase A and 95% acetonitrile and 0.1 % formic acid as mobile phase B. A Waters Acquity UPLCO CSH™ Fluoro-Phenyl 1.7 pm, 2.1x100mm column, was used as a stationary phase and thermoregulated at 60 °C. SIL-cGMP, endogenous cGMP, and MMPX were detected in the MS/MS in positive ion mode by selective reaction monitoring.

Acceptance criteria for the analytical run: The SIL-cGMP standard curve was established with a 1/x2 weighting and was evaluated in terms of linearity, precision, and accuracy. At least 75% of the calibration standards had to meet the following criteria when back calculated: Calibration standards had to fall within ± 15% of the nominal concentration of the respective calibration standards, except for LLOQ that had to fall within ± 20% of the nominal concentration of the LLOQ standards. Values falling outside these limits must be discarded provided they did not change the established model. If discarding one calibration standard resulted in another calibration standard being outside the boundaries, then this calibration standard was also discarded.

At least two-thirds of the QC samples had to be within 15% of their respective nominal values. One-third of the QC samples could be outside 15% of their respective nominal value, but never more than 50% of the QC samples at the same nominal concentration.

Quantitative plasma analysis of CNP-compounds: Plasma concentrations of CNP compounds were assayed by plasma protein precipitation and analysed by turboflow liquid chromatography mass spectrometry (TF-LC-MS). Calibrators were prepared by spiking either blank rat or minipig plasma with the relevant CNP compound in the range from 0.5 to 2000 nM. Calibrators, plasma blanks or study samples were prepared for TF-LC-MS by protein precipitation by adding three or four volumes of either ethanol or methanol containing 20 nM of internal standard to one volume of sample. For some compounds, formic acid was added to the precipitation reagent (the final concentration was 1% v/v). After the addition of the precipitation reagent, the mixture was centrifuged at 6200 rpm at 4 °C for 30 minutes. After centrifugation, one volume of supernatant was mixed with two volumes of water (with 1% v/v formic acid). The mixture was analysed by TF-LC-MS using a Cyclone turboflow column (0.5 x 50 mm, ThermoFisher Scientific) and either a XBridge Protein BEH C4 3.5 pm 300A or a XBridge Protein BEH C18 3.5 pm 130A analytical column (both were 50 x 2.1 mm and obtained from Waters). A gradient elution was conducted using mobile phase A (consisting of milli-Q water with 1% formic acid and 5% methanol/acetonitrile (50/50)) and mobile phase B (consisting of methanol/acetonitrile (50/50) with 1% formic acid and 5% milli-Q water). The mass spectrometer was operated in positive ionisation mode. A TSQ Altis mass spectrometer (ThermoFisher Scientific) was used as detector in selected reaction monitoring mode (specific transition were optimised for each CNP compound). Linear calibration curves (weighed 1/x2) were used for calculating the concentration in the plasma samples. Quality control samples were included. The deviation between nominal and calculated concentration in the calibrators and quality control samples were below 15%.

Animals and dosing: Groups of 4-6 rats (male, Sprague Dawley, 350 g at arrival, Janvier, France) per compound and route of administration were dosed with a CNP compound formulated either in A) 8mM sodium phosphate, 250 mM glycerol, 0.007% polysorbate 20, pH 7.4 or B) 5 mM sodium acetate, 250 mM glycerol, 0.007% polysorbate 20, pH 4.0 depending on the respective compound. S.c. dose was 300 nmol/kg, at a concentration of 1000 nmol/L resulting in a dosing volume of 0.3 mL/kg, whereas i.v. dose was 100 nmol/kg, at a concentration of 100 nmol/L resulting in a dosing volume of 1 mL/kg.

Sampling: Sublingual blood samples of 250 uL were collected from unanaesthetised rats in EDTA-coated vials (Microvette 600K3E ref # 15.1673.100 Sarstedt) at baseline (-1 h before dosing) as well as 5 min (only i.v. dosed groups), 2 h, 6 h, 24 h, 48 h and 72 h (only for exposure analysis) post-dosing. The blood samples were quickly stored on ice and centrifuged (4 °C, 8000 RPM, 5 min) within 10 min of collection. Plasma samples of 50 pL were transferred to each micronic tube for either exposure or cGMP analysis, kept on dry ice and stored in a freezer (-20 °C). Rats had access to food (Altromin) and tap water ad libitum.

Analysis: PK parameters were calculated by non-compartment analysis (NCA) using software Phoenix WinNonlin (ver. 8.1 or later, Certara) for each animal. Clearance (Cl) was calculated as: Dose I AUCinf (linear up, log down). Half-life (t 1 X) was calculated as ln(2) I A were X is estimated by linear regression of time vs. log concentration, typically in a time range between 2 to 48 hours (e.g. from 6 to 48 hours). Bioavailability was calculated as dose normalized AUC’s: (AUC(sc) I Dose(sc)) I (AUC(iv) I Dose(iv)). Values in the table are means from individual animals (n = 4-6 individual animals). The subsequent plots for cGMP plasma concentration versus time are (Y-axis) mean cGMP concentration (n= 4-6 individual animals) after IV dosing and (X-axis) nominal plasma sampling time.

Results The PK data with clearance (CL) half-life T% and bioavailability (F%) are summarised in Table 20. Plasma cGMP concentrations after i.v. dosing of CNP compounds are shown in Figures 1-27, the dose is shown in Table 20. Plasma cGMP are reported as the mean.

Table 20 - Pharmacokinetic profile of CNP compounds dosed i.v. or s.c. in rats | 1235 | 93.9 | 0.0115 6.2 | 329 | 6.28 | 65.8 |

In conclusion this experiment shows that the CNP compounds of the present invention show prolonged half-lifes and reduced clearance in a in vivo rat model. Furthermore, the experiment shows that the CNP compounds are biologically active based on their ability to elicit a cGMP response in the dosed animals (Figure 1-27).

Example 12- PK/PD of CNP compounds after i.v. and s.c. administration to minipigs and LYD pigs

The purpose of this study was to investigate pharmacokinetic and pharmacodynamic properties after intravenous (i.v.) and subcutaneous (s.c.) administration to Gottingen Minipig and domestic LYD pig, and to estimate bioavailability after s.c. dosing. Quantitative plasma analysis of CNP and cGMP levels were performed as described in Example 11.

Animals and dosing: The pharmacokinetic and pharmacodynamic studies in Gottingen Minipig or domestic LYD pig were conducted at CRO Minerva Imaging or Novo Nordisk A/S, respectively. CNP compounds were dosed to normal female 1) Gottingen minipigs 6-12 months of age with an average weight of 22 kg or 2) domestic LYD pigs 4-5 months of age with and average weight of 80 kg. At least one week prior to dosing, permanent central venous catheters were implanted for blood sampling and intravenous (i.v.) dosing. For subcutaneous (s.c.) dosing, the pigs were ultrasound scanned and the optimal injection area laterally on the neck marked by a permanent tattoo. An insulin pen (NovoPen Echo or NovoPen 4) and insulin needle (NovoFine 32G/4mm or NovoTwist 32G/5mm) were used for accurate deposition of the CNP formulations in the subcutaneous fat tissue with the needle perpendicular to the skin.

CNP compounds were formulated according to the principles in General Methods of Preparation - Method G and were either A) 8 mM sodium phosphate, 250 mM glycerol, pH 6.5, B) 5 mM sodium acetate, 250 mM glycerol, pH 4.0, C) 5 mM sodium acetate, 240 mM propylene glycol, pH=4.0, D) 8 mM sodium phosphate, 250 mM glycerol, pH 7.5 or E) 20 mM sodium phosphate, 223 mM propylene glycol, pH 6.0.

Intravenously, the CNP compounds were dosed at 30-60 nmol/kg to Minipig and 15-43 nmol/kg to domestic pig using formulations A-E. Subcutaneously, the CNP compounds were dosed at 55-62 nmol/kg to Minipig and 20-30 nmol/kg to domestic pig using formulations A- D. Sampling: Blood samples of approximately 1 mL were collected pre dose and up to 14 days post dose into EDTA-coated tubes (8 mM) for cGMP and CNP compound analysis by LC-MS. In few instances, cGMP was only analysed up to 48 hours post dose after intravenous dosing in domestic LYD pig. The blood samples were kept on wet ice for maximum 30 minutes until centrifugation for 10 minutes at 4 °C and minimum 1500G, and the plasma samples were stored at -20 °C until analysis.

Plasma concentration-time profiles were analyzed by non-compartmental PK analysis using Phoenix WinNonlin 8.1, Pharsight Inc., Mountain View, CA, USA. Calculation of the area under the plasma concentration-time curve (AUC) was based on the “linear up log down” method, and uniform weighting was used for estimation of the terminal rate constant (Az). S.c. bioavailability (F) was calculated as the dose-normalized AUC (AUC/dose) after s.c. administration divided by the AUC/dose after i.v. administration.

Results: The PK data with clearance (CL), half-life T 1 Z> and bioavailability (F%) in minipig are summarised in Table 21. The PK data with clearance (CL), half-life T 1 Z> and bioavailability (F%) in LYD domestic pig are summarised in Table 22. Plasma cGMP concentrations after i.v. or s.c. dosing of CNP compounds in minipigs and domestic pigs are shown in Figures 28-48 the dose is shown in Tables 21 and 22. Plasma cGMP are reported as the mean of n=2-4 for 14 days in minipigs and the mean of n=2-4 for 2 days in domestic LYD pigs.

Table 21. Pharmacokinetic parameters after i.v. and s.c. administration of CNP compounds to Gottingen Minipig:

Table 22 - Pharmacokinetic parameters after i.v. and s.c. administration of CNP compounds to domestic LYD pig:

Half-life (T%) and s.c. bioavailability (F) given as mean in Table 21 and 22.

Conclusion: this experiment shows that the CNP compounds of the present invention show prolonged half-lifes and reduced clearance in both minipig and domestic LYD pig. Furthermore, the experiment shows that the CNP compounds are biologically active based on their ability to elicit a cGMP response in the dosed animals (Figure 28-48).

Furthermore, the experiment shows subcutaneous bioavailabilities (F) (Table 21 and 22) above 40% for the compounds of the invention. Whereas the non-working positively charged examples (Compound ID 0776 and 0312) show low subcutaneous bioavailabilities (7-13%). The non-working example (Compound ID 1235) with around neutral charge shows medium subcutaneous bioavailability of 25%.

Example 13 - Telemetry measurement of heart rate and blood pressure

The purpose of the study was to investigate the effect of acute dosing with the CNP compound 9482 (Chem. 137) on mean blood pressure (MAP) and heart rate (HR) in awake rats.

Procedure: The transducers are implanted in Sprague Dawley rats (Charles River) and the rats are allowed a 2-3-week period for recovery. Before surgery, the devices are registered in the software by placing them on a receiver plate and powered on. Sterile saline is added to the transducer catheter before surgery start, and the transmitter is then powered on. The transmitters are placed in the abdomen with the sensor in aorta abdominalis. Isoflurane is used as anaesthetic, and during and after surgery, the rats receive Temgesic (0.05 mg/kg s.c.), Norodyl (5 mg/kg s.c.), and Baytril (10 mg/kg s.c.) as pain relief and to prevent bacterial infection.

Study design: Rats are housed 2/cage (1 with device and 1 as social partner). All animals will have free access to water and food (altromin) throughout the entire study. The rats will be housed in light cycles with light from 6 AM to 6 PM and dark from 6 PM to 6 AM. Eight rats are divided into 2 groups according to a crossover study design.

Telemetry: Each rat is equipped with a transducer (HD-S10 from DSI) capable of measuring blood pressure, heart rate, and activity using Ponemah software with a 100 Hz frequency. During measurements, there should be no disturbances in the room that the rats are housed in to minimize variability in the data. A 4-hour baseline recording will be taken prior to start of the study to capture mean arterial pressure (MAP) and heart rate (HR) patterns in untreated, undisturbed rats. The recording period after drug administration was 24 hours.

Dosing scheme: Rats are dosed in a crossover study design with 4 rats in each group. Each rat is given a washout period of 1 week prior to the next dosing event. Dosing will be intravenous (IV) in the tail vein. Dosing of 9482 was tested in 30, 100, and 300 nmol/kg i.v. in separate experiments. The vehicle consists of 8 mM phosphate, 250 mM glycerol, pH 7.4.

Data analysis and statistics was conducted in Ponemah software and Graphpad prism. For statistics, a paired t test was applied with a confidence level of 95% and P<0.05 denoting statistical significance.

Results: Within the first 30 min after dosing, no difference in MAP and HR was observed with 30, 100, or 300 nmol/kg of CNP compound 9482 compared to vehicle (Table 23 and Table 25). An average of the first 12 h resulted in no differences in MAP between vehicle and the three tested doses of 9482 (Table 24). An increase (P<0.05) of 8.8±10.1% and 6.4±6.6% in HR was detected in the same period with 100 and 300 nmol/kg (Table 26). No change in HR was observed with a dose of 30 nmol/kg (Table 26).

Table 23 - Mean arterial pressure: 30 min

Table 24 - Mean arterial pressure: 12 h

Table 25 - Heart rate: 30 min

Table 26 - Heart rate: 12 h

Conclusion: Acute IV infusion of CNP compound 9482 was not associated with any major hemodynamic changes over a 12 h period as evidenced by unaltered MAP and only minor increases in HR at the two highest doses. Example 14 - Mouse metatarsal bone dissection and culture:

The purpose of this study was to evaluate bone growth after administration of CNP compounds in an ex vivo mouse model.

Procedure: One-day old mouse pups (NMRI, Javier Labs France) were euthanised prior to dissection. All applicable international and internal Novo Nordisk guidelines for care and use of animals were followed. The three middle metatarsal bones were dissected out from each hind paw. The dissected bones were placed in 24-well cell culture plates and cultured in 400 pl a-Minimum Essential Media supplemented with 0.2% BSA, 1% Pen/Strep at 37 °C and 5% CO2. The bones from all animals were randomised into a control group and six CNP compound-treated groups (100 nM; n=8). The medium was changed every 2-3 days. All compounds were formulated according to the principles described in General Methods of Preparation - Method G. Compounds 9435 and 9483 were formulated in A) 5 mM sodium acetate, 250 mM glycerol, pH 4.0 while compounds 9384, 9407, 9480 and 9482 were formulated in B) 8 mM sodium phosphate, 250 mM glycerol, pH 7.4. Vehicle alone did not affect bone growth compared to media alone.

Digital pictures were captured on day 0, 4, 7, 11, and 14 using a digital camera attached to a Nikon microscope. The length of each metatarsal bone was measured using Imaged software and increase in bone length was expressed as percentage change from the length measured at the day of dissection (Mean (SD)).

Results: All CNP compounds significantly increased bone length compared to control group after 11 days of treatment (p<0.05; two-way ANOVA). Total increases in bone length were 28-48% higher after treatment with CNP compounds compared to the control group after 14 days in culture. The results from the study are summarised in Table 27.

Table 27 - Increase in bone length after administration of CNP compounds (100 nM):

In Table 27, metatarsal bones were isolated from mice and cultured for up to 14 days. Length was measured every 3-4 days throughout the study and expressed as percentage change from day 0 (Mean (SD)). Statistically significant differences are indicated compared to control group (two-way ANOVA).

Conclusion: This experiment demonstrates that the CNP compounds of the current invention are able to significantly increase bone length in an ex vivo mouse model.

Example 15 - Mouse growth study

The purpose of this study was to evaluate growth in mice after treatment with two doses of CNP compound.

Procedure: Mice (C57BL/6J, male, age 4 weeks; n=10) received daily subcutaneous injections of compound 9482 or vehicle for 35 days. Formulations were prepared according to the principles described in General Methods of Preparation - Method G (30 and 70 nmol/kg, 10 mL/kg; Formulation buffer s mM sodium phosphate, 250 mM glycerol, 0.007% polysorbate 20, pH 7.4). Body weight and tail and body length were measured weekly throughout the study. The increase in growth was expressed as percentage change from day 0 (mean (SD)).

Results: Both 30 and 70 nmol/kg doses of CNP compound 9482 significantly increased tail and body length after 7 and 18 days, respectively, (p<0.05, two-way ANOVA) compared to control. After 35 days, the change in tail length (from day 0) was increased by 45 and 83%, respectively, after treatment with 30 and 70nmol/kg CNP compound compared to control animals. Body length was 30 and 67% higher, respectively, compared to control group after treatment with 30 and 70 nmol/kg CNP compound for 35 days. The results from the study are summarised in Tables 28 and Table 29. Table 28 - Tail length of mice treated with daily injections of CNP compound for 35 days

In Table 28, increase in tail length is expressed as percentage change from day 0 (mean (SD)). Statistically significant differences are indicated compared to control group (two-way AN OVA).

Table 29 - Body length of mice treated with daily injections of CNP compound for 35 days

In Table 29, increase in body length is expressed as percentage change from day 0 (mean (SD)). Statistically significant differences are indicated compared to control group (two-way A N O VA) .

Conclusion: This experiment shows that CNP compounds of the present invention increase tail and body length of mice to a significant degree when administered subcutaneously in a pharmaceutically relevant formulation.