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El Harchi A, Brincourt O. Pharmacological activation of the hERG K + channel for the management of the long QT syndrome: A review. J Arrhythm 2022; 38:554-569. [PMID: 35936037 PMCID: PMC9347208 DOI: 10.1002/joa3.12741] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/28/2022] [Accepted: 05/16/2022] [Indexed: 11/10/2022] Open
Abstract
In the human heart, the rapid delayed rectifier K+ current (I Kr) contributes significantly to ventricular action potential (AP) repolarization and to set the duration of the QT interval of the surface electrocardiogram (ECG). The pore-forming (α) subunit of the I Kr channel is encoded by KCNH2 or human ether-à-go-go-related gene 1 (hERG1). Impairment of hERG function through either gene mutation (congenital) or pharmacological blockade by diverse drugs in clinical use (acquired) can cause a prolongation of the AP duration (APD) reflected onto the surface ECG as a prolonged QT interval or Long QT Syndrome (LQTS). LQTS can increase the risk of triggered activity of ventricular cardiomyocytes and associated life-threatening arrhythmia. Current treatments all focus on reducing the incidence of arrhythmia or terminating it after its onset but there is to date no prophylactic treatment for the pharmacological management of LQTS. A new class of hERG modulators (agonists) have been suggested through direct interaction with the hERG channel to shorten the action potential duration (APD) and/or increase the postrepolarisation refractoriness period (PRRP) of ventricular cardiomyocytes protecting thereby against triggered activity and associated arrhythmia. Although promising drug candidates, there remain major obstacles to their clinical development. The aim of this review is to summarize the latest advances as well as the limitations of this proposed pharmacotherapy.
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Affiliation(s)
- Aziza El Harchi
- School of Physiology, Pharmacology and Neuroscience, Biomedical Sciences BuildingUniversity of Bristol, University WalkBristolUK
| | - Oriane Brincourt
- School of Physiology, Pharmacology and Neuroscience, Biomedical Sciences BuildingUniversity of Bristol, University WalkBristolUK
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2
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Patel MV, Peltier HM, Matulenko MA, Koenig JR, C Scanio MJ, Gum RJ, El-Kouhen OF, Fricano MM, Lundgaard GL, Neelands T, Zhang XF, Zhan C, Pai M, Ghoreishi-Haack N, Hudzik T, Gintant G, Martin R, McGaraughty S, Xu J, Bow D, Kalvass JC, Kym PR, DeGoey DA, Kort ME. Discovery of (R)-(3-fluoropyrrolidin-1-yl)(6-((5-(trifluoromethyl)pyridin-2-yl)oxy)quinolin-2-yl)methanone (ABBV-318) and analogs as small molecule Na v1.7/ Nav1.8 blockers for the treatment of pain. Bioorg Med Chem 2022; 63:116743. [PMID: 35436748 DOI: 10.1016/j.bmc.2022.116743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 04/01/2022] [Accepted: 04/02/2022] [Indexed: 11/24/2022]
Abstract
The voltage-gated sodium channel Nav1.7 is an attractive target for the treatment of pain based on the high level of target validation with genetic evidence linking Nav1.7 to pain in humans. Our effort to identify selective, CNS-penetrant Nav1.7 blockers with oral activity, improved selectivity, good drug-like properties, and safety led to the discovery of 2-substituted quinolines and quinolones as potent small molecule Nav1.7 blockers. The design of these molecules focused on maintaining potency at Nav1.7, improving selectivity over the hERG channel, and overcoming phospholipidosis observed with the initial leads. The structure-activity relationship (SAR) studies leading to the discovery of (R)-(3-fluoropyrrolidin-1-yl)(6-((5-(trifluoromethyl)pyridin-2-yl)oxy)quinolin-2-yl)methanone (ABBV-318) are described herein. ABBV-318 displayed robust in vivo efficacy in both inflammatory and neuropathic rodent models of pain. ABBV-318 also inhibited Nav1.8, another sodium channel isoform that is an active target for the development of new pain treatments.
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Affiliation(s)
- Meena V Patel
- AbbVie, Research and Development, 1 North Waukegan Road, North Chicago, IL 60064, USA.
| | - Hillary M Peltier
- AbbVie, Research and Development, 1 North Waukegan Road, North Chicago, IL 60064, USA
| | - Mark A Matulenko
- AbbVie, Research and Development, 1 North Waukegan Road, North Chicago, IL 60064, USA
| | - John R Koenig
- AbbVie, Research and Development, 1 North Waukegan Road, North Chicago, IL 60064, USA
| | - Marc J C Scanio
- AbbVie, Research and Development, 1 North Waukegan Road, North Chicago, IL 60064, USA
| | - Rebecca J Gum
- AbbVie, Research and Development, 1 North Waukegan Road, North Chicago, IL 60064, USA
| | - Odile F El-Kouhen
- AbbVie, Research and Development, 1 North Waukegan Road, North Chicago, IL 60064, USA
| | - Meagan M Fricano
- AbbVie, Research and Development, 1 North Waukegan Road, North Chicago, IL 60064, USA
| | - Greta L Lundgaard
- AbbVie, Research and Development, 1 North Waukegan Road, North Chicago, IL 60064, USA
| | - Torben Neelands
- AbbVie, Research and Development, 1 North Waukegan Road, North Chicago, IL 60064, USA
| | - Xu-Feng Zhang
- AbbVie, Research and Development, 1 North Waukegan Road, North Chicago, IL 60064, USA
| | - Cenchen Zhan
- AbbVie, Research and Development, 1 North Waukegan Road, North Chicago, IL 60064, USA
| | - Madhavi Pai
- AbbVie, Research and Development, 1 North Waukegan Road, North Chicago, IL 60064, USA
| | | | - Thomas Hudzik
- AbbVie, Research and Development, 1 North Waukegan Road, North Chicago, IL 60064, USA
| | - Gary Gintant
- AbbVie, Research and Development, 1 North Waukegan Road, North Chicago, IL 60064, USA
| | - Ruth Martin
- AbbVie, Research and Development, 1 North Waukegan Road, North Chicago, IL 60064, USA
| | - Steve McGaraughty
- AbbVie, Research and Development, 1 North Waukegan Road, North Chicago, IL 60064, USA
| | - Jun Xu
- AbbVie, Research and Development, 1 North Waukegan Road, North Chicago, IL 60064, USA
| | - Daniel Bow
- AbbVie, Research and Development, 1 North Waukegan Road, North Chicago, IL 60064, USA
| | - John C Kalvass
- AbbVie, Research and Development, 1 North Waukegan Road, North Chicago, IL 60064, USA
| | - Philip R Kym
- AbbVie, Research and Development, 1 North Waukegan Road, North Chicago, IL 60064, USA
| | - David A DeGoey
- AbbVie, Research and Development, 1 North Waukegan Road, North Chicago, IL 60064, USA
| | - Michael E Kort
- AbbVie, Research and Development, 1 North Waukegan Road, North Chicago, IL 60064, USA
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3
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Sanchez-Conde FG, Jimenez-Vazquez EN, Auerbach DS, Jones DK. The ERG1 K+ Channel and Its Role in Neuronal Health and Disease. Front Mol Neurosci 2022; 15:890368. [PMID: 35600076 PMCID: PMC9113952 DOI: 10.3389/fnmol.2022.890368] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 04/11/2022] [Indexed: 11/30/2022] Open
Abstract
The ERG1 potassium channel, encoded by KCNH2, has long been associated with cardiac electrical excitability. Yet, a growing body of work suggests that ERG1 mediates physiology throughout the human body, including the brain. ERG1 is a regulator of neuronal excitability, ERG1 variants are associated with neuronal diseases (e.g., epilepsy and schizophrenia), and ERG1 serves as a potential therapeutic target for neuronal pathophysiology. This review summarizes the current state-of-the-field regarding the ERG1 channel structure and function, ERG1’s relationship to the mammalian brain and highlights key questions that have yet to be answered.
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Affiliation(s)
| | - Eric N. Jimenez-Vazquez
- Department of Pharmacology, University of Michigan Medical School, Ann Arbor, MI, United States
| | - David S. Auerbach
- Department of Pharmacology, State University of New York Upstate Medical University, Syracuse, NY, United States
- *Correspondence: David S. Auerbach,
| | - David K. Jones
- Department of Pharmacology, University of Michigan Medical School, Ann Arbor, MI, United States
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, United States
- David K. Jones,
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4
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Creanza TM, Delre P, Ancona N, Lentini G, Saviano M, Mangiatordi GF. Structure-Based Prediction of hERG-Related Cardiotoxicity: A Benchmark Study. J Chem Inf Model 2021; 61:4758-4770. [PMID: 34506150 PMCID: PMC9282647 DOI: 10.1021/acs.jcim.1c00744] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
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Drug-induced blockade of the human
ether-à-go-go-related
gene (hERG) channel is today considered the main
cause of cardiotoxicity in postmarketing surveillance. Hence, several
ligand-based approaches were developed in the last years and are currently
employed in the early stages of a drug discovery process for in silico cardiac safety assessment of drug candidates.
Herein, we present the first structure-based classifiers able to discern hERG binders from nonbinders. LASSO regularized support
vector machines were applied to integrate docking scores and protein–ligand
interaction fingerprints. A total of 396 models were trained and validated
based on: (i) high-quality experimental bioactivity information returned
by 8337 curated compounds extracted from ChEMBL (version 25) and (ii)
structural predictor data. Molecular docking simulations were performed
using GLIDE and GOLD software programs and four different hERG structural models, namely, the recently published structures
obtained by cryoelectron microscopy (PDB codes: 5VA1 and 7CN1) and
two published homology models selected for comparison. Interestingly,
some classifiers return performances comparable to ligand-based models
in terms of area under the ROC curve (AUCMAX = 0.86 ±
0.01) and negative predictive values (NPVMAX = 0.81 ±
0.01), thus putting forward the herein proposed computational workflow
as a valuable tool for predicting hERG-related cardiotoxicity
without the limitations of ligand-based models, typically affected
by low interpretability and a limited applicability domain. From a
methodological point of view, our study represents the first example
of a successful integration of docking scores and protein–ligand
interaction fingerprints (IFs) through a support vector machine (SVM)
LASSO regularized strategy. Finally, the study highlights the importance
of using hERG structural models accounting for ligand-induced
fit effects and allowed us to select the best-performing protein conformation
(made available in the Supporting Information, SI) to be employed
for a reliable structure-based prediction of hERG-related cardiotoxicity.
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Affiliation(s)
- Teresa Maria Creanza
- CNR-Institute of Intelligent Industrial Technologies and Systems for Advanced Manufacturing, Via Amendola 122/o, 70126 Bari, Italy
| | - Pietro Delre
- Chemistry Department, University of Bari "Aldo Moro", via E. Orabona, 4, I-70125 Bari, Italy.,CNR-Institute of Crystallography, Via Amendola 122/o, 70126 Bari, Italy
| | - Nicola Ancona
- CNR-Institute of Intelligent Industrial Technologies and Systems for Advanced Manufacturing, Via Amendola 122/o, 70126 Bari, Italy
| | - Giovanni Lentini
- Department of Pharmacy-Pharmaceutical Sciences, University of Bari "Aldo Moro", via E. Orabona, 4, I-70125 Bari, Italy
| | - Michele Saviano
- CNR-Institute of Crystallography, Via Amendola 122/o, 70126 Bari, Italy
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Zhang KP, Yang BF, Li BX. Translational toxicology and rescue strategies of the hERG channel dysfunction: biochemical and molecular mechanistic aspects. Acta Pharmacol Sin 2014; 35:1473-84. [PMID: 25418379 PMCID: PMC4261120 DOI: 10.1038/aps.2014.101] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Accepted: 08/20/2014] [Indexed: 01/08/2023] Open
Abstract
The human ether-à-go-go related gene (hERG) potassium channel is an obligatory anti-target for drug development on account of its essential role in cardiac repolarization and its close association with arrhythmia. Diverse drugs have been removed from the market owing to their inhibitory activity on the hERG channel and their contribution to acquired long QT syndrome (LQTS). Moreover, mutations that cause hERG channel dysfunction may induce congenital LQTS. Recently, an increasing number of biochemical and molecular mechanisms underlying hERG-associated LQTS have been reported. In fact, numerous potential biochemical and molecular rescue strategies are hidden within the biogenesis and regulating network. So far, rescue strategies of hERG channel dysfunction and LQTS mainly include activators, blockers, and molecules that interfere with specific links and other mechanisms. The aim of this review is to discuss the rescue strategies based on hERG channel toxicology from the biochemical and molecular perspectives.
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Affiliation(s)
- Kai-ping Zhang
- Department of Pharmacology, Harbin Medical University, Harbin, China
- The State-Province Key Laboratories of Biomedicine-Pharmaceutics of China (Key Laboratory of Cardiovascular Research, Ministry of Education), China
| | - Bao-feng Yang
- Department of Pharmacology, Harbin Medical University, Harbin, China
- The State-Province Key Laboratories of Biomedicine-Pharmaceutics of China (Key Laboratory of Cardiovascular Research, Ministry of Education), China
| | - Bao-xin Li
- Department of Pharmacology, Harbin Medical University, Harbin, China
- The State-Province Key Laboratories of Biomedicine-Pharmaceutics of China (Key Laboratory of Cardiovascular Research, Ministry of Education), China
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