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Discovery of the potent non-steroidal glucocorticoid receptor modulator BAY 1003803 as clinical candidate. Bioorg Med Chem Lett 2020; 30:127298. [DOI: 10.1016/j.bmcl.2020.127298] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 05/25/2020] [Accepted: 05/29/2020] [Indexed: 01/09/2023]
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Usanov SA, Kliuchenovich AV, Strushkevich NV. Drug design strategies for Cushing's syndrome. Expert Opin Drug Discov 2018; 14:143-151. [PMID: 30572739 DOI: 10.1080/17460441.2019.1559146] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Cushing's syndrome (CS) is a metabolic disorder caused by chronic hypercortisolism. CS is associated with cardiovascular, metabolic, skeletal and psychological dysfunctions and can be fatal if left untreated. The first-line treatment for all forms of CS is a surgery. However, medical therapy has to be chosen if surgical resection is not an option or is deemed ineffective. Currently available therapeutics are either not selective and have side effects or are only available as an injection (pasireotide). Areas covered: The authors discuss the recent drug developments for the medical treatment of CS through two validated molecular targets. Specifically, the authors look at selective inhibitors of CYP11B1 that reduce cortisol production by inhibiting steroid 11beta-hydroxylase and glucocorticoid receptor (GR) antagonists that interrupt cortisol-mediating transcriptional regulation of related genes. Expert opinion: Patients with CS have limited treatment options; indeed, there is an unmet need for new compounds that target CYP11B1 selectively versus several steroidogenic enzymes and/or GR-signaling pathways. The complexity of steroid biosynthesis and signaling requires the application of structure-based drug discovery techniques that use molecular targets and highly similar off-targets. Significant differences in steroidogenesis between humans and other species necessitates caution over the choice of in vivo model for the preclinical evaluation of future potential compounds.
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Affiliation(s)
- S A Usanov
- a Institute of Bioorganic Chemistry of the National Academy of Science of Belarus , Minsk , Republic of Belarus
| | - A V Kliuchenovich
- b Target Medicals LLC , Skolkovo Innovation Center (Technopark) , Moscow , Russian Federation
| | - N V Strushkevich
- a Institute of Bioorganic Chemistry of the National Academy of Science of Belarus , Minsk , Republic of Belarus
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Berger M, Rehwinkel H, Schmees N, Schäcke H, Edman K, Wissler L, Reichel A, Jaroch S. Discovery of new selective glucocorticoid receptor agonist leads. Bioorg Med Chem Lett 2017; 27:437-442. [DOI: 10.1016/j.bmcl.2016.12.047] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 12/15/2016] [Accepted: 12/18/2016] [Indexed: 10/20/2022]
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Beaudry JL, Dunford EC, Teich T, Zaharieva D, Hunt H, Belanoff JK, Riddell MC. Effects of selective and non-selective glucocorticoid receptor II antagonists on rapid-onset diabetes in young rats. PLoS One 2014; 9:e91248. [PMID: 24642683 PMCID: PMC3958344 DOI: 10.1371/journal.pone.0091248] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 02/10/2014] [Indexed: 12/11/2022] Open
Abstract
The blockade of glucocorticoid (GC) action through antagonism of the glucocorticoid receptor II (GRII) has been used to minimize the undesirable effects of chronically elevated GC levels. Mifepristone (RU486) is known to competitively block GRII action, but not exclusively, as it antagonizes the progesterone receptor. A number of new selective GRII antagonists have been developed, but limited testing has been completed in animal models of overt type 2 diabetes mellitus. Therefore, two selective GRII antagonists (C113176 and C108297) were tested to determine their effects in our model of GC-induced rapid-onset diabetes (ROD). Male Sprague-Dawley rats (∼ six weeks of age) were placed on a high-fat diet (60%), surgically implanted with pellets containing corticosterone (CORT) or wax (control) and divided into five treatment groups. Each group was treated with either a GRII antagonist or vehicle for 14 days after surgery: CORT pellets (400 mg/rat) + antagonists (80 mg/kg/day); CORT pellets + drug vehicle; and wax pellets (control) + drug vehicle. After 10 days of CORT treatment, body mass gain was increased with RU486 (by ∼20% from baseline) and maintained with C113176 administration, whereas rats given C108297 had similar body mass loss (∼15%) to ROD animals. Fasting glycemia was elevated in the ROD animals (>20 mM), normalized completely in animals treated with RU486 (6.2±0.1 mM, p<0.05) and improved in animals treated with C108297 and C113176 (14.0±1.6 and 8.8±1.6 mM, p<0.05 respectively). Glucose intolerance was normalized with RU486 treatment, whereas acute insulin response was improved with RU486 and C113176 treatment. Also, peripheral insulin resistance was attenuated with C113176 treatment along with improved levels of β-cell function while C108297 antagonism only provided modest improvements. In summary, C113176 is an effective agent that minimized some GC-induced detrimental metabolic effects and may provide an alternative to the effective, but non-selective, GRII antagonist RU486.
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Affiliation(s)
- Jacqueline L. Beaudry
- School of Kinesiology and Health Science, Faculty of Health, Muscle Health Research Center and Physical Activity and Chronic Disease Unit, York University, Toronto, Ontario, Canada
| | - Emily C. Dunford
- School of Kinesiology and Health Science, Faculty of Health, Muscle Health Research Center and Physical Activity and Chronic Disease Unit, York University, Toronto, Ontario, Canada
| | - Trevor Teich
- School of Kinesiology and Health Science, Faculty of Health, Muscle Health Research Center and Physical Activity and Chronic Disease Unit, York University, Toronto, Ontario, Canada
| | - Dessi Zaharieva
- School of Kinesiology and Health Science, Faculty of Health, Muscle Health Research Center and Physical Activity and Chronic Disease Unit, York University, Toronto, Ontario, Canada
| | - Hazel Hunt
- Corcept Therapeutics, Menlo Park, California, United States of America
| | | | - Michael C. Riddell
- School of Kinesiology and Health Science, Faculty of Health, Muscle Health Research Center and Physical Activity and Chronic Disease Unit, York University, Toronto, Ontario, Canada
- * E-mail:
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Mitra R. Adverse effects of corticosteroids on bone metabolism: a review. PM R 2011; 3:466-71; quiz 471. [PMID: 21570035 DOI: 10.1016/j.pmrj.2011.02.017] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2010] [Revised: 02/01/2011] [Accepted: 02/07/2011] [Indexed: 12/29/2022]
Abstract
Glucocorticoid (GC) exposure is the most common etiology of drug-induced (secondary) osteoporosis. Twenty percent of all cases of osteoporosis have been attributed to GC exposure. Significant risk factors for the development of fractures after GC exposure include age older than 65 years, prolonged GC exposure (>3 months), positive family history of osteoporosis, and low calcium intake. GCs are known to inhibit bone remodeling and to increase fracture risk. GC exposure alters the fragile balance between osteoclast and osteoblast activity in bone metabolism. GC stimulates osteoclast-mediated bone resorption and reduces osteoblast-mediated bone formation, which results in increased overall net bone resorption. Specifically, the 2 main effects of GCs on bone metabolism are (1) inducing apoptosis in osteoblasts and osteocytes, thereby decreasing bone formation, and (2) prolonging the lifespan of osteoclasts and increasing bone resorption. The risk of fracture decreases 3 months after cessation of GC therapy; thus, a 3-month period may be ideal between GC exposures in patients at high risk for the development of osteoporosis. Patients managed with GCs who are at high risk for the development of secondary osteoporosis should have appropriate diagnostic testing; pre-GC exposure medication management (ie, use of bisphosphonates, human parathyroid hormone); and a limitation of GC therapy, with a wait period of 3 months between GC exposures if possible.
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Affiliation(s)
- Raj Mitra
- Stanford University School of Medicine, 450 Broadway St, Mailcode 6342, Redwood City, CA 94063, USA.
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Berlin M. Recent advances in the development of novel glucocorticoid receptor modulators. Expert Opin Ther Pat 2010; 20:855-73. [PMID: 20553093 DOI: 10.1517/13543776.2010.493876] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
IMPORTANCE OF THE FIELD The glucocorticoid receptor plays a number of fundamental roles in human physiology. Glucocorticosteroids are the ultimate anti-inflammatory and immunosuppressive agents highly efficacious in the treatment of serious diseases, but also associated with serious side effects. Improvement in the therapeutic profiles of drugs, acting at the glucocorticoid receptor, is highly desired and may potentially arise from the separation of their gene transactivating and gene transrepressing properties. AREAS COVERED IN THIS REVIEW The review summarizes progress towards novel glucocorticoid drug candidates as indicated by the patent applications over the last 2 years (2008 - 2009). A brief discussion of glucocorticoid receptor biology and previous drug candidates is included. WHAT THE READER WILL GAIN The understanding of the structural scope and biological profiles of the glucocorticoid receptor modulators, currently in preclinical and clinical development, based on the review of approximately 180 composition-of-matter and method-of-use patent applications. TAKE HOME MESSAGE The information on the good chemotypical diversity of glucocorticoid receptor modulators needs to be supplemented by the clinical data - presumably, soon to become available - to allow a look into a possible improvement in therapeutic index over the classic glucocorticosteroids.
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Affiliation(s)
- Michael Berlin
- Merck Research Laboratories, Department of Chemical Research, Kenilworth, NJ 07033, USA.
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Yates CM, Brown PJ, Stewart EL, Patten C, Austin RJH, Holt JA, Maglich JM, Angell DC, Sasse RZ, Taylor SJ, Uings IJ, Trump RP. Structure guided design of 5-arylindazole glucocorticoid receptor agonists and antagonists. J Med Chem 2010; 53:4531-44. [PMID: 20469868 DOI: 10.1021/jm100447c] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Glucocorticoid receptor (GR) agonists have been used for more than half a century as the most effective treatment of acute and chronic inflammatory conditions despite serious side effects that accompany their extended use that include glucose intolerance, muscle wasting, skin thinning, and osteoporosis. As a starting point for the identification of GR ligands with an improved therapeutic index, we wished to discover selective nonsteroidal GR agonists and antagonists with simplified structure compared to known GR ligands to serve as starting points for the optimization of dissociated GR modulators. To do so, we selected multiple chemical series by structure guided docking studies and evaluated GR agonist activity. From these efforts we identified 5-arylindazole compounds that showed moderate binding to the glucocorticoid receptor (GR) with clear opportunities for further development. Structure guided optimization was used to design arrays that led to potent GR agonists and antagonists. Several in vitro and in vivo experiments were utilized to demonstrate that GR agonist 23a (GSK9027) had a profile similar to that of a classical steroidal GR agonist.
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Affiliation(s)
- Christopher M Yates
- Molecular Discovery Research, GlaxoSmithKline, Research Triangle Park, North Carolina 27709-3398, USA
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Schoch GA, D'Arcy B, Stihle M, Burger D, Bär D, Benz J, Thoma R, Ruf A. Molecular Switch in the Glucocorticoid Receptor: Active and Passive Antagonist Conformations. J Mol Biol 2010; 395:568-77. [DOI: 10.1016/j.jmb.2009.11.011] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2009] [Revised: 11/03/2009] [Accepted: 11/05/2009] [Indexed: 10/20/2022]
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Anthranilimide-based glycogen phosphorylase inhibitors for the treatment of Type 2 diabetes: 2. Optimization of serine and threonine ether amino acid residues. Bioorg Med Chem Lett 2009; 19:981-5. [DOI: 10.1016/j.bmcl.2008.11.084] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2008] [Revised: 11/17/2008] [Accepted: 11/19/2008] [Indexed: 11/19/2022]
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Mohler ML, He Y, Wu Z, Hwang DJ, Miller DD. Recent and emerging anti-diabetes targets. Med Res Rev 2009; 29:125-95. [DOI: 10.1002/med.20142] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Narayanan R, Mohler ML, Bohl CE, Miller DD, Dalton JT. Selective androgen receptor modulators in preclinical and clinical development. NUCLEAR RECEPTOR SIGNALING 2008; 6:e010. [PMID: 19079612 PMCID: PMC2602589 DOI: 10.1621/nrs.06010] [Citation(s) in RCA: 121] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2008] [Accepted: 11/12/2008] [Indexed: 01/09/2023]
Abstract
Androgen receptor (AR) plays a critical role in the function of several organs including primary and accessory sexual organs, skeletal muscle, and bone, making it a desirable therapeutic target. Selective androgen receptor modulators (SARMs) bind to the AR and demonstrate osteo- and myo-anabolic activity; however, unlike testosterone and other anabolic steroids, these nonsteroidal agents produce less of a growth effect on prostate and other secondary sexual organs. SARMs provide therapeutic opportunities in a variety of diseases, including muscle wasting associated with burns, cancer, or end-stage renal disease, osteoporosis, frailty, and hypogonadism. This review summarizes the current standing of research and development of SARMs, crystallography of AR with SARMs, plausible mechanisms for their action and the potential therapeutic indications for this emerging class of drugs.
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Affiliation(s)
- Ramesh Narayanan
- Preclinical Research and Development, GTx, Inc., Memphis, Tennessee, USA
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1H-Pyrazolo[3,4-g]hexahydro-isoquinolines as selective glucocorticoid receptor antagonists with high functional activity. Bioorg Med Chem Lett 2008; 18:1312-7. [PMID: 18226897 DOI: 10.1016/j.bmcl.2008.01.027] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2007] [Revised: 01/04/2008] [Accepted: 01/08/2008] [Indexed: 11/21/2022]
Abstract
Addition of the 4-fluorophenylpyrazole group to the previously described 2-azadecalin glucocorticoid receptor (GR) antagonist 1 resulted in significantly enhanced functional activity. SAR of the bridgehead substituent indicated that whereas groups as small as methyl afforded high GR binding, GR functional activity was enhanced by larger groups such as benzyl, substituted ethers, and aminoalkyl derivatives. GR antagonists with binding and functional activity comparable to mifepristone were discovered (e.g., 52: GR binding K(i) 0.7 nM; GR reporter gene functional K(i) 0.6 nM) and found to be highly selective over other steroid receptors. Analogues 43 and 45 had >50% oral bioavailability in the dog.
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Clark RD, Ray NC, Blaney P, Crackett PH, Hurley C, Williams K, Dyke HJ, Clark DE, Lockey PM, Devos R, Wong M, White A, Belanoff JK. 2-Benzenesulfonyl-8a-benzyl-hexahydro-2H-isoquinolin-6-ones as selective glucocorticoid receptor antagonists. Bioorg Med Chem Lett 2007; 17:5704-8. [PMID: 17822897 DOI: 10.1016/j.bmcl.2007.07.055] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2007] [Revised: 07/12/2007] [Accepted: 07/16/2007] [Indexed: 11/28/2022]
Abstract
The 2-azadecalin ring system was evaluated as a scaffold for the preparation of glucocorticoid receptor (GR) antagonists. High affinity, selective GR antagonists were discovered based on a hypothetical binding mode related to the steroidal GR antagonist RU-43044. 2-Benzenesulfonyl substituted 8a-benzyl-hexahydro-2H-isoquinolin-6-ones exemplified by (R)-37 had low nanomolar affinity for GR with moderate functional activity (200 nM) in a reporter gene assay. These compounds were devoid of affinity for other steroidal receptors (ER, AR, MR, and PR). Analogues based on an alternative putative binding mode (CP-like) were found to be inactive.
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Affiliation(s)
- Robin D Clark
- Corcept Therapeutics, 149 Commonwealth Avenue, Menlo Park, CA 94025, USA.
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Ray NC, Clark RD, Clark DE, Williams K, Hickin HG, Crackett PH, Dyke HJ, Lockey PM, Wong M, Devos R, White A, Belanoff JK. Discovery and optimization of novel, non-steroidal glucocorticoid receptor modulators. Bioorg Med Chem Lett 2007; 17:4901-5. [PMID: 17587578 DOI: 10.1016/j.bmcl.2007.06.036] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2007] [Revised: 06/08/2007] [Accepted: 06/10/2007] [Indexed: 10/23/2022]
Abstract
A virtual screening approach comprising a 3-D similarity search based on known GR modulators was used to identify a novel series of non-steroidal glucocorticoid receptor (GR) antagonists. Optimization of the initial hit to provide potent compounds which exhibit good selectivity against other steroidal nuclear hormone receptors is described.
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Affiliation(s)
- Nicholas C Ray
- Argenta Discovery Ltd, 8/9 Spire Green Centre, Flex Meadow, Harlow, Essex, UK.
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