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Ippolito M, De Pascali F, Hopfinger N, Komolov KE, Laurinavichyute D, Reddy PAN, Sakkal LA, Rajkowski KZ, Nayak AP, Lee J, Lee J, Cao G, Donover PS, Reichman M, An SS, Salvino JM, Penn RB, Armen RS, Scott CP, Benovic JL. Identification of a β-arrestin-biased negative allosteric modulator for the β 2-adrenergic receptor. Proc Natl Acad Sci U S A 2023; 120:e2302668120. [PMID: 37490535 PMCID: PMC10401000 DOI: 10.1073/pnas.2302668120] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 06/26/2023] [Indexed: 07/27/2023] Open
Abstract
Catecholamine-stimulated β2-adrenergic receptor (β2AR) signaling via the canonical Gs-adenylyl cyclase-cAMP-PKA pathway regulates numerous physiological functions, including the therapeutic effects of exogenous β-agonists in the treatment of airway disease. β2AR signaling is tightly regulated by GRKs and β-arrestins, which together promote β2AR desensitization and internalization as well as downstream signaling, often antithetical to the canonical pathway. Thus, the ability to bias β2AR signaling toward the Gs pathway while avoiding β-arrestin-mediated effects may provide a strategy to improve the functional consequences of β2AR activation. Since attempts to develop Gs-biased agonists and allosteric modulators for the β2AR have been largely unsuccessful, here we screened small molecule libraries for allosteric modulators that selectively inhibit β-arrestin recruitment to the receptor. This screen identified several compounds that met this profile, and, of these, a difluorophenyl quinazoline (DFPQ) derivative was found to be a selective negative allosteric modulator of β-arrestin recruitment to the β2AR while having no effect on β2AR coupling to Gs. DFPQ effectively inhibits agonist-promoted phosphorylation and internalization of the β2AR and protects against the functional desensitization of β-agonist mediated regulation in cell and tissue models. The effects of DFPQ were also specific to the β2AR with minimal effects on the β1AR. Modeling, mutagenesis, and medicinal chemistry studies support DFPQ derivatives binding to an intracellular membrane-facing region of the β2AR, including residues within transmembrane domains 3 and 4 and intracellular loop 2. DFPQ thus represents a class of biased allosteric modulators that targets an allosteric site of the β2AR.
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Affiliation(s)
- Michael Ippolito
- Department of Biochemistry and Molecular Biology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA19107
| | - Francesco De Pascali
- Department of Biochemistry and Molecular Biology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA19107
| | - Nathan Hopfinger
- Department of Biochemistry and Molecular Biology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA19107
| | - Konstantin E. Komolov
- Department of Biochemistry and Molecular Biology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA19107
| | - Daniela Laurinavichyute
- Department of Biochemistry and Molecular Biology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA19107
| | | | - Leon A. Sakkal
- Department of Pharmaceutical Sciences, College of Pharmacy, Thomas Jefferson University, Philadelphia, PA19107
| | - Kyle Z. Rajkowski
- Department of Pharmaceutical Sciences, College of Pharmacy, Thomas Jefferson University, Philadelphia, PA19107
| | - Ajay P. Nayak
- Center for Translational Medicine, Department of Medicine, and Jane and Leonard Korman Respiratory Institute, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA19107
| | - Justin Lee
- Rutgers Institute for Translational Medicine and Science, New Brunswick, NJ08901
| | - Jordan Lee
- Rutgers Institute for Translational Medicine and Science, New Brunswick, NJ08901
| | - Gaoyuan Cao
- Rutgers Institute for Translational Medicine and Science, New Brunswick, NJ08901
| | | | | | - Steven S. An
- Rutgers Institute for Translational Medicine and Science, New Brunswick, NJ08901
- Department of Pharmacology, Rutgers-Robert Wood Johnson Medical School, The State University of New Jersey, Piscataway, NJ08854
| | | | - Raymond B. Penn
- Center for Translational Medicine, Department of Medicine, and Jane and Leonard Korman Respiratory Institute, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA19107
| | - Roger S. Armen
- Department of Pharmaceutical Sciences, College of Pharmacy, Thomas Jefferson University, Philadelphia, PA19107
| | - Charles P. Scott
- Department of Biochemistry and Molecular Biology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA19107
| | - Jeffrey L. Benovic
- Department of Biochemistry and Molecular Biology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA19107
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Weber JS, Poretta T, Stwalley BD, Sakkal LA, Du EX, Wang T, Chen Y, Wang Y, Betts KA, Shoushtari AN. Nivolumab versus placebo as adjuvant therapy for resected stage III melanoma: a propensity weighted indirect treatment comparison and number needed to treat analysis for recurrence-free survival and overall survival. Cancer Immunol Immunother 2023; 72:945-954. [PMID: 36197494 PMCID: PMC10025222 DOI: 10.1007/s00262-022-03302-5] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 09/23/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Recurrence-free survival (RFS) and overall survival (OS) data for adjuvant nivolumab versus placebo (proxy for routine surveillance) in patients with high-risk, resected melanoma are lacking. This post hoc, indirect treatment comparison (ITC) used pooled data from the phase 3 EORTC 18,071 (ipilimumab vs. placebo) and CheckMate 238 (nivolumab vs. ipilimumab) trials to assess RFS and OS with nivolumab versus placebo and the numbers needed to treat (NNT) over 4 years. METHODS Patients with resected stage IIIB-C cutaneous melanoma (American Joint Committee on Cancer seventh edition) were included. Inverse probability treatment weighting (IPTW) was used to balance baseline characteristics. RFS NNTs were calculated for nivolumab versus ipilimumab and placebo. OS NNTs were calculated for nivolumab versus placebo. To adjust for different post-recurrence treatments, the difference in post-recurrence survival between the two ipilimumab arms was added to OS of the placebo arm. RESULTS This ITC included 278, 643, and 365 patients treated with nivolumab, ipilimumab, and placebo, respectively. Following IPTW, nivolumab was associated with improved RFS versus placebo (hazard ratio [HR]: 0.49; 95% confidence interval [CI] 0.39-0.61) and ipilimumab (HR: 0.69; 95% CI 0.56-0.85). RFS NNT was 4.2 for nivolumab versus placebo and 8.9 for nivolumab versus ipilimumab. After post-recurrence survival adjustment, weighted 4-year OS rates were 75.8% for nivolumab and 64.1% for placebo; OS NNT for nivolumab versus placebo was 8.5. CONCLUSIONS In patients with resected stage IIIB-C cutaneous melanoma in this ITC, nivolumab improved RFS versus placebo and ipilimumab, and OS versus placebo after post-recurrence survival adjustment.
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Affiliation(s)
- Jeffrey S Weber
- Laura and Isaac Perlmutter Cancer Center at NYU Langone Health, New York, NY, USA.
| | | | | | | | - Ella X Du
- Analysis Group, Inc., Los Angeles, CA, USA
| | | | - Yan Chen
- Analysis Group, Inc., Los Angeles, CA, USA
| | - Yan Wang
- Analysis Group, Inc., Los Angeles, CA, USA
| | | | - Alexander N Shoushtari
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medical College, New York, NY, USA
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Weber JS, Poretta T, Stwalley BD, Sakkal LA, Du EX, Wang T, Chen Y, Wang Y, Betts KA, Shoushtari AN. Correction to: Nivolumab versus placebo as adjuvant therapy for resected stage III melanoma: a propensity weighted indirect treatment comparison and number needed to treat analysis for recurrence-free survival and overall survival. Cancer Immunol Immunother 2023; 72:955. [PMID: 36538061 PMCID: PMC10025208 DOI: 10.1007/s00262-022-03351-w] [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: 12/24/2022]
Affiliation(s)
- Jeffrey S Weber
- Laura and Isaac Perlmutter Cancer Center at NYU Langone Health, New York, NY, USA.
| | | | | | | | - Ella X Du
- Analysis Group, Inc., Los Angeles, CA, USA
| | | | - Yan Chen
- Analysis Group, Inc., Los Angeles, CA, USA
| | - Yan Wang
- Analysis Group, Inc., Los Angeles, CA, USA
| | | | - Alexander N Shoushtari
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medical College, New York, NY, USA
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Ippolito M, Hopfinger N, Nayak AP, Sakkal LA, Rajkowski KZ, Liu X, Kobilka BK, Penn RB, Armen RS, Scott CP, Benovic JL. Negative Allosteric Modulation of Arrestin Recruitment to the β
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‐Adrenergic Receptor. FASEB J 2019. [DOI: 10.1096/fasebj.2019.33.1_supplement.503.15] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Michael Ippolito
- Department of Biochemistry and Molecular BiologyThomas Jefferson UniversityPhiladelphiaPA
| | - Nathan Hopfinger
- Department of Biochemistry and Molecular BiologyThomas Jefferson UniversityPhiladelphiaPA
| | - Ajay P. Nayak
- Center for Translational MedicineThomas Jefferson UniversityPhiladelphiaPA
| | - Leon A. Sakkal
- Department of Pharmaceutical SciencesThomas Jefferson UniversityPhiladelphiaPA
| | - Kyle Z. Rajkowski
- Department of Pharmaceutical SciencesThomas Jefferson UniversityPhiladelphiaPA
| | - Xiangyu Liu
- School of MedicineTsinghua UniversityBeijingPeople's Republic of China
| | - Brian K. Kobilka
- Department of Molecular and Cellular PhysiologyStanford University School of MedicineStanfordCA
| | - Raymond B. Penn
- Center for Translational MedicineThomas Jefferson UniversityPhiladelphiaPA
| | - Roger S. Armen
- Department of Pharmaceutical SciencesThomas Jefferson UniversityPhiladelphiaPA
| | - Charles P. Scott
- Department of Biochemistry and Molecular BiologyThomas Jefferson UniversityPhiladelphiaPA
| | - Jeffrey L. Benovic
- Department of Biochemistry and Molecular BiologyThomas Jefferson UniversityPhiladelphiaPA
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Sakkal LA, Rajkowski KZ, Armen RS. Prediction of consensus binding mode geometries for related chemical series of positive allosteric modulators of adenosine and muscarinic acetylcholine receptors. J Comput Chem 2017; 38:1209-1228. [PMID: 28130813 PMCID: PMC5403616 DOI: 10.1002/jcc.24728] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2016] [Revised: 11/29/2016] [Accepted: 12/20/2016] [Indexed: 12/13/2022]
Abstract
Following insights from recent crystal structures of the muscarinic acetylcholine receptor, binding modes of Positive Allosteric Modulators (PAMs) were predicted under the assumption that PAMs should bind to the extracellular surface of the active state. A series of well-characterized PAMs for adenosine (A1 R, A2A R, A3 R) and muscarinic acetylcholine (M1 R, M5 R) receptors were modeled using both rigid and flexible receptor CHARMM-based molecular docking. Studies of adenosine receptors investigated the molecular basis of the probe-dependence of PAM activity by modeling in complex with specific agonist radioligands. Consensus binding modes map common pharmacophore features of several chemical series to specific binding interactions. These models provide a rationalization of how PAM binding slows agonist radioligand dissociation kinetics. M1 R PAMs were predicted to bind in the analogous M2 R PAM LY2119620 binding site. The M5 R NAM (ML-375) was predicted to bind in the PAM (ML-380) binding site with a unique induced-fit receptor conformation. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Leon A. Sakkal
- Department of Pharmaceutical Sciences, College of Pharmacy, Thomas Jefferson University, 901 Walnut St. Suite 918. Philadelphia, PA 19170
| | - Kyle Z. Rajkowski
- Department of Pharmaceutical Sciences, College of Pharmacy, Thomas Jefferson University, 901 Walnut St. Suite 918. Philadelphia, PA 19170
| | - Roger S. Armen
- Department of Pharmaceutical Sciences, College of Pharmacy, Thomas Jefferson University, 901 Walnut St. Suite 918. Philadelphia, PA 19170
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