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Witkin JM, Shafique H, Smith JL, Cerne R. Is there a biochemical basis for purinergic P2X3 and P2X4 receptor antagonists to be considered as anti-seizure medications? Biochem Pharmacol 2024; 222:116046. [PMID: 38341001 DOI: 10.1016/j.bcp.2024.116046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 12/15/2023] [Accepted: 02/05/2024] [Indexed: 02/12/2024]
Abstract
Patients with epilepsy require improved medications. Purinergic receptors were identified as late as 1976 and are slowly emerging as potential drug targets for the discovery of antiseizure medications. While compounds interacting with these receptors have been approved for use as medicines (e.g., gefapixant for cough) and continue to be explored for a number of diseases (e.g., pain, cancer), there have been no purinergic receptor antagonists that have been advanced for epilepsy. There are very few studies on the channel conducting receptors, P2X3 and P2X4, that suggest their possible role in seizure generation or control. However, the limited data available provides some compelling reasons to believe that they could be valuable antiseizure medication drug targets. The data implicating P2X3 and P2X4 receptors in epilepsy includes the role played by ATP in neuronal excitability and seizures, receptor localization, increased receptor expression in epileptic brain, the involvement of these receptors in seizure-associated inflammation, crosstalk between these purinergic receptors and neuronal processes involved in seizures (GABAergic and glutamatergic neurotransmission), and the significant attenuation of seizures and seizure-like activity with P2X receptor blockade. The discovery of new and selective antagonists for P2X3 and P2X4 receptors is ongoing, armed with new structural data to guide rational design. The availability of safe, brain-penetrant compounds will likely encourage the clinical exploration of epilepsy as a disease entity.
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Affiliation(s)
- Jeffrey M Witkin
- Laboratory of Antiepileptic Drug Discovery, Ascension St. Vincent, Indianapolis, IN, USA; Department of Neuroscience and Trauma Research, Ascension St. Vincent, Indianapolis, IN, USA; Department of Chemistry & Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, WI, USA.
| | | | - Jodi L Smith
- Laboratory of Antiepileptic Drug Discovery, Ascension St. Vincent, Indianapolis, IN, USA
| | - Rok Cerne
- Laboratory of Antiepileptic Drug Discovery, Ascension St. Vincent, Indianapolis, IN, USA; Department of Anatomy and Cell Biology, Indiana University/Purdue University, Indianapolis, IN, USA; Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
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2
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Witkin JM, Shafique H, Cerne R, Smith JL, Marini AM, Lipsky RH, Delery E. Mechanistic and therapeutic relationships of traumatic brain injury and γ-amino-butyric acid (GABA). Pharmacol Ther 2024; 256:108609. [PMID: 38369062 DOI: 10.1016/j.pharmthera.2024.108609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 01/18/2024] [Accepted: 02/01/2024] [Indexed: 02/20/2024]
Abstract
Traumatic brain injury (TBI) is a highly prevalent medical condition for which no medications specific for the prophylaxis or treatment of the condition as a whole exist. The spectrum of symptoms includes coma, headache, seizures, cognitive impairment, depression, and anxiety. Although it has been known for years that the inhibitory neurotransmitter γ-amino-butyric acid (GABA) is involved in TBI, no novel therapeutics based upon this mechanism have been introduced into clinical practice. We review the neuroanatomical, neurophysiological, neurochemical, and neuropharmacological relationships of GABA neurotransmission to TBI with a view toward new potential GABA-based medicines. The long-standing idea that excitatory and inhibitory (GABA and others) balances are disrupted by TBI is supported by the experimental data but has failed to invent novel methods of restoring this balance. The slow progress in advancing new treatments is due to the complexity of the disorder that encompasses multiple dynamically interacting biological processes including hemodynamic and metabolic systems, neurodegeneration and neurogenesis, major disruptions in neural networks and axons, frank brain lesions, and a multitude of symptoms that have differential neuronal and neurohormonal regulatory mechanisms. Although the current and ongoing clinical studies include GABAergic drugs, no novel GABA compounds are being explored. It is suggested that filling the gap in understanding the roles played by specific GABAA receptor configurations within specific neuronal circuits could help define new therapeutic approaches. Further research into the temporal and spatial delivery of GABA modulators should also be useful. Along with GABA modulation, research into the sequencing of GABA and non-GABA treatments will be needed.
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Affiliation(s)
- Jeffrey M Witkin
- Laboratory of Antiepileptic Drug Discovery, Ascension St. Vincent Hospital, Indianapolis, IN, USA; Departments of Neuroscience and Trauma Research, Ascension St. Vincent Hospital, Indianapolis, IN, USA; RespireRx Pharmaceuticals Inc, Glen Rock, NJ, USA.
| | | | - Rok Cerne
- Laboratory of Antiepileptic Drug Discovery, Ascension St. Vincent Hospital, Indianapolis, IN, USA; RespireRx Pharmaceuticals Inc, Glen Rock, NJ, USA; Department of Anatomy and Cell Biology, Indiana University/Purdue University, Indianapolis, IN, USA
| | - Jodi L Smith
- Laboratory of Antiepileptic Drug Discovery, Ascension St. Vincent Hospital, Indianapolis, IN, USA
| | - Ann M Marini
- Department of Neurology, Program in Neuroscience, and Molecular and Cellular Biology Program, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Robert H Lipsky
- Department of Neurology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Elizabeth Delery
- College of Osteopathic Medicine, Marian University, Indianapolis, IN, USA.
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3
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Sharmin D, Divović B, Ping X, Cerne R, Smith JL, Rezvanian S, Mondal P, Meyer MJ, Kiley ME, Arnold LA, Mian MY, Pandey KP, Jin X, Mitrović JR, Djorović D, Lippa A, Cook JM, Golani LK, Scholze P, Savić MM, Witkin JM. New Imidazodiazepine Analogue, 5-(8-Bromo-6-(pyridin-2-yl)-4 H-benzo[ f]imidazo[1,5- a][1,4]diazepin-3-yl)oxazole, Provides a Simplified Synthetic Scheme, High Oral Plasma and Brain Exposures, and Produces Antiseizure Efficacy in Mice, and Antiepileptogenic Activity in Neural Networks in Brain Slices from a Patient with Mesial Temporal Lobe Epilepsy. ACS Chem Neurosci 2024; 15:517-526. [PMID: 38175916 DOI: 10.1021/acschemneuro.3c00555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2024] Open
Abstract
KRM-II-81 (1) is an imidazodiazepine GABAA receptor (GABAAR) potentiator with broad antiseizure efficacy and a low sedative burden. A brominated analogue, DS-II-73 (5), was synthesized and pharmacologically characterized as a potential backup compound as KRM-II-81 moves forward into development. The synthesis from 2-amino-5-bromophenyl)(pyridin-2yl)methanone (6) was processed in five steps with an overall yield of 38% and without the need for a palladium catalyst. GABAAR binding occurred with a Ki of 150 nM, and only 3 of 41 screened binding sites produced inhibition ≥50% at 10 μM, and the potency to induce cytotoxicity was ≥240 mM. DS-II-73 was selective for α2/3/5- over that of α1-containing GABAARs. Oral exposure of plasma and brain of rats was more than sufficient to functionally impact GABAARs. Tonic convulsions in mice and lethality induced by pentylenetetrazol were suppressed by DS-II-73 after oral administration and latencies to clonic and tonic seizures were prolonged. Cortical slice preparations from a patient with pharmacoresistant epilepsy (mesial temporal lobe) showed decreases in the frequency of local field potentials by DS-II-73. As with KRM-II-81, the motor-impairing effects of DS-II-73 were low compared to diazepam. Molecular docking studies of DS-II-73 with the α1β3γ2L-configured GABAAR showed low interaction with α1His102 that is suggested as a potential molecular mechanism for its low sedative side effects. These findings support the viability of DS-II-73 as a backup molecule for its ethynyl analogue, KRM-II-81, with the human tissue data providing translational credibility.
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Affiliation(s)
- Dishary Sharmin
- Department of Chemistry & Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin 53211, United States
| | - Branka Divović
- Department of Pharmacology, Faculty of Pharmacy, University of Belgrade, Belgrade 11221, Serbia
| | - Xingjie Ping
- Department of Anatomy and Cell Biology, Indiana University/Purdue University, Indianapolis, Indiana 46202, United States
| | - Rok Cerne
- Department of Anatomy and Cell Biology, Indiana University/Purdue University, Indianapolis, Indiana 46202, United States
- Laboratory of Antiepileptic Drug Discovery, St. Vincent's Hospital, Indianapolis, Indiana 46260, United States
- RespireRx Pharmaceuticals Inc, Glen Rock, New Jersey 07452, United States
- Faculty of Medicine, University of Ljubljana, Zaloška cesta 4, Ljubljana 1000, Slovenia
| | - Jodi L Smith
- Laboratory of Antiepileptic Drug Discovery, St. Vincent's Hospital, Indianapolis, Indiana 46260, United States
| | - Sepideh Rezvanian
- Department of Chemistry & Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin 53211, United States
| | - Prithu Mondal
- Department of Chemistry & Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin 53211, United States
| | - Michelle Jean Meyer
- Department of Chemistry & Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin 53211, United States
| | - Molly E Kiley
- Department of Chemistry & Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin 53211, United States
| | - Leggy A Arnold
- Department of Chemistry & Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin 53211, United States
| | - Md Yeunus Mian
- Department of Chemistry & Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin 53211, United States
| | - Kamal P Pandey
- Department of Chemistry & Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin 53211, United States
| | - Xiaoming Jin
- Department of Anatomy and Cell Biology, Indiana University/Purdue University, Indianapolis, Indiana 46202, United States
| | - Jelena R Mitrović
- Department of Pharmaceutical Technology and Cosmetology, Faculty of Pharmacy, University of Belgrade, Belgrade 11221, Serbia
| | - Djordje Djorović
- Institute of Anatomy, School of Medicine, University of Belgrade, Belgrade 11221, Serbia
| | - Arnold Lippa
- RespireRx Pharmaceuticals Inc, Glen Rock, New Jersey 07452, United States
| | - James M Cook
- Department of Chemistry & Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin 53211, United States
- RespireRx Pharmaceuticals Inc, Glen Rock, New Jersey 07452, United States
| | - Lalit K Golani
- Department of Chemistry and Chemical Biology, Northeastern University, Boston, Massachusetts 02115, United States
| | - Petra Scholze
- Department of Pathobiology of the Nervous System, Center for Brain Research, Medical University of Vienna, Vienna 1090, Austria
| | - Miroslav M Savić
- Department of Pharmacology, Faculty of Pharmacy, University of Belgrade, Belgrade 11221, Serbia
| | - Jeffrey M Witkin
- Department of Chemistry & Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin 53211, United States
- Laboratory of Antiepileptic Drug Discovery, St. Vincent's Hospital, Indianapolis, Indiana 46260, United States
- RespireRx Pharmaceuticals Inc, Glen Rock, New Jersey 07452, United States
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Smith JL, Wertz J, Lippa A, Ping X, Jin X, Cook JM, Witkin JM, Cerne R. KRM-II-81 suppresses epileptifom activity across the neural network of cortical tissue from a patient with pharmacoresistant epilepsy. Heliyon 2024; 10:e23752. [PMID: 38223703 PMCID: PMC10784158 DOI: 10.1016/j.heliyon.2023.e23752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 10/27/2023] [Accepted: 12/12/2023] [Indexed: 01/16/2024] Open
Abstract
A clinical case of a 19-year-old male patient with pharmacoresistant seizures occurring following parieto-occipital tumor-resection at age 6 is described. Seizure surgery work-up included prolonged video EEG monitoring and head CT without contrast. Seizure focus was localized to the left temporal lobe, and we felt that the patient was an excellent candidate for seizure surgery. The patient underwent a left frontotemporal craniotomy for removal of the seizure focus with intraoperative electrocorticography (ECoG) conducted pre and post resection. ECoG recordings pre- and post-resection confirmed resolution of seizure generation. Imaging obtained immediately postoperatively showed complete resection of the residual tumor with no evidence of recurrence in follow-ups. A year after the surgery the patient is seizure-free but remains on seizure medication. With the patient's consent the excised epileptogenic tissue was used for ex-vivo research studies. The microelectrode recordings confirmed epileptiform activity in the excised tissue incubated in excitatory artificial cerebrospinal fluid. The epileptiform activity in the epileptogenic tissue was suppressed by addition of KRM-II-81, a novel α2/3 subtype preferring GABAA receptor (GABAAR) potentiator with previously demonstrated antiepileptic efficacy in multiple animal models of epilepsy and with reduced potential for CNS side-effects compared to classical benzodiazepine GABAAR potentiators. These findings support the proposition that KRM-II-81 might reduce seizure burden in pharmacoresistant patients.
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Affiliation(s)
- Jodi L. Smith
- Laboratory of Antiepileptic Drug Discovery, Ascension St. Vincent, Indianapolis, IN, USA
| | | | - Arnold Lippa
- RespireRx Pharmaceuticals Inc, Glen Rock, NJ, USA
| | - Xingjie Ping
- Department of Anatomy and Cell Biology, Indiana University/Purdue University, Indianapolis, IN, USA
| | - Xiaoming Jin
- Department of Anatomy and Cell Biology, Indiana University/Purdue University, Indianapolis, IN, USA
| | - James M. Cook
- RespireRx Pharmaceuticals Inc, Glen Rock, NJ, USA
- Department of Chemistry & Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Jeffrey M. Witkin
- Laboratory of Antiepileptic Drug Discovery, Ascension St. Vincent, Indianapolis, IN, USA
- RespireRx Pharmaceuticals Inc, Glen Rock, NJ, USA
- Department of Chemistry & Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Rok Cerne
- Laboratory of Antiepileptic Drug Discovery, Ascension St. Vincent, Indianapolis, IN, USA
- RespireRx Pharmaceuticals Inc, Glen Rock, NJ, USA
- Department of Anatomy and Cell Biology, Indiana University/Purdue University, Indianapolis, IN, USA
- Faculty of Medicine, University of Ljubljana, Zaloška cesta 4, Ljubljana, Slovenia
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5
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Affiliation(s)
| | - Arnold Lippa
- RespireRx Pharmaceuticals Inc, Glen Rock, NJ, USA
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6
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Sharmin D, Mian MY, Marcotte M, Prevot TD, Sibille E, Witkin JM, Cook JM. Synthesis and Receptor Binding Studies of α5 GABA AR Selective Novel Imidazodiazepines Targeted for Psychiatric and Cognitive Disorders. Molecules 2023; 28:4771. [PMID: 37375326 DOI: 10.3390/molecules28124771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/09/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
GABA mediates inhibitory actions through various GABAA receptor subtypes, including 19 subunits in human GABAAR. Dysregulation of GABAergic neurotransmission is associated with several psychiatric disorders, including depression, anxiety, and schizophrenia. Selective targeting of α2/3 GABAARs can treat mood and anxiety, while α5 GABAA-Rs can treat anxiety, depression, and cognitive performance. GL-II-73 and MP-III-022, α5-positive allosteric modulators have shown promising results in animal models of chronic stress, aging, and cognitive disorders, including MDD, schizophrenia, autism, and Alzheimer's disease. Described in this article is how small changes in the structure of imidazodiazepine substituents can greatly impact the subtype selectivity of benzodiazepine GABAAR. To investigate alternate and potentially more effective therapeutic compounds, modifications were made to the structure of imidazodiazepine 1 to synthesize different amide analogs. The novel ligands were screened at the NIMH PDSP against a panel of 47 receptors, ion channels, including hERG, and transporters to identify on- and off-target interactions. Any ligands with significant inhibition in primary binding were subjected to secondary binding assays to determine their Ki values. The newly synthesized imidazodiazepines were found to have variable affinities for the benzodiazepine site and negligible or no binding to any off-target profile receptors that could cause other physiological problems.
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Affiliation(s)
- Dishary Sharmin
- Department of Chemistry and Biochemistry, Milwaukee Institute of Drug Discovery, University of Wisconsin Milwaukee, Milwaukee, WI 53201, USA
| | - Md Yeunus Mian
- Department of Chemistry and Biochemistry, Milwaukee Institute of Drug Discovery, University of Wisconsin Milwaukee, Milwaukee, WI 53201, USA
| | - Michael Marcotte
- Campbell Family Mental Health Research Institute of CAMH, Toronto, ON M5S 2S1, Canada
| | - Thomas D Prevot
- Campbell Family Mental Health Research Institute of CAMH, Toronto, ON M5S 2S1, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada
| | - Etienne Sibille
- Campbell Family Mental Health Research Institute of CAMH, Toronto, ON M5S 2S1, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON M5T 1R8, Canada
| | - Jeffrey M Witkin
- Department of Chemistry and Biochemistry, Milwaukee Institute of Drug Discovery, University of Wisconsin Milwaukee, Milwaukee, WI 53201, USA
- Laboratory of Antiepileptic Drug Discovery, Ascension, St. Vincent, Indianapolis, IN 46260, USA
| | - James M Cook
- Department of Chemistry and Biochemistry, Milwaukee Institute of Drug Discovery, University of Wisconsin Milwaukee, Milwaukee, WI 53201, USA
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7
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Pandey KP, Divović B, Rashid F, Golani LK, Cerne R, Zahn NM, Meyer MJ, Arnold LA, Sharmin D, Mian MY, Smith JL, Ping X, Jin X, Lippa A, Tiruveedhula VVNPB, Cook JM, Savić MM, Witkin JM. Structural Analogs of the GABAkine KRM-II-81 Are Orally Bioavailable Anticonvulsants without Sedation. J Pharmacol Exp Ther 2023; 385:50-61. [PMID: 36746611 PMCID: PMC10029819 DOI: 10.1124/jpet.122.001362] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 12/22/2022] [Accepted: 01/19/2023] [Indexed: 02/08/2023] Open
Abstract
To provide back-up compounds to support the development of the GABAA receptor (GABAAR) potentiator KRM-II-81, three novel analogs were designed: replacing the pyridinyl with 2'-Cl-phenyl (FR-II-60), changing the positions of the N and O atoms in the oxazole ring with addition of an ethyl group (KPP-III-34 and KPP-III-51), or substituting a Br atom for the ethynyl of KRM-II-81 (KPP-III-34). The compounds bound to brain GABAARs. Intraperitoneal administration of FR-II-60 and KPP-III-34 produced anticonvulsant activity in mice [maximal electroshock (MES)-induced seizures or 6 Hz-induced seizures], whereas KPP-III-51 did not. Although all compounds were orally bioavailable, structural changes reduced the plasma and brain (FR-II-60 and KPP-III-51) exposures relative to KRM-II-81. Oral administration of each compound produced dose-dependent increases in the latency for both clonic and tonic seizures and the lethality induced by pentylenetetrazol (PTZ) in mice. Since KPP-III-34 produced the highest brain area under the curve (AUC) exposures, it was selected for further profiling. Oral administration of KPP-III-34 suppressed seizures in corneal-kindled mice, hippocampal paroxysmal discharges in mesial temporal lobe epileptic mice, and PTZ-induced convulsions in rats. Only transient sensorimotor impairment was observed in mice, and doses of KPP-III-34 up to 500 mg/kg did not produce impairment in rats. Molecular docking studies demonstrated that all compounds displayed a reduced propensity for binding to α1His102 compared with the sedating compound alprazolam; the bromine-substituted KPP-III-34 achieved the least interaction. Overall, these findings document the oral bioavailability and anticonvulsant efficacy of three novel analogs of KRM-II-81 with reduced sedative effects. SIGNIFICANCE STATEMENT: A new non-sedating compound, KRM-II-81, with reduced propensity for tolerance is moving into clinical development. Three new analogs were orally bioavailable, produced anticonvulsant effects in rodents, and displayed low sensorimotor impairment. KPP-III-34 demonstrated efficacy in models of pharmacoresistant epilepsy. Docking studies demonstrated a low propensity for compound binding to the α1His102 residue implicated in sedation. Thus, three additional structures have been added to the list of non-sedating imidazodiazepine anticonvulsants that could serve as backups in the clinical development of KRM-II-81.
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Affiliation(s)
- Kamal P Pandey
- Department of Chemistry and Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin (K.P.P., F.R., L.K.G., N.M.Z., M.J.M., L.A.A., D.S., M.Y.M., V.V.N.P.B.T., J.M.C., J.M.W.);
- Department of Pharmacology, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia (B.D., M.M.S.);
- Laboratory of Antiepileptic Drug Discovery, St. Vincent's Hospital, Indianapolis, Indiana (R.C., J.L.S., J.M.W.);
- Department of Anatomy and Cell BiologyIndiana University/Purdue University, Indianapolis, Indiana (R.C., X.P., X.J.);
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia (R.C.); and RespireRx Pharmaceuticals Inc., Glen Rock, New Jersey (A.L., J.M.C., J.M.W.)
| | - Branka Divović
- Department of Chemistry and Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin (K.P.P., F.R., L.K.G., N.M.Z., M.J.M., L.A.A., D.S., M.Y.M., V.V.N.P.B.T., J.M.C., J.M.W.)
- Department of Pharmacology, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia (B.D., M.M.S.)
- Laboratory of Antiepileptic Drug Discovery, St. Vincent's Hospital, Indianapolis, Indiana (R.C., J.L.S., J.M.W.)
- Department of Anatomy and Cell BiologyIndiana University/Purdue University, Indianapolis, Indiana (R.C., X.P., X.J.)
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia (R.C.); and RespireRx Pharmaceuticals Inc., Glen Rock, New Jersey (A.L., J.M.C., J.M.W.)
| | - Farjana Rashid
- Department of Chemistry and Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin (K.P.P., F.R., L.K.G., N.M.Z., M.J.M., L.A.A., D.S., M.Y.M., V.V.N.P.B.T., J.M.C., J.M.W.)
- Department of Pharmacology, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia (B.D., M.M.S.)
- Laboratory of Antiepileptic Drug Discovery, St. Vincent's Hospital, Indianapolis, Indiana (R.C., J.L.S., J.M.W.)
- Department of Anatomy and Cell BiologyIndiana University/Purdue University, Indianapolis, Indiana (R.C., X.P., X.J.)
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia (R.C.); and RespireRx Pharmaceuticals Inc., Glen Rock, New Jersey (A.L., J.M.C., J.M.W.)
| | - Lalit K Golani
- Department of Chemistry and Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin (K.P.P., F.R., L.K.G., N.M.Z., M.J.M., L.A.A., D.S., M.Y.M., V.V.N.P.B.T., J.M.C., J.M.W.)
- Department of Pharmacology, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia (B.D., M.M.S.)
- Laboratory of Antiepileptic Drug Discovery, St. Vincent's Hospital, Indianapolis, Indiana (R.C., J.L.S., J.M.W.)
- Department of Anatomy and Cell BiologyIndiana University/Purdue University, Indianapolis, Indiana (R.C., X.P., X.J.)
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia (R.C.); and RespireRx Pharmaceuticals Inc., Glen Rock, New Jersey (A.L., J.M.C., J.M.W.)
| | - Rok Cerne
- Department of Chemistry and Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin (K.P.P., F.R., L.K.G., N.M.Z., M.J.M., L.A.A., D.S., M.Y.M., V.V.N.P.B.T., J.M.C., J.M.W.)
- Department of Pharmacology, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia (B.D., M.M.S.)
- Laboratory of Antiepileptic Drug Discovery, St. Vincent's Hospital, Indianapolis, Indiana (R.C., J.L.S., J.M.W.)
- Department of Anatomy and Cell BiologyIndiana University/Purdue University, Indianapolis, Indiana (R.C., X.P., X.J.)
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia (R.C.); and RespireRx Pharmaceuticals Inc., Glen Rock, New Jersey (A.L., J.M.C., J.M.W.)
| | - Nicolas M Zahn
- Department of Chemistry and Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin (K.P.P., F.R., L.K.G., N.M.Z., M.J.M., L.A.A., D.S., M.Y.M., V.V.N.P.B.T., J.M.C., J.M.W.)
- Department of Pharmacology, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia (B.D., M.M.S.)
- Laboratory of Antiepileptic Drug Discovery, St. Vincent's Hospital, Indianapolis, Indiana (R.C., J.L.S., J.M.W.)
- Department of Anatomy and Cell BiologyIndiana University/Purdue University, Indianapolis, Indiana (R.C., X.P., X.J.)
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia (R.C.); and RespireRx Pharmaceuticals Inc., Glen Rock, New Jersey (A.L., J.M.C., J.M.W.)
| | - Michelle Jean Meyer
- Department of Chemistry and Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin (K.P.P., F.R., L.K.G., N.M.Z., M.J.M., L.A.A., D.S., M.Y.M., V.V.N.P.B.T., J.M.C., J.M.W.)
- Department of Pharmacology, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia (B.D., M.M.S.)
- Laboratory of Antiepileptic Drug Discovery, St. Vincent's Hospital, Indianapolis, Indiana (R.C., J.L.S., J.M.W.)
- Department of Anatomy and Cell BiologyIndiana University/Purdue University, Indianapolis, Indiana (R.C., X.P., X.J.)
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia (R.C.); and RespireRx Pharmaceuticals Inc., Glen Rock, New Jersey (A.L., J.M.C., J.M.W.)
| | - Leggy A Arnold
- Department of Chemistry and Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin (K.P.P., F.R., L.K.G., N.M.Z., M.J.M., L.A.A., D.S., M.Y.M., V.V.N.P.B.T., J.M.C., J.M.W.)
- Department of Pharmacology, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia (B.D., M.M.S.)
- Laboratory of Antiepileptic Drug Discovery, St. Vincent's Hospital, Indianapolis, Indiana (R.C., J.L.S., J.M.W.)
- Department of Anatomy and Cell BiologyIndiana University/Purdue University, Indianapolis, Indiana (R.C., X.P., X.J.)
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia (R.C.); and RespireRx Pharmaceuticals Inc., Glen Rock, New Jersey (A.L., J.M.C., J.M.W.)
| | - Dishary Sharmin
- Department of Chemistry and Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin (K.P.P., F.R., L.K.G., N.M.Z., M.J.M., L.A.A., D.S., M.Y.M., V.V.N.P.B.T., J.M.C., J.M.W.)
- Department of Pharmacology, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia (B.D., M.M.S.)
- Laboratory of Antiepileptic Drug Discovery, St. Vincent's Hospital, Indianapolis, Indiana (R.C., J.L.S., J.M.W.)
- Department of Anatomy and Cell BiologyIndiana University/Purdue University, Indianapolis, Indiana (R.C., X.P., X.J.)
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia (R.C.); and RespireRx Pharmaceuticals Inc., Glen Rock, New Jersey (A.L., J.M.C., J.M.W.)
| | - Md Yeunus Mian
- Department of Chemistry and Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin (K.P.P., F.R., L.K.G., N.M.Z., M.J.M., L.A.A., D.S., M.Y.M., V.V.N.P.B.T., J.M.C., J.M.W.)
- Department of Pharmacology, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia (B.D., M.M.S.)
- Laboratory of Antiepileptic Drug Discovery, St. Vincent's Hospital, Indianapolis, Indiana (R.C., J.L.S., J.M.W.)
- Department of Anatomy and Cell BiologyIndiana University/Purdue University, Indianapolis, Indiana (R.C., X.P., X.J.)
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia (R.C.); and RespireRx Pharmaceuticals Inc., Glen Rock, New Jersey (A.L., J.M.C., J.M.W.)
| | - Jodi L Smith
- Department of Chemistry and Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin (K.P.P., F.R., L.K.G., N.M.Z., M.J.M., L.A.A., D.S., M.Y.M., V.V.N.P.B.T., J.M.C., J.M.W.)
- Department of Pharmacology, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia (B.D., M.M.S.)
- Laboratory of Antiepileptic Drug Discovery, St. Vincent's Hospital, Indianapolis, Indiana (R.C., J.L.S., J.M.W.)
- Department of Anatomy and Cell BiologyIndiana University/Purdue University, Indianapolis, Indiana (R.C., X.P., X.J.)
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia (R.C.); and RespireRx Pharmaceuticals Inc., Glen Rock, New Jersey (A.L., J.M.C., J.M.W.)
| | - Xingjie Ping
- Department of Chemistry and Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin (K.P.P., F.R., L.K.G., N.M.Z., M.J.M., L.A.A., D.S., M.Y.M., V.V.N.P.B.T., J.M.C., J.M.W.)
- Department of Pharmacology, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia (B.D., M.M.S.)
- Laboratory of Antiepileptic Drug Discovery, St. Vincent's Hospital, Indianapolis, Indiana (R.C., J.L.S., J.M.W.)
- Department of Anatomy and Cell BiologyIndiana University/Purdue University, Indianapolis, Indiana (R.C., X.P., X.J.)
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia (R.C.); and RespireRx Pharmaceuticals Inc., Glen Rock, New Jersey (A.L., J.M.C., J.M.W.)
| | - Xiaoming Jin
- Department of Chemistry and Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin (K.P.P., F.R., L.K.G., N.M.Z., M.J.M., L.A.A., D.S., M.Y.M., V.V.N.P.B.T., J.M.C., J.M.W.)
- Department of Pharmacology, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia (B.D., M.M.S.)
- Laboratory of Antiepileptic Drug Discovery, St. Vincent's Hospital, Indianapolis, Indiana (R.C., J.L.S., J.M.W.)
- Department of Anatomy and Cell BiologyIndiana University/Purdue University, Indianapolis, Indiana (R.C., X.P., X.J.)
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia (R.C.); and RespireRx Pharmaceuticals Inc., Glen Rock, New Jersey (A.L., J.M.C., J.M.W.)
| | - Arnold Lippa
- Department of Chemistry and Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin (K.P.P., F.R., L.K.G., N.M.Z., M.J.M., L.A.A., D.S., M.Y.M., V.V.N.P.B.T., J.M.C., J.M.W.)
- Department of Pharmacology, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia (B.D., M.M.S.)
- Laboratory of Antiepileptic Drug Discovery, St. Vincent's Hospital, Indianapolis, Indiana (R.C., J.L.S., J.M.W.)
- Department of Anatomy and Cell BiologyIndiana University/Purdue University, Indianapolis, Indiana (R.C., X.P., X.J.)
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia (R.C.); and RespireRx Pharmaceuticals Inc., Glen Rock, New Jersey (A.L., J.M.C., J.M.W.)
| | - V V N Phani Babu Tiruveedhula
- Department of Chemistry and Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin (K.P.P., F.R., L.K.G., N.M.Z., M.J.M., L.A.A., D.S., M.Y.M., V.V.N.P.B.T., J.M.C., J.M.W.)
- Department of Pharmacology, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia (B.D., M.M.S.)
- Laboratory of Antiepileptic Drug Discovery, St. Vincent's Hospital, Indianapolis, Indiana (R.C., J.L.S., J.M.W.)
- Department of Anatomy and Cell BiologyIndiana University/Purdue University, Indianapolis, Indiana (R.C., X.P., X.J.)
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia (R.C.); and RespireRx Pharmaceuticals Inc., Glen Rock, New Jersey (A.L., J.M.C., J.M.W.)
| | - James M Cook
- Department of Chemistry and Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin (K.P.P., F.R., L.K.G., N.M.Z., M.J.M., L.A.A., D.S., M.Y.M., V.V.N.P.B.T., J.M.C., J.M.W.)
- Department of Pharmacology, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia (B.D., M.M.S.)
- Laboratory of Antiepileptic Drug Discovery, St. Vincent's Hospital, Indianapolis, Indiana (R.C., J.L.S., J.M.W.)
- Department of Anatomy and Cell BiologyIndiana University/Purdue University, Indianapolis, Indiana (R.C., X.P., X.J.)
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia (R.C.); and RespireRx Pharmaceuticals Inc., Glen Rock, New Jersey (A.L., J.M.C., J.M.W.)
| | - Miroslav M Savić
- Department of Chemistry and Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin (K.P.P., F.R., L.K.G., N.M.Z., M.J.M., L.A.A., D.S., M.Y.M., V.V.N.P.B.T., J.M.C., J.M.W.)
- Department of Pharmacology, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia (B.D., M.M.S.)
- Laboratory of Antiepileptic Drug Discovery, St. Vincent's Hospital, Indianapolis, Indiana (R.C., J.L.S., J.M.W.)
- Department of Anatomy and Cell BiologyIndiana University/Purdue University, Indianapolis, Indiana (R.C., X.P., X.J.)
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia (R.C.); and RespireRx Pharmaceuticals Inc., Glen Rock, New Jersey (A.L., J.M.C., J.M.W.)
| | - Jeffrey M Witkin
- Department of Chemistry and Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin (K.P.P., F.R., L.K.G., N.M.Z., M.J.M., L.A.A., D.S., M.Y.M., V.V.N.P.B.T., J.M.C., J.M.W.);
- Department of Pharmacology, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia (B.D., M.M.S.);
- Laboratory of Antiepileptic Drug Discovery, St. Vincent's Hospital, Indianapolis, Indiana (R.C., J.L.S., J.M.W.);
- Department of Anatomy and Cell BiologyIndiana University/Purdue University, Indianapolis, Indiana (R.C., X.P., X.J.);
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia (R.C.); and RespireRx Pharmaceuticals Inc., Glen Rock, New Jersey (A.L., J.M.C., J.M.W.)
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8
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Witkin JM, Golani LK, Smith JL. Clinical pharmacological innovation in the treatment of depression. Expert Rev Clin Pharmacol 2023; 16:349-362. [PMID: 37000975 DOI: 10.1080/17512433.2023.2198703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Abstract
INTRODUCTION Deficiencies in standard of care antidepressants are driving novel drug discovery. A new age of antidepressant medications has emerged with the introduction of rapid-acting antidepressants with efficacy in treatment-resistant patients. AREAS COVERED The newly approved medicines and those in clinical development for major depressive disorder (MDD) are documented in this scoping review of newly approved and emerging antidepressants. Compounds are evaluated for clinical efficacy, tolerability, and safety and compared to those of standard of care medicines. EXPERT OPINION A new age of antidepressant discovery relies heavily on glutamatergic mechanisms. New medicines based upon the model of ketamine have been delivered and are in clinical development. Rapid onset and the ability to impact treatment-resistant depression, raises the question of the best first-line medicines for patients. Drugs with improvements in tolerability are being investigated (e.g. mGlu2/3 receptor antagonists, AMPA receptor potentiators, and novel NMDA receptor modulators). Multiple companies are working toward the identification of novel psychedelic drugs where the requirement for psychedelic activity is not fully known. Gaps still exist - methods for matching patients with specific medicines are needed, and medicines for the prevention of MDD and its disease progression need research attention.
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Affiliation(s)
- Jeffrey M Witkin
- Laboratory of Antiepileptic Drug Discovery, Ascension St. Vincent Hospital, Indianapolis, IN, USA
- Departments of Neuroscience and Trauma Research, Ascension St. Vincent Hospital, Indianapolis, IN USA
| | - Lalit K Golani
- Department of Chemistry and Chemical Biology, Northeastern University, Boston, MA, USA
| | - Jodi L Smith
- Laboratory of Antiepileptic Drug Discovery, Ascension St. Vincent Hospital, Indianapolis, IN, USA
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9
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Ping X, Meyer MJ, Zahn NM, Golani LK, Sharmin D, Pandey KP, Revanian S, Mondal P, Jin X, Arnold LA, Cerne R, Cook JM, Divović B, Savić MM, Lippa A, Smith JL, Witkin JM. Comparative anticonvulsant activity of the GABAkine KRM-II-81 and a deuterated analog. Drug Dev Res 2023; 84:527-531. [PMID: 36748904 DOI: 10.1002/ddr.22042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/27/2022] [Accepted: 01/19/2023] [Indexed: 02/08/2023]
Abstract
A series of imidazodiazepines has been developed that possess reduced sedative liabilities but retain efficacy in anticonvulsant screening models. The latest of these compounds, (5-(8-ethynyl-6-(pyridin-2-yl)-4H-benzo[f]imidazole[1,5-α][1,4]diazepin-3-yl) oxazole known as KRM-II-81) is currently awaiting advancement into the clinic. A deuterated structural analog (D5-KRM-II-81) was made as a potential backup compound and studied here in comparison to KRM-II-81. In the present study, both compounds significantly prevented seizures in mice induced by 6 Hz (44 mA) electrical stimulation without significantly altering motoric function on a rotarod after intraperitoneal administration. Both compounds also significantly prevented clonic seizures, tonic seizures, and lethality induced by pentylenetetrazol in mice when given orally. D5-KRM-II-81 had a slightly longer duration of action against clonic and tonic seizures than KRM-II-81. Oral administration of 100 mg/kg of either KRM-II-81 or D5-KRM-II-81 was significantly less disruptive of sensorimotor function in mice than diazepam (5 mg/kg, p.o.). The present report documents that D5-KRM-II-81 represents another in this series of imidazodiazepines with anticonvulsant activity at doses that do not impair sensorimotor function.
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Affiliation(s)
- Xingjie Ping
- Department of Anatomy and Cell Biology, Indiana University/Purdue University, Indianapolis, Indiana, USA
| | - Michelle J Meyer
- Department of Chemistry & Biochemistry, Milwaukee Institute of Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Nicolas M Zahn
- Department of Chemistry & Biochemistry, Milwaukee Institute of Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Lalit K Golani
- Department of Chemistry & Biochemistry, Milwaukee Institute of Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Dishary Sharmin
- Department of Chemistry & Biochemistry, Milwaukee Institute of Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Kamal P Pandey
- Department of Chemistry & Biochemistry, Milwaukee Institute of Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Sepideh Revanian
- Department of Chemistry & Biochemistry, Milwaukee Institute of Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Prithu Mondal
- Department of Chemistry & Biochemistry, Milwaukee Institute of Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Xiaoming Jin
- Department of Anatomy and Cell Biology, Indiana University/Purdue University, Indianapolis, Indiana, USA
| | - Leggy A Arnold
- Department of Chemistry & Biochemistry, Milwaukee Institute of Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Rok Cerne
- Department of Anatomy and Cell Biology, Indiana University/Purdue University, Indianapolis, Indiana, USA.,Laboratory of Antiepileptic Drug Discovery, St. Vincent's Hospital, Indianapolis, Indiana, USA.,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.,RespireRx Pharmaceuticals Inc, Glen Rock, New Jersey, USA
| | - James M Cook
- Department of Chemistry & Biochemistry, Milwaukee Institute of Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA.,RespireRx Pharmaceuticals Inc, Glen Rock, New Jersey, USA
| | - Branka Divović
- Department of Pharmacology, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia
| | - Miroslav M Savić
- Department of Pharmacology, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia
| | - Arnold Lippa
- RespireRx Pharmaceuticals Inc, Glen Rock, New Jersey, USA
| | - Jodi L Smith
- Laboratory of Antiepileptic Drug Discovery, St. Vincent's Hospital, Indianapolis, Indiana, USA
| | - Jeffrey M Witkin
- Department of Chemistry & Biochemistry, Milwaukee Institute of Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA.,Laboratory of Antiepileptic Drug Discovery, St. Vincent's Hospital, Indianapolis, Indiana, USA.,RespireRx Pharmaceuticals Inc, Glen Rock, New Jersey, USA
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10
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Kosmowska B, Paleczna M, Biała D, Kadłuczka J, Wardas J, Witkin JM, Cook JM, Sharmin D, Marcinkowska M, Kuter KZ. GABA-A Alpha 2/3 but Not Alpha 1 Receptor Subunit Ligand Inhibits Harmaline and Pimozide-Induced Tremor in Rats. Biomolecules 2023; 13:biom13020197. [PMID: 36830567 PMCID: PMC9953228 DOI: 10.3390/biom13020197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/11/2023] [Accepted: 01/15/2023] [Indexed: 01/20/2023] Open
Abstract
Treatment of tremors, such as in essential tremor (ET) and Parkinson's disease (PD) is mostly ineffective. Exact tremor pathomechanisms are unknown and relevant animal models are missing. GABA-A receptor is a target for tremorolytic medications, but current non-selective drugs produce side effects and have safety liabilities. The aim of this study was a search for GABA-A subunit-specific tremorolytics using different tremor-generating mechanisms. Two selective positive allosteric modulators (PAMs) were tested. Zolpidem, targeting GABA-A α1, was not effective in models of harmaline-induced ET, pimozide- or tetrabenazine-induced tremulous jaw movements (TJMs), while the novel GABA-A α2/3 selective MP-III-024 significantly reduced both the harmaline-induced ET tremor and pimozide-induced TJMs. While zolpidem decreased the locomotor activity of the rats, MP-III-024 produced small increases. These results provide important new clues into tremor suppression mechanisms initiated by the enhancement of GABA-driven inhibition in pathways controlled by α2/3 but not α1 containing GABA-A receptors. Tremor suppression by MP-III-024 provides a compelling reason to consider selective PAMs targeting α2/3-containing GABA-A receptors as novel therapeutic drug targets for ET and PD-associated tremor. The possibility of the improved tolerability and safety of this mechanism over non-selective GABA potentiation provides an additional rationale to further pursue the selective α2/3 hypothesis.
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Affiliation(s)
- Barbara Kosmowska
- Department of Neuropsychopharmacology, Maj Institute of Pharmacology, Polish Academy of Sciences, 12 Smetna St., 31-343 Krakow, Poland
| | - Martyna Paleczna
- Department of Neuropsychopharmacology, Maj Institute of Pharmacology, Polish Academy of Sciences, 12 Smetna St., 31-343 Krakow, Poland
| | - Dominika Biała
- Department of Neuropsychopharmacology, Maj Institute of Pharmacology, Polish Academy of Sciences, 12 Smetna St., 31-343 Krakow, Poland
| | - Justyna Kadłuczka
- Department of Neuropsychopharmacology, Maj Institute of Pharmacology, Polish Academy of Sciences, 12 Smetna St., 31-343 Krakow, Poland
| | - Jadwiga Wardas
- Department of Neuropsychopharmacology, Maj Institute of Pharmacology, Polish Academy of Sciences, 12 Smetna St., 31-343 Krakow, Poland
| | - Jeffrey M. Witkin
- Department of Chemistry and Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA
- RespireRx Pharmaceuticals Inc., Glen Rock, NJ 07452, USA
| | - James M. Cook
- Department of Chemistry and Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA
- RespireRx Pharmaceuticals Inc., Glen Rock, NJ 07452, USA
| | - Dishary Sharmin
- Department of Chemistry and Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA
| | - Monika Marcinkowska
- Department of Pharmaceutical Chemistry, Jagiellonian University, Medical College, 9 Medyczna St., 30-688 Krakow, Poland
| | - Katarzyna Z. Kuter
- Department of Neuropsychopharmacology, Maj Institute of Pharmacology, Polish Academy of Sciences, 12 Smetna St., 31-343 Krakow, Poland
- Correspondence: ; Tel.: +48-12-662-32-26
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11
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Pilc A, Machaczka A, Kawalec P, Smith JL, Witkin JM. Where do we go next in antidepressant drug discovery? A new generation of antidepressants: a pivotal role of AMPA receptor potentiation and mGlu2/3 receptor antagonism. Expert Opin Drug Discov 2022; 17:1131-1146. [PMID: 35934973 DOI: 10.1080/17460441.2022.2111415] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Major depressive disorder remains a prevalent world-wide health problem. Currently available antidepressant medications take weeks of dosing, do not produce antidepressant response in all patients, and have undesirable ancillary effects. AREAS COVERED The present opinion piece focuses on the major inroads to the creation of new antidepressants. These include N-methyl-D-aspartate (NMDA) receptor antagonists and related compounds like ketamine, psychedelic drugs like psilocybin, and muscarinic receptor antagonists like scopolamine. The preclinical and clinical pharmacological profile of these new-age antidepressant drugs is discussed. EXPERT OPINION Preclinical and clinical data have accumulated to predict a next generation of antidepressant medicines. In contrast to the current standard of care antidepressant drugs, these compounds differ in that they demonstrate rapid activity, often after a single dose, and effects that outlive their presence in brain. These compounds also can provide efficacy for treatment-resistant depressed patients. The mechanism of action of these compounds suggests a strong glutamatergic component that involves the facilitation of AMPA receptor function. Antagonism of mGlu2/3 receptors is also relevant to the antidepressant pharmacology of this new class of drugs. Based upon the ongoing efforts to develop these new-age antidepressants, new drug approvals are predicted in the near future.
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Affiliation(s)
- Andrzej Pilc
- Department of Neurobiology, Maj Institute of Pharmacology, Polish Academy of Sciences, Krakow, Poland.,Drug Management Department, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University, Krakow, Poland
| | - Agata Machaczka
- Department of Neurobiology, Maj Institute of Pharmacology, Polish Academy of Sciences, Krakow, Poland
| | - Paweł Kawalec
- Drug Management Department, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University, Krakow, Poland
| | - Jodi L Smith
- Laboratory of Antiepileptic Drug Discovery, Ascension St. Vincent, Indianapolis, IN, USA
| | - Jeffrey M Witkin
- Laboratory of Antiepileptic Drug Discovery, Ascension St. Vincent, Indianapolis, IN, USA
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12
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Witkin JM, Pandey KP, Smith JL. Clinical investigations of compounds targeting metabotropic glutamate receptors. Pharmacol Biochem Behav 2022; 219:173446. [PMID: 35987339 DOI: 10.1016/j.pbb.2022.173446] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/22/2022] [Accepted: 08/08/2022] [Indexed: 11/15/2022]
Abstract
Pharmacological modulation of glutamate has long been considered to be of immense therapeutic utility. The metabotropic glutamate receptors (mGluRs) are potential targets for safely altering glutamate-driven excitation. Data support the potential therapeutic use of mGluR modulators in the treatment of anxiety, depression, schizophrenia, and other psychiatric disorders, pain, epilepsy, as well as neurodegenerative and neurodevelopmental disorders. For each of the three mGluR groups, compounds have been constructed that produce either potentiation or functional blockade. PET ligands for mGlu5Rs have been studied in a range of patient populations and several mGlu5R antagonists have been tested for potential efficacy in patients including mavoglurant, diploglurant, basimglurant, GET 73, and ADX10059. Efficacy with mGlu5R antagonists has been reported in trials with patients with gastroesophageal reflux disease; data from patients with Parkinson's disease or Fragile X syndrome have not been as robust as hoped. Fenobam was approved for use as an anxiolytic prior to its recognition as an mGlu5R antagonist. mGlu2/3R agonists (pomaglumated methionil) and mGlu2R agonists (JNJ-40411813, AZD 8529, and LY2979165) have been studied in patients with schizophrenia with promising but mixed results. Antagonists of mGlu2/3Rs (decoglurant and TS-161) have been studied in depression where TS-161 has advanced into a planned Phase 2 study in treatment-resistant depression. The Group III mGluRs are the least developed of the mGluR receptor targets. The mGlu4R potentiator, foliglurax, did not meet its primary endpoint in patients with Parkinson's disease. Ongoing efforts to develop mGluR-targeted compounds continue to promise these glutamate modulators as medicines for psychiatric and neurological disorders.
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Affiliation(s)
- Jeffrey M Witkin
- Laboratory of Antiepileptic Drug Discovery, Ascension St. Vincent, Indianapolis, IN, USA; Department of Chemistry & Biochemistry, Milwaukee Institute of Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, WI, USA; RespireRx Pharmaceuticals Inc, Glen Rock, NJ, USA.
| | - Kamal P Pandey
- Department of Chemistry & Biochemistry, Milwaukee Institute of Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Jodi L Smith
- Laboratory of Antiepileptic Drug Discovery, Ascension St. Vincent, Indianapolis, IN, USA
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13
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Mian MY, Divović B, Sharmin D, Pandey KP, Golani LK, Tiruveedhula VVNP, Cerne R, Smith JL, Ping X, Jin X, Imler GH, Deschamps JR, Lippa A, Cook JM, Savić MM, Rowlett J, Witkin JM. Hydrochloride Salt of the GABAkine KRM-II-81. ACS Omega 2022; 7:27550-27559. [PMID: 35967038 PMCID: PMC9366947 DOI: 10.1021/acsomega.2c03029] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 07/14/2022] [Indexed: 06/15/2023]
Abstract
Imidazodiazepine (5-(8-ethynyl-6-(pyridin-2-yl)-4H-benzo[f]imidazole[1,5-α][1,4]diazepin-3-yl) oxazole or KRM-II-81) is a potentiator of GABAA receptors (a GABAkine) undergoing preparation for clinical development. KRM-II-81 is active against many seizure and pain models in rodents, where it exhibits improved pharmacological properties over standard-of-care agents. Since salts can be utilized to create opportunities for increased solubility, enhanced absorption, and distribution, as well as for efficient methods of bulk synthesis, a hydrochloride salt of KRM-II-81 was prepared. KRM-II-81·HCl was produced from the free base with anhydrous hydrochloric acid. The formation of the monohydrochloride salt was confirmed by X-ray crystallography, as well as 1H NMR and 13C NMR analyses. High water solubility and a lower partition coefficient (octanol/water) were exhibited by KRM-II-81·HCl as compared to the free base. Oral administration of either KRM-II-81·HCl or the free base resulted in high concentrations in the brain and plasma of rats. Oral dosing in mice significantly increased the latency to both clonic and tonic convulsions and decreased pentylenetetrazol-induced lethality. The increased water solubility of the HCl salt enables intravenous dosing and the potential for higher concentration formulations compared with the free base without impacting anticonvulsant potency. Thus, KRM-II-81·HCl adds an important new compound to facilitate the development of these imidazodiazepines for clinical evaluation.
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Affiliation(s)
- Md Yeunus Mian
- Department
of Chemistry and Biochemistry, Milwaukee Institute of Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin 53211, United States
| | - Branka Divović
- Department
of Pharmacology, Faculty of Pharmacy, University
of Belgrade, Belgrade 11000, Serbia
| | - Dishary Sharmin
- Department
of Chemistry and Biochemistry, Milwaukee Institute of Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin 53211, United States
| | - Kamal P. Pandey
- Department
of Chemistry and Biochemistry, Milwaukee Institute of Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin 53211, United States
| | - Lalit K. Golani
- Department
of Chemistry and Biochemistry, Milwaukee Institute of Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin 53211, United States
| | - V. V. N. Phani
Babu Tiruveedhula
- Department
of Chemistry and Biochemistry, Milwaukee Institute of Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin 53211, United States
| | - Rok Cerne
- Laboratory
of Antiepileptic Drug Discovery, St. Vincent’s
Hospital, Indianapolis, Indiana 46260, United
States
- Department
of Anatomy and Cell Biology, Indiana University/Purdue
University, Indianapolis, Indiana 46202, United States
- Faculty
of Medicine, University of Ljubljana, Zaloška cesta 4, 1000 Ljubljana, Slovenia
- RespireRx
Pharmaceuticals Inc., Glen Rock, New Jersey 07452, United States
| | - Jodi L. Smith
- Laboratory
of Antiepileptic Drug Discovery, St. Vincent’s
Hospital, Indianapolis, Indiana 46260, United
States
| | - Xingjie Ping
- Department
of Anatomy and Cell Biology, Indiana University/Purdue
University, Indianapolis, Indiana 46202, United States
| | - Xiaoming Jin
- Department
of Anatomy and Cell Biology, Indiana University/Purdue
University, Indianapolis, Indiana 46202, United States
| | - Gregory H. Imler
- Naval
Research Laboratory, Washington, District of Columbia 20375, United States
| | - Jeffrey R. Deschamps
- Naval
Research Laboratory, Washington, District of Columbia 20375, United States
| | - Arnold Lippa
- RespireRx
Pharmaceuticals Inc., Glen Rock, New Jersey 07452, United States
| | - James M. Cook
- Department
of Chemistry and Biochemistry, Milwaukee Institute of Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin 53211, United States
- RespireRx
Pharmaceuticals Inc., Glen Rock, New Jersey 07452, United States
| | - Miroslav M. Savić
- Department
of Pharmacology, Faculty of Pharmacy, University
of Belgrade, Belgrade 11000, Serbia
| | - James Rowlett
- Department
of Psychiatry and Human Behavior, University
of Mississippi Medical Center, Jackson, Mississippi 39216, United States
| | - Jeffrey M. Witkin
- Department
of Chemistry and Biochemistry, Milwaukee Institute of Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin 53211, United States
- Laboratory
of Antiepileptic Drug Discovery, St. Vincent’s
Hospital, Indianapolis, Indiana 46260, United
States
- RespireRx
Pharmaceuticals Inc., Glen Rock, New Jersey 07452, United States
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14
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Cerne R, Lippa A, Poe MM, Smith JL, Jin X, Ping X, Golani LK, Cook JM, Witkin JM. GABAkines - Advances in the discovery, development, and commercialization of positive allosteric modulators of GABA A receptors. Pharmacol Ther 2022; 234:108035. [PMID: 34793859 PMCID: PMC9787737 DOI: 10.1016/j.pharmthera.2021.108035] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 11/08/2021] [Indexed: 12/25/2022]
Abstract
Positive allosteric modulators of γ-aminobutyric acid-A (GABAA) receptors or GABAkines have been widely used medicines for over 70 years for anxiety, epilepsy, sleep, and other disorders. Traditional GABAkines like diazepam have safety and tolerability concerns that include sedation, motor-impairment, respiratory depression, tolerance and dependence. Multiple GABAkines have entered clinical development but the issue of side-effects has not been fully solved. The compounds that are presently being developed and commercialized include several neuroactive steroids (an allopregnanolone formulation (brexanolone), an allopregnanolone prodrug (LYT-300), Sage-324, zuranolone, and ganaxolone), the α2/3-preferring GABAkine, KRM-II-81, and the α2/3/5-preferring GABAkine PF-06372865 (darigabat). The neuroactive steroids are in clinical development for post-partum depression, intractable epilepsy, tremor, status epilepticus, and genetic epilepsy disorders. Darigabat is in development for epilepsy and anxiety. The imidazodiazepine, KRM-II-81 is efficacious in animal models for the treatment of epilepsy and post-traumatic epilepsy, acute and chronic pain, as well as anxiety and depression. The efficacy of KRM-II-81 in models of pharmacoresistant epilepsy, preventing the development of seizure sensitization, and in brain tissue of intractable epileptic patients bodes well for improved therapeutics. Medicinal chemistry efforts are also ongoing to identify novel and improved GABAkines. The data document gaps in our understanding of the molecular pharmacology of GABAkines that drive differential pharmacological profiles, but emphasize advancements in the ability to successfully utilize GABAA receptor potentiation for therapeutic gain in neurology and psychiatry.
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Affiliation(s)
- Rok Cerne
- Laboratory of Antiepileptic Drug Discovery, Ascension St. Vincent, Indianapolis, IN USA,Faculty of Medicine, University of Ljubljana, Zaloška cesta 4, Ljubljana, Slovenia.,RespireRx Pharmaceuticals Inc, Glen Rock, NJ, USA,Department of Anatomy and Cell Biology, Indiana University/Purdue University, Indianapolis, IN, USA
| | - Arnold Lippa
- RespireRx Pharmaceuticals Inc, Glen Rock, NJ, USA
| | | | - Jodi L. Smith
- Laboratory of Antiepileptic Drug Discovery, Ascension St. Vincent, Indianapolis, IN USA
| | - Xiaoming Jin
- Department of Anatomy and Cell Biology, Indiana University/Purdue University, Indianapolis, IN, USA
| | - Xingjie Ping
- Department of Anatomy and Cell Biology, Indiana University/Purdue University, Indianapolis, IN, USA
| | - Lalit K. Golani
- Department of Chemistry and Biochemistry, Milwaukee Institute of Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - James M. Cook
- RespireRx Pharmaceuticals Inc, Glen Rock, NJ, USA,Department of Chemistry and Biochemistry, Milwaukee Institute of Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Jeffrey M. Witkin
- Laboratory of Antiepileptic Drug Discovery, Ascension St. Vincent, Indianapolis, IN USA,RespireRx Pharmaceuticals Inc, Glen Rock, NJ, USA,Department of Chemistry and Biochemistry, Milwaukee Institute of Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
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15
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Golani LK, Yeunus Mian M, Ahmed T, Pandey KP, Mondal P, Sharmin D, Rezvanian S, Witkin JM, Cook JM. Rationalizing the binding and α subtype selectivity of synthesized imidazodiazepines and benzodiazepines at GABAA receptors by using molecular docking studies. Bioorg Med Chem Lett 2022; 62:128637. [PMID: 35218882 DOI: 10.1016/j.bmcl.2022.128637] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 02/18/2022] [Accepted: 02/20/2022] [Indexed: 11/16/2022]
Abstract
The pharmacological actions exerted by benzodiazepines are dependent on the discrete α protein subunits of the γ-aminobutyric acid type A receptor (GABAA R). Recent developments via a cryo-EM structure of the α1β3γ2L GABAA R ion channel provide crucial insights into ligand efficacy and binding affinity at this subtype. We investigated the molecular interactions of diazepam and alprazolam bound GABAA R structures (6HUP and 6HUO) to determine key binding interaction domains. A halogen bond between the chlorine atoms of diazepam and alprazolam with the group on the backbone of the α1 histidine amino acid 102 is important to the positive allosteric modulatory actions of diazepam and alprazolam in the α1β3γ2L GABAA R ion channel. In order to gain insight into α subtype selectivity we designed and synthesized close structural analogs of diazepam and alprazolam. These compounds were then docked into the recently publish cryo-EM structures of GABAA Rs (6HUP and 6HUO). This modeling along with radio-ligand binding data resulted in the conclusion that the non-classical bioisosteric replacement of the chlorine atom at C7 with an ethinyl group (compound 5) resulted in an 11-fold gain in α5 binding selectivity over the α1 subtype. Moreover, the potency of compound 5 resulted in a ligand with less sedation than diazepam, while still maintaining the same anxiolytic potency. These modeling data extend our understanding of the structural requirements for α-subtype-selective compounds that can be utilized to achieve improved medical treatments. It is clear that the ethinyl group in place of a halogen atom decreases the affinity and efficacy of benzodiazepines and imidazodiazepines at α1 subtypes, which results in less sedation and ataxia.
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Affiliation(s)
- Lalit K Golani
- Department of Chemistry and Biochemistry, Milwaukee Institute of Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Md Yeunus Mian
- Department of Chemistry and Biochemistry, Milwaukee Institute of Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Taukir Ahmed
- Department of Chemistry and Biochemistry, Milwaukee Institute of Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Kamal P Pandey
- Department of Chemistry and Biochemistry, Milwaukee Institute of Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Prithu Mondal
- Department of Chemistry and Biochemistry, Milwaukee Institute of Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Dishary Sharmin
- Department of Chemistry and Biochemistry, Milwaukee Institute of Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Sepideh Rezvanian
- Department of Chemistry and Biochemistry, Milwaukee Institute of Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Jeffrey M Witkin
- Department of Chemistry and Biochemistry, Milwaukee Institute of Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, WI, USA; Laboratory of Antiepileptic Drug Discovery, St. Vincent's Hospital, Indianapolis, IN USA
| | - James M Cook
- Department of Chemistry and Biochemistry, Milwaukee Institute of Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, WI, USA.
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16
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Mian MY, Mondal P, Sharmin D, Pandey KP, Rashid F, Rezvanian S, Golani LK, Tiruveedhula VPB, Rajaratnam V, Mirza SP, Chan JD, Witkin JM, Cook JM. An efficient debromination technique using PMHS with a number of ligands containing different functional groups. ARKIVOC 2022. [DOI: 10.24820/ark.5550190.p011.712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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17
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Golani LK, Divović B, Sharmin D, Pandey KP, Mian MY, Cerne R, Zahn NM, Meyer MJ, Tiruveedhula VVNPB, Smith JL, Ping X, Jin X, Lippa A, Schkeryantz JM, Arnold LA, Cook JM, Savić MM, Witkin JM. Metabolism, pharmacokinetics, and anticonvulsant activity of a deuterated analog of the α2/3-selective GABAkine KRM-II-81. Biopharm Drug Dispos 2022; 43:66-75. [PMID: 35194800 DOI: 10.1002/bdd.2313] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 02/14/2022] [Accepted: 02/16/2022] [Indexed: 11/06/2022]
Abstract
The imidazodiazepine, (5-(8-ethynyl-6-(pyridin-2-yl)-4H-benzo [f]imidazole[1,5-α][1,4]diazepin-3-yl) oxazole or KRM-II-81) is a new α2/3-selective GABAkine (gamma aminobutyric acid A receptor potentiator) with anticonvulsant, anxiolytic, and antinociceptive activity in preclinical models. Reducing metabolism was utilized as a means of potentially extending the half-life of KRM-II-81. In vitro and in vivo studies were conducted to evaluate metabolic liabilities. Incubation of KRM-II-81 in hepatocytes revealed sites of potential metabolism on the oxazole and the diazepine rings. These sites were targeted in the design of a deuterated analog (D5-KRM-II-81) that could be evaluated as a potentially longer-acting analog. In contrast to computer predictions, peak plasma concentrations of D5-KRM-II-81 in rats were not significantly greater than those produced by KRM-II-81 after oral administration. Furthermore, brain disposition of KRM-II-81 was higher than that of D5-KRM-II-81. The half-life of the two compounds in either plasma or brain did not statistically differ from one another but the tmax for D5-KRM-II-81 occurred slightly earlier than for KRM-II-81. Non-metabolic considerations might be relevant to the lack of increases in exposure by D5-KRM-II-81. Alternative sites of metabolism on KRM-II-81, not targeted by the current deuteration process, are also possible. Despite its lack of augmented exposure, D5-KRM-II-81, like KRM-II-81, significantly prevented seizures induced by pentylenetetrazol when given orally. The present findings introduce a new orally active anticonvulsant GABAkine, D5-KRM-II-81.
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Affiliation(s)
- Lalit K Golani
- Department of Chemistry & Biochemistry, Milwaukee Institute of Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Branka Divović
- Department of Pharmacology, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia
| | - Dishary Sharmin
- Department of Chemistry & Biochemistry, Milwaukee Institute of Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Kamal P Pandey
- Department of Chemistry & Biochemistry, Milwaukee Institute of Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Md Yeunus Mian
- Department of Chemistry & Biochemistry, Milwaukee Institute of Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Rok Cerne
- Laboratory of Antiepileptic Drug Discovery, Ascencion St. Vincent, Indianapolis, Indiana, USA.,Department of Anatomy and Cell Biology, Indiana University/Purdue University, Indianapolis, Indiana, USA.,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.,RespireRx Pharmaceuticals Inc, Glen Rock, New Jersey, USA
| | - Nicolas M Zahn
- Department of Chemistry & Biochemistry, Milwaukee Institute of Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Michelle J Meyer
- Department of Chemistry & Biochemistry, Milwaukee Institute of Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Veera V N P B Tiruveedhula
- Department of Chemistry & Biochemistry, Milwaukee Institute of Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Jodi L Smith
- Laboratory of Antiepileptic Drug Discovery, Ascencion St. Vincent, Indianapolis, Indiana, USA
| | - Xingjie Ping
- Department of Anatomy and Cell Biology, Indiana University/Purdue University, Indianapolis, Indiana, USA
| | - Xiaoming Jin
- Department of Anatomy and Cell Biology, Indiana University/Purdue University, Indianapolis, Indiana, USA
| | - Arnold Lippa
- RespireRx Pharmaceuticals Inc, Glen Rock, New Jersey, USA
| | | | - Leggy A Arnold
- Department of Chemistry & Biochemistry, Milwaukee Institute of Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - James M Cook
- Department of Chemistry & Biochemistry, Milwaukee Institute of Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA.,RespireRx Pharmaceuticals Inc, Glen Rock, New Jersey, USA
| | - Miroslav M Savić
- Department of Pharmacology, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia
| | - Jeffrey M Witkin
- Department of Chemistry & Biochemistry, Milwaukee Institute of Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA.,Laboratory of Antiepileptic Drug Discovery, Ascencion St. Vincent, Indianapolis, Indiana, USA.,RespireRx Pharmaceuticals Inc, Glen Rock, New Jersey, USA
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18
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Witkin JM. The romantic age of pharmacological science. Pharmacol Biochem Behav 2022; 214:173354. [DOI: 10.1016/j.pbb.2022.173354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 02/08/2022] [Accepted: 02/09/2022] [Indexed: 11/25/2022]
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19
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Shafique H, Witkin JM, Smith JL, Kaniecki K, Sporn J, Holuj M, Krawczyk M, Kuziak A, Popik P. Rapid tolerance to behavioral effects of ethanol in rats: Prevention by R-(-)-ketamine. Pharmacol Biochem Behav 2021; 203:173152. [PMID: 33577868 DOI: 10.1016/j.pbb.2021.173152] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 12/22/2020] [Accepted: 02/03/2021] [Indexed: 10/22/2022]
Abstract
R-(-)-ketamine has emerged as a potentially improved medication over that of the (S)-isomer (marketed as Spravato for depression). Recent data have suggested (R)-ketamine could have value in the treatment of substance use disorder. The present set of experiments was undertaken to examine whether (R)-ketamine might prevent tolerance development. Rapid ethanol (ETOH) tolerance was studied since racemic ketamine had previously been shown to block this tolerance development in rats. In the present study, male Sprague-Dawley rats were given two large doses of ETOH on Day 1 (2.3 + 1.7 g/kg) and 2.3 g/kg ETOH on Day 2. Animals were tested for effects of 2.3 g/kg ETOH on grip strength, inclined screen performance and rotarod performance on Day 1 with or without (R)-ketamine as a pretreatment. (R)-ketamine alone was tested at the highest dose studied (10 mg/kg) and did not significantly influence any dependent measure. (R)-ketamine (1-10 mg/kg) did not alter the acute effects of ETOH except for enhancing the effects of ETOH on the inclined screen test at 3 mg/kg. Between-subjects analysis documented that tolerance developed to the effects of ETOH only on the measure of grip strength. (R)-ketamine (3 mg/kg) given prior to ETOH on Day 1 exhibited a strong trend toward preventing tolerance development (p = 0.062). The present results extend prior findings on the potential value of (R)-ketamine in substance abuse disorder therapeutics and add to the literature on NMDA receptor blockade as a tolerance-regulating mechanism.
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Affiliation(s)
| | - Jeffrey M Witkin
- Witkin Consulting Group, Carmel, IN, USA; Perception Neuroscience Holdings, New York, NY, USA; Departments of Neuroscience and Trauma Research, Ascension St. Vincent Hospital, Indianapolis, IN, USA; Laboratory of Antiepileptic Drug Discovery, Peyton Manning Hospital for Children, Ascension St. Vincent, Indianapolis, IN, USA.
| | - Jodi L Smith
- Laboratory of Antiepileptic Drug Discovery, Peyton Manning Hospital for Children, Ascension St. Vincent, Indianapolis, IN, USA
| | | | | | - Malgorzata Holuj
- Behavioral Neuroscience and Drug Development, Maj Institute of Pharmacology, Polish Academy of Sciences, Kraków, Poland
| | - Martyna Krawczyk
- Behavioral Neuroscience and Drug Development, Maj Institute of Pharmacology, Polish Academy of Sciences, Kraków, Poland
| | - Agata Kuziak
- Behavioral Neuroscience and Drug Development, Maj Institute of Pharmacology, Polish Academy of Sciences, Kraków, Poland
| | - Piotr Popik
- Behavioral Neuroscience and Drug Development, Maj Institute of Pharmacology, Polish Academy of Sciences, Kraków, Poland
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20
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Witkin JM, Cerne R, Newman AH, Izenwasser S, Smith JL, Tortella FC. N-Substituted-3-alkoxy-derivatives of dextromethorphan are functional NMDA receptor antagonists in vivo: Evidence from an NMDA-induced seizure model in rats. Pharmacol Biochem Behav 2021; 203:173154. [PMID: 33609599 PMCID: PMC9659398 DOI: 10.1016/j.pbb.2021.173154] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 02/11/2021] [Accepted: 02/12/2021] [Indexed: 11/30/2022]
Abstract
Interest in developing NMDA receptor antagonists with reduced side-effects for neurological and psychiatric disorders has been re-energized by the recent introduction of esketamine into clinical practice for treatment-resistant depression. Structural analogs of dextromethorphan bind with low affinity to the NMDA receptor ion channel, have functional effects in vivo, and generally display a lower propensity for side-effects than that of ketamine and other higher affinity antagonists. As such, the aim of the present study was to determine whether a series of N-substituted-3-alkoxy-substituted dextromethorphan analogs produce their anticonvulsant effects through NMDA receptor blockade. Compounds were studied against NMDA-induced seizures in rats. Compounds were administered intracerebroventricularly in order to mitigate confounds of drug metabolism that arise from systemic administration. Comparison of the anticonvulsant potencies to their affinities for NMDA, σ1, and σ2 binding sites were made in order to evaluate the contribution of these receptors to anticonvulsant efficacy. The potencies to block convulsions were positively associated with their affinities to bind to the NMDA receptor ion channel ([3H]-TCP binding) (r = 0.71, p < 0.05) but not to σ1 receptors ([3H]-SKF 10047 binding) (r = -0.31, p = 0.46) or to σ2 receptors ([3H]-DTG binding) (p = -0.38, p = 0.36). This is the first report demonstrating that these dextromethorphan analogs are functional NMDA receptor antagonists in vivo. Given their potential therapeutic utility and favorable side-effect profiles, such low affinity NMDA receptor antagonists could be considered for further development in neurological (e.g., anticonvulsant) and psychiatric (e.g., antidepressant) disorders.
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Affiliation(s)
- Jeffrey M Witkin
- Laboratory of Antiepileptic Drug Discovery, Ascension St. Vincent, Indianapolis, IN, USA; Department of Chemistry & Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, WI, USA.
| | - Rok Cerne
- Laboratory of Antiepileptic Drug Discovery, Ascension St. Vincent, Indianapolis, IN, USA; Institute of Pathophysiology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia; Department of Anatomy, Cell Biology, and Physiology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Amy H Newman
- Molecular Targets and Medications Discovery Branch, National Institute on Drug Abuse-Intramural Research Program, National Institutes of Health, Baltimore, MD, USA
| | - Sari Izenwasser
- Department of Psychiatry & Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jodi L Smith
- Laboratory of Antiepileptic Drug Discovery, Ascension St. Vincent, Indianapolis, IN, USA
| | - Frank C Tortella
- Department of Neuropharmacology and Molecular Biology, Walter Reed Army Institute of Research, Silver Spring, MD, USA
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21
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Knutson DE, Smith JL, Ping X, Jin X, Golani LK, Li G, Tiruveedhula VVNPB, Rashid F, Mian MY, Jahan R, Sharmin D, Cerne R, Cook JM, Witkin JM. Imidazodiazepine Anticonvulsant, KRM-II-81, Produces Novel, Non-diazepam-like Antiseizure Effects. ACS Chem Neurosci 2020; 11:2624-2637. [PMID: 32786313 DOI: 10.1021/acschemneuro.0c00295] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The need for improved medications for the treatment of epilepsy and chronic pain is essential. Epileptic patients typically take multiple antiseizure drugs without complete seizure freedom, and chronic pain is not fully managed with current medications. A positive allosteric modulator (PAM) of α2/3-containing GABAA receptors (5-(8-ethynyl-6-(pyridin-2-yl)-4H-benzo[f]imidazole[1,5-α][1,4]diazepin-3-yl) oxazole or KRM-II-81 (8) is a lead compound in a series of imidazodiazepines. We previously reported that KRM-II-81 produces broad-based anticonvulsant and antinociceptive efficacy in rodent models and provides a wider margin over motoric side effects than that of other GABAA receptor PAMs. The present series of experiments was designed to fill key missing gaps in prior preclinical studies assessing whether KRM-II-81 could be further differentiated from nonselective GABAA receptor PAMs using the anticonvulsant diazepam (DZP) as a comparator. In multiple chemical seizure provocation models in mice, KRM-II-81 was either equally or more efficacious than DZP. Most strikingly, KRM-II-81 but not DZP blocked the development of seizure sensitivity to the chemoconvulsants cocaine and pentylenetetrazol in seizure kindling models. These and predecessor data have placed KRM-II-81 into consideration for clinical development requiring the manufacture of kilogram amounts of good manufacturing practice material. We describe here a novel synthetic route amenable to kilogram quantity production. The new biological and chemical data provide key steps forward in the development of KRM-II-81 (8) as an improved treatment option for patients suffering from epilepsy.
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Affiliation(s)
- Daniel E. Knutson
- Department of Chemistry & Biochemistry, Milwaukee Institute for Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin 53211, United States
| | - Jodi L. Smith
- Laboratory of Antiepileptic Drug Discovery, Peyton Manning Hospital for Children Ascension St. Vincent, Indianapolis, Indiana 46260, United States
| | - Xingjie Ping
- Department of Anatomy and Cell Biology, Indiana University/Purdue University, Indianapolis, Indiana 46202,United States
| | - Xiaoming Jin
- Department of Anatomy and Cell Biology, Indiana University/Purdue University, Indianapolis, Indiana 46202,United States
| | - Lalit K. Golani
- Department of Chemistry & Biochemistry, Milwaukee Institute for Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin 53211, United States
| | - Guanguan Li
- Department of Chemistry & Biochemistry, Milwaukee Institute for Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin 53211, United States
| | - V. V. N. Phani Babu Tiruveedhula
- Department of Chemistry & Biochemistry, Milwaukee Institute for Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin 53211, United States
| | - Farjana Rashid
- Department of Chemistry & Biochemistry, Milwaukee Institute for Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin 53211, United States
| | - Md Yeunus Mian
- Department of Chemistry & Biochemistry, Milwaukee Institute for Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin 53211, United States
| | - Rajwana Jahan
- Department of Chemistry & Biochemistry, Milwaukee Institute for Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin 53211, United States
| | - Dishary Sharmin
- Department of Chemistry & Biochemistry, Milwaukee Institute for Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin 53211, United States
| | - Rok Cerne
- Laboratory of Antiepileptic Drug Discovery, Peyton Manning Hospital for Children Ascension St. Vincent, Indianapolis, Indiana 46260, United States
- Institute of Pathophysiology, Faculty of Medicine, University of Ljubljana, Zaloška cesta 4, 1000 Ljubljana, Slovenia
| | - James M. Cook
- Department of Chemistry & Biochemistry, Milwaukee Institute for Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin 53211, United States
| | - Jeffrey M. Witkin
- Department of Chemistry & Biochemistry, Milwaukee Institute for Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin 53211, United States
- Laboratory of Antiepileptic Drug Discovery, Peyton Manning Hospital for Children Ascension St. Vincent, Indianapolis, Indiana 46260, United States
- Departments of Neuroscience and Trauma Research, Ascension St. Vincent Hospital, Indianapolis, Indiana 46260, United States
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22
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Popik P, Khoo SYS, Kuziak A, Golebiowska J, Potasiewicz A, Hogendorf A, Popik O, Matloka M, Moszczynski R, Nikiforuk A, Witkin JM. Distinct cognitive and discriminative stimulus effects of ketamine enantiomers in rats. Pharmacol Biochem Behav 2020; 197:173011. [PMID: 32758523 DOI: 10.1016/j.pbb.2020.173011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 07/01/2020] [Accepted: 07/31/2020] [Indexed: 01/21/2023]
Abstract
Although (S)-ketamine was approved for use in treatment-resistant depression in 2019, new preclinical findings suggest that (R)-ketamine might produce better efficacy and tolerability relative to (S)-ketamine. Here we evaluated the effects of (R)-, (S)-, and (R,S)-ketamine on executive functions as measured in the attentional set shifting task (ASST) and on their discriminative stimulus effects in rats. Earlier data demonstrated that cognitive flexibility is compromised by (R,S)-ketamine, but the effects of enantiomers in rats are unknown. Separate cohorts of rats were tested in ASST and trained to discriminate either (R,S)-ketamine, (S)-ketamine, or (R)-ketamine (all at 10 mg/kg) from saline; in order to maintain the discrimination, a higher (R)-ketamine dose (17.5 mg/kg) was subsequently instituted. In ASST, all three forms increased the trials to criterion measure at reversal learning and extra-dimensional set-shifting phases. However, in contrast to (R)- and (S)-ketamine, (R,S)-ketamine prolonged the mean time to complete a single trial during early stages, suggesting increased reaction time, and/or unspecific side-effects related to motor or motivational impairments. In the drug discriminations, all rats acquired their respective discriminations between drug and saline. In (R,S)-ketamine-trained rats, (R)-ketamine and (S)-ketamine only partially substituted for the training dose of (R,S)-ketamine. Further, (R)-ketamine did not fully substitute in rats trained to (S)-ketamine. The data suggest more serious cognitive deficits produced by (R,S)-ketamine than its enantiomers. Furthermore, (R,S)-ketamine and its isomers share overlapping but not isomorphic discriminative stimulus effects predicting distinct subjective responses to (R)- vs. (S)-ketamine in humans.
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Affiliation(s)
- Piotr Popik
- Behavioral Neuroscience and Drug Development, Maj Institute of Pharmacology, Polish Academy of Sciences, Smętna 12, 31-343 Kraków, Poland.
| | - Shaun Yon-Seng Khoo
- Department of Pharmacology and Physiology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Agata Kuziak
- Behavioral Neuroscience and Drug Development, Maj Institute of Pharmacology, Polish Academy of Sciences, Smętna 12, 31-343 Kraków, Poland
| | - Joanna Golebiowska
- Behavioral Neuroscience and Drug Development, Maj Institute of Pharmacology, Polish Academy of Sciences, Smętna 12, 31-343 Kraków, Poland
| | - Agnieszka Potasiewicz
- Behavioral Neuroscience and Drug Development, Maj Institute of Pharmacology, Polish Academy of Sciences, Smętna 12, 31-343 Kraków, Poland
| | - Adam Hogendorf
- Department of Medicinal Chemistry, Maj Institute of Pharmacology, Polish Academy of Sciences, Smętna 12, 31-343 Kraków, Poland
| | - Oskar Popik
- Institute of Organic Chemistry, Polish Academy of Sciences, Kasprzaka 44/52, 01-224 Warszawa, Poland
| | | | | | - Agnieszka Nikiforuk
- Behavioral Neuroscience and Drug Development, Maj Institute of Pharmacology, Polish Academy of Sciences, Smętna 12, 31-343 Kraków, Poland
| | - Jeffrey M Witkin
- Department of Neuroscience, Ascension St. Vincent Hospital, Indianapolis, IN, USA; Department of Chemistry and Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, WI, USA; Department of Trauma Research, Ascension St. Vincent Hospital, Indianapolis, IN, USA
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Biggerstaff A, Kivell B, Smith JL, Mian MY, Golani LK, Rashid F, Sharmin D, Knutson DE, Cerne R, Cook JM, Witkin JM. The α2,3-selective potentiators of GABA A receptors, KRM-II-81 and MP-III-80, produce anxiolytic-like effects and block chemotherapy-induced hyperalgesia in mice without tolerance development. Pharmacol Biochem Behav 2020; 196:172996. [PMID: 32668266 DOI: 10.1016/j.pbb.2020.172996] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 07/03/2020] [Accepted: 07/07/2020] [Indexed: 12/13/2022]
Abstract
Opiate analgesics are one of the treatment options for severe chronic pain, including late-stage cancer, chronic back pain and other disorders. The recent resurgence in opioid overdose has highlighted the serious need for alternative medicines for pain management. While a role for potentiators of α2/3-containing GABAA receptors in the modulation of pain has been known for several years, advancements in this area required data from selective compounds. KRM-II-81(5-(8-ethynyl-6-(pyridin-2-yl)-4H-benzo[f]imidazo[1,5-a][1,4]diazepin-3- yl)oxazole) and analogs selectively potentiate GABAA receptors containing α2/3 subunits and have recently been shown to attenuate pain behaviors in several acute and chronic pain models in rodents. The present study was designed to ascertain whether KRM-II-81 and the structural analog MP-III-80 (3-ethyl-5-(8-ethynyl-6-(pyridin-2-yl)-4H-benzo[f]imidazo[1,5-a][1,4]diazepin-3-yl)-1,2,4-oxadiazole) would block chemotherapeutic agent paclitaxel-induced pain in male, C57BL/6 mice. Both compounds significantly inhibited pain behaviors evoked by cold and tactile stimulation in paclitaxel-treated mice as did the neuropathic pain drug gabapentin. Subchronic dosing for 22 days with KRM-II-81 and MP-III-80 demonstrated enduring analgesic efficacy without tolerance development, while the effects of gabapentin showed evidence of tolerance development. KRM-II-81 and MP-III-80 also decreased marble-burying behavior in this mouse strain as did the anxiolytic drug chlordiazepoxide. In contrast to KRM-II-81 and MP-III-80, chlordiazepoxide had motor-impairing effects at anxiolytic-like doses. The data add to the literature documenting that these selective potentiators of α2/3-containing GABAA receptors are effective in a host of animal models used to detect novel analgesic drugs. The anxiolytic-like efficacy of these compounds fits well with the comorbidity of anxiety in patients with chronic pain and cancer.
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Affiliation(s)
- A Biggerstaff
- School of Biological Sciences, Centre for Biodiscovery, Victoria University of Wellington, Wellington, New Zealand
| | - B Kivell
- School of Biological Sciences, Centre for Biodiscovery, Victoria University of Wellington, Wellington, New Zealand
| | - J L Smith
- Laboratory of Antiepileptic Drug Discovery, Peyton Manning Hospital for Children, Ascension St. Vincent, Indianapolis, IN, USA
| | - Md Y Mian
- Department of Chemistry & Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - L K Golani
- Department of Chemistry & Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - F Rashid
- Department of Chemistry & Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - D Sharmin
- Department of Chemistry & Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - D E Knutson
- Department of Chemistry & Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - R Cerne
- Laboratory of Antiepileptic Drug Discovery, Peyton Manning Hospital for Children, Ascension St. Vincent, Indianapolis, IN, USA; Institute of Pathophysiology, Faculty of Medicine, University of Ljubljana, Zaloška cesta 4, Ljubljana, Slovenia
| | - J M Cook
- Department of Chemistry & Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - J M Witkin
- Laboratory of Antiepileptic Drug Discovery, Peyton Manning Hospital for Children, Ascension St. Vincent, Indianapolis, IN, USA; Department of Chemistry & Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, WI, USA; Departments of Neuroscience and Trauma Research, Ascension St. Vincent Hospital, Indianapolis, IN, USA.
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Witkin JM, Smith JL, Golani LK, Brooks EA, Martin AE. Involvement of muscarinic receptor mechanisms in antidepressant drug action. Adv Pharmacol 2020; 89:311-356. [PMID: 32616212 DOI: 10.1016/bs.apha.2020.03.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Conventional antidepressants typically require weeks of daily dosing to achieve full antidepressant response in antidepressant responders. A newly evolving group of compounds can engender more rapid response times in depressed patients. These drugs include the newly approved antidepressant (S)-ketamine (esketamine, Spravato). A seminal study by Furey and Drevets in 2006 showed antidepressant response in patients after only a few doses with the antimuscarinic drug scopolamine. Several clinical reports have generally confirmed scopolamine as a rapid-acting antidepressant. The data with scopolamine are consistent with the adrenergic/cholinergic hypothesis of mania/depression derived from clinical reports originating in the 1970s from Janowsky and colleagues. Additional support for a role for muscarinic receptors in mood disorders comes from the greater efficacy of conventional antidepressants that have relatively high levels of muscarinic receptor blocking actions (e.g., the tricyclic antidepressant amitriptyline vs the selective serotonin reuptake inhibitor fluoxetine). There appears to be appreciable overlap in the mechanisms of action of scopolamine and other rapid-acting antidepressants (ketamine) or putative rapid-acting agents (mGlu2/3 receptor antagonists) although gaps exist in the experimental literature. Current hypotheses regarding the mechanisms underlying the rapid antidepressant response to scopolamine posit an M1 receptor subtype-initiated cascade of biological events that involve the amplification of AMPA receptors. Consequent impact on brain-derived neurotrophic factor and mTor signaling pathways result in the induction of dendritic spines that enable augmented functional connectivity in brain areas regulating mood. Two major goals for research in this area focus on finding ways in which scopolamine might best be utilized for depressed patients and the discovery of alternative compounds that improve upon the efficacy and safety of scopolamine.
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Affiliation(s)
- Jeffrey M Witkin
- Witkin Consulting Group, Carmel, IN, United States; Departments of Neuroscience and Trauma Research, Ascension St. Vincent Hospital, Indianapolis, IN, United States; Department of Chemistry & Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, WI, United States.
| | - Jodi L Smith
- Peyton Manning Children's Hospital, Ascension St. Vincent, Indianapolis, IN, United States
| | - Lalit K Golani
- Department of Chemistry & Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, WI, United States
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Witkin JM, Kranzler J, Kaniecki K, Popik P, Smith JL, Hashimoto K, Sporn J. R-(-)-ketamine modifies behavioral effects of morphine predicting efficacy as a novel therapy for opioid use disorder 1. Pharmacol Biochem Behav 2020; 194:172927. [PMID: 32333922 DOI: 10.1016/j.pbb.2020.172927] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 02/27/2020] [Accepted: 04/03/2020] [Indexed: 12/21/2022]
Abstract
Substance abuse disorder continues to have devastating consequences for individuals and society and current therapies are not sufficient to provide the magnitude of medical impact required. Although some evidence suggests the use of ketamine in treating various substance use related- symptoms, its adverse event profile including dissociation, dysphoria, and abuse liability limit its potential as a therapy. Here, we outline experiments to test our hypothesis that (R)-ketamine can both alleviate withdrawal symptoms and produce effects that help sustain abstinence. In morphine-dependent rats, (R)-ketamine alleviated naloxone-precipitated withdrawal signs. (R)-ketamine also blocked morphine-induced place preference in mice without inducing place preference on its own. We also evaluated whether (R)-ketamine would induce anhedonia, a counter-indicated effect for a drug abuse treatment agent. S-(+)- but not R-(-)-ketamine produced anhedonia-like responses in rats that electrically self-stimulated the medial forebrain bundle (ICSS). However, time-course studies of ICSS are needed to fully appreciate these differences. These data begin to support the claim that (R)-ketamine will dampen withdrawal symptoms and drug liking, factors known to contribute to the cycle of drug addiction. In addition, these data suggest that (R)-ketamine would not produce negative mood or anhedonia that could interfere with treatment. It is suggested that continued investigation of (R)-ketamine as a novel therapeutic for substance abuse disorder be given consideration by the preclinical and clinical research communities. This suggestion is further encouraged by a recent report on the efficacy of (R)-ketamine in treatment-resistant depressed patients at a dose with little measurable dissociative side-effects.
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Affiliation(s)
- J M Witkin
- Perception Neuroscience Holdings, New York, NY, USA; Departments of Neuroscience and Trauma Research, Ascension St. Vincent Hospital, Indianapolis, IN, USA; Laboratory of Antiepileptic Drug Discovery, Peyton Manning Hospital for Children, Ascension St. Vincent Indianapolis, IN, USA.
| | - J Kranzler
- Perception Neuroscience Holdings, New York, NY, USA
| | - K Kaniecki
- Perception Neuroscience Holdings, New York, NY, USA
| | - P Popik
- Behavioral Neuroscience and Drug Development, Maj Institute of Pharmacology, Polish Academy of Sciences Kraków, Poland
| | - J L Smith
- Laboratory of Antiepileptic Drug Discovery, Peyton Manning Hospital for Children, Ascension St. Vincent Indianapolis, IN, USA
| | | | - J Sporn
- Perception Neuroscience Holdings, New York, NY, USA
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Pandey KP, Khan ZA, Golani LK, Mondal P, Mian Y, Rashid F, Tiruveedhula VVNPB, Knutson DE, Sharmin D, Ahmed T, Rezvanian S, Zahn NM, Arnold LA, Witkin JM, Cook JM. Design, synthesis and characterization of novel gamma‑aminobutyric acid type A receptor ligands. ARKIVOC 2020; 2020:242-256. [PMID: 33642954 DOI: 10.24820/ark.5550190.p011.398] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Antinociceptive ligand HZ-166 is a GABAA α2/α3 receptor subtype-selective potentiator. It has been shown to exhibit anxiolytic-like effects in rodent and rhesus monkeys, as well as reduced sedative/ataxic liabilities. In order to improve the metabolic stability of HZ-166, the ethyl ester moiety was bioisosterically replaced with 2,4-disubstituted oxazoles and oxazolines. The new analogs of HZ-166 were synthesized, characterized, and evalutated for their biological activity and docked in the human full-length heteromeric α1β3γ2L GABAA receptor subtype CyroEM structure (6HUO). Importantly no sedation nor ataxia was observed on the rotorod for LKG-I-70 (6) or KPP-III-51 (6c) at 100 and 120 mg/kg, respectively. These was also no loss of righting response for either ligand.
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Affiliation(s)
- Kamal P Pandey
- Department of Chemistry and Biochemistry, Milwaukee Institute for Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin 53211, USA
| | - Zubair Ahmed Khan
- Department of Chemistry and Biochemistry, Milwaukee Institute for Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin 53211, USA
| | - Lalit K Golani
- Department of Chemistry and Biochemistry, Milwaukee Institute for Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin 53211, USA
| | - Prithu Mondal
- Department of Chemistry and Biochemistry, Milwaukee Institute for Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin 53211, USA
| | - Yeunus Mian
- Department of Chemistry and Biochemistry, Milwaukee Institute for Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin 53211, USA
| | - Farjana Rashid
- Department of Chemistry and Biochemistry, Milwaukee Institute for Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin 53211, USA
| | - V V N Phani Babu Tiruveedhula
- Department of Chemistry and Biochemistry, Milwaukee Institute for Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin 53211, USA
| | - Daniel E Knutson
- Department of Chemistry and Biochemistry, Milwaukee Institute for Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin 53211, USA
| | - Dishary Sharmin
- Department of Chemistry and Biochemistry, Milwaukee Institute for Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin 53211, USA
| | - Taukir Ahmed
- Department of Chemistry and Biochemistry, Milwaukee Institute for Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin 53211, USA
| | - Sepideh Rezvanian
- Department of Chemistry and Biochemistry, Milwaukee Institute for Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin 53211, USA
| | - Nicolas M Zahn
- Department of Chemistry and Biochemistry, Milwaukee Institute for Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin 53211, USA
| | - Leggy A Arnold
- Department of Chemistry and Biochemistry, Milwaukee Institute for Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin 53211, USA
| | - Jeffrey M Witkin
- Department of Chemistry and Biochemistry, Milwaukee Institute for Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin 53211, USA
| | - James M Cook
- Department of Chemistry and Biochemistry, Milwaukee Institute for Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin 53211, USA
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Witkin JM, Li G, Golani LK, Xiong W, Smith JL, Ping X, Rashid F, Jahan R, Cerne R, Cook JM, Jin X. The Positive Allosteric Modulator of α2/3-Containing GABA A Receptors, KRM-II-81, Is Active in Pharmaco-Resistant Models of Epilepsy and Reduces Hyperexcitability after Traumatic Brain Injury. J Pharmacol Exp Ther 2020; 372:83-94. [PMID: 31694876 PMCID: PMC6927408 DOI: 10.1124/jpet.119.260968] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Accepted: 10/17/2019] [Indexed: 12/14/2022] Open
Abstract
The imidizodiazepine, 5-(8-ethynyl-6-(pyridin-2-yl)-4H-benzo[f]imidazo[1,5-a][1,4]diazepin-3-yl)oxazole (KRM-II-81), is selective for α2/3-containing GABAA receptors. KRM-II-81 dampens seizure activity in rodent models with enhanced efficacy and reduced motor-impairment compared with diazepam. In the present study, KRM-II-81 was studied in assays designed to detect antiepileptics with improved chances of impacting pharmaco-resistant epilepsies. The potential for reducing neural hyperactivity weeks after traumatic brain injury was also studied. KRM-II-81 suppressed convulsions in corneal-kindled mice. Mice with kainate-induced mesial temporal lobe seizures exhibited spontaneous recurrent hippocampal paroxysmal discharges that were significantly reduced by KRM-II-81 (15 mg/kg, orally). KRM-II-81 also decreased convulsions in rats undergoing amygdala kindling in the presence of lamotrigine (lamotrigine-insensitive model) (ED50 = 19 mg/kg, i.p.). KRM-II-81 reduced focal and generalized seizures in a kainate-induced chronic epilepsy model in rats (20 mg/kg, i.p., three times per day). In mice with damage to the left cerebral cortex by controlled-cortical impact, enduring neuronal hyperactivity was dampened by KRM-II-81 (10 mg/kg, i.p.) as observed through in vivo two-photon imaging of layer II/III pyramidal neurons in GCaMP6-expressing transgenic mice. No notable side effects emerged up to doses of 300 mg/kg KRM-II-81. Molecular modeling studies were conducted: docking in the binding site of the α1β3γ2L GABAA receptor showed that replacing the C8 chlorine atom of alprazolam with the acetylene of KRM-II-81 led to loss of the key interaction with α1His102, providing a structural rationale for its low affinity for α1-containing GABAA receptors compared with benzodiazepines such as alprazolam. Overall, these findings predict that KRM-II-81 has improved therapeutic potential for epilepsy and post-traumatic epilepsy. SIGNIFICANCE STATEMENT: We describe the effects of a relatively new orally bioavailable small molecule in rodent models of pharmaco-resistant epilepsy and traumatic brain injury. KRM-II-81 is more potent and generally more efficacious than standard-of-care antiepileptics. In silico docking experiments begin to describe the structural basis for the relative lack of motor impairment induced by KRM-II-81. KRM-II-81 has unique structural and anticonvulsant effects, predicting its potential as an improved antiepileptic drug and novel therapy for post-traumatic epilepsy.
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Affiliation(s)
- Jeffrey M Witkin
- Department of Neurologic Surgery, Indiana University School of Medicine, Indianapolis, Indiana (W.X., X.P., R.C., X.J.); Department of Chemistry and Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin (J.M.W., G.L., L.K.G., F.R., R.J., J.M.C.); Department of Anatomy, Cell Biology, and Physiology, Indiana University School of Medicine, Indianapolis, Indiana (W.X., X.P., X.J.); and Laboratory of Antiepileptic Drug Discovery, St. Vincent's Hospital, Indianapolis, Indiana (J.L.S.)
| | - Guanguan Li
- Department of Neurologic Surgery, Indiana University School of Medicine, Indianapolis, Indiana (W.X., X.P., R.C., X.J.); Department of Chemistry and Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin (J.M.W., G.L., L.K.G., F.R., R.J., J.M.C.); Department of Anatomy, Cell Biology, and Physiology, Indiana University School of Medicine, Indianapolis, Indiana (W.X., X.P., X.J.); and Laboratory of Antiepileptic Drug Discovery, St. Vincent's Hospital, Indianapolis, Indiana (J.L.S.)
| | - Lalit K Golani
- Department of Neurologic Surgery, Indiana University School of Medicine, Indianapolis, Indiana (W.X., X.P., R.C., X.J.); Department of Chemistry and Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin (J.M.W., G.L., L.K.G., F.R., R.J., J.M.C.); Department of Anatomy, Cell Biology, and Physiology, Indiana University School of Medicine, Indianapolis, Indiana (W.X., X.P., X.J.); and Laboratory of Antiepileptic Drug Discovery, St. Vincent's Hospital, Indianapolis, Indiana (J.L.S.)
| | - Wenhui Xiong
- Department of Neurologic Surgery, Indiana University School of Medicine, Indianapolis, Indiana (W.X., X.P., R.C., X.J.); Department of Chemistry and Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin (J.M.W., G.L., L.K.G., F.R., R.J., J.M.C.); Department of Anatomy, Cell Biology, and Physiology, Indiana University School of Medicine, Indianapolis, Indiana (W.X., X.P., X.J.); and Laboratory of Antiepileptic Drug Discovery, St. Vincent's Hospital, Indianapolis, Indiana (J.L.S.)
| | - Jodi L Smith
- Department of Neurologic Surgery, Indiana University School of Medicine, Indianapolis, Indiana (W.X., X.P., R.C., X.J.); Department of Chemistry and Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin (J.M.W., G.L., L.K.G., F.R., R.J., J.M.C.); Department of Anatomy, Cell Biology, and Physiology, Indiana University School of Medicine, Indianapolis, Indiana (W.X., X.P., X.J.); and Laboratory of Antiepileptic Drug Discovery, St. Vincent's Hospital, Indianapolis, Indiana (J.L.S.)
| | - Xingjie Ping
- Department of Neurologic Surgery, Indiana University School of Medicine, Indianapolis, Indiana (W.X., X.P., R.C., X.J.); Department of Chemistry and Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin (J.M.W., G.L., L.K.G., F.R., R.J., J.M.C.); Department of Anatomy, Cell Biology, and Physiology, Indiana University School of Medicine, Indianapolis, Indiana (W.X., X.P., X.J.); and Laboratory of Antiepileptic Drug Discovery, St. Vincent's Hospital, Indianapolis, Indiana (J.L.S.)
| | - Farjana Rashid
- Department of Neurologic Surgery, Indiana University School of Medicine, Indianapolis, Indiana (W.X., X.P., R.C., X.J.); Department of Chemistry and Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin (J.M.W., G.L., L.K.G., F.R., R.J., J.M.C.); Department of Anatomy, Cell Biology, and Physiology, Indiana University School of Medicine, Indianapolis, Indiana (W.X., X.P., X.J.); and Laboratory of Antiepileptic Drug Discovery, St. Vincent's Hospital, Indianapolis, Indiana (J.L.S.)
| | - Rajwana Jahan
- Department of Neurologic Surgery, Indiana University School of Medicine, Indianapolis, Indiana (W.X., X.P., R.C., X.J.); Department of Chemistry and Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin (J.M.W., G.L., L.K.G., F.R., R.J., J.M.C.); Department of Anatomy, Cell Biology, and Physiology, Indiana University School of Medicine, Indianapolis, Indiana (W.X., X.P., X.J.); and Laboratory of Antiepileptic Drug Discovery, St. Vincent's Hospital, Indianapolis, Indiana (J.L.S.)
| | - Rok Cerne
- Department of Neurologic Surgery, Indiana University School of Medicine, Indianapolis, Indiana (W.X., X.P., R.C., X.J.); Department of Chemistry and Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin (J.M.W., G.L., L.K.G., F.R., R.J., J.M.C.); Department of Anatomy, Cell Biology, and Physiology, Indiana University School of Medicine, Indianapolis, Indiana (W.X., X.P., X.J.); and Laboratory of Antiepileptic Drug Discovery, St. Vincent's Hospital, Indianapolis, Indiana (J.L.S.)
| | - James M Cook
- Department of Neurologic Surgery, Indiana University School of Medicine, Indianapolis, Indiana (W.X., X.P., R.C., X.J.); Department of Chemistry and Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin (J.M.W., G.L., L.K.G., F.R., R.J., J.M.C.); Department of Anatomy, Cell Biology, and Physiology, Indiana University School of Medicine, Indianapolis, Indiana (W.X., X.P., X.J.); and Laboratory of Antiepileptic Drug Discovery, St. Vincent's Hospital, Indianapolis, Indiana (J.L.S.)
| | - Xiaoming Jin
- Department of Neurologic Surgery, Indiana University School of Medicine, Indianapolis, Indiana (W.X., X.P., R.C., X.J.); Department of Chemistry and Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin (J.M.W., G.L., L.K.G., F.R., R.J., J.M.C.); Department of Anatomy, Cell Biology, and Physiology, Indiana University School of Medicine, Indianapolis, Indiana (W.X., X.P., X.J.); and Laboratory of Antiepileptic Drug Discovery, St. Vincent's Hospital, Indianapolis, Indiana (J.L.S.)
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Smith JL, Ping X, Jin X, Golani LK, Li G, Rashid F, Jahan R, Cook JM, Witkin JM. The Positive Allosteric Modulator of Alpha-2/3-Containing γ-Aminobutyric Acid Type A Receptors, KRM-II-81, Is Active in Pharmacoresistant Models of Epilepsy and in Human Epileptic Tissue. Neurosurgery 2019. [DOI: 10.1093/neuros/nyz310_697] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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29
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Witkin JM, Ping X, Cerne R, Mouser C, Jin X, Hobbs J, Tiruveedhula VVNPB, Li G, Jahan R, Rashid F, Kumar Golani L, Cook JM, Smith JL. The value of human epileptic tissue in the characterization and development of novel antiepileptic drugs: The example of CERC-611 and KRM-II-81. Brain Res 2019; 1722:146356. [PMID: 31369732 DOI: 10.1016/j.brainres.2019.146356] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 07/17/2019] [Accepted: 07/29/2019] [Indexed: 12/25/2022]
Abstract
The need for improved antiepileptics is clearly mandated despite the existence of multiple existing medicines from different chemical and mechanistic classes. Standard of care agents do not fully control epilepsies and have a variety of side-effect and safety issues. Patients typically take multiple antiepileptic drugs and yet many continue to have seizures. Antiepileptic-unresponsive seizures are life-disrupting and life-threatening. One approach to seizure control is surgical resection of affected brain tissue and associated neural circuits. Although non-human brain studies can provide insight into novel antiepileptic mechanisms, human epileptic brain is the bottom-line biological substrate. Human epileptic brain can provide definitive information on the presence or absence of the putative protein targets of interest in the patient population, the potential changes in these proteins in the epileptic state, and the engagement of novel molecules and their functional impact in target tissue. In this review, we discuss data on two novel potential antiepileptic drugs. CERC-611 (LY3130481) is an AMPA receptor antagonist that selectively blocks AMPA receptors associated with the auxiliary protein TARP γ-8 and is in clinical development. KRM-II-81 is a positive allosteric modulator of GABAA receptors selectively associated with protein subunits α2 and α 3. Preclinical data on these compounds argue that patient-based biological data increase the probability that a newly discovered molecule will translate its antiepileptic potential to patients.
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Affiliation(s)
- Jeffrey M Witkin
- Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, IN, USA; Department of Chemistry & Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, WI, USA.
| | - Xingjie Ping
- Department of Anatomy and Cell Biology, Indiana University/Purdue University, Indianapolis, IN, USA
| | - Rok Cerne
- Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Claire Mouser
- Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Xiaoming Jin
- Department of Anatomy and Cell Biology, Indiana University/Purdue University, Indianapolis, IN, USA
| | - Jon Hobbs
- Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | | | - Guanguan Li
- Department of Chemistry & Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Rajwana Jahan
- Department of Chemistry & Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Farjana Rashid
- Department of Chemistry & Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Lalit Kumar Golani
- Department of Chemistry & Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - James M Cook
- Department of Chemistry & Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Jodi L Smith
- Laboratory of Antiepileptic Drug Discovery, St. Vincent's Hospital, Indianapolis, IN, USA.
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Eiler WJA, Gleason SD, Smith JL, Witkin JM. A medium throughput rodent model of relapse from addiction with behavioral and pharmacological specificity. Pharmacol Biochem Behav 2019; 183:72-79. [PMID: 31202811 DOI: 10.1016/j.pbb.2019.06.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 05/31/2019] [Accepted: 06/12/2019] [Indexed: 12/21/2022]
Abstract
One of most formidable problems in the treatment of addiction is the high rate of relapse. The discovery of medicines to help mitigate relapse are aided by animal models that currently involve weeks of training and require surgical preparations and drug delivery devices. The present set of experiments was initiated to investigate a rapid 8-day screening method that utilizes food instead of intravenous drug administration. Male Sprague-Dawley rats were trained in a reinstatement paradigm in which every lever press produced a 45 mg food pellet concurrently paired with a light and tone. Behavior was subsequently extinguished with lever responses producing neither food nor food-associated stimuli. Reinstatement of responding was evaluated under conditions in which the first three responses of every 5 min time bin produced a food pellet along with food-associated stimuli. The mGlu5 receptor antagonists MPEP and MTEP produced a significant reduction in reinstatement while failing to alter responding where every response produced food. The cannabinoid CB1 receptor antagonist rimonabant and the mGlu2/3 receptor agonist LY379268 also selectively reduced reinstatement. Other compounds including clozapine, d-amphetamine, chlordiazepoxide, ABT-431, naltrexone and citalopram were without effect. The results suggest that relapse-like behavioral effects can be extended to non-pharmacological reinforcers. Drug effects demonstrated both behavioral and pharmacological specificity. The present experimental design thus allows for efficient and rapid assessment of the effects of drugs that might be useful in the treatment of addiction-associated relapse.
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Affiliation(s)
- William J A Eiler
- Department of Psychology, Franklin College, Franklin, IN, USA; Neuroscience Discovery, Lilly Research Labs, Indianapolis, IN, USA
| | - Scott D Gleason
- Neuroscience Discovery, Lilly Research Labs, Indianapolis, IN, USA
| | - Jodi L Smith
- Laboratory of Antiepileptic Drug Discovery, St. Vincent's Hospital, Indianapolis, IN, USA
| | - Jeffrey M Witkin
- Neuroscience Discovery, Lilly Research Labs, Indianapolis, IN, USA; Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, IN, USA; Department of Chemistry & Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, WI, USA.
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Witkin JM, Cerne R, Davis PG, Freeman KB, do Carmo JM, Rowlett JK, Methuku KR, Okun A, Gleason SD, Li X, Krambis MJ, Poe M, Li G, Schkeryantz JM, Jahan R, Yang L, Guo W, Golani LK, Anderson WH, Catlow JT, Jones TM, Porreca F, Smith JL, Knopp KL, Cook JM. The α2,3-selective potentiator of GABA A receptors, KRM-II-81, reduces nociceptive-associated behaviors induced by formalin and spinal nerve ligation in rats. Pharmacol Biochem Behav 2019; 180:22-31. [PMID: 30825491 PMCID: PMC6529285 DOI: 10.1016/j.pbb.2019.02.013] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 02/24/2019] [Accepted: 02/25/2019] [Indexed: 02/03/2023]
Abstract
Clinical evidence indicates that positive allosteric modulators (PAMs) of GABAA receptors have analgesic benefit in addition to efficacy in anxiety disorders. However, the utility of GABAA receptor PAMs as analgesics is compromised by the central nervous system side effects of non-selective potentiators. A selective potentiator of GABAA receptors associated with α2/3 subunits, KRM-II-81(5-(8-ethynyl-6-(pyridin-2-yl)-4H-benzo[f]imidazo[1,5-a][1,4]diazepin-3-yl)oxazole), has demonstrated anxiolytic, anticonvulsant, and antinociceptive effects in rodents with reduced motoric side effects. The present study evaluated the potential of KRM-II-81 as a novel analgesic. Oral administration of KRM-II-81 attenuated formalin-induced flinching; in contrast, diazepam was not active. KRM-II-81 attenuated nociceptive-associated behaviors engendered by chronic spinal nerve ligation (L5/L6). Diazepam decreased locomotion of rats at the dose tested in the formalin assay (10 mg/kg) whereas KRM-II-81 produced small decreases that were not dose-dependent (10-100 mg/kg). Plasma and brain levels of KRM-II-81 were used to demonstrate selectivity for α2/3- over α1-associated GABAA receptors and to define the degree of engagement of these receptors. Plasma and brain concentrations of KRM-II-81 were positively-associated with analgesic efficacy. GABA currents from isolated rat dorsal-root ganglion cultures were potentiated by KRM-II-81 with an ED50 of 32 nM. Measures of respiratory depression were reduced by alprazolam whereas KRM-II-81 was either inactive or produced effects with lower potency and efficacy. These findings add to the growing body of data supporting the idea that α2/3-selective GABAA receptor PAMs will have efficacy and tolerability as pain medications including those for neuropathic pain. Given their predicted anxiolytic effects, α2/3-selective GABAA receptor PAMs offer an additional inroad into the management of pain.
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Affiliation(s)
- J M Witkin
- The Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, USA; Department of Chemistry & Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, WI, USA; Laboratory of Antiepileptic Drug Discovery, Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.
| | - R Cerne
- The Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, USA
| | | | - K B Freeman
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, USA
| | - J M do Carmo
- Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, MS, USA
| | - J K Rowlett
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, USA
| | - K R Methuku
- Department of Chemistry & Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - A Okun
- The Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, USA
| | - S D Gleason
- The Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, USA
| | - X Li
- The Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, USA
| | - M J Krambis
- The Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, USA
| | - M Poe
- Department of Chemistry & Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - G Li
- Department of Chemistry & Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - J M Schkeryantz
- The Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, USA
| | - R Jahan
- Department of Chemistry & Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - L Yang
- The Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, USA
| | - W Guo
- The Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, USA
| | - L K Golani
- Department of Chemistry & Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - W H Anderson
- The Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, USA
| | - J T Catlow
- The Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, USA
| | - T M Jones
- The Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, USA
| | - F Porreca
- Department of Pharmacology, University of Arizona, Tucson, AZ, USA
| | - J L Smith
- Laboratory of Antiepileptic Drug Discovery, Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - K L Knopp
- The Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, USA
| | - J M Cook
- Department of Chemistry & Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
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Knopp KL, Simmons RMA, Guo W, Adams BL, Gardinier KM, Gernert DL, Ornstein PL, Porter W, Reel J, Ding C, Wang H, Qian Y, Burris KD, Need A, Barth V, Swanson S, Catlow J, Witkin JM, Zwart R, Sher E, Choong KC, Wall TM, Schober D, Felder CC, Kato AS, Bredt DS, Nisenbaum ES. Modulation of TARP γ8–Containing AMPA Receptors as a Novel Therapeutic Approach for Chronic Pain. J Pharmacol Exp Ther 2019; 369:345-363. [DOI: 10.1124/jpet.118.250126] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 03/06/2019] [Indexed: 12/30/2022] Open
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Witkin JM, Wallace TL, Martin WJ. Therapeutic Approaches for NOP Receptor Antagonists in Neurobehavioral Disorders: Clinical Studies in Major Depressive Disorder and Alcohol Use Disorder with BTRX-246040 (LY2940094). Handb Exp Pharmacol 2019; 254:399-415. [PMID: 30701317 DOI: 10.1007/164_2018_186] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Conventional antidepressants increase the efflux of biogenic amine neurotransmitters (the monoamine hypothesis of depression) in the central nervous system (CNS) and are the principle drugs used to treat major depressive disorder (MDD). However, the lack of efficacy in some patients, the slow onset of action, and the side effect profiles of existing antidepressants necessitate the exploration of additional treatment options. The discovery of the nociceptin/orphanin FQ peptide NOP receptor (N/OFQ-NOP receptor) system and its characterization in preclinical biological and pharmacological stress-related conditions supports the potential antidepressant and anti-stress properties of a NOP receptor antagonist for the treatment of neurobehavioral disorders. BTRX-246040 (formerly LY2940094) was designed to test this hypothesis in the clinic. A small clinical proof of concept study demonstrated efficacy of BTRX-246040 in MDD patients. In this study, BTRX-246040 (40 mg, p.o.) significantly reduced negative bias as assessed by the facial recognition test within 1 week of treatment and decreased depression symptoms after 8 weeks. BTRX-246040 also reduced depression symptoms in a second trial with heavy alcohol drinkers. Given the comorbidity of MDD and alcohol use disorder, a compound with such effects in patients could be a valuable addition to the medications available. A proof of concept study showed efficacy of BTRX-246040 in reducing heavy drinking and increasing the probability of abstinence in individuals diagnosed with alcohol dependence. In addition, plasma levels of gamma-glutamyl transferase were decreased by BTRX-246040 compared to placebo control implying improvement in liver function. Collectively, the clinical data reviewed within this chapter suggest that BTRX-264040 functions to normalize dysfunction in reward circuits. The overall efficacy and safety of this compound with a novel mechanism of action are encouraging of further clinical development. BTRX-246040 is currently under development for MDD by BlackThorn Therapeutics.
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Maxwell J, Gleason SD, Falcone J, Svensson K, Balcer OM, Li X, Witkin JM. Effects of 5-HT 7 receptor antagonists on behaviors of mice that detect drugs used in the treatment of anxiety, depression, or schizophrenia. Behav Brain Res 2018; 359:467-473. [PMID: 30471311 DOI: 10.1016/j.bbr.2018.11.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 11/12/2018] [Accepted: 11/13/2018] [Indexed: 10/27/2022]
Abstract
5-HT7 receptors have been suggested to play a role in the regulation of psychiatric disorders. The experimental literature however is not fully consistent on this possibility. Two selective 5-HT7 receptor antagonists, DR-4004 and SB-269970, were evaluated in mouse models used to detect drugs used to treat anxiety, depression, or schizophrenia. A 5-HT-induced hypothermia assay was used to define the doses of DR-4004 and SB-269970 predicted to impact 5-HT7 receptors in the brain in vivo. 5-HT produced hypothermia in wildtype mice by either i.p. or i.c.v. routes but did not in 5-HT7 receptor knockout mice. 5-HT-induced hypothermia was not attenuated by drugs selectively blocking alpha1 or 5-HT1A receptors. Doses of DR-4004 and SB-269970 that blocked 5-HT-induced hypothermia, did not display significant anxiolytic-like (elevated plus maze; vogel conflict) or antidepressant-like efficacy (tail-suspension test) in mouse models. These compounds did demonstrate some antipsychotic-like properties in the PCP-induced hyperactivity assay and anxiolytic/anti-stress effects in the stress-induced cGMP assay. Negative findings were substantiated by positive control drugs that were active in each assay system. We conclude that 5-HT-induced hypothermia can be used to estimate blockade of central 5-HT7 receptors. Effects of DR-4004 and SB-269970 in animal models are generally consistent with the experimental literature that the evidence is mixed or not robust regarding the potential efficacy of 5-HT7 receptor antagonism in the treatment of anxiety, depression, or schizophrenia.
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Affiliation(s)
- Julia Maxwell
- Neuroscience Discovery, Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN, USA
| | - Scott D Gleason
- Neuroscience Discovery, Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN, USA
| | - Julie Falcone
- Neuroscience Discovery, Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN, USA
| | - Kjell Svensson
- Neuroscience Discovery, Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN, USA
| | - Olivia M Balcer
- Neuroscience Discovery, Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN, USA
| | - Xia Li
- Neuroscience Discovery, Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN, USA
| | - Jeffrey M Witkin
- Neuroscience Discovery, Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN, USA.
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Witkin JM, Knutson DE, Rodriguez GJ, Shi S. Rapid-Acting Antidepressants. Curr Pharm Des 2018; 24:2556-2563. [DOI: 10.2174/1381612824666180730104707] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 07/18/2018] [Accepted: 07/27/2018] [Indexed: 11/22/2022]
Abstract
Background:
Conventional antidepressants are thought to produce their impact on clinical symptoms
by increasing the central availability of biogenic amine neurotransmitters (the monoamine hypothesis of depression).
These drugs continue to be the primary medicines used in major depressive disorder. Although they have
biological effects after acute dosing, full antidepressant response generally takes weeks of daily administration.
Lack of rapid onset is a large limitation in antidepressant therapy (e.g., suicide, lack of medication compliance,
difficulty switching medications).
Methods:
The present review of the literature discusses the preclinical and clinical findings on compounds that
can produce immediate symptom relief.
Results:
These compounds include ketamine, scopolamine, and mechanistically-related drugs. Newer additions to
the list of potential rapid-acting agents include antagonists of metabotropic (mGlu) 2/3 receptors, negative allosteric
modulators of α5-containing GABAA receptors, and psychedelic compounds. An additional benefit of these
compounds is that they have demonstrated large effect sizes and, importantly, demonstrated efficacy in patient’s
refractory to other treatments. A drawback of some of these compounds, to date, is finding ways to expand the
duration of clinical efficacy. In addition, for some compounds, the side-effect profile requires management. A
primary mechanism by which rapid effects might be produced is through the amplification of excitatory neurotransmission
through activation of AMPA receptors. The extracellular efflux of glutamate induced by these drugs
has been documented and provides the hypothesized triggering mechanism for AMPA receptor amplification.
Conclusion:
The preclinical and clinical literature strongly suggests that rapid-acting antidepressants are the
current focus of antidepressant drug discovery. Promising clinical findings exist for several compounds including
ketamine and other NMDA receptor antagonists, scopolamine, and psilocybin. Two compounds are in late stage
clinical development: GLYX-13 (Rapastinel) and eskekamine.
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Affiliation(s)
| | - Daniel E. Knutson
- Department of Chemistry and Biochemistry, University of Wisconsin- Milwaukee, Milwaukee Wisconsin, United States
| | | | - Samuel Shi
- Witkin Consulting Group, Carmel, Indiana, 46033, United States
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Witkin JM, Shenvi RA, Li X, Gleason SD, Weiss J, Morrow D, Catow JT, Wakulchik M, Ohtawa M, Lu HH, Martinez MD, Schkeryantz JM, Carpenter TS, Lightstone FC, Cerne R. Pharmacological characterization of the neurotrophic sesquiterpene jiadifenolide reveals a non-convulsant signature and potential for progression in neurodegenerative disease studies. Biochem Pharmacol 2018; 155:61-70. [PMID: 29940173 DOI: 10.1016/j.bcp.2018.06.022] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 06/18/2018] [Indexed: 11/17/2022]
Abstract
The 'neurotrophic sesquiterpenes' refer to a group of molecules derived from the Illicium genus of flowering plant. They display neurotrophic effects in cultured neuron preparations and have been suggested to be cognitive enhancers and potential therapeutics for neurodegenerative disorders and dementias. Recent synthetic advances generated sufficient quantities of jiadifenolide for in vivo investigation into its biological effects. Jiadifenolide did not induce convulsions in mice nor did it enhance or diminish convulsions induced by pentylenetetrazole. Other negative allosteric modulators of GABAA receptors, picrotoxin, tetramethylenedisulfotetramine (TETS), and bilobalide all induced convulsions. Either i.p. or i.c.v. dosing generated micromolar plasma and brain levels of jiadifenolide but only small effects on locomotion of mice. However, jiadifenolide decreased d-amphetamine-induced hyperlocomotion in mice, an antipsychotic-like drug effect. Jiadifenolide did not significantly alter body temperature or behavior in the forced-swim test in mice. Molecular simulation data suggested a potential site in the pore/M2 helix region that is at an overlapping, yet lower position than those observed for other 'cage convulsant' compounds such as TETS and picrotoxin. We hypothesize that a position nearer to the entrance of the pore channel may allow for easier displacement of jiadifenolide from its blocking location leading to lower potency and lower side-effect liability. Like jiadifenolide, memantine (Namenda), one of the few drugs used in the symptomatic treatment of dementias, occupies a unique site on the NMDA receptor complex that creates low binding affinity that is associated with its reduced side-effect profile. Given the potential therapeutic applications of jiadifenolide and its relatively inert effects on overt behavior, the possibility of clinical utility for jiadifenolide and related compounds becomes intriguing.
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Affiliation(s)
- Jeffrey M Witkin
- The Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, USA.
| | - Ryan A Shenvi
- Department of Chemistry, The Scripps Research Institute, La Jolla, CA, USA
| | - Xia Li
- The Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, USA
| | - Scott D Gleason
- The Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, USA
| | - Julie Weiss
- The Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, USA
| | - Denise Morrow
- The Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, USA
| | - John T Catow
- The Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, USA
| | - Mark Wakulchik
- The Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, USA
| | - Masaki Ohtawa
- Department of Chemistry, The Scripps Research Institute, La Jolla, CA, USA
| | - Hai-Hua Lu
- Department of Chemistry, The Scripps Research Institute, La Jolla, CA, USA
| | - Michael D Martinez
- Department of Chemistry, The Scripps Research Institute, La Jolla, CA, USA
| | | | - Timothy S Carpenter
- Biosciences and Biotechnology Division, Lawrence Livermore National Laboratory, Livermore, CA, USA
| | - Felice C Lightstone
- Biosciences and Biotechnology Division, Lawrence Livermore National Laboratory, Livermore, CA, USA
| | - Rok Cerne
- The Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, USA
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Martin AE, Schober DA, Nikolayev A, Tolstikov VV, Anderson WH, Higgs RE, Kuo MS, Laksmanan A, Catlow JT, Li X, Felder CC, Witkin JM. Further Evaluation of Mechanisms Associated with the Antidepressantlike Signature of Scopolamine in Mice. CNS Neurol Disord Drug Targets 2018; 16:492-500. [PMID: 28294051 DOI: 10.2174/1871527316666170309142646] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 01/24/2017] [Accepted: 02/01/2017] [Indexed: 11/22/2022]
Abstract
BACKGROUND Conventional antidepressants lack efficacy for many patients (treatmentresistant depression or TRD) and generally take weeks to produce full therapeutic response in others. Emerging data has identified certain drugs such as ketamine as rapidly-acting antidepressants for major depressive disorder and TRD. Scopolamine, a drug used to treat motion sickness and nausea, has also been demonstrated to function as a rapidly-acting antidepressant. The mechanisms associated with efficacy in TRD patients and rapid onset of action have been suggested to involve a-Amino-3-hydroxy- 5-methyl-4-isoxazolepropionic acid (AMPA) receptor and mammalian target of rapamycin (mTOR) signaling. Since the work on these mechanisms with scopolamine has been limited, the present set of experiments was designed to further explore these mechanisms of action. METHOD Male, NIH Swiss mice demonstrated a robust and immediate antidepressant signature with ketamine or scopolamine when studied under the forced-swim test. RESULTS The AMPA receptor antagonist NBQX prevented this antidepressant-like effect of scopolamine and ketamine. An orally-bioavilable mTOR inhibitor (AZD8055) also attenuated the antidepressant- like effects of scopolamine and ketamine. Scopolamine was also shown to augment the antidepressant- like effect of the selective serotonin reuptake inhibitor citalopram. When given in combination, scopolamine and ketamine acted synergistically to produce antidepressant-like effects. Although drug interaction data suggested that additional mechanisms might be at play, metabolomic analysis of frontal cortex and plasma from muscarinic M1+/+ and M1 -/- mice given scopolamine or vehicle did not reveal any hints as to the nature of these additional mechanisms of action. CONCLUSION Overall, the data substantiate and extend the idea that AMPA and mTOR signaling pathways are necessary for the antidepressant-like effects of scopolamine and ketamine, mechanisms that appear to be of general significance for TRD therapeutic agents.
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Affiliation(s)
- Anna E Martin
- Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, United States
| | - Douglas A Schober
- Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, United States
| | | | | | - Wesley H Anderson
- Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, United States
| | - Richard E Higgs
- Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, United States
| | - Ming-Shang Kuo
- Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, United States
| | | | - John T Catlow
- Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, United States
| | - Xia Li
- Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, United States
| | - Christian C Felder
- Neuroscience Discovery Research, Lilly Research Labs, Lilly Corporate Center, Indianapolis, IN 46285-0510, United States
| | - Jeffrey M Witkin
- Neuroscience Discovery Research, Lilly Research Labs, Lilly Corporate Center, Indianapolis, IN 46285-0510, United States
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Xu NZ, Ernst M, Treven M, Cerne R, Wakulchik M, Li X, Jones TM, Gleason SD, Morrow D, Schkeryantz JM, Rahman MT, Li G, Poe MM, Cook JM, Witkin JM. Negative allosteric modulation of alpha 5-containing GABA A receptors engenders antidepressant-like effects and selectively prevents age-associated hyperactivity in tau-depositing mice. Psychopharmacology (Berl) 2018; 235:1151-1161. [PMID: 29374303 DOI: 10.1007/s00213-018-4832-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 01/07/2018] [Indexed: 02/08/2023]
Abstract
RATIONALE Associated with frank neuropathology, patients with Alzheimer's disease suffer from a host of neuropsychiatric symptoms that include depression, apathy, agitation, and aggression. Negative allosteric modulators (NAMs) of α5-containing GABAA receptors have been suggested to be a novel target for antidepressant action. We hypothesized that pharmacological modulation of this target would engender increased motivation in stressful environments. METHODS We utilized electrophysiological recordings from Xenopus oocytes and behavioral measures in mice to address this hypothesis. RESULTS In the forced-swim assay in mice that detects antidepressant drugs, the α5β3γ2 GABAΑ receptor NAM, RY-080 produced a marked antidepressant phenotype. Another compound, PWZ-029, was characterized as an α5β3γ2 receptor NAM of lower intrinsic efficacy in electrophysiological studies in Xenopus oocytes. In contrast to RY-080, PWZ-029 was only moderately active in the forced-swim assay and the α5β3γ2 receptor antagonist, Xli-093, was not active at all. The effects of RY-080 were prevented by the non-selective benzodiazepine receptor antagonist flumazenil as well as by the selective ligands, PWZ-029 and Xli-093. These findings demonstrate that this effect of RY-080 is driven by negative allosteric modulation of α5βγ2 GABAA receptors. RY-080 was not active in the tail-suspension test. We also demonstrated a reduction in the age-dependent hyperactivity exhibited by transgenic mice that accumulate pathological tau (rTg4510 mice) by RY-080. The decrease in hyperactivity by RY-080 was selective for the hyperactivity of the rTg4510 mice since the locomotion of control strains of mice were not significantly affected by RY-080. CONCLUSIONS α5βγ2 GABAA receptor NAMs might function as a pharmacological treatment for mood, amotivational syndromes, and psychomotor agitation in patients with Alzheimer's and other neurodegenerative disorders.
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Affiliation(s)
- Nina Z Xu
- The Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, USA
| | - Margot Ernst
- Department of Molecular Neurosciences Center for Brain Research, Medical University of Vienna, Spitalgasse 4, Vienna, Austria
| | - Marco Treven
- Department of Molecular Neurosciences Center for Brain Research, Medical University of Vienna, Spitalgasse 4, Vienna, Austria
| | - Rok Cerne
- The Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, USA
| | - Mark Wakulchik
- The Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, USA
| | - Xia Li
- The Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, USA
| | - Timothy M Jones
- The Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, USA
| | - Scott D Gleason
- The Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, USA
| | - Denise Morrow
- The Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, USA
| | | | - Md Toufiqur Rahman
- Department of Chemistry and Biochemistry, University of Wisconsin Milwaukee, Milwaukee, WI, USA
| | - Guanguan Li
- Department of Chemistry and Biochemistry, University of Wisconsin Milwaukee, Milwaukee, WI, USA
| | - Michael M Poe
- Department of Chemistry and Biochemistry, University of Wisconsin Milwaukee, Milwaukee, WI, USA
| | - James M Cook
- Department of Chemistry and Biochemistry, University of Wisconsin Milwaukee, Milwaukee, WI, USA
| | - Jeffrey M Witkin
- The Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, USA.
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Witkin JM, Schober DA, Gleason SD, Catlow JT, Porter WJ, Reel J, Jin X, Hobbs J, Gehlert D, Gernert DL, Gardinier KM, Kato AS, Ping X, Smith JL. Targeted Blockade of TARP-γ8-Associated AMPA Receptors: Anticonvulsant Activity with the Selective Antagonist LY3130481 (CERC-611). CNSNDDT 2018; 16:1099-1110. [DOI: 10.2174/1871527316666171101132047] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 10/16/2017] [Accepted: 10/20/2017] [Indexed: 11/22/2022]
Affiliation(s)
- Jeffrey M. Witkin
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana, United States
| | - Douglas A. Schober
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana, United States
| | - Scott D. Gleason
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana, United States
| | - John T. Catlow
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana, United States
| | - Warren J. Porter
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana, United States
| | - Jon Reel
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana, United States
| | - Xiaoming Jin
- Indiana University/Purdue University, Riley Hospital, Indianapolis, Indiana, United States
| | - Jonathan Hobbs
- Indiana University/Purdue University, Riley Hospital, Indianapolis, Indiana, United States
| | - Donald Gehlert
- Cerecor, Baltimore, MD (DG) and Matrix Pharmaceutical Consulting, Boulder, CO, United States
| | - Douglas L. Gernert
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana, United States
| | - Kevin M. Gardinier
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana, United States
| | - Akihiko S. Kato
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana, United States
| | - Xingjie Ping
- Indiana University/Purdue University, Riley Hospital, Indianapolis, Indiana, United States
| | - Jodi L. Smith
- Indiana University/Purdue University, Riley Hospital, Indianapolis, Indiana, United States
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41
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Abstract
The need for improved medications for psychiatric and neurological disorders is clear. Difficulties in finding such drugs demands that all strategic means be utilized for their invention. The discovery of forebrain specific AMPA receptor antagonists, which selectively block the specific combinations of principal and auxiliary subunits present in forebrain regions but spare targets in the cerebellum, was recently disclosed. This discovery raised the possibility that other auxiliary protein systems could be utilized to help identify new medicines. Discussion of the TARP-dependent AMPA receptor antagonists has been presented elsewhere. Here we review the diversity of protein complexes of neurotransmitter receptors in the nervous system to highlight the broad range of protein/protein drug targets. We briefly outline the structural basis of protein complexes as drug targets for G-protein-coupled receptors, voltage-gated ion channels, and ligand-gated ion channels. This review highlights heterodimers, subunit-specific receptor constructions, multiple signaling pathways, and auxiliary proteins with an emphasis on the later. We conclude that the use of auxiliary proteins in chemical compound screening could enhance the detection of specific, targeted drug searches and lead to novel and improved medicines for psychiatric and neurological disorders.
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Affiliation(s)
- Akihiko S Kato
- Neuroscience Discovery, Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, USA.
| | - Jeffrey M Witkin
- Neuroscience Discovery, Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, USA
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42
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Lee MR, Gardinier KM, Gernert DL, Schober DA, Wright RA, Wang H, Qian Y, Witkin JM, Nisenbaum ES, Kato AS. Structural Determinants of the γ-8 TARP Dependent AMPA Receptor Antagonist. ACS Chem Neurosci 2017; 8:2631-2647. [PMID: 28825787 DOI: 10.1021/acschemneuro.7b00186] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
The forebrain specific AMPA receptor antagonist, LY3130481/CERC-611, which selectively antagonizes the AMPA receptors associated with TARP γ-8, an auxiliary subunit enriched in the forebrain, has potent antiepileptic activities without motor side effects. We designated the compounds with such activities as γ-8 TARP dependent AMPA receptor antagonists (γ-8 TDAAs). In this work, we further investigated the mechanisms of action using a radiolabeled γ-8 TDAA and ternary structural modeling with mutational validations to characterize the LY3130481 binding to γ-8. The radioligand binding to the cells heterologously expressing GluA1 and/or γ-8 revealed that γ-8 TDAAs binds to γ-8 alone without AMPA receptors. Homology modeling of γ-8, based on the crystal structures of a distant TARP homologue, murine claudin 19, in conjunction with knowledge of two γ-8 residues previously identified as critical for the LY3130481 TARP-dependent selectivity provided the basis for a binding mode prediction. This allowed further rational mutational studies for characterization of the structural determinants in TARP γ-8 for LY3130481 activities, both thermodynamically as well as kinetically.
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Affiliation(s)
- Matthew R. Lee
- Lilly
Biotechnology Center, Eli Lilly and Company, 10300 Campus Point Dr. #200, San Diego, California 92121, United States
| | - Kevin M. Gardinier
- Neuroscience
Discovery, Lilly Research Laboratory, 355 E Merril St., Indianapolis, Indiana 46285, United States
| | - Douglas L. Gernert
- Neuroscience
Discovery, Lilly Research Laboratory, 355 E Merril St., Indianapolis, Indiana 46285, United States
| | - Douglas A. Schober
- Neuroscience
Discovery, Lilly Research Laboratory, 355 E Merril St., Indianapolis, Indiana 46285, United States
| | - Rebecca A. Wright
- Neuroscience
Discovery, Lilly Research Laboratory, 355 E Merril St., Indianapolis, Indiana 46285, United States
| | - He Wang
- Neuroscience
Discovery, Lilly Research Laboratory, 355 E Merril St., Indianapolis, Indiana 46285, United States
| | - Yuewei Qian
- Neuroscience
Discovery, Lilly Research Laboratory, 355 E Merril St., Indianapolis, Indiana 46285, United States
| | - Jeffrey M. Witkin
- Neuroscience
Discovery, Lilly Research Laboratory, 355 E Merril St., Indianapolis, Indiana 46285, United States
| | - Eric S. Nisenbaum
- Neuroscience
Discovery, Lilly Research Laboratory, 355 E Merril St., Indianapolis, Indiana 46285, United States
| | - Akihiko S. Kato
- Neuroscience
Discovery, Lilly Research Laboratory, 355 E Merril St., Indianapolis, Indiana 46285, United States
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43
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Bruns RF, Mitchell SN, Wafford KA, Harper AJ, Shanks EA, Carter G, O'Neill MJ, Murray TK, Eastwood BJ, Schaus JM, Beck JP, Hao J, Witkin JM, Li X, Chernet E, Katner JS, Wang H, Ryder JW, Masquelin ME, Thompson LK, Love PL, Maren DL, Falcone JF, Menezes MM, Zhang L, Yang CR, Svensson KA. Preclinical profile of a dopamine D1 potentiator suggests therapeutic utility in neurological and psychiatric disorders. Neuropharmacology 2017; 128:351-365. [PMID: 29102759 DOI: 10.1016/j.neuropharm.2017.10.032] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 08/24/2017] [Accepted: 10/24/2017] [Indexed: 01/11/2023]
Abstract
DETQ, an allosteric potentiator of the dopamine D1 receptor, was tested in therapeutic models that were known to respond to D1 agonists. Because of a species difference in affinity for DETQ, all rodent experiments used transgenic mice expressing the human D1 receptor (hD1 mice). When given alone, DETQ reversed the locomotor depression caused by a low dose of reserpine. DETQ also acted synergistically with L-DOPA to reverse the strong hypokinesia seen with a higher dose of reserpine. These results indicate potential as both monotherapy and adjunct treatment in Parkinson's disease. DETQ markedly increased release of both acetylcholine and histamine in the prefrontal cortex, and increased levels of histamine metabolites in the striatum. In the hippocampus, the combination of DETQ and the cholinesterase inhibitor rivastigmine increased ACh to a greater degree than either agent alone. DETQ also increased phosphorylation of the AMPA receptor (GluR1) and the transcription factor CREB in the striatum, consistent with enhanced synaptic plasticity. In the Y-maze, DETQ increased arm entries but (unlike a D1 agonist) did not reduce spontaneous alternation between arms at high doses. DETQ enhanced wakefulness in EEG studies in hD1 mice and decreased immobility in the forced-swim test, a model for antidepressant-like activity. In rhesus monkeys, DETQ increased spontaneous eye-blink rate, a measure that is known to be depressed in Parkinson's disease. Together, these results provide support for potential utility of D1 potentiators in the treatment of several neuropsychiatric disorders, including Parkinson's disease, Alzheimer's disease, cognitive impairment in schizophrenia, and major depressive disorder.
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Affiliation(s)
- Robert F Bruns
- Lilly Research Laboratories, Eli Lilly & Co., Lilly Corporate Center, Indianapolis, IN 46285, USA
| | - Stephen N Mitchell
- Lilly Research Laboratories, Eli Lilly & Co., Erl Wood Manor, United Kingdom
| | - Keith A Wafford
- Lilly Research Laboratories, Eli Lilly & Co., Erl Wood Manor, United Kingdom
| | - Alex J Harper
- Lilly Research Laboratories, Eli Lilly & Co., Erl Wood Manor, United Kingdom
| | - Elaine A Shanks
- Lilly Research Laboratories, Eli Lilly & Co., Erl Wood Manor, United Kingdom
| | - Guy Carter
- Lilly Research Laboratories, Eli Lilly & Co., Erl Wood Manor, United Kingdom
| | - Michael J O'Neill
- Lilly Research Laboratories, Eli Lilly & Co., Erl Wood Manor, United Kingdom
| | - Tracey K Murray
- Lilly Research Laboratories, Eli Lilly & Co., Erl Wood Manor, United Kingdom
| | - Brian J Eastwood
- Lilly Research Laboratories, Eli Lilly & Co., Erl Wood Manor, United Kingdom
| | - John M Schaus
- Lilly Research Laboratories, Eli Lilly & Co., Lilly Corporate Center, Indianapolis, IN 46285, USA
| | - James P Beck
- Lilly Research Laboratories, Eli Lilly & Co., Lilly Corporate Center, Indianapolis, IN 46285, USA
| | - Junliang Hao
- Lilly Research Laboratories, Eli Lilly & Co., Lilly Corporate Center, Indianapolis, IN 46285, USA
| | - Jeffrey M Witkin
- Lilly Research Laboratories, Eli Lilly & Co., Lilly Corporate Center, Indianapolis, IN 46285, USA
| | - Xia Li
- Lilly Research Laboratories, Eli Lilly & Co., Lilly Corporate Center, Indianapolis, IN 46285, USA
| | - Eyassu Chernet
- Lilly Research Laboratories, Eli Lilly & Co., Lilly Corporate Center, Indianapolis, IN 46285, USA
| | - Jason S Katner
- Lilly Research Laboratories, Eli Lilly & Co., Lilly Corporate Center, Indianapolis, IN 46285, USA
| | - Hong Wang
- Lilly Research Laboratories, Eli Lilly & Co., Lilly Corporate Center, Indianapolis, IN 46285, USA
| | - John W Ryder
- Lilly Research Laboratories, Eli Lilly & Co., Lilly Corporate Center, Indianapolis, IN 46285, USA
| | - Meghane E Masquelin
- Lilly Research Laboratories, Eli Lilly & Co., Lilly Corporate Center, Indianapolis, IN 46285, USA
| | - Linda K Thompson
- Lilly Research Laboratories, Eli Lilly & Co., Lilly Corporate Center, Indianapolis, IN 46285, USA
| | - Patrick L Love
- Lilly Research Laboratories, Eli Lilly & Co., Lilly Corporate Center, Indianapolis, IN 46285, USA
| | - Deanna L Maren
- Lilly Research Laboratories, Eli Lilly & Co., Lilly Corporate Center, Indianapolis, IN 46285, USA
| | - Julie F Falcone
- Lilly Research Laboratories, Eli Lilly & Co., Lilly Corporate Center, Indianapolis, IN 46285, USA
| | - Michelle M Menezes
- Lilly Research Laboratories, Eli Lilly & Co., Lilly Corporate Center, Indianapolis, IN 46285, USA
| | - Linli Zhang
- Shanghai ChemPartner, Pudong, Shanghai 201203, China
| | | | - Kjell A Svensson
- Lilly Research Laboratories, Eli Lilly & Co., Lilly Corporate Center, Indianapolis, IN 46285, USA.
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44
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Kato AS, Witkin JM. Auxiliary subunits of AMPA receptors: The discovery of a forebrain-selective antagonist, LY3130481/CERC-611. Biochem Pharmacol 2017; 147:191-200. [PMID: 28987594 DOI: 10.1016/j.bcp.2017.09.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 09/27/2017] [Indexed: 12/11/2022]
Abstract
Drugs originate from the discovery of compounds, natural or synthetic, that bind to proteins (receptors, enzymes, transporters, etc.), the interaction of which modulates biological cascades that have potential therapeutic benefit. Rational strategies for identifying novel drug therapies are typically based on knowledge of the structure of the target proteins and the design of new chemical entities that modulate these proteins in a beneficial manner. The present review discusses a novel approach to drug discovery based on the identification and characterization of auxiliary proteins, the transmembrane AMPA receptor regulatory proteins (TARPs) that are associated with AMPA receptors. Utilizing these auxiliary proteins in compound screening led to the discovery of the TARP-dependent-AMPA forebrain selective receptor antagonist (TDAA), LY3130481/CERC-611 that is currently in clinical development for epilepsy.
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Affiliation(s)
- Akihiko S Kato
- Neuroscience Discovery Research, Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN 46285-0510, United States.
| | - Jeffrey M Witkin
- Neuroscience Discovery Research, Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN 46285-0510, United States.
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45
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Yuen E, Swanson S, Witkin JM. Prediction of human efficacious antidepressant doses using the mouse forced swim test. Pharmacol Biochem Behav 2017; 161:22-29. [DOI: 10.1016/j.pbb.2017.09.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 08/21/2017] [Accepted: 09/04/2017] [Indexed: 12/23/2022]
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46
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Witkin JM, Li J, Gilmour G, Mitchell SN, Carter G, Gleason SD, Seidel WF, Eastwood BJ, McCarthy A, Porter WJ, Reel J, Gardinier KM, Kato AS, Wafford KA. Electroencephalographic, cognitive, and neurochemical effects of LY3130481 (CERC-611), a selective antagonist of TARP-γ8-associated AMPA receptors. Neuropharmacology 2017; 126:257-270. [PMID: 28757050 DOI: 10.1016/j.neuropharm.2017.07.028] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 06/27/2017] [Accepted: 07/26/2017] [Indexed: 11/18/2022]
Abstract
6-[(1S)-1-[1-[5-(2-hydroxyethoxy)-2-pyridyl]pyrazol-3-yl]ethyl]-3H-1,3-benzothiazol-2-one (LY3130481 or CERC-611) is a selective antagonist of AMPA receptors containing transmembrane AMPA receptor regulatory protein (TARP) γ-8. This molecule has been characterized as a potent and efficacious anticonvulsant in an array of acute and chronic epilepsy models in rodents. The present set of experiments was designed to assess the effects of LY3130481 on the electroencephelogram (EEG), cognitive function, and neurochemical outflow. LY3130481 disrupted food-maintained responding in rats and spontaneous alternation in a Y-maze in mice. In rat fear conditioning, LY3130481 caused a deficit in trace (hippocampal-dependent), but not in delay fear conditioning. Although these effects on cognitive performances were observed, the known cognitive-impairing anticonvulsant, topiramate, did not always produce deficits under these assay conditions. LY3130481 produced modest increases in wake times in rats. In addition, LY3130481 was able to attenuate some impairing effects of standard antiepileptic drugs. The motor-impairing effects of the lacosamide were attenuated by LY3130481 as was the decrease in non-rapid-eye movement sleep induced by carbamazepine. Evaluation of the effect of LY3130481 on neurotransmitter and metabolite efflux in the rat medial prefrontal cortex, using in vivo microdialysis, revealed significant increases in the pro-cognitive and wake-promoting neurotransmitters, histamine and acetylcholine, as well as in serotonin, telemethylhistamine, 5-HIAA, HVA and MHPG. LY3130481 thus presents a novel behavioral profile that will have to be evaluated in patients to fully appreciate its implications for therapeutics. LY3130481 is currently under clinical development as CERC-611 as an antiepileptic.
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Affiliation(s)
- Jeffrey M Witkin
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana, USA.
| | - Jennifer Li
- Lilly Research Laboratories, Eli Lilly and Company, Windlesham, Surrey, UK
| | - Gary Gilmour
- Lilly Research Laboratories, Eli Lilly and Company, Windlesham, Surrey, UK
| | - Stephen N Mitchell
- Lilly Research Laboratories, Eli Lilly and Company, Windlesham, Surrey, UK
| | - Guy Carter
- Lilly Research Laboratories, Eli Lilly and Company, Windlesham, Surrey, UK
| | - Scott D Gleason
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana, USA
| | - Wesley F Seidel
- Lilly Research Laboratories, Eli Lilly and Company, Windlesham, Surrey, UK
| | - Brian J Eastwood
- Lilly Research Laboratories, Eli Lilly and Company, Windlesham, Surrey, UK
| | - Andrew McCarthy
- Lilly Research Laboratories, Eli Lilly and Company, Windlesham, Surrey, UK
| | - Warren J Porter
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana, USA
| | - Jon Reel
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana, USA
| | - Kevin M Gardinier
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana, USA
| | - Akihiko S Kato
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana, USA
| | - Keith A Wafford
- Lilly Research Laboratories, Eli Lilly and Company, Windlesham, Surrey, UK.
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47
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Ohtawa M, Krambis MJ, Cerne R, Schkeryantz JM, Witkin JM, Shenvi RA. Synthesis of (-)-11-O-Debenzoyltashironin: Neurotrophic Sesquiterpenes Cause Hyperexcitation. J Am Chem Soc 2017. [PMID: 28644021 DOI: 10.1021/jacs.7b04206] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
11-O-Debenzoyltashironin (1) is a member of the neurotrophic sesquiterpenes, trace plant metabolites that enhance neurite outgrowth in cultured neurons. We report its synthesis in six steps from a butenolide heterodimer via its likely biosynthetic precursor, 3,6-dideoxy-10-hydroxypseudoanisatin, here identified as the chain tautomer of 1. Access to the tashironin chemotype fills a gap in a comparison set of convulsive and neurotrophic sesquiterpenes, which we hypothesized to share a common target. Here we show that both classes mutually hyperexcite rat cortical neurons, consistent with antagonism of inhibitory channels and a mechanism of depolarization-induced neurite outgrowth.
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Affiliation(s)
- Masaki Ohtawa
- Department of Chemistry, The Scripps Research Institute , La Jolla, California 92037, United States
| | - Michael J Krambis
- Eli Lilly and Company , Lilly Corporate Center, Indianapolis, Indiana 46285, United States
| | - Rok Cerne
- Eli Lilly and Company , Lilly Corporate Center, Indianapolis, Indiana 46285, United States
| | - Jeffrey M Schkeryantz
- Eli Lilly and Company , Lilly Corporate Center, Indianapolis, Indiana 46285, United States
| | - Jeffrey M Witkin
- Eli Lilly and Company , Lilly Corporate Center, Indianapolis, Indiana 46285, United States
| | - Ryan A Shenvi
- Department of Chemistry, The Scripps Research Institute , La Jolla, California 92037, United States
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48
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Sher E, Mazzo F, Hutton MI, O'Neill MJ, Bose S, Kerridge C, Murray TK, Grubisha O, Ursu D, Broad L, Sanger HE, Wang Y, Pan F, Monn J, Witkin JM, Li X, Schiavo G, Goedert M. [O1–07–05]: REGULATED RELEASE OF HYPER‐PHOSPHORYLATED, AGGREGATED AND SEEDING COMPETENT TAU FROM RODENT BRAINS AND HUMAN SYNAPTOSOMES. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.07.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Emanuele Sher
- Eli LillyWindleshamUnited Kingdom
- Eli Lilly & Co LtdWindleshamUnited Kingdom
- Eli Lilly and CoIndianapolisINUSA
- University College LondonLondonUnited Kingdom
- MRC Laboratory of Molecular BiologyCambridgeUnited Kingdom
| | | | | | | | | | | | | | | | | | | | | | - Yaming Wang
- Eli LillyWindleshamUnited Kingdom
- Eli Lilly and CompanyIndianapolisINUSA
- Eli‐Lilly and CompanyIndianapolisINUSA
| | - Feng Pan
- Eli LillyWindleshamUnited Kingdom
| | | | | | - Xia Li
- Eli LillyWindleshamUnited Kingdom
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49
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Witkin JM, Cerne R, Wakulchik M, S J, Gleason SD, Jones TM, Li G, Arnold LA, Li JX, Schkeryantz JM, Methuku KR, Cook JM, Poe MM. Further evaluation of the potential anxiolytic activity of imidazo[1,5-a][1,4]diazepin agents selective for α2/3-containing GABA A receptors. Pharmacol Biochem Behav 2017; 157:35-40. [PMID: 28442369 PMCID: PMC5519285 DOI: 10.1016/j.pbb.2017.04.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 04/20/2017] [Accepted: 04/21/2017] [Indexed: 11/24/2022]
Abstract
Positive allosteric modulators of GABAA receptors transduce a host of beneficial effects including anxiolytic actions. We have recently shown that bioavailability and anxiolytic-like activity can be improved by eliminating the ester functionality in imidazo[1,5-a][1,4]diazepines. In the present series of experiments, we further substantiate the value of heterocyle replacement of the ester for potential treatment of anxiety. None of three esters was active in a Vogel conflict test in rats that detects anxiolytic drugs like diazepam. Compounds 7 and 8, ester bioisosters, were selective for alpha 2 and 3 over alpha 1-containing GABAA receptors but also had modest efficacy at GABAA alpha 5-containing receptors. Compound 7 was efficacious and potent in this anxiolytic-detecting assay without affecting non-punished responding. The efficacies of the esters and of compound 7 were predicted from their efficacies as anticonvulsants against the GABAA antagonist pentylenetetrazole (PTZ). In contrast, the related structural analog, compound 8, did not produce anxiolytic-like effects in rats despite anticonvulsant efficacy. These data thus support the following conclusions: 1) ancillary pharmacological actions of compound 8 might be responsible for its lack of anxiolytic-like efficacy despite its efficacy as an anticonvulsant 2) esters of imidazo[1,5-a][1,4]diazepines do not demonstrate anxiolytic-like effects in rats due to their low bioavailability and 3) replacement of the ester function with suitable heterocycles markedly improves bioavailability and engenders molecules with the opportunity to have potent and efficacious effects in vivo that correspond to human anxiolytic actions.
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Affiliation(s)
- J M Witkin
- Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, United States.
| | - R Cerne
- Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, United States
| | - M Wakulchik
- Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, United States
| | - J S
- Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, United States
| | - S D Gleason
- Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, United States
| | - T M Jones
- Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, United States
| | - G Li
- Department of Chemistry & Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, WI, United States
| | - L A Arnold
- Department of Chemistry & Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, WI, United States
| | - J-X Li
- Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, United States
| | - J M Schkeryantz
- Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, United States
| | - K R Methuku
- Department of Chemistry & Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, WI, United States
| | - J M Cook
- Department of Chemistry & Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, WI, United States
| | - M M Poe
- Department of Chemistry & Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, WI, United States
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50
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Witkin JM, Mitchell SN, Wafford KA, Carter G, Gilmour G, Li J, Eastwood BJ, Overshiner C, Li X, Rorick-Kehn L, Rasmussen K, Anderson WH, Nikolayev A, Tolstikov VV, Kuo MS, Catlow JT, Li R, Smith SC, Mitch CH, Ornstein PL, Swanson S, Monn JA. Comparative Effects of LY3020371, a Potent and Selective Metabotropic Glutamate (mGlu) 2/3 Receptor Antagonist, and Ketamine, a Noncompetitive N-Methyl-d-Aspartate Receptor Antagonist in Rodents: Evidence Supporting the Use of mGlu2/3 Antagonists, for the Treatment of Depression. J Pharmacol Exp Ther 2017; 361:68-86. [PMID: 28138040 DOI: 10.1124/jpet.116.238121] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Accepted: 01/05/2017] [Indexed: 12/17/2022] Open
Abstract
The ability of the N-methyl-d-aspartate receptor antagonist ketamine to alleviate symptoms in patients suffering from treatment-resistant depression (TRD) is well documented. In this paper, we directly compare in vivo biologic responses in rodents elicited by a recently discovered metabotropic glutamate (mGlu) 2/3 receptor antagonist 2-amino-3-[(3,4-difluorophenyl)sulfanylmethyl]-4-hydroxy-bicyclo[3.1.0]hexane-2,6-dicarboxylic acid (LY3020371) with those produced by ketamine. Both LY3020371 and ketamine increased the number of spontaneously active dopamine cells in the ventral tegmental area of anesthetized rats, increased O2 in the anterior cingulate cortex, promoted wakefulness, enhanced the efflux of biogenic amines in the prefrontal cortex, and produced antidepressant-related behavioral effects in rodent models. The ability of LY3020371 to produce antidepressant-like effects in the forced-swim assay in rats was associated with cerebrospinal fluid (CSF) drug levels that matched concentrations required for functional antagonist activity in native rat brain tissue preparations. Metabolomic pathway analyses from analytes recovered from rat CSF and hippocampus demonstrated that both LY3020371 and ketamine activated common pathways involving GRIA2 and ADORA1. A diester analog of LY3020371 [bis(((isopropoxycarbonyl)oxy)-methyl) (1S,2R,3S,4S,5R,6R)-2-amino-3-(((3,4-difluorophenyl)thio)methyl)-4-hydroxy-bicyclo[3.1.0]hexane-2,6-dicarboxylate (LY3027788)] was an effective oral prodrug; when given orally, it recapitulated effects of intravenous doses of LY3020371 in the forced-swim and wake-promotion assays, and augmented the antidepressant-like effects of fluoxetine or citalopram without altering plasma or brain levels of these compounds. The broad overlap of biologic responses produced by LY3020371 and ketamine supports the hypothesis that mGlu2/3 receptor blockade might be a novel therapeutic approach for the treatment of TRD patients. LY3020371 and LY3027788 represent molecules that are ready for clinical tests of this hypothesis.
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Affiliation(s)
- J M Witkin
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN (J.M.W., C.O., X.L., L.R.-K., K.R., W.H.A., A.N., V.V.T., M.-S.K., J.T.C., R.L., S.C.S., C.H.M., P.L.O., S.S., J.A.M.); and Lilly Research Laboratories, Eli Lilly and Company, Windlesham, Surrey, United Kingdom (S.N.M., K.A.W., G.C., G.G., J.L., B.J.E.)
| | - S N Mitchell
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN (J.M.W., C.O., X.L., L.R.-K., K.R., W.H.A., A.N., V.V.T., M.-S.K., J.T.C., R.L., S.C.S., C.H.M., P.L.O., S.S., J.A.M.); and Lilly Research Laboratories, Eli Lilly and Company, Windlesham, Surrey, United Kingdom (S.N.M., K.A.W., G.C., G.G., J.L., B.J.E.)
| | - K A Wafford
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN (J.M.W., C.O., X.L., L.R.-K., K.R., W.H.A., A.N., V.V.T., M.-S.K., J.T.C., R.L., S.C.S., C.H.M., P.L.O., S.S., J.A.M.); and Lilly Research Laboratories, Eli Lilly and Company, Windlesham, Surrey, United Kingdom (S.N.M., K.A.W., G.C., G.G., J.L., B.J.E.)
| | - G Carter
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN (J.M.W., C.O., X.L., L.R.-K., K.R., W.H.A., A.N., V.V.T., M.-S.K., J.T.C., R.L., S.C.S., C.H.M., P.L.O., S.S., J.A.M.); and Lilly Research Laboratories, Eli Lilly and Company, Windlesham, Surrey, United Kingdom (S.N.M., K.A.W., G.C., G.G., J.L., B.J.E.)
| | - G Gilmour
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN (J.M.W., C.O., X.L., L.R.-K., K.R., W.H.A., A.N., V.V.T., M.-S.K., J.T.C., R.L., S.C.S., C.H.M., P.L.O., S.S., J.A.M.); and Lilly Research Laboratories, Eli Lilly and Company, Windlesham, Surrey, United Kingdom (S.N.M., K.A.W., G.C., G.G., J.L., B.J.E.)
| | - J Li
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN (J.M.W., C.O., X.L., L.R.-K., K.R., W.H.A., A.N., V.V.T., M.-S.K., J.T.C., R.L., S.C.S., C.H.M., P.L.O., S.S., J.A.M.); and Lilly Research Laboratories, Eli Lilly and Company, Windlesham, Surrey, United Kingdom (S.N.M., K.A.W., G.C., G.G., J.L., B.J.E.)
| | - B J Eastwood
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN (J.M.W., C.O., X.L., L.R.-K., K.R., W.H.A., A.N., V.V.T., M.-S.K., J.T.C., R.L., S.C.S., C.H.M., P.L.O., S.S., J.A.M.); and Lilly Research Laboratories, Eli Lilly and Company, Windlesham, Surrey, United Kingdom (S.N.M., K.A.W., G.C., G.G., J.L., B.J.E.)
| | - C Overshiner
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN (J.M.W., C.O., X.L., L.R.-K., K.R., W.H.A., A.N., V.V.T., M.-S.K., J.T.C., R.L., S.C.S., C.H.M., P.L.O., S.S., J.A.M.); and Lilly Research Laboratories, Eli Lilly and Company, Windlesham, Surrey, United Kingdom (S.N.M., K.A.W., G.C., G.G., J.L., B.J.E.)
| | - X Li
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN (J.M.W., C.O., X.L., L.R.-K., K.R., W.H.A., A.N., V.V.T., M.-S.K., J.T.C., R.L., S.C.S., C.H.M., P.L.O., S.S., J.A.M.); and Lilly Research Laboratories, Eli Lilly and Company, Windlesham, Surrey, United Kingdom (S.N.M., K.A.W., G.C., G.G., J.L., B.J.E.)
| | - L Rorick-Kehn
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN (J.M.W., C.O., X.L., L.R.-K., K.R., W.H.A., A.N., V.V.T., M.-S.K., J.T.C., R.L., S.C.S., C.H.M., P.L.O., S.S., J.A.M.); and Lilly Research Laboratories, Eli Lilly and Company, Windlesham, Surrey, United Kingdom (S.N.M., K.A.W., G.C., G.G., J.L., B.J.E.)
| | - K Rasmussen
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN (J.M.W., C.O., X.L., L.R.-K., K.R., W.H.A., A.N., V.V.T., M.-S.K., J.T.C., R.L., S.C.S., C.H.M., P.L.O., S.S., J.A.M.); and Lilly Research Laboratories, Eli Lilly and Company, Windlesham, Surrey, United Kingdom (S.N.M., K.A.W., G.C., G.G., J.L., B.J.E.)
| | - W H Anderson
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN (J.M.W., C.O., X.L., L.R.-K., K.R., W.H.A., A.N., V.V.T., M.-S.K., J.T.C., R.L., S.C.S., C.H.M., P.L.O., S.S., J.A.M.); and Lilly Research Laboratories, Eli Lilly and Company, Windlesham, Surrey, United Kingdom (S.N.M., K.A.W., G.C., G.G., J.L., B.J.E.)
| | - A Nikolayev
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN (J.M.W., C.O., X.L., L.R.-K., K.R., W.H.A., A.N., V.V.T., M.-S.K., J.T.C., R.L., S.C.S., C.H.M., P.L.O., S.S., J.A.M.); and Lilly Research Laboratories, Eli Lilly and Company, Windlesham, Surrey, United Kingdom (S.N.M., K.A.W., G.C., G.G., J.L., B.J.E.)
| | - V V Tolstikov
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN (J.M.W., C.O., X.L., L.R.-K., K.R., W.H.A., A.N., V.V.T., M.-S.K., J.T.C., R.L., S.C.S., C.H.M., P.L.O., S.S., J.A.M.); and Lilly Research Laboratories, Eli Lilly and Company, Windlesham, Surrey, United Kingdom (S.N.M., K.A.W., G.C., G.G., J.L., B.J.E.)
| | - M-S Kuo
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN (J.M.W., C.O., X.L., L.R.-K., K.R., W.H.A., A.N., V.V.T., M.-S.K., J.T.C., R.L., S.C.S., C.H.M., P.L.O., S.S., J.A.M.); and Lilly Research Laboratories, Eli Lilly and Company, Windlesham, Surrey, United Kingdom (S.N.M., K.A.W., G.C., G.G., J.L., B.J.E.)
| | - J T Catlow
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN (J.M.W., C.O., X.L., L.R.-K., K.R., W.H.A., A.N., V.V.T., M.-S.K., J.T.C., R.L., S.C.S., C.H.M., P.L.O., S.S., J.A.M.); and Lilly Research Laboratories, Eli Lilly and Company, Windlesham, Surrey, United Kingdom (S.N.M., K.A.W., G.C., G.G., J.L., B.J.E.)
| | - R Li
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN (J.M.W., C.O., X.L., L.R.-K., K.R., W.H.A., A.N., V.V.T., M.-S.K., J.T.C., R.L., S.C.S., C.H.M., P.L.O., S.S., J.A.M.); and Lilly Research Laboratories, Eli Lilly and Company, Windlesham, Surrey, United Kingdom (S.N.M., K.A.W., G.C., G.G., J.L., B.J.E.)
| | - S C Smith
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN (J.M.W., C.O., X.L., L.R.-K., K.R., W.H.A., A.N., V.V.T., M.-S.K., J.T.C., R.L., S.C.S., C.H.M., P.L.O., S.S., J.A.M.); and Lilly Research Laboratories, Eli Lilly and Company, Windlesham, Surrey, United Kingdom (S.N.M., K.A.W., G.C., G.G., J.L., B.J.E.)
| | - C H Mitch
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN (J.M.W., C.O., X.L., L.R.-K., K.R., W.H.A., A.N., V.V.T., M.-S.K., J.T.C., R.L., S.C.S., C.H.M., P.L.O., S.S., J.A.M.); and Lilly Research Laboratories, Eli Lilly and Company, Windlesham, Surrey, United Kingdom (S.N.M., K.A.W., G.C., G.G., J.L., B.J.E.)
| | - P L Ornstein
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN (J.M.W., C.O., X.L., L.R.-K., K.R., W.H.A., A.N., V.V.T., M.-S.K., J.T.C., R.L., S.C.S., C.H.M., P.L.O., S.S., J.A.M.); and Lilly Research Laboratories, Eli Lilly and Company, Windlesham, Surrey, United Kingdom (S.N.M., K.A.W., G.C., G.G., J.L., B.J.E.)
| | - S Swanson
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN (J.M.W., C.O., X.L., L.R.-K., K.R., W.H.A., A.N., V.V.T., M.-S.K., J.T.C., R.L., S.C.S., C.H.M., P.L.O., S.S., J.A.M.); and Lilly Research Laboratories, Eli Lilly and Company, Windlesham, Surrey, United Kingdom (S.N.M., K.A.W., G.C., G.G., J.L., B.J.E.)
| | - J A Monn
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN (J.M.W., C.O., X.L., L.R.-K., K.R., W.H.A., A.N., V.V.T., M.-S.K., J.T.C., R.L., S.C.S., C.H.M., P.L.O., S.S., J.A.M.); and Lilly Research Laboratories, Eli Lilly and Company, Windlesham, Surrey, United Kingdom (S.N.M., K.A.W., G.C., G.G., J.L., B.J.E.)
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