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Wegert A, Monnee M, de Graaf W, van Holst F, Bolcato G, Díaz JL, Dordal A, Portillo-Salido E, Reinoso RF, Yeste S, Torrens A, Almansa C. Towards Multitargeted Ligands as Pain Therapeutics: Dual Ligands of the Ca vα2δ-1 Subunit of Voltage-Gated Calcium Channel and the μ-Opioid Receptor. ChemMedChem 2024; 19:e202300473. [PMID: 38230842 DOI: 10.1002/cmdc.202300473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 12/05/2023] [Indexed: 01/18/2024]
Abstract
The synthesis and pharmacological activity of a new series of dual ligands combining activities towards the α2δ-1 subunit of voltage-gated calcium channels (Cavα2δ-1) and the μ-opioid receptor (MOR) as novel pain therapeutics are reported. A careful exploration of the pharmacophores related to both targets, which in principle had few common characteristics, led to the design of novel compounds exhibiting both activities. The construction of the dual ligands started from published Cavα2δ-1 ligands, onto which MOR ligand pharmacophoric elements were added. This exercise led to new amino-acidic substances with good affinities on both targets as well as good metabolic and physicochemical profiles and low potential for drug-drug interactions. A representative compound, (2S,4S)-4-(4-chloro-3-(((cis)-4-(dimethylamino)-4-phenylcyclohexyl)methyl)-5-fluorophenoxy)pyrrolidine-2-carboxylic acid, displayed promising analgesic activities in several in vivo pain models as well as a reduced side-effect profile in relation to morphine.
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Affiliation(s)
- Anita Wegert
- Symeres, Kerkenbos 1013, 6546 BB, Nijmegen, The, Netherlands
| | - Menno Monnee
- Symeres, Kerkenbos 1013, 6546 BB, Nijmegen, The, Netherlands
| | - Wouter de Graaf
- Symeres, Kerkenbos 1013, 6546 BB, Nijmegen, The, Netherlands
| | - Frank van Holst
- Symeres, Kerkenbos 1013, 6546 BB, Nijmegen, The, Netherlands
| | | | - José Luis Díaz
- WELAB, Parc Científic Barcelona, C/Baldiri Reixac 4-8, 08028, Barcelona, Spain
| | - Albert Dordal
- WELAB, Parc Científic Barcelona, C/Baldiri Reixac 4-8, 08028, Barcelona, Spain
| | | | - Raquel F Reinoso
- WELAB, Parc Científic Barcelona, C/Baldiri Reixac 4-8, 08028, Barcelona, Spain
| | - Sandra Yeste
- WELAB, Parc Científic Barcelona, C/Baldiri Reixac 4-8, 08028, Barcelona, Spain
| | - Antoni Torrens
- WELAB, Parc Científic Barcelona, C/Baldiri Reixac 4-8, 08028, Barcelona, Spain
| | - Carmen Almansa
- WELAB, Parc Científic Barcelona, C/Baldiri Reixac 4-8, 08028, Barcelona, Spain
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Pellitteri G, Versace S, Merlino G, Nilo A, Gigli GL, Valente M. A comprehensive update on the ADMET considerations for α2δ calcium channel ligand medications for treating restless legs syndrome. Expert Opin Drug Metab Toxicol 2024; 20:133-142. [PMID: 38482850 DOI: 10.1080/17425255.2024.2329738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 03/08/2024] [Indexed: 03/26/2024]
Abstract
INTRODUCTION Restless legs syndrome/Willis-Ekbom disease (RLS/WED) is a sleep-related sensory-motor disorder associated with poor sleep quality and impaired daily functioning. In patients affected by chronic RLS/WED, a pharmacological therapy is recommended. International guidelines suggest to start the treatment with a α2δ calcium channel ligand in most cases, unless contraindicated. AREAS COVERED The present review is based on an extensive Internet and PubMed search from 1986 to 2024. Our purpose is to describe the absorption, distribution, metabolism, and toxicology (ADMET) of the α2δ ligands, with common consideration for the therapeutic class, specificities of different compounds, efficacy, and safety in relation to other treatment options. EXPERT OPINION α2δ ligands are quite similar in their ADMET profiles, sharing most of the pharmacokinetics and potential adverse effects. However, we highlight the linear kinetic of gabapentin enacarbil and pregabalin, differently from gabapentin. α2δ ligands are safe and effective for the treatment of RLS/WED. Additional benefits can be obtained in comorbid insomnia, chronic pain syndromes, history of impulse control disorder, and comorbid anxiety. The use of α2δ ligands is associated with poor risk of augmentation. We still need new long-term safe and effective treatments, which could be developed along with our knowledge of RLS/WED pathophysiology.
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Affiliation(s)
- Gaia Pellitteri
- Clinical Neurology Unit, Udine University Hospital, Udine, Italy
| | - Salvatore Versace
- Clinical Neurology Unit, Udine University Hospital, Udine, Italy
- Department of Medicine (DMED), University of Udine, Udine, Italy
| | - Giovanni Merlino
- Clinical Neurology Unit, Udine University Hospital, Udine, Italy
| | - Annacarmen Nilo
- Clinical Neurology Unit, Udine University Hospital, Udine, Italy
- Department of Medicine (DMED), University of Udine, Udine, Italy
| | - Gian Luigi Gigli
- Department of Medicine (DMED), University of Udine, Udine, Italy
| | - Mariarosaria Valente
- Clinical Neurology Unit, Udine University Hospital, Udine, Italy
- Department of Medicine (DMED), University of Udine, Udine, Italy
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3
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Tang M, Sun Q, Zhang Y, Li H, Wang D, Wang Y, Wang Z. Circadian rhythm in restless legs syndrome. Front Neurol 2023; 14:1105463. [PMID: 36908590 PMCID: PMC9995399 DOI: 10.3389/fneur.2023.1105463] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 02/07/2023] [Indexed: 02/25/2023] Open
Abstract
Restless legs syndrome (RLS) is a sensorimotor disorder with a obvious circadian rhythm, as its symptoms often occur or worsen only in the evening or at night. The mechanisms behind the rhythms of RLS have not yet been fully elucidated. This review explores possible causes for the circadian fluctuations of the symptomatology, including the levels of iron, dopamine, melatonin, melanocortin, and thyroid-stimulating hormone in the brain, as well as conditions such as peripheral hypoxia and microvascular function disorders. The metabolic disturbances of the substances above can create a pathological imbalance, which is further aggravated by physiological fluctuations of circadian rhythms, and results in the worsening of RLS symptoms at night. The review concludes with the suggestions for RLS treatment and research directions in the future.
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Affiliation(s)
- Mingyang Tang
- Sleep Center, Department of Neurology, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Qingqing Sun
- Sleep Center, Department of Neurology, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Yanan Zhang
- Sleep Center, Department of Neurology, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Huimin Li
- Sleep Center, Department of Neurology, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Dong Wang
- Sleep Center, Department of Neurology, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Ying Wang
- Sleep Center, Department of Neurology, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Zan Wang
- Sleep Center, Department of Neurology, The First Hospital of Jilin University, Changchun, Jilin, China
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Bae H, Cho YW, Kim KT, Allen RP, Earley CJ. The Safety and Efficacy of Pregabalin Add-on Therapy in Restless Legs Syndrome Patients. Front Neurol 2021; 12:786408. [PMID: 34912291 PMCID: PMC8666621 DOI: 10.3389/fneur.2021.786408] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 10/20/2021] [Indexed: 12/04/2022] Open
Abstract
Pregabalin is increasingly being used as a first-line treatment for symptomatic control of restless legs syndrome (RLS). This study aimed to evaluate the efficacy and safety of pregabalin as add-on therapy in RLS patients already taking dopamine agonists (DA) but still in need of further management. Patients with idiopathic RLS were enrolled, and all had already been prescribed DA for at least 3 months but still had either persistent symptoms, side effects, or comorbid insomnia. An initial dose of 75 mg pregabalin was begun, adjusted as needed, and maintained at a stable dose for 4 weeks, followed by observation for a total of 8 weeks. RLS symptoms and insomnia scores were evaluated before and after add-on pregabalin treatment. Patients were monitored for side effects that could be attributed to pregabalin. A total of 32 RLS patients were enrolled, and 20 subjects remained until the endpoint. After the pregabalin add-on, the mean IRLS score showed significant improvement compared to the baseline (p < 0.001). The insomnia severity index score also improved (p = 0.036), and no serious adverse effects were observed. Our preliminary data suggests the potential for pregabalin as an add-on therapy to DA with regards to both efficacy and safety in patients who have inadequate RLS improvement.
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Affiliation(s)
- Hyoeun Bae
- Department of Neurology, Keimyung University School of Medicine, Daegu, South Korea
| | - Yong Won Cho
- Department of Neurology, Keimyung University School of Medicine, Daegu, South Korea
| | - Keun Tae Kim
- Department of Neurology, Keimyung University School of Medicine, Daegu, South Korea
| | - Richard P Allen
- Department of Neurology, Hopkins Bayview Medical Center, Johns Hopkins University, Baltimore, MD, United States
| | - Christopher J Earley
- Department of Neurology, Hopkins Bayview Medical Center, Johns Hopkins University, Baltimore, MD, United States
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Fernández A, Díaz JL, García M, Rodríguez-Escrich S, Lorente A, Enrech R, Dordal A, Portillo-Salido E, Porras M, Fernández B, Reinoso RF, Vela JM, Almansa C. Piperazinyl Bicyclic Derivatives as Selective Ligands of the α2δ-1 Subunit of Voltage-Gated Calcium Channels. ACS Med Chem Lett 2021; 12:1802-1809. [PMID: 34795870 DOI: 10.1021/acsmedchemlett.1c00416] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 10/01/2021] [Indexed: 12/14/2022] Open
Abstract
The synthesis and pharmacological activities of a new series of piperazinyl quinazolin-4-(3H)-one derivatives acting toward the α2δ-1 subunit of voltage-gated calcium channels (Cavα2δ-1) are reported. Different positions of a micromolar HTS hit were explored, and best activities were obtained for compounds containing a small alkyl group in position 3 of the quinazolin-4-(3H)-one scaffold and a 3-methyl-piperazin-1-yl- or 3,5-dimethyl-piperazin-1-yl-butyl group in position 2. The activity was shown to reside in the R enantiomer of the chain in position 2, and several eutomers reached single digit nanomolar affinities. Final modification of the central scaffold to reduce lipophilicity provided the pyrido[4,3-d]pyrimidin-4(3H)-one 16RR, which showed high selectivity for Cavα2δ-1 versus Cavα2δ-2, probably linked to its improved analgesic efficacy-safety ratio in mice over pregabalin.
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Affiliation(s)
- Ariadna Fernández
- Welab Barcelona, Parc Científic Barcelona, C/Baldiri Reixac 4-8, 08028 Barcelona, Spain
| | - José Luis Díaz
- Welab Barcelona, Parc Científic Barcelona, C/Baldiri Reixac 4-8, 08028 Barcelona, Spain
| | - Mónica García
- Welab Barcelona, Parc Científic Barcelona, C/Baldiri Reixac 4-8, 08028 Barcelona, Spain
| | | | - Adriana Lorente
- Welab Barcelona, Parc Científic Barcelona, C/Baldiri Reixac 4-8, 08028 Barcelona, Spain
| | - Raquel Enrech
- Welab Barcelona, Parc Científic Barcelona, C/Baldiri Reixac 4-8, 08028 Barcelona, Spain
| | - Albert Dordal
- Welab Barcelona, Parc Científic Barcelona, C/Baldiri Reixac 4-8, 08028 Barcelona, Spain
| | | | - Mónica Porras
- Welab Barcelona, Parc Científic Barcelona, C/Baldiri Reixac 4-8, 08028 Barcelona, Spain
| | - Begoña Fernández
- Welab Barcelona, Parc Científic Barcelona, C/Baldiri Reixac 4-8, 08028 Barcelona, Spain
| | - Raquel F. Reinoso
- Welab Barcelona, Parc Científic Barcelona, C/Baldiri Reixac 4-8, 08028 Barcelona, Spain
| | - José Miguel Vela
- Welab Barcelona, Parc Científic Barcelona, C/Baldiri Reixac 4-8, 08028 Barcelona, Spain
| | - Carmen Almansa
- Welab Barcelona, Parc Científic Barcelona, C/Baldiri Reixac 4-8, 08028 Barcelona, Spain
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Díaz JL, Cuevas F, Pazos G, Álvarez-Bercedo P, Oliva AI, Sarmentero MÁ, Font D, Jiménez-Aquino A, Morón M, Port A, Pascual R, Dordal A, Portillo-Salido E, Reinoso RF, Vela JM, Almansa C. Bicyclic Diazepinones as Dual Ligands of the α2δ-1 Subunit of Voltage-Gated Calcium Channels and the Norepinephrine Transporter. J Med Chem 2021; 64:2167-2185. [PMID: 33591743 DOI: 10.1021/acs.jmedchem.0c01867] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The synthesis and pharmacological activity of a new series of bicyclic diazepinones with dual activity toward the α2δ-1 subunit of voltage-gated calcium channels (Cavα2δ-1) and the norepinephrine transporter (NET) are reported. Exploration of the positions amenable for substitution on a nonaminoacidic Cavα2δ-1 scaffold allowed the identification of favorable positions for the attachment of NET pharmacophores. Among the patterns explored, attachment of the 2-ethylamino-9-methyl-6-phenyl-6,7,8,9-tetrahydro-5H-pyrimido[4,5-e][1,4]diazepin-5-one framework to the meta-position of the phenyl ring of the 3-methylamino-1-phenylpropoxy and 3-methylamino-1-thiophenylpropoxy moieties provided dual compounds with excellent NET functionality. Alternative bicyclic frameworks were also explored, and some lead molecules were identified, which showed a balanced dual profile and exhibited good ADMET properties.
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Affiliation(s)
- José Luis Díaz
- ESTEVE Pharmaceuticals, Torre Esteve, Passeig de la Zona Franca, 109, 08038 Barcelona, Spain
| | - Félix Cuevas
- Institute of Chemical Research of Catalonia (ICIQ), Barcelona Institute of Science and Technology, Av. Països Catalans 16, 43007 Tarragona, Spain
| | - Gonzalo Pazos
- Institute of Chemical Research of Catalonia (ICIQ), Barcelona Institute of Science and Technology, Av. Països Catalans 16, 43007 Tarragona, Spain
| | - Paula Álvarez-Bercedo
- Institute of Chemical Research of Catalonia (ICIQ), Barcelona Institute of Science and Technology, Av. Països Catalans 16, 43007 Tarragona, Spain
| | - Ana I Oliva
- Institute of Chemical Research of Catalonia (ICIQ), Barcelona Institute of Science and Technology, Av. Països Catalans 16, 43007 Tarragona, Spain
| | - M Ángeles Sarmentero
- Institute of Chemical Research of Catalonia (ICIQ), Barcelona Institute of Science and Technology, Av. Països Catalans 16, 43007 Tarragona, Spain
| | - Daniel Font
- Institute of Chemical Research of Catalonia (ICIQ), Barcelona Institute of Science and Technology, Av. Països Catalans 16, 43007 Tarragona, Spain
| | - Agustín Jiménez-Aquino
- Institute of Chemical Research of Catalonia (ICIQ), Barcelona Institute of Science and Technology, Av. Països Catalans 16, 43007 Tarragona, Spain
| | - María Morón
- Institute of Chemical Research of Catalonia (ICIQ), Barcelona Institute of Science and Technology, Av. Països Catalans 16, 43007 Tarragona, Spain
| | - Adriana Port
- ESTEVE Pharmaceuticals, Torre Esteve, Passeig de la Zona Franca, 109, 08038 Barcelona, Spain
| | - Rosalía Pascual
- ESTEVE Pharmaceuticals, Torre Esteve, Passeig de la Zona Franca, 109, 08038 Barcelona, Spain
| | - Albert Dordal
- ESTEVE Pharmaceuticals, Torre Esteve, Passeig de la Zona Franca, 109, 08038 Barcelona, Spain
| | - Enrique Portillo-Salido
- ESTEVE Pharmaceuticals, Torre Esteve, Passeig de la Zona Franca, 109, 08038 Barcelona, Spain
| | - Raquel F Reinoso
- ESTEVE Pharmaceuticals, Torre Esteve, Passeig de la Zona Franca, 109, 08038 Barcelona, Spain
| | - José Miguel Vela
- ESTEVE Pharmaceuticals, Torre Esteve, Passeig de la Zona Franca, 109, 08038 Barcelona, Spain
| | - Carmen Almansa
- ESTEVE Pharmaceuticals, Torre Esteve, Passeig de la Zona Franca, 109, 08038 Barcelona, Spain
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Memon MD, Faiz S, Zaveri MP, Perry JC, Schuetz TM, Cancarevic I. Unraveling the Mysteries of Restless Leg Syndrome. Cureus 2020; 12:e10951. [PMID: 33083159 PMCID: PMC7567326 DOI: 10.7759/cureus.10951] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Restless leg syndrome (RLS) or Willis-Ekbom disease (WED) is an under-diagnosed, chronic, and progressive primary sensory-motor disorder. It is characterized by an uncontrollable urge to move the legs due to uncomfortable and sometimes painful sensations, with a diurnal variation. RLS can lead to severe sleep disturbances, a usual cause of consultation. The pathophysiology is known partially, and it is believed that there is an association between the different variants of genetic mutations combined with dopaminergic and brain iron dysregulation, which plays an important role. The data used for this study were extracted from the articles found in the PubMed database that discuss different gene variants, pathophysiology, and various methods of treatment. They also highlight the role of iron in the pathogenesis of RLS as it is required for the synthesis of tyrosine hydroxylase, which is the rate-limiting step for dopamine synthesis. This review article provides a clinically useful overview of RLS in terms of pathophysiological findings, its genetic associations, and therapeutic options by using the currently available literature. Because RLS presents with vague symptoms and shares similarities with many other diseases, it might be overlooked by many physicians resulting in underdiagnosis and under-treatment. While these discoveries provide a breakthrough in understanding the details of RLS, further studies are recommended as these studies are limited to animal models and provide a limited representation of the general population.
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Affiliation(s)
- Mohammad D Memon
- Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Sadaf Faiz
- Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Mitul P Zaveri
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Jamal C Perry
- Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Tayná M Schuetz
- Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Ivan Cancarevic
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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Hein M, Lanquart JP, Hubain P, Loas G. Risk of resistant hypertension associated with restless legs syndrome and periodic limb movements during sleep: a study on 673 treated hypertensive individuals. Sleep Med 2019; 63:46-56. [PMID: 31606649 DOI: 10.1016/j.sleep.2019.05.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 05/02/2019] [Accepted: 05/07/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Given the limited data available in the literature, the aim of this study was to examine the risk of resistant hypertension (RHT) associated with restless legs syndrome (RLS) and periodic limb movements during sleep (PLMS) in a large sample of treated hypertensive individuals. METHODS Demographic and polysomnographic (PSG) data from 673 treated hypertensive individuals recruited from the research database of the sleep laboratory of Erasme Hospital were analysed. After exclusion of the main causes of pseudo-resistance and secondary hypertension, RHT status was defined by the presence of an uncontrolled hypertension despite treatment with at least three antihypertensive agents (including a diuretic) from different classes in correct combination and at the highest tolerated doses or by the presence of controlled hypertension requiring the use of at least four antihypertensive agents. Logistic regression analyses were conducted to examine the risk of RHT associated with RLS and PLMS in treated hypertensive individuals. RESULTS After adjustment for major confounding factors associated with RHT, multivariate logistic regression analysis revealed that frequent RLS (≥2 episodes/week) combined with PLMS index ≥26/h [odds ratio (OR) 2.20; 95% confidence interval (CI) 1.35-3.61, p = 0.021] was a significant risk factor of RHT in treated hypertensive individuals. CONCLUSION In treated hypertensive individuals, frequent RLS combined with PLMS index ≥26/h is associated with higher risk of RHT which suggests that this pathology may be a secondary cause of RHT (eg, obstructive sleep apnoea syndrome and insomnia with short sleep duration) justifying the establishment of effective treatments in this particular subpopulation.
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Affiliation(s)
- Matthieu Hein
- Erasme Hospital, Department of Psychiatry and Sleep Laboratory, Université libre de Bruxelles, ULB, Brussels, Belgium.
| | - Jean-Pol Lanquart
- Erasme Hospital, Department of Psychiatry and Sleep Laboratory, Université libre de Bruxelles, ULB, Brussels, Belgium
| | - Philippe Hubain
- Erasme Hospital, Department of Psychiatry and Sleep Laboratory, Université libre de Bruxelles, ULB, Brussels, Belgium
| | - Gwenolé Loas
- Erasme Hospital, Department of Psychiatry and Sleep Laboratory, Université libre de Bruxelles, ULB, Brussels, Belgium
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Cortés A, Casadó-Anguera V, Moreno E, Casadó V. The heterotetrameric structure of the adenosine A 1-dopamine D 1 receptor complex: Pharmacological implication for restless legs syndrome. ADVANCES IN PHARMACOLOGY (SAN DIEGO, CALIF.) 2019; 84:37-78. [PMID: 31229177 DOI: 10.1016/bs.apha.2019.01.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Dopaminergic and purinergic signaling play a pivotal role in neurological diseases associated with motor symptoms, including Parkinson's disease (PD), multiple sclerosis, amyotrophic lateral sclerosis, Huntington disease, Restless Legs Syndrome (RLS), spinal cord injury (SCI), and ataxias. Extracellular dopamine and adenosine exert their functions interacting with specific dopamine (DR) or adenosine (AR) receptors, respectively, expressed on the surface of target cells. These receptors are members of the family A of G protein-coupled receptors (GPCRs), which is the largest protein superfamily in mammalian genomes. GPCRs are target of about 40% of all current marketed drugs, highlighting their importance in clinical medicine. The striatum receives the densest dopamine innervations and contains the highest density of dopamine receptors. The modulatory role of adenosine on dopaminergic transmission depends largely on the existence of antagonistic interactions mediated by specific subtypes of DRs and ARs, the so-called A2AR-D2R and A1R-D1R interactions. Due to the dopamine/adenosine antagonism in the CNS, it was proposed that ARs and DRs could form heteromers in the neuronal cell surface. Therefore, adenosine can affect dopaminergic signaling through receptor-receptor interactions and by modulations in their shared intracellular pathways in the striatum and spinal cord. In this work we describe the allosteric modulations between GPCR protomers, focusing in those of adenosine and dopamine within the A1R-D1R heteromeric complex, which is involved in RLS. We also propose that the knowledge about the intricate allosteric interactions within the A1R-D1R heterotetramer, may facilitate the treatment of motor alterations, not only when the dopamine pathway is hyperactivated (RLS, chorea, etc.) but also when motor function is decreased (SCI, aging, PD, etc.).
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Affiliation(s)
- Antoni Cortés
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain; Institute of Biomedicine of the University of Barcelona (IBUB), Barcelona, Spain; Department of Biochemistry and Molecular Biomedicine, Faculty of Biology, University of Barcelona, Barcelona, Spain
| | - Verònica Casadó-Anguera
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain; Institute of Biomedicine of the University of Barcelona (IBUB), Barcelona, Spain; Department of Biochemistry and Molecular Biomedicine, Faculty of Biology, University of Barcelona, Barcelona, Spain
| | - Estefanía Moreno
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain; Institute of Biomedicine of the University of Barcelona (IBUB), Barcelona, Spain; Department of Biochemistry and Molecular Biomedicine, Faculty of Biology, University of Barcelona, Barcelona, Spain
| | - Vicent Casadó
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain; Institute of Biomedicine of the University of Barcelona (IBUB), Barcelona, Spain; Department of Biochemistry and Molecular Biomedicine, Faculty of Biology, University of Barcelona, Barcelona, Spain.
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