[Show abstract][Hide abstract] ABSTRACT: Background
Under physiological conditions, the melanocortin system is a crucial part of the complex network regulating food intake and energy expenditure. In pathological states, like cachexia, these two parameters are deregulated, i.e., food intake is decreased and energy expenditure is increased—a vicious combination leading to catabolism. Agouti-related protein (AgRP), the endogenous antagonist at the melanocortin-4 receptor (MC-4R), was found to increase food intake and to reduce energy expenditure. This qualifies MC-4R blockade as an attractive mode of action for the treatment of cachexia. Based on this rationale, a novel series of small-molecule MC-4R antagonists was designed, from which the orally active compound BL-6020/979 (formerly known as SNT207979) emerged as the first promising development candidate showing encouraging pre-clinical efficacy and safety properties which are presented here.
Methods and results
BL-6020/979 is an orally available, selective and potent MC-4R antagonist with a drug-like profile. It increased food intake and decreased energy expenditure in healthy wild-type but not in MC-4R deficient mice. More importantly, it ameliorated cachexia-like symptoms in the murine C26 adenocarcinoma model; with an effect on body mass and body composition and on the expression of catabolic genes. Moreover, BL-6020/979 showed antidepressant-like properties in the chronic mild stress model in rats and exhibits a favorable safety profile.
The properties of BL-6020/979 demonstrated in animal models and presented here make it a promising candidate suitable for further development towards a first-in-class treatment option for cachexia that potentially opens up the opportunity to treat two hallmarks of the disease, i.e., decreased food intake and increased energy expenditure, with one drug.
[Show abstract][Hide abstract] ABSTRACT: The present invention relates to substituted imidazopyridine derivatives as melanocortin-4 receptor (MC-4R) modulators, in particular as melanocortin 4 receptor antagonists. The antagonists are useful for the treatment of disorders and diseases such as cachexia induced by e.g. cancer, chronic kidney disease (CKD) or chronic heart failure (CHF), muscle wasting, anorexia induced by e.g. chemotherapy or radiotherapy, anorexia nervosa, amyotrophic lateral sclerosis (ALS), pain, neuropathic pain, anxiety and depression.
[Show abstract][Hide abstract] ABSTRACT: Cancer cachexia represents a complex syndrome caused by an interaction between tumor and host. It includes several major metabolic abnormalities and maladaptations: Energy intake is reduced, resting energy expenditure is increased and catabolism is accelerated. Despite high medical need, no effective treatments are available. Melanocortin- 4 receptor (MC4- R) antagonists are among the most promising drug candidates for the treatment of cachexia. We will present our efforts in the design, synthesis, and in vivo evaluation of a novel MC4- R selective antagonist lead for the treatment of cancer cachexia. The non- peptide small mol. is orally bioavailable and penetrates the blood brain barrier. In healthy mice, the compd. increases food intake upon oral administration. In a 2- wk study with mice implanted with C26 adenocarcinoma, once daily oral dosing significantly inhibited the development of cachexia. The data presented here suggest that this class of novel MC4- R antagonists bears the potential to deliver a development candidate.
[Show abstract][Hide abstract] ABSTRACT: Cancer cachexia, a severe form of muscle wasting, is a consequence of a decrease of appetite and a loss of lean body mass as response to a chronic inflammation, which cannot be compensated by increased nutrient intake. Currently no treatment is available for cachexia patients. Based on their recently demonstrated effects on feeding behavior and energy homeostasis in rodent models, Melanocortin- 4 receptor (MC4- R) antagonists are perceived as a promising, novel approach for the treatment of cancer cachexia by increasing appetite and reducing energy expenditure. We report on the discovery of a novel chem. series of potent and selective MC4- R antagonists. In vivo efficacy upon oral administration of the lead compd. in animal models for food intake and cancer cachexia as well as pharmacokinetic data will be disclosed. The data presented here suggest further investigations on this novel class of MC4- R antagonists bear the potential to indentify a development candidate.
[Show abstract][Hide abstract] ABSTRACT: The present invention relates to substituted heteroarylpiperidine derivative (I) as melanocortin-4 receptor modulators. Depending on the structure and the stereochemistry the compounds of the invention are either selective agonists or selective antagonists of the human melanocortin-4 receptor (MC-4R). The agonists can be used for the treatment of disorders and diseases such as obesity, diabetes and sexual dysfunction, whereas the antagonists are useful for the treatment of disorders and diseases such as cancer cachexia, muscle wasting, anorexia, amyotrophic lateral sclerosis (ALS), anxiety and depression. Generally all diseases and disorders where the regulation of the MC-4R is involved can be treated with the compounds of the invention.
[Show abstract][Hide abstract] ABSTRACT: The present invention relates to substituted imidazopyridine derivatives as melanocortin-4 receptor (MC-4R) modulators, in particular as melanocortin-4 receptor antagonists. The antagonists are useful for the treatment of disorders and diseases such as cancer cachexia, muscle wasting, anorexia, amytrophic lateral sclerosis (ALS), anxiety and depression.
[Show abstract][Hide abstract] ABSTRACT: Dystrophin deficiency is the underlying molecular cause of progressive muscle weakness observed in Duchenne muscular dystrophy (DMD). Loss of functional dystrophin leads to elevated levels of intracellular Ca(2+), a key step in the cellular pathology of DMD. The cysteine protease calpain is activated in dystrophin-deficient muscle, and its inhibition is regarded as a potential therapeutic approach. In addition, previous work has shown that the ubiquitin-proteasome system also contributes to muscle protein breakdown in dystrophic muscle and, therefore, also qualifies as a potential target for therapeutic intervention in DMD. The relative contribution of calpain- and proteasome-mediated proteolysis induced by increased Ca(2+) levels was characterized in cultured muscle cells and revealed initial Ca(2+) influx-dependent calpain activity and subsequent Ca(2+)-independent activity of the ubiquitin-proteasome system. We then set out to optimize novel small-molecule inhibitors that inhibit both calpain as well as the 20S proteasome in a cellular system with impaired Ca(2+) homeostasis. On administration of such inhibitors to mdx mice, quantitative histological parameters improved significantly, in particular with compounds strongly inhibiting the 20S proteasome. To investigate the role of calpain inhibition without interfering with the ubiquitin-proteasome system, we crossed mdx mice with transgenic mice, overexpressing the endogenous calpain inhibitor calpastatin. Although our data show that proteolysis by calpain is strongly inhibited in the transgenic mdx mouse, this calpain inhibition did not ameliorate muscle histology. Our results indicate that inhibition of the proteasome rather than calpain is required for histological improvement of dystrophin-deficient muscle. In conclusion, we have identified novel proteasome inhibitors that qualify as potential candidates for pharmacological intervention in muscular dystrophy.
Full-text · Article · Sep 2008 · The FASEB Journal
[Show abstract][Hide abstract] ABSTRACT: Inhibition of the cysteine protease calpain is a promising strategy for the treatment of muscular dystrophies including Duchenne Muscular Dystrophy. For the treatment to be effective, uptake of the inhibitors into the muscle cells is a prerequisite. A series of α-ketoamide calpain inhibitors carrying various muscle cell targeting capping groups was synthesized. Compounds with charged or highly polar targeting groups were not able to cross the cellular membrane. Introduction of lipoic acid as end cap yielded cell permeable calpain inhibitors with nanomolar potency.
No preview · Article · Mar 2006 · Letters in Drug Design & Discovery
[Show abstract][Hide abstract] ABSTRACT: Dipeptide-derived alpha-keto-amide compounds with potent calpain inhibitory activity have been identified. These reversible covalent inhibitors have IC50 values down to 25 nM and exhibit greatly improved activity in muscle cells compared to the reference compound MDL28170. Several novel calpain inhibitors have shown positive effects on histological parameters in an animal model of Duchenne muscular dystrophy demonstrating their potential as a treatment option for this fatal disease. (c) 2005 Elsevier Ltd. All rights reserved.