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1.
Bioorg Med Chem Lett ; 29(4): 668-673, 2019 02 15.
Article in English | MEDLINE | ID: mdl-30554956

ABSTRACT

Parkinson's disease is a relatively common neurological disorder with incidence increasing with age. Present treatments merely alleviate the symptoms and do not alter the course of the disease, thus identification of disease modifying therapies represents a significant unmet medical need. Mutations in the LRRK2 gene are risk-factors for developing PD and it has been hypothesized that the increased kinase activity of certain LRRK2 mutants are responsible for the damage of the dopaminergic neurons, thus LRRK2 inhibitors offer the potential to target an underlying cause of the disease. In this communication, we describe hit-to-lead medicinal chemistry program on a novel series of 5-azaindazoles. Compound 1, obtained from high-throughput screening was optimized to a highly potent, selective series of molecules with promising DMPK properties. Introduction of heterocycles at the 3-position were found to significantly increase the potency and kinase selectivity, whilst changes to the 4-chlorobenzyl group improved the physicochemical properties. Our series was licensed to a major pharmaceutical company for further development.


Subject(s)
Leucine-Rich Repeat Serine-Threonine Protein Kinase-2/antagonists & inhibitors , Protein Kinase Inhibitors/pharmacology , Animals , Humans , Parkinson Disease/metabolism
2.
Cell Mol Life Sci ; 74(7): 1335-1345, 2017 04.
Article in English | MEDLINE | ID: mdl-27853832

ABSTRACT

The efficiency of drug research and development has paradoxically declined over the last decades despite major scientific and technological advances, promoting new cost-effective strategies such as drug repositioning by systematic screening for new actions of known drugs. Here, we performed a screening for positive allosteric modulators (PAMs) at melanocortin (MC) receptors. The non-steroidal anti-inflammatory drug fenoprofen, but not the similar compound ibuprofen, presented PAM activity at MC3, MC4, and MC5 receptors. In a model of inflammatory arthritis, fenoprofen afforded potent inhibition while ibuprofen was nearly inactive. Fenoprofen presented anti-arthritic actions on cartilage integrity and synovitis, effects markedly attenuated in Mc3r-/- mice. Fenoprofen displayed pro-resolving properties promoting macrophage phagocytosis and efferocytosis, independently of cyclooxygenase inhibition. In conclusion, combining repositioning with advances in G-protein coupled receptor biology (allosterism) may lead to potential new therapeutics. In addition, MC3 PAMs emerged as a viable approach to the development of innovative therapeutics for joint diseases.


Subject(s)
Allosteric Regulation/drug effects , Anti-Inflammatory Agents, Non-Steroidal/pharmacology , Drug Repositioning , Fenoprofen/pharmacology , Receptor, Melanocortin, Type 3/metabolism , Animals , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Arthritis/drug therapy , Arthritis/etiology , CHO Cells , Cricetinae , Cricetulus , Disease Models, Animal , Fenoprofen/therapeutic use , Joints/metabolism , Joints/pathology , Macrophages/cytology , Macrophages/immunology , Macrophages/metabolism , Male , Melanocortins/analysis , Mice , Mice, Inbred C57BL , Mice, Knockout , Peritonitis/chemically induced , Peritonitis/drug therapy , Peritonitis/pathology , Phagocytosis/drug effects , Prostaglandin-Endoperoxide Synthases/chemistry , Prostaglandin-Endoperoxide Synthases/metabolism , Receptor, Melanocortin, Type 3/chemistry , Receptor, Melanocortin, Type 3/deficiency , Receptor, Melanocortin, Type 3/genetics
3.
Antimicrob Agents Chemother ; 60(3): 1464-75, 2015 Dec 28.
Article in English | MEDLINE | ID: mdl-26711771

ABSTRACT

Imidazopyridazine compounds are potent, ATP-competitive inhibitors of calcium-dependent protein kinase 1 (CDPK1) and of Plasmodium falciparum parasite growth in vitro. Here, we show that these compounds can be divided into two classes depending on the nature of the aromatic linker between the core and the R2 substituent group. Class 1 compounds have a pyrimidine linker and inhibit parasite growth at late schizogony, whereas class 2 compounds have a nonpyrimidine linker and inhibit growth in the trophozoite stage, indicating different modes of action for the two classes. The compounds also inhibited cyclic GMP (cGMP)-dependent protein kinase (PKG), and their potency against this enzyme was greatly reduced by substitution of the enzyme's gatekeeper residue at the ATP binding site. The effectiveness of the class 1 compounds against a parasite line expressing the modified PKG was also substantially reduced, suggesting that these compounds kill the parasite primarily through inhibition of PKG rather than CDPK1. HSP90 was identified as a binding partner of class 2 compounds, and a representative compound bound to the ATP binding site in the N-terminal domain of HSP90. Reducing the size of the gatekeeper residue of CDPK1 enabled inhibition of the enzyme by bumped kinase inhibitors; however, a parasite line expressing the modified enzyme showed no change in sensitivity to these compounds. Taken together, these findings suggest that CDPK1 may not be a suitable target for further inhibitor development and that the primary mechanism through which the imidazopyridazines kill parasites is by inhibition of PKG or HSP90.


Subject(s)
Antimalarials/pharmacology , Plasmodium falciparum/drug effects , Protozoan Proteins/antagonists & inhibitors , Antimalarials/chemistry , Cell Line , Cyclic GMP-Dependent Protein Kinases/antagonists & inhibitors , Cyclic GMP-Dependent Protein Kinases/metabolism , HSP90 Heat-Shock Proteins/antagonists & inhibitors , HSP90 Heat-Shock Proteins/metabolism , Humans , Imidazoles/chemistry , Imidazoles/pharmacology , Molecular Docking Simulation , Molecular Targeted Therapy/methods , Plasmodium falciparum/growth & development , Plasmodium falciparum/metabolism , Protein Kinase Inhibitors/chemistry , Protein Kinase Inhibitors/pharmacology , Protein Kinases/metabolism , Protozoan Proteins/genetics , Protozoan Proteins/metabolism , Pyridazines/chemistry , Pyridazines/pharmacology
4.
Antimicrob Agents Chemother ; 58(10): 6032-43, 2014 Oct.
Article in English | MEDLINE | ID: mdl-25070106

ABSTRACT

PfCDPK1 is a Plasmodium falciparum calcium-dependent protein kinase, which has been identified as a potential target for novel antimalarial chemotherapeutics. In order to further investigate the role of PfCDPK1, we established a high-throughput in vitro biochemical assay and used it to screen a library of over 35,000 small molecules. Five chemical series of inhibitors were initially identified from the screen, from which series 1 and 2 were selected for chemical optimization. Indicative of their mechanism of action, enzyme inhibition by these compounds was found to be sensitive to both the ATP concentration and substitution of the amino acid residue present at the "gatekeeper" position at the ATP-binding site of the enzyme. Medicinal chemistry efforts led to a series of PfCDPK1 inhibitors with 50% inhibitory concentrations (IC50s) below 10 nM against PfCDPK1 in a biochemical assay and 50% effective concentrations (EC50s) less than 100 nM for inhibition of parasite growth in vitro. Potent inhibition was combined with acceptable absorption, distribution, metabolism, excretion, and toxicity (ADMET) properties and equipotent inhibition of Plasmodium vivax CDPK1. However, we were unable to correlate biochemical inhibition with parasite growth inhibition for this series overall. Inhibition of Plasmodium berghei CDPK1 correlated well with PfCDPK1 inhibition, enabling progression of a set of compounds to in vivo evaluation in the P. berghei rodent model for malaria. These chemical series have potential for further development as inhibitors of CDPK1.


Subject(s)
Antimalarials/pharmacology , Plasmodium falciparum/drug effects , Plasmodium falciparum/enzymology , Protein Kinase Inhibitors/pharmacology , Protein Kinases/metabolism , Protozoan Proteins/metabolism , Animals , Antimalarials/therapeutic use , Malaria/drug therapy , Mice , Plasmodium berghei/drug effects , Plasmodium berghei/pathogenicity , Plasmodium falciparum/pathogenicity , Plasmodium vivax/drug effects , Plasmodium vivax/pathogenicity , Protein Kinase Inhibitors/therapeutic use , Protozoan Proteins/antagonists & inhibitors
5.
J Med Chem ; 57(8): 3570-87, 2014 Apr 24.
Article in English | MEDLINE | ID: mdl-24689770

ABSTRACT

A structure-guided design approach using a homology model of Plasmodium falciparum calcium-dependent protein kinase 1 (PfCDPK1) was used to improve the potency of a series of imidazopyridazine inhibitors as potential antimalarial agents. This resulted in high affinity compounds with PfCDPK1 enzyme IC50 values less than 10 nM and in vitro P. falciparum antiparasite EC50 values down to 12 nM, although these compounds did not have suitable ADME properties to show in vivo efficacy in a mouse model. Structural modifications designed to address the ADME issues, in particular permeability, were initially accompanied by losses in antiparasite potency, but further optimization allowed a good balance in the compound profile to be achieved. Upon testing in vivo in a murine model of efficacy against malaria, high levels of compound exposure relative to their in vitro activities were achieved, and the modest efficacy that resulted raises questions about the level of effect that is achievable through the targeting of PfCDPK1.


Subject(s)
Antimalarials/chemical synthesis , Plasmodium falciparum/drug effects , Protein Kinase Inhibitors/chemical synthesis , Protozoan Proteins/antagonists & inhibitors , Pyridazines/chemical synthesis , Animals , Antimalarials/pharmacology , Mice , Plasmodium falciparum/enzymology , Protein Kinase Inhibitors/pharmacology , Protein Kinases/chemistry , Protozoan Proteins/chemistry , Pyridazines/pharmacology , Structure-Activity Relationship
6.
Bioorg Med Chem Lett ; 23(21): 6019-24, 2013 Nov 01.
Article in English | MEDLINE | ID: mdl-24035097

ABSTRACT

The structural diversity and SAR in a series of imidazopyridazine inhibitors of Plasmodium falciparum calcium dependent protein kinase 1 (PfCDPK1) has been explored and extended. The opportunity to further improve key ADME parameters by means of lowering logD was identified, and this was achieved by replacement of a six-membered (hetero)aromatic linker with a pyrazole. A short SAR study has delivered key examples with useful in vitro activity and ADME profiles, good selectivity against a human kinase panel and improved levels of lipophilic ligand efficiency. These new analogues thus provide a credible additional route to further development of the series.


Subject(s)
Antimalarials/chemistry , Antimalarials/pharmacology , Plasmodium falciparum/enzymology , Protozoan Proteins/antagonists & inhibitors , Pyridazines/chemistry , Pyridazines/pharmacology , Humans , Malaria, Falciparum/drug therapy , Malaria, Falciparum/parasitology , Plasmodium falciparum/drug effects , Protein Kinases/metabolism , Protozoan Proteins/metabolism
7.
J Biomol Screen ; 18(5): 599-609, 2013 Jun.
Article in English | MEDLINE | ID: mdl-23396314

ABSTRACT

A variety of G-protein-coupled receptor (GPCR) screening technologies have successfully partnered a number of GPCRs with their cognate ligands. GPCR-mediated ß-arrestin recruitment is now recognized as a distinct intracellular signaling pathway, and ligand-receptor interactions may show a bias toward ß-arrestin over classical GPCR signaling pathways. We hypothesized that the failure to identify native ligands for the remaining orphan GPCRs may be a consequence of biased ß-arrestin signaling. To investigate this, we assembled 10 500 candidate ligands and screened 82 GPCRs using PathHunter ß-arrestin recruitment technology. High-quality screening assays were validated by the inclusion of liganded receptors and the detection and confirmation of these established ligand-receptor pairings. We describe a candidate endogenous orphan GPCR ligand and a number of novel surrogate ligands. However, for the majority of orphan receptors studied, measurement of ß-arrestin recruitment did not lead to the identification of cognate ligands from our screening sets. ß-Arrestin recruitment represents a robust GPCR screening technology, and ligand-biased signaling is emerging as a therapeutically exploitable feature of GPCR biology. The identification of cognate ligands for the orphan GPCRs and the extent to which receptors may exist to preferentially signal through ß-arrestin in response to their native ligand remain to be determined.


Subject(s)
Arrestins/metabolism , High-Throughput Screening Assays/methods , Receptors, G-Protein-Coupled/agonists , Animals , CHO Cells , Cells, Cultured , Cricetinae , Cricetulus , Drug Discovery/methods , HEK293 Cells , Humans , Ligands , Protein Binding/physiology , Receptors, G-Protein-Coupled/metabolism , Saccharomyces cerevisiae , Small Molecule Libraries/analysis , beta-Arrestins
8.
J Pharmacol Exp Ther ; 344(3): 568-78, 2013 Mar.
Article in English | MEDLINE | ID: mdl-23262279

ABSTRACT

Drugs targeting the orphan receptor GPR35 have potential therapeutic application in a number of disease areas, including inflammation, metabolic disorders, nociception, and cardiovascular disease. Currently available surrogate GPR35 agonists identified from pharmacologically relevant compound libraries have limited utility due to the likelihood of off-target effects in vitro and in vivo and the variable potency that such ligands exhibit across species. We sought to identify and characterize novel GPR35 agonists to facilitate studies aimed at defining the physiologic role of GPR35. PathHunter ß-arrestin recruitment technology was validated as a human GPR35 screening assay, and a high-throughput screen of 100,000 diverse low molecular weight compounds was conducted. Confirmed GPR35 agonists from five distinct chemotypes were selected for detailed characterization using both ß-arrestin recruitment and G protein-dependent assays and each of the human, mouse, and rat GPR35 orthologs. These studies identified 4-{(Z)-[(2Z)-2-(2-fluorobenzylidene)-4-oxo-1,3-thiazolidin-5-ylidene]methyl}benzoic acid (compound 1) as the highest potency full agonist of human GPR35 yet described. As with certain other GPR35 agonists, compound 1 was markedly selective for human GPR35, but displayed elements of signal bias between ß-arrestin-2 and G protein-dependent assays. Compound 1 also displayed competitive behavior when assessed against the human GPR35 antagonist, ML-145 (2-hydroxy-4-[4-(5Z)-5-[(E)-2-methyl-3-phenylprop-2-enylidene]-4-oxo-2-sulfanylidene-1,3-thiazolidin-3-yl]butanoylamino]benzoic acid). Of the other chemotypes studied, compounds 2 and 3 were selective for the human receptor, but compounds 4 and 5 demonstrated similar activity at human, rat, and mouse GPR35 orthologs. Further characterization of these compounds and related analogs is likely to facilitate a better understanding of GPR35 in health and disease.


Subject(s)
Arrestins/metabolism , Receptors, G-Protein-Coupled/agonists , Receptors, G-Protein-Coupled/metabolism , Animals , Benzoates/chemistry , Benzoates/pharmacology , CHO Cells , Cell Line , Cricetinae , GTP-Binding Proteins/metabolism , HEK293 Cells , High-Throughput Screening Assays/methods , Humans , Ligands , Mice , Rats , beta-Arrestin 2 , beta-Arrestins
9.
J Pharmacol Exp Ther ; 343(3): 683-95, 2012 Dec.
Article in English | MEDLINE | ID: mdl-22967846

ABSTRACT

Variation in pharmacology and function of ligands at species orthologs can be a confounding feature in understanding the biology and role of poorly characterized receptors. Substantial selectivity in potency of a number of GPR35 agonists has previously been demonstrated between human and rat orthologs of this G protein-coupled receptor. Via a bioluminescence resonance energy transfer-based assay of induced interactions between GPR35 and ß-arrestin-2, addition of the mouse ortholog to such studies indicated that, as for the rat ortholog, murine GPR35 displayed very low potency for pamoate, whereas potency for the reference GPR35 agonist zaprinast was intermediate between the rat and human orthologs. This pattern was replicated in receptor internalization and G protein activation assays. The effectiveness and mode of action of two recently reported GPR35 antagonists, methyl-5-[(tert-butylcarbamothioylhydrazinylidene)methyl]-1-(2,4-difluorophenyl)pyrazole-4-carboxylate (CID-2745687) and 2-hydroxy-4-[4-(5Z)-5-[(E)-2-methyl-3-phenylprop-2-enylidene]-4-oxo-2-sulfanylidene-1,3-thiazolidin-3-yl]butanoylamino)benzoic acid (ML-145), were investigated. Both CID-2745687 and ML-145 competitively inhibited the effects at human GPR35 of cromolyn disodium and zaprinast, two agonists that share an overlapping binding site. By contrast, although ML-145 also competitively antagonized the effects of pamoate, CID-2745687 acted in a noncompetitive fashion. Neither ML-145 nor CID-2745687 was able to effectively antagonize the agonist effects of either zaprinast or cromolyn disodium at either rodent ortholog of GPR35. These studies demonstrate that marked species selectivity of ligands at GPR35 is not restricted to agonists and considerable care is required to select appropriate ligands to explore the function of GPR35 in nonhuman cells and tissues.


Subject(s)
Aminosalicylic Acids/pharmacology , Hydrazones/pharmacology , Receptors, G-Protein-Coupled/antagonists & inhibitors , Thiazolidines/pharmacology , Thiourea/analogs & derivatives , Aminosalicylic Acids/chemistry , Animals , Arrestins/metabolism , Bioluminescence Resonance Energy Transfer Techniques , Cell Culture Techniques , Dose-Response Relationship, Drug , Drug Partial Agonism , HEK293 Cells , Humans , Hydrazones/chemistry , Ligands , Mice , Microscopy, Fluorescence , Molecular Structure , Protein Binding , Rats , Receptors, G-Protein-Coupled/agonists , Receptors, G-Protein-Coupled/genetics , Species Specificity , Thiazolidines/chemistry , Thiourea/chemistry , Thiourea/pharmacology , Transfection , beta-Arrestin 2 , beta-Arrestins
10.
Bioorg Med Chem Lett ; 22(9): 3349-53, 2012 May 01.
Article in English | MEDLINE | ID: mdl-22469702

ABSTRACT

A high-throughput screen against PknB, an essential serine-threonine protein kinase present in Mycobacterium tuberculosis (M. tuberculosis), allowed the identification of an aminoquinazoline inhibitor which was used as a starting point for SAR investigations. Although a significant improvement in enzyme affinity was achieved, the aminoquinazolines showed little or no cellular activity against M. tuberculosis. However, switching to an aminopyrimidine core scaffold and the introduction of a basic amine side chain afforded compounds with nanomolar enzyme binding affinity and micromolar minimum inhibitory concentrations against M. tuberculosis. Replacement of the pyrazole head group with pyridine then allowed equipotent compounds with improved selectivity against a human kinase panel to be obtained.


Subject(s)
Mycobacterium tuberculosis/drug effects , Protein Kinase Inhibitors/pharmacology , Proto-Oncogene Proteins c-akt/antagonists & inhibitors , Pyrimidines/pharmacology , Amines , Humans , Microbial Sensitivity Tests , Quinazolines , Structure-Activity Relationship
11.
Tuberculosis (Edinb) ; 91(4): 277-86, 2011 Jul.
Article in English | MEDLINE | ID: mdl-21482481

ABSTRACT

PknB is an essential serine/threonine kinase of Mycobacterium tuberculosis with possible roles in a number of signalling pathways involved in cell division and metabolism. We screened a library of >50,000 compounds for inhibitors of the in vitro phosphorylation of GarA (Rv1827) by PknB and identified a number of inhibitors. A program of synthetic medicinal chemistry was subsequently conducted around one class of inhibitors and was successful in generating ATP competitive inhibitors with potency in the nanomolar range. Compounds in this class showed cross-reactivity with the related M. tuberculosis kinase, PknF, but not with PknG in an in vitro autophosphorylation assay. These synthesised inhibitors were able to prevent the growth of M. tuberculosis in an Alamar blue assay and in an intracellular model of infection, but only in the micromolar range. We attempted to determine if cell wall permeability was an explanation for the discrepancy between the potent in vitro compared with relatively poor in vivo activity, but found no evidence that the activity of the inhibitors could be improved by weakening the cell wall. Despite a number of drug discovery efforts attempting to develop inhibitors against PknB, it is yet to be reported that any such inhibitors prevent mycobacterial growth at submicromolar concentrations.


Subject(s)
Anti-Bacterial Agents/pharmacology , Macrophages/drug effects , Mycobacterium tuberculosis/drug effects , Protein Kinase Inhibitors/pharmacology , Protein Serine-Threonine Kinases/antagonists & inhibitors , Tuberculosis/drug therapy , Anti-Bacterial Agents/metabolism , Cell Division , Cells, Cultured , Drug Discovery , Humans , Mycobacterium tuberculosis/growth & development , Mycobacterium tuberculosis/metabolism , Signal Transduction/drug effects , Tuberculosis/metabolism
12.
J Pediatr Gastroenterol Nutr ; 50(4): 377-84, 2010 Apr.
Article in English | MEDLINE | ID: mdl-20216101

ABSTRACT

OBJECTIVES: The aim of this study was to determine whether screening for food hypersensitivity could be a clinically useful biomarker for eosinophilic duodenitis in the pediatric population. PATIENTS AND METHODS: Twenty-two patients with functional dyspepsia and 19 controls with no significant history of gastrointestinal or allergic disorders were enrolled. Participants underwent skin prick, atopy patch, and serum-specific (S)-IgE, -IgG, and -IgG4 testing to corn, wheat, soy, peanut, milk, and egg. Participants in the patient group also underwent endoscopy with biopsies as part of standard care. RESULTS: Three participants in the patient group did not exhibit duodenal eosinophilia on biopsy and were excluded from data analyses. The patient group consisted of 13 females and 6 males, 8 to 17 years of age. The control group consisted of 10 females and 9 males, 8 to 17 years of age. Seven patients had at least 1 positive reaction to food by skin prick, atopy patch, or SIgE testing compared with 7 controls; odds ratio 1; 95% confidence interval 0.3 to 3.7. Receiver operating characteristics curves showed SIgG and SIgG4 performed poorly or no better than chance for predicting group assignment. CONCLUSIONS: Allergy screening for the foods tested was not useful as a biomarker for eosinophilic duodenitis in this small study. A higher rate of positive reactions to patch testing was observed in the control group than previous studies have reported. The incidence of a positive food patch test in nonselected subjects needs further investigation. Method standardization and establishment of reference intervals are needed for atopy patch tests, SIgG, and SIgG4 to better evaluate the clinical value of these measures.


Subject(s)
Duodenitis/diagnosis , Dyspepsia/etiology , Eosinophilia/diagnosis , Eosinophils/metabolism , Food Hypersensitivity/diagnosis , Immunoglobulin E/blood , Somatoform Disorders/complications , Adolescent , Biomarkers/blood , Case-Control Studies , Child , Duodenitis/complications , Duodenitis/immunology , Dyspepsia/blood , Dyspepsia/immunology , Eosinophilia/blood , Eosinophilia/complications , Female , Food Hypersensitivity/blood , Food Hypersensitivity/complications , Humans , Immunoglobulin G/blood , Male , Odds Ratio , Patch Tests , Pilot Projects , ROC Curve , Single-Blind Method , Somatoform Disorders/blood , Somatoform Disorders/immunology
13.
Tuberculosis (Edinb) ; 89(5): 364-70, 2009 Sep.
Article in English | MEDLINE | ID: mdl-19699151

ABSTRACT

Mycobacterium tuberculosis has an on-going impact on global public health and new therapeutics to treat tuberculosis are urgently required. The emergence of drug resistant tuberculosis poses a serious threat to the control of this pathogen, and the development of drugs that are active against the resistant strains is vital. A medium-throughput assay using the Alamar Blue reagent was set-up to identify novel inhibitors of M. tuberculosis from a library of known drugs, for which there has already been extensive research investigating their suitability and safety as human therapeutics. Of the 1514 compounds screened, 53 were demonstrated to possess inhibitory properties against M. tuberculosis at a concentration of 5microM or below. Of these, 17 were novel inhibitors while 36 were known tuberculosis drugs or had been previously described as possessing anti-tuberculosis activity. Five compounds were selected as those which represent the most promising starting points for new anti-tuberculosis agents. It was demonstrated that all five were active against intracellular M. tuberculosis in a macrophage model of infection. The anti-tuberculosis agents identified in this screen represent promising new scaffolds on which future drug development efforts can be focused.


Subject(s)
Antitubercular Agents/pharmacology , Bacterial Proteins/drug effects , Drug Design , Drug Resistance, Bacterial/drug effects , Mycobacterium tuberculosis/drug effects , Small Molecule Libraries , Tuberculosis/drug therapy , Bacterial Proteins/genetics , Drug Evaluation, Preclinical , Drug Resistance, Bacterial/genetics , Drug Resistance, Bacterial/immunology , Humans , Mycobacterium tuberculosis/genetics , Tuberculosis/genetics , Tuberculosis/immunology
14.
BMC Gastroenterol ; 9: 32, 2009 May 11.
Article in English | MEDLINE | ID: mdl-19432972

ABSTRACT

BACKGROUND: We have previously demonstrated the clinical efficacy of montelukast in a randomized double-blind controlled cross-over trial in patients with dyspepsia in association with duodenal eosinophilia. The mechanism of this clinical response is unknown but could involve a decrease in eosinophil density or activation. METHODS: Twenty-four dyspeptic patients 8-17 years of age underwent initial blood sampling and endoscopy with biopsy. Eighteen of these patients had elevated duodenal eosinophil density and underwent repeat blood sampling and endoscopy following 21 days of therapy with montelukast (10 mg/day). The following were determined: global clinical response on a 5-point Lickert-type scale, eosinophil density utilizing H & E staining, eosinophil activation determined by degranulation indices on electron microscopy, and serum cytokine concentrations. On day 21, pharmacokinetics and duodenal mucosal drug concentrations were determined. RESULTS: Eighty-three percent of the patients had a positive clinical response to montelukast with regard to relief of pain with 50% having a complete or nearly complete clinical response. The response was unrelated to systemic drug exposure or to mucosal drug concentration. Other than a mild decrease in eosinophil density in the second portion of the duodenum, there were no significant changes in eosinophil density, eosinophil activation, or serum cytokine concentrations following treatment with montelukast. Pre-treatment TNF-alpha concentration was negatively correlated with clinical response. CONCLUSION: The short-term clinical response to montelukast does not appear to result from changes in eosinophil density or activation. Whether the effect is mediated through specific mediators or non-inflammatory cells such as enteric nerves remains to be determined. TRIAL REGISTRATION: ClinicalTrials.gov; NCT00148603.


Subject(s)
Acetates/pharmacokinetics , Acetates/therapeutic use , Duodenum/pathology , Dyspepsia/drug therapy , Eosinophilia/drug therapy , Leukotriene Antagonists/pharmacokinetics , Leukotriene Antagonists/therapeutic use , Quinolines/pharmacokinetics , Quinolines/therapeutic use , Acetates/pharmacology , Adolescent , Biopsy , Cell Count , Child , Cyclopropanes , Cytokines/blood , Dose-Response Relationship, Drug , Dyspepsia/pathology , Eosinophilia/pathology , Eosinophils/drug effects , Eosinophils/pathology , Female , Humans , Intestinal Mucosa/drug effects , Intestinal Mucosa/pathology , Leukotriene Antagonists/pharmacology , Male , Quinolines/pharmacology , Sulfides , Treatment Outcome
15.
Nat Cell Biol ; 7(5): 493-500, 2005 May.
Article in English | MEDLINE | ID: mdl-15834407

ABSTRACT

Chemotherapy that is used to treat human immunodeficiency virus type-1 (HIV-1) infection focuses primarily on targeting virally encoded proteins. However, the combination of a short retroviral life cycle and high mutation rate leads to the selection of drug-resistant HIV-1 variants. One way to address this problem is to inhibit non-essential host cell proteins that are required for viral replication. Here we show that the activity of HIV-1 integrase stimulates an ataxia-telangiectasia-mutated (ATM)-dependent DNA damage response, and that a deficiency of this ATM kinase sensitizes cells to retrovirus-induced cell death. Consistent with these observations, we demonstrate that a novel and specific small molecule inhibitor of ATM kinase activity, KU-55933, is capable of suppressing the replication of both wild-type and drug-resistant HIV-1.


Subject(s)
HIV Infections/virology , HIV-1/physiology , Virus Replication/physiology , Animals , Ataxia Telangiectasia Mutated Proteins , Cell Cycle Proteins/antagonists & inhibitors , Cell Cycle Proteins/metabolism , Cell Death/drug effects , Cell Death/physiology , Cells, Cultured , DNA Repair/drug effects , DNA Repair/physiology , DNA-Binding Proteins/antagonists & inhibitors , DNA-Binding Proteins/metabolism , Drug Resistance, Viral/drug effects , Drug Resistance, Viral/physiology , HIV Infections/drug therapy , HIV Integrase/drug effects , HIV Integrase/metabolism , HIV Protease Inhibitors/pharmacology , HIV-1/drug effects , Humans , Mice , Morpholines/pharmacology , Mutation/genetics , Protein Serine-Threonine Kinases/antagonists & inhibitors , Protein Serine-Threonine Kinases/metabolism , Pyrones/pharmacology , Tumor Suppressor Proteins/antagonists & inhibitors , Tumor Suppressor Proteins/metabolism , Virus Replication/drug effects
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