5-HT6 receptor signal transduction second messenger systems

Progress in Investigational Agents Targeting Serotonin-6 Receptors for the Treatment of Brain Disorders

Serotonin (5-HT) plays an important role in the regulation of several basic functions of the central and peripheral nervous system. Among the 5-HT receptors, serotonin-6 (5-HT6) receptor has been an area of substantial research. 5-HT6 receptor is a G-protein-coupled receptor mediating its effects through diverse signaling pathways. Exceptional features of the receptors fueling drug discovery efforts include unique localization and specific distribution in the brain regions having a role in learning, memory, mood, and behavior, and the affinity of several clinically used psychotropic agents. Although non-clinical data suggest that both agonist and antagonist may have similar behavioral effects, most of the agents that entered clinical evaluation were antagonists. Schizophrenia was the initial target; more recently, cognitive deficits associated with Alzheimer's disease (AD) or other neurological disorders has been the target for clinically evaluated 5-HT6 receptor antagonists. Several 5-HT6 receptor antagonists (idalopirdine, intepirdine and latrepirdine) showed efficacy in alleviating cognitive deficits associated with AD in the proof-of-concept clinical studies; however, the outcomes of the subsequent phase 3 studies were largely disappointing. The observations from both non-clinical and clinical studies suggest that 5-HT6 receptor antagonists may have a role in the management of neuropsychiatric symptoms in dementia. Masupirdine, a selective 5-HT6 receptor antagonist, reduced agitation/aggression-like behaviors in animal models, and a post hoc analysis of a phase 2 trial suggested potential beneficial effects on agitation/aggression and psychosis in AD. This agent will be assessed in additional trials, and the outcome of the trials will inform the use of 5-HT6 receptor antagonists in the treatment of agitation in dementia of the Alzheimer's type.

The 5-HT1A receptor as a serotonergic target for neuroprotection in cerebral ischemia

Cerebral ischemia due to stroke or cardiac arrest greatly affects daily functioning and the quality of life of patients and has a high socioeconomic impact due to the surge in their prevalence. Advances in the identification of an effective pharmacotherapy to promote neuroprotection and recovery after a cerebral ischemic insult are, however, limited. The serotonin 1A (5-HT_1A) receptor has been implicated in the regulation of several brain functions, including mood, emotions, memory, and neuroplasticity, all of which are deleteriously affected by cerebral ischemia. This review focuses on the specific roles and mechanisms of 5-HT_1A receptors in neuroprotection in experimental models of cerebral ischemia. We present experimental evidence that 5-HT_1A receptor agonists can prevent neuronal damage and promote functional recovery induced by focal and transient global ischemia in rodents. However, indiscriminate activation of pre-and postsynaptic by non-biased 5-HT_1A receptor agonists may be a limiting factor in the anti-ischemic clinical efficacy of these compounds since 5-HT_1A receptors in different brain regions can mediate diverging or even contradictory responses. Current insights are presented into the 'biased' 5-HT_1A post-synaptic heteroreceptor agonist NLX-101 (also known as F15599), a compound that preferentially and potently stimulates postsynaptic cortical pyramidal neurons without inhibiting firing of serotoninergic neurons, as a potential strategy providing neuroprotection in cerebral ischemic conditions.

2-Aminoimidazole-based antagonists of the 5-HT6 receptor - A new concept in aminergic GPCR ligand design

A new strategy in the design of aminergic GPCR ligands is proposed - the use of aromatic, heterocyclic basic moieties in place of the evergreen piperazine or alicyclic and aliphatic amines. This hypothesis has been tested using a benchmark series of 5-HT₆R antagonists obtained by coupling variously substituted 2-aminoimidazole moieties to the well established 1-benzenesulfonyl-1H-indoles, which served as the ligands cores. The crystallographic studies revealed that upon protonation, the 2-aminoimidazole fragment triggers a resonance driven conformational change leading to a form of higher affinity. This molecular switch may be responsible for the observed differences in 5-HT₆R activity of the studied chemotypes with different amine-like fragments. Considering the multiple functionalization sites of the embedded guanidine fragment, diverse libraries were constructed, and the relationships between the structure and activity, metabolic stability, and solubility were established. Compounds from the N-(1H-imidazol-2-yl)acylamide chemotype (10a-z) exhibited high affinity for 5-HT₆R and very high selectivity over 5-HT_1A, 5-HT_2A, 5-HT₇ and D₂ receptors (negligible binding), which was attributed to their very weak basicity. The lead compound in the series 4-methyl-5-[1-(naphthalene-1-sulfonyl)-1H-indol-3-yl]-1H-imidazol-2-amine (9i) was shown to reverse the cognitive impairment caused by the administration of scopolamine in rats indicating procognitive potential.

Physical interaction between neurofibromin and serotonin 5-HT6 receptor promotes receptor constitutive activity

Active G protein-coupled receptor (GPCR) conformations not only are promoted by agonists but also occur in their absence, leading to constitutive activity. Association of GPCRs with intracellular protein partners might be one of the mechanisms underlying GPCR constitutive activity. Here, we show that serotonin 5 hydroxytryptamine 6 (5-HT₆) receptor constitutively activates the Gs/adenylyl cyclase pathway in various cell types, including neurons. Constitutive activity is strongly reduced by silencing expression of the Ras-GTPase activating protein (Ras-GAP) neurofibromin, a 5-HT₆ receptor partner. Neurofibromin is a multidomain protein encoded by the NF1 gene, the mutation of which causes Neurofibromatosis type 1 (NF1), a genetic disorder characterized by multiple benign and malignant nervous system tumors and cognitive deficits. Disrupting association of 5-HT₆ receptor with neurofibromin Pleckstrin Homology (PH) domain also inhibits receptor constitutive activity, and PH domain expression rescues 5-HT₆ receptor-operated cAMP signaling in neurofibromin-deficient cells. Furthermore, PH domains carrying mutations identified in NF1 patients that prevent interaction with the 5-HT₆ receptor fail to rescue receptor constitutive activity in neurofibromin-depleted cells. Further supporting a role of neurofibromin in agonist-independent Gs signaling elicited by native receptors, the phosphorylation of cAMP-responsive element-binding protein (CREB) is strongly decreased in prefrontal cortex of Nf1^+/- mice compared with WT mice. Moreover, systemic administration of a 5-HT₆ receptor inverse agonist reduces CREB phosphorylation in prefrontal cortex of WT mice but not Nf1^+/- mice. Collectively, these findings suggest that disrupting 5-HT₆ receptor-neurofibromin interaction prevents agonist-independent 5-HT₆ receptor-operated cAMP signaling in prefrontal cortex, an effect that might underlie neuronal abnormalities in NF1 patients.

5-HT6 Receptor: A New Player Controlling the Development of Neural Circuits

5-HT6 receptor (5-HT6R) is a G protein-coupled receptor that has recently emerged as a new regulator of neural development. In addition to the canonical Gs adenylyl cyclase pathway, recent proteomics approaches reveal that 5-HT6R is able to engage key developmental signaling pathways controlling neuronal circuit formation, neuronal connectivity, and psychiatric-relevant behaviors. For example, at early stages of neuronal development, expression of 5-HT6R constitutively regulates the activity of the cyclin-dependent kinase (Cdk)5 and, through this mechanism, controls cellular processes involved in circuit formation, including neuronal migration and neurite outgrowth. In addition to the Cdk5 pathway, 5-HT6R modulates a variety of key developmental targets such as Fyn, Jab1, and mammalian target of rapamycin (mTOR). Engagement of developmental pathways through 5-HT6R pharmacological manipulation has led to interesting new therapeutic perspectives in the field of psychiatric-related disorders. Indeed, 5-HT6R blockade can rescue a pathological overactivation of the mTOR pathway induced by early life insults in rodents and normalizes the associated social and episodic memory deficits. Here, we review recent evidence supporting the notion that 5-HT6R is at the interface of key developmental signaling pathways and a novel actor in the orchestration of neural circuit formation.

Effects of ST1936, a selective serotonin-6 agonist, on electrical activity of putative mesencephalic dopaminergic neurons in the rat brain

The serotonin-6 (5-HT6) receptor is the most recently discovered serotonin receptor, and it represents an increasingly promising target for improving cognition in both normal and disease states. Recently, a new selective 5-HT6 receptor agonist, 2-(5 chloro-2-methyl-1H-indol-3-yl)-N,N-dimethylethanamine (ST1936), with nanomolar affinity for 5-HT6 receptors was described. We performed in-vivo electrophysiological studies to investigate the physiological role of 5-HT6 receptors in the control of the function of the substantia nigra pars compacta (SNc) and ventral tegmental area (VTA). Extracellular single-unit recordings were performed from putative dopamine-containing neurons in the SNc and VTA of anesthetised rats. In the SNc, acute systemic administration of ST1936 had no effects on basal firing activity of these dopamine neurons; however, in the VTA, ST1936 induced either dose-related increases (45% of cells) or decreases in basal activity of these dopaminergic neurons. Local application of ST1936 into the VTA caused excitation in all of the dopamine neurons, but had no effects on non-dopamine VTA neurons. Both effects of systemic and microiontophoretic ST1936 were completely reversed by the potent and selective 5-HT6 receptor antagonist 5-chloro-N-(4-methoxy-3-piperazin-1-ylphenyl)-3-methyl-2- benzothiophene-sulfonamide (SB271046). Systemic application of another 5-HT6 agonist, 2-(1-{6-chloroimidazo[2,1-b] [1,3]thiazole-5-sulfonyl}-1H-indol-3-yl)ethan-1-amine (WAY-181187), induced dose-dependent inhibition of these VTA dopaminergic neurons. ST1936 and WAY-181187 appear to have different effects on these VTA dopaminergic neurons, potentially due to different mechanisms of action or to the complexity of 5-HT6 receptor functions. Our data demonstrate the need for further investigations into the use of 5-HT6 receptor agonists to control cognitive disfunction, such as in schizophrenia and depression.

The procognitive effects of 5-HT6 receptor ligands in animal models of schizophrenia

In addition to positive and negative symptoms, cognitive deficits are increasingly being recognized as a core feature of schizophrenia. Neurocognitive impairments are strongly associated with functional outcomes; thus, the treatment of cognitive impairments is of central importance. A large body of evidence suggests that the serotonin 6 (5-HT6) receptors may be potential targets for cognitive improvement. Clinical and preclinical studies have supported the notion that using 5-HT6 receptor antagonists is a promising component in the treatment of cognitive dysfunctions associated with aging and Alzheimer's disease. However, less is known about the efficacy of this strategy in the treatment of schizophrenia-like cognitive disturbances. The purpose of this review is to summarize existing data on the effects of 5-HT6 receptor antagonists in animal experiments, utilizing tasks that assess cognitive domains that are relevant to the cognitive deficits characterizing schizophrenia. This review focuses primarily on animal models of schizophrenia that are based on the blockade of N-methyl-d-aspartate receptors; however, when relevant, data obtained in other models are also discussed. The putative procognitive actions of 5-HT6 agonists are also reviewed. Finally, the mechanisms that are putatively responsible for the procognitive effects of 5-HT6 receptor ligands are briefly discussed.

Partial agonist efficacy of EMD386088, a 5-HT6 receptor ligand, in functional in vitro assays

BACKGROUND

Over recent years, the 5-hydroxytryptamine6 (5-HT6) receptor has emerged as a promising molecular target which interacts with several central nervous system acting drugs. In animal models, both agonists and antagonists of this receptor exhibit equivalent potency and efficacy as potential antidepressants, anxiolytics and anti-obesity or anti-dementia drugs. EMD386088 (5-chloro-2-methyl-3-(1,2,3,6-tetrahydro-4-pyridinyl)-1H-indole hydrochloride) has been described as a high affinity 5-HT6 receptor ligand with a full agonist activity and with moderate affinity for 5-HT3 sites.

METHODS

We have extended these data by broadening its profile for other, not yet tested, monoaminergic, GABA(A), opioid μ receptors and serotonin transporter (SERT) and we have conducted functional in vitro assays; i.e., measurement of cAMP by homogeneous TR-FRET immunoassay and HTRF method made by CEREP as well as aequorin-based calcium flux assay.

RESULTS

In two in vitro models based on cAMP formation, maximal efficacy values for EMD386088 were 65 and 31%, for in house and CEREP experiments, respectively. In a model based on calcium response, the studied compound showed 46% of maximal serotonin (5-HT) signal. EMD386088 antagonizes 5-HT response in increasing concentrations from 10(-9) to 10(-6) M.

CONCLUSIONS

The present in vitro findings confirm that EMD386088 is a selective 5-HT6 receptor ligand with moderate affinity for 5-HT3 sites only and it behaves as a potent partial agonist of 5-HT6 receptor with varying levels of agonist intrinsic activity, depending on a method employed. In view of these results, caution is recommended in the interpretation of pharmacological in vivo studies with EMD386088.