Synthesis and Evaluation of Novel Radioligands for Positron Emission Tomography Imaging of the Orexin-2 Receptor

Resting phase-administration of lemborexant ameliorates sleep and glucose tolerance in type 2 diabetic mice

Sleep disorders are associated with increased risk of obesity and type 2 diabetes. Lemborexant, a dual orexin receptor antagonist (DORA), is clinically used to treat insomnia. However, the influence of lemborexant on sleep and glucose metabolism in type 2 diabetic state has remained unknown. In the present study, we investigated the effect of lemborexant in type 2 diabetic db/db mice exhibiting both sleep disruption and glucose intolerance. Single administration of lemborexant at the beginning of the light phase (i.e., resting phase) acutely increased total time spent in non-rapid eye movement (NREM) and REM sleep in db/db mice. Durations of NREM sleep-, REM sleep-, and wake-episodes were also increased by this administration. Daily resting-phase administration of lemborexant for 3-6 weeks improved glucose tolerance without changing body weight and glucose-stimulated insulin secretion in db/db mice. Similar improvement of glucose tolerance was caused by daily resting-phase administration of lemborexant in obese C57BL/6J mice fed high fat diet, whereas no such effect was observed in non-diabetic db/m+ mice. Diabetic db/db mice treated daily with lemborexant exhibited increased locomotor activity in the dark phase (i.e., awake phase), although they did not show any behavioral abnormality in the Y-maze, elevated plus maze, and forced swim tests. These results suggest that timely promotion of sleep by lemborexant improved the quality of wakefulness in association with increased physical activity during the awake phase, and these changes may underlie the amelioration of glucose metabolism under type 2 diabetic conditions.

Development of Novel 11C-Labeled Selective Orexin-2 Receptor Radioligands for Positron Emission Tomography Imaging

Orexin 2 receptors (OX2R) represent a vital subtype of orexin receptors intricately involved in the regulation of wakefulness, arousal, and sleep-wake cycles. Despite their importance, there are currently no positron emission tomography (PET) tracers available for imaging the OX2R in vivo. Herein, we report [11C]1 ([11C]OX2-2201) and [11C]2 ([11C]OX2-2202) as novel PET ligands. Both compounds 1 (Ki = 3.6 nM) and 2 (Ki = 2.2 nM) have excellent binding affinity activities toward OX2R and target selectivity (OX2/OX1 > 600 folds). In vitro autoradiography in the rat brain suggested good to excellent in vitro binding specificity for [11C]1 and [11C]2. PET imaging in rat brains indicated that the low brain uptake of [11C]2 may be due to P-glycoprotein and/or breast cancer resistance protein efflux interaction and/or low passive permeability. Continuous effort in medicinal chemistry optimization is necessary to improve the brain permeability of this scaffold.

Targeting orexin receptors: Recent advances in the development of subtype selective or dual ligands for the treatment of neuropsychiatric disorders

Orexin-A and orexin-B, also named hypocretin-1 and hypocretin-2, are two hypothalamic neuropeptides highly conserved across mammalian species. Their effects are mediated by two distinct G protein-coupled receptors, namely orexin receptor type 1 (OX1-R) and type 2 (OX2-R), which share 64% amino acid identity. Given the wide expression of OX-Rs in different central nervous system and peripheral areas and the several pathophysiological functions in which they are involved, including sleep-wake cycle regulation (mainly mediated by OX2-R), emotion, panic-like behaviors, anxiety/stress, food intake, and energy homeostasis (mainly mediated by OX1-R), both subtypes represent targets of interest for many structure-activity relationship (SAR) campaigns carried out by pharmaceutical companies and academies. However, before 2017 the research was predominantly directed towards dual-orexin ligands, and limited chemotypes were investigated. Analytical characterizations, including resolved structures for both OX1-R and OX2-R in complex with agonists and antagonists, have improved the understanding of the molecular basis of receptor recognition and are assets for medicinal chemists in the design of subtype-selective ligands. This review is focused on the medicinal chemistry aspects of small molecules acting as dual or subtype selective OX1-R/OX2-R agonists and antagonists belonging to different chemotypes and developed in the last years, including radiolabeled OX-R ligands for molecular imaging. Moreover, the pharmacological effects of the most studied ligands in different neuropsychiatric diseases, such as sleep, mood, substance use, and eating disorders, as well as pain, have been discussed. Poly-pharmacology applications and multitarget ligands have also been considered.

Synthesis and Characterization of Novel Radioiodinated Triazole-Pyrolidine Derivative to Detect Orexin 2 Receptor in the Brain

It is generally accepted that the orexin 2 receptor (OX₂R) plays a critical role in the arousal-promoting function, and in vivo imaging of OX₂R is expected to contribute to elucidation of orexin systems and the development of drugs to treat sleep disorder. In this study, we newly synthesized and characterized a radioiodinated triazole-pyrolidine derivative ([¹²⁵I]TPI) to detect OX₂R in the brain. In vitro studies using OX₁R or OX₂R expression cells showed selective binding of [¹²⁵I]TPI to OX₂R. In addition, in vitro autoradiography using rat brain sections showed high accumulation of radioactivity in the OX₂R expression region. However, [¹²⁵I]TPI showed low brain uptake in normal mice. These results suggest that [¹²⁵I]TPI has a fundamental character to detect OX₂R in vitro, but further structural modification to improve brain pharmacokinetics is required to use it for in vivo detection of OX₂R.

11C-Labeled Radiotracer for Noninvasive and Quantitative Assessment of the Thiocyanate Efflux System in the Brain

Thiocyanate (SCN^-) alters the potency of certain agonists for the α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor, and dysfunctions in AMPA receptor signaling are considered to underlie a number of neurological diseases. While humans may be exposed to SCN^- from the environment, including food sources, a carrier-mediated system transports SCN^- from the brain into the blood and is an important regulator of SCN^- distribution in the central nervous system. The assessment of this SCN^- efflux system in the brain would thus be useful for understanding the mechanisms underlying the neurotoxicity of SCN^- and for elucidating the relationship between the efflux system and brain diseases. However, the currently available technique for studying SCN^- efflux is severely limited by its invasiveness. Here, we describe the development of a SCN^- protracer, 9-pentyl-6-[¹¹C]thiocyanatopurine ([¹¹C]1), to overcome this limitation. [¹¹C]1 was synthesized by the reaction of the iodo-precursor and [¹¹C]SCN^- or the reaction of the disulfide precursor with [¹¹C]NH₄CN. The protracer [¹¹C]1 entered the brain after intravenous injection into mice and was rapidly metabolized to [¹¹C]SCN^-, which was then eliminated from the brain. The efflux of [¹¹C]SCN^- was dose-dependently inhibited by perchlorate, a monovalent anion, and the highest dose caused an 82% reduction in the efflux rate. Our findings demonstrate that [¹¹C]1 can be used for the noninvasive and quantitative assessment of the SCN^- efflux system in the brain.

Synthesis and characterization of a new Positron emission tomography probe for orexin 2 receptors neuroimaging

The orexin receptors (OXRs) have been involved in multiple physiological and neuropsychiatric functions. Identification of PET imaging probes specifically targeting OXRs enables us to better understand the OX system. Seltorexant (JNJ-42847922) is a potent OX₂R antagonist with the potential to be an OX₂R PET imaging probe. Here, we describe the synthesis and characterization of [¹⁸F]Seltorexant as an OX₂R PET probe. The ex vivo autoradiography studies indicated the good binding specificity of [¹⁸F]Seltorexant. In vivo PET imaging of [¹⁸F]Seltorexant in rodents showed suitable BBB penetration with the highest brain uptake of %ID/cc = 3.4 at 2 min post-injection in mice. The regional brain biodistribution analysis and blocking studies showed that [¹⁸F]Seltorexant had good binding selectivity and specificity. However, pretreatment with unlabelled Seltorexant and P-gp competitor CsA observed significantly increased brain uptake of [¹⁸F]Seltorexant, indicating [¹⁸F]Seltorexant could interact P-gp at the blood-brain barrier. Our findings demonstrated that [¹⁸F]Seltorexant is a potential brain OX₂R PET imaging probe, which paves the way for new OX₂R PET probes development and OX system investigation.

Automated radiosynthesis of [11 C]MTP38-a phosphodiesterase 7 imaging tracer-using [11 C]hydrogen cyanide for clinical applications

We have developed 8-amino-3-(2S,5R-dimethyl-1-piperidyl)-[1,2,4]triazolo[4,3-a]pyrazine-5-[¹¹ C]carbonitrile ([¹¹ C]MTP38) as a PET tracer for the imaging of phosphodiesterase 7. For the fully automated production of [¹¹ C]MTP38 routinely and efficiently for clinical applications, we determined the radiosynthesis procedure of [¹¹ C]MTP38 using [¹¹ C]hydrogen cyanide ([¹¹ C]HCN) as a PET radiopharmaceutical. Radiosynthesis of [¹¹ C]MTP38 was performed using an automated ¹¹ C-labeling synthesizer developed in-house within 40 min after the end of irradiation. [¹¹ C]MTP38 was obtained with a relatively high radiochemical yield (33 ± 5.5% based on [¹¹ C]CO₂ at the end of irradiation, decay-corrected, n = 15), radiochemical purity (>97%, n = 15), and molar activity (47 ± 12 GBq/μmol at the end of synthesis, n = 15). All the results of the quality control (QC) testing for the [¹¹ C]MTP38 injection complied with our in-house QC and quality assurance specifications. We successfully automated the radiosynthesis of [¹¹ C]MTP38 for clinical applications using an ¹¹ C-labeling synthesizer and sterile isolator. Taken together, this protocol provides a new radiopharmaceutical [¹¹ C]MTP38 suitable for clinical applications.

Radiolabeling with [11C]HCN for Positron emission tomography

Hydrogen cyanide (HCN) is a versatile synthon for generating carbon‑carbon and carbon-heteroatom bonds. Unlike other one-carbon synthons (i.e., CO, CO2), HCN can function as a nucleophile (as in potassium cyanide, KCN) and an electrophile (as in cyanogen bromide, (CN)Br). The incorporation of the CN motif into organic molecules generates nitriles, hydantoins and (thio)cyanates, which can be converted to carboxylic acids, aldehydes, amides and amines. Such versatile chemistry is particularly attractive in PET radiochemistry where diverse bioactive small molecules incorporating carbon-11 in different positions need to be produced. The first examples of making [11C]HCN for radiolabeling date back to the 1960s. During the ensuing decades, [11C]cyanide labeling was popular for producing biologically important molecules including 11C-labeled α-amino acids, sugars and neurotransmitters. [11C]cyanation is now reemerging in many PET centers due to its versatility for making novel tracers. Here, we summarize the chemistry of [11C]HCN, review the methods to make [11C]HCN past and present, describe methods for labeling different types of molecules with [11C]HCN, and provide an overview of the reactions available to convert nitriles into other functional groups. Finally, we discuss some of the challenges and opportunities in [11C]HCN labeling such as developing more robust methods to produce [11C]HCN and developing rapid and selective methods to convert nitriles into other functional groups in complex molecules.

Synthesis and biological evaluation of novel 18F-labeled phenylbenzofuran-2-carboxamide derivative for detection of orexin 1 receptor in the brain

Although the orexin 1 receptor (OX₁R) in the brain is considered to regulate reward and feeding, the in vivo function of OX₁R has not been fully elucidated. In vivo imaging of OX₁R with positron emission tomography (PET) may be useful to further understand the molecular details of OX₁R. In this study, we newly designed and synthesized a phenylbenzofuran-2-carboxamide (PBC) derivative ([¹⁸F]PBC-1) and evaluated its utility as a PET probe targeting OX₁R in the brain. The results of cell binding assays suggested that [¹⁸F]PBC-1 has affinity for OX₁R. In an in vitro competitive inhibition assay, PBC-1 showed selective binding affinity for OX₁R (IC₅₀ = 19.5 nM) over orexin 2 receptor (IC₅₀ = 456.7 nM). Furthermore, [¹⁸F]PBC-1 displayed sufficient brain uptake for in vivo imaging with PET in a biodistribution study using normal mice, but in vivo instability was observed. These results suggest that further modifications for improvement of the pharmacokinetics are needed, but the PBC scaffold has potential for the development of useful PET probes targeting OX₁R in the brain.

Synthesis and preclinical evaluation of [11C]MTP38 as a novel PET ligand for phosphodiesterase 7 in the brain

Purpose

Phosphodiesterase (PDE) 7 is a potential therapeutic target for neurological and inflammatory diseases, although in vivo visualization of PDE7 has not been successful. In this study, we aimed to develop [¹¹C]MTP38 as a novel positron emission tomography (PET) ligand for PDE7.

Methods

[¹¹C]MTP38 was radiosynthesized by ¹¹C-cyanation of a bromo precursor with [¹¹C]HCN. PET scans of rat and rhesus monkey brains and in vitro autoradiography of brain sections derived from these species were conducted with [¹¹C]MTP38. In monkeys, dynamic PET data were analyzed with an arterial input function to calculate the total distribution volume (V_T). The non-displaceable binding potential (BP_ND) in the striatum was also determined by a reference tissue model with cerebellar reference. Finally, striatal occupancy of PDE7 by an inhibitor was calculated in monkeys according to changes in BP_ND.

Results

[¹¹C]MTP38 was synthesized with radiochemical purity ≥99.4% and molar activity of 38.6 ± 12.6 GBq/μmol. Autoradiography revealed high radioactivity in the striatum and its reduction by non-radiolabeled ligands, in contrast with unaltered autoradiographic signals in other regions. In vivo PET after radioligand injection to rats and monkeys demonstrated that radioactivity was rapidly distributed to the brain and intensely accumulated in the striatum relative to the cerebellum. Correspondingly, estimated V_T values in the monkey striatum and cerebellum were 3.59 and 2.69 mL/cm³, respectively. The cerebellar V_T value was unchanged by pretreatment with unlabeled MTP38. Striatal BP_ND was reduced in a dose-dependent manner after pretreatment with MTP-X, a PDE7 inhibitor. Relationships between PDE7 occupancy by MTP-X and plasma MTP-X concentration could be described by Hill’s sigmoidal function.

Conclusion

We have provided the first successful preclinical demonstration of in vivo PDE7 imaging with a specific PET radioligand. [¹¹C]MTP38 is a feasible radioligand for evaluating PDE7 in the brain and is currently being applied to a first-in-human PET study.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00259-021-05269-4.

Synthesis and characterization of a novel 18F-labeled 2,5-diarylnicotinamide derivative targeting orexin 2 receptor

Orexin 2 receptor (OX2R) is thought to play an important role in the arousal-promoting function, but its distribution and function in the pathophysiology of orexin-mediated disorders remains to be fully elucidated. In the present study, we synthesized and characterized a novel 18F-labeled 2,5-diarylnicotinamide (DAN) derivative as a potential positron emission tomography (PET) probe for in vivo imaging of OX2R. In in vitro binding experiments, [18F]DAN-1 selectively bound to OX2R. In a biodistribution study using normal mice, [18F]DAN-1 displayed moderate brain uptake (2.10% ID per g at 10 min post-injection). In addition, the radioactivity in the mouse brain at 30 min post-injection was significantly decreased by co-injection with nonradioactive DAN-1, but high nonspecific binding was observed. These results suggested that further structural modifications of [18F]DAN-1 are needed to use it for imaging OX2R in the brain.

Recent progress in [11 C]carbon dioxide ([11 C]CO2 ) and [11 C]carbon monoxide ([11 C]CO) chemistry

[11 C]Carbon dioxide ([11 C]CO2 ) and [11 C]carbon monoxide ([11 C]CO) are 2 attractive precursors for labelling the carbonyl position (C═O) in a vast range of functionalised molecules (eg, ureas, amides, and carboxylic acids). The development of radiosynthetic methods to produce functionalised 11 C-labelled compounds is required to enhance the radiotracers available for positron emission tomography, molecular, and medical imaging applications. Following a brief summary of secondary 11 C-precursor production and uses, the review focuses on recent progress with direct 11 C-carboxylation routes with [11 C]CO2 and 11 C-carbonylation with [11 C]CO. Novel approaches to generate [11 C]CO using CO-releasing molecules (CO-RMs), such as silacarboxylic acids and disilanes, applied to radiochemistry are described and compared with standard [11 C]CO production methods. These innovative [11 C]CO synthesis strategies represent efficient and reliable [11 C]CO production processes, enabling the widespread use of [11 C]CO chemistry within the wider radiochemistry community.

Imaging transporters: Transforming diagnostic and therapeutic development

Molecular imaging allows noninvasive assessment of drug distribution across pharmacological barriers. Thus, it plays an increasingly important role in efforts to understand the interactions of molecules with membrane transporters during drug development and in clinical pharmacology. We describe established and emerging imaging modalities utilized for studying transporter expression and function. We further present examples of how molecular imaging could provide insights into the contribution of transporters to drug disposition and effects.

Development of TASP0410457 (TASP457), a novel dihydroquinolinone derivative as a PET radioligand for central histamine H3 receptors

Background

Histamine H₃ receptor (H₃R) is a potential therapeutic target of sleep- and cognition-related disorders. The purpose of the present study is to develop a novel positron emission tomography (PET) ligand for H₃Rs from dihydroquinolinone derivatives, which we previously found to have high affinity with these receptors.

Methods

Six compounds were selected from a dihydroquinolinone compound library based on structural capability for ¹¹C labeling and binding affinity for H₃Rs. Their in vivo kinetics in the rat brain were examined in a comparative manner by liquid chromatography and tandem mass spectrometry (LC-MS/MS). Chemicals with appropriate kinetic properties were then labeled with ¹¹C and evaluated in rats and monkeys using PET.

Results

Of the six compounds, TASP0410457 (also diminutively called TASP457) and TASP0434988 exhibited fast kinetics and relatively high brain uptakes in ex vivo LC-MS/MS and were selected as candidate PET imaging agents. PET data in rat brains were mostly consistent with LC-MS/MS findings, and rat and monkey PET scans demonstrated that [¹¹C]TASP0410457 was superior to [¹¹C]TASP0434988 for high-contrast H₃R PET imaging. In the monkey brain PET, distribution volume for [¹¹C]TASP0410457 could be quantified, and receptor occupancy by a nonradioactive compound was measurable using this radioligand. The specific binding of [¹¹C]TASP0410457 to H₃Rs was confirmed by autoradiography using rat and monkey brain sections.

Conclusions

We developed [¹¹C]TASP0410457 as a radioligand enabling a robust quantification of H₃Rs in all brain regions and demonstrated the utility of ex vivo LC-MS/MS and in vivo PET assays for selecting appropriate imaging tracers. [¹¹C]TASP0410457 will help to examine the implication of H₃Rs in neuropsychiatric disorders and to characterize emerging therapeutic agents targeting H₃Rs.

Electronic supplementary material

The online version of this article (doi:10.1186/s13550-016-0170-2) contains supplementary material, which is available to authorized users.

Orexin receptor antagonists--a patent review (2010 to August 2014)

INTRODUCTION

The orexin (hypocretin) system is an evolutionarily conserved neuropeptide-G-protein-coupled receptor system, consisting of two neuropeptides the orexin-A and the orexin-B peptides as well as two receptors the orexin-1 and the orexin-2 receptors. The orexin system is crucially involved in the regulation of the circadian rhythm, states of wakefulness and arousal and the modulation of emotions and has attracted the interest of many researchers which resulted in an enormous amount of insight, mainly in the field of antagonists. Clinical proof of concept was obtained with dual orexin receptor antagonists in primary insomnia. Merck's suvorexant got FDA approval on 13 August 2014 for the treatment of insomnia.

AREAS COVERED

The patent applications from Thomson Reuters Integrity Database (covering 2010-August 2014) are summarized, analyzed and discussed in the review.

EXPERT OPINION

Intense patenting activities have been observed over the past 3 years in the field of orexin antagonists. Several compounds have been investigated in clinical trials mainly for the treatment of primary insomnia. The advantage of orexin antagonists, based on animal pharmacology results, is the promotion and maintenance of physiological sleep which should avoid hangover phenomena reported as side effects of approved treatments. Many other potential treatment options are mentioned for orexin antagonists of different selectivity profiles.