GABA-A receptor subtypes in the brain: a paradigm for CNS drug discovery?

The clinical importance of benzodiazepines, barbiturates and general anesthetics, all of which act through the gamma-aminobutyric acid (GABA)-A neurotransmitter receptor, is testament to its significance as a CNS drug target. These drugs were all developed before there was any understanding of the diversity of this receptor gene family. Recent studies using genetically modified mice and GABA-A receptor-subtype-selective compounds have helped to delineate the function of some of these subtypes, and have revealed that it might be possible to develop a new generation of selective drugs with improved profiles or novel applications.     

MAPK-specific tyrosine phosphatases: new targets for drug discovery?

Protein tyrosine phosphatases (PTPs) have key roles in a diverse range of cellular processes, and their dysregulation is associated with several human diseases. Many PTPs are recognized as potential drug targets; however, inhibitor development has focused only on a small number of enzymes, most notably PTP1B for type II diabetes and obesity, and MKP1 and CDC25 for cancer. The future challenge of selective-inhibitor development for PTPs will be significantly facilitated by the recent rapid progress in the structural biology of the 'PTPome'. In this article, we focus on the family of mitogen-activated protein kinase (MAPK)-specific tyrosine phosphatases--PTPN5 [also called striatal-enriched phosphatase (STEP)], PTPN7 (also called hematopoietic PTP) and PTPRR (also called PC12 PTP or STEP-like PTP)--and discuss approaches for achieving selectivity for the MAPK-PTPs at the molecular level using recently determined high-resolution X-ray crystal structures. We believe that the development of specific inhibitors would provide a valuable set of experimental pharmacological tools for investigating the physiological role of these phosphatases and exploring their emerging role in human disease.     

Natural products as drug leads: an old process or the new hope for drug discovery?

Although the use of natural products as leads to drugs waned in the early 1980s with the rise of combinatorial chemistry as a putative discovery tool, inspection of the chemical literature shows that research in natural products, in one guise or another, is alive and active and the 'chemical inspiration' from these privileged structures is leading to novel approaches in drug design and discovery. In this short article, we propose why we consider natural products are poised for a renaissance as tools for drug discovery.     

5-HT receptor-associated protein networks: new targets for drug discovery in psychiatric disorders?

Serotonin (5-HT) is a phylogenetically ancient transmitter implicated in many vital functions in human such as sleep, food intake, reproduction, nociception, regulation of mood and emotions as well as cognitive functions. Correspondingly, dysfunction of serotonergic transmission has been implicated in numerous psychiatric disorders such as anxio-depressive states, psychoses and addiction, and serotonergic systems are targets for a large array of psychoactive compounds including antidepressants, antipsychotics and hallucinogens. 5-HT acts on numerous receptor subtypes (14). Except for 5-HT3 receptors, which are cationic channels, 5-HT receptors belong to the G protein-coupled receptor (GPCR) superfamily and allow an extraordinarily diverse and complex pattern of cellular signalling. Over the past ten years, the majority of metabotropic 5-HT receptors has been found to interact with specific protein partners in addition to the ubiquitous GPCR modulators, GPCR kinases and β-arrestins, mainly by mean of two-hybrid and proteomic screens. These proteins, called GPCR-interacting proteins (GIPs) were found to profoundly influence the targeting, trafficking and signal transduction properties of 5-HT receptors. This article first describes our current knowledge of the nature of GIPs that bind to the different metabotropic 5-HT receptor categories. It then focuses on their impact on receptor functional status at the cellular level and illustrates how GIPs permit G protein-independent signal transduction at G protein-coupled 5-HT receptors. Finally, it reports recent data dealing with the roles of GIPs in 5-HT-related behaviours and highlights the potential of manipulating 5-HT receptor-GIP interactions to design new treatments in psychiatric disorders related to perturbations of serotonergic systems.     

Where is the hope for drug discovery? Let history tell the future

For drug discovery, historical experience is always of significance. Through examining the history of traditional medicines, we find that these medicines have more implications for drug discovery than just providing new chemical entities. The history of traditional medicines indicates that they depended more on the combination of natural agents than on screening new agents to find new remedies. This phenomenon suggests that shifting the current drug discovery paradigm from 'finding new-entity drugs' to 'combining existing agents' may be helpful for overcoming the 'more investment, fewer drugs' challenge. We show that clues to finding antidementia combinatorial drugs can be derived from traditional medicine formulae. It seems that to create a brighter future of drug discovery, we would better go back to history.     

Are we moving in the right direction with osteoarthritis drug discovery?

INTRODUCTION: The success of targeted biologic therapy against rheumatoid arthritis has meant that much research has been devoted to investigating the pathophysiology of osteoarthritis, in the hope of defining novel therapeutic targets. Osteoarthritis has long been thought of mainly as a degenerative disease of cartilage, with secondary bony damage and osteophytes. However, in recent years, the importance of the synovium, and in particular the synovial macrophages, has been highlighted in both in vitro and in vivo studies. AREAS COVERED: The recent progress in osteoarthritis drug discovery, particularly with regard to the search for therapeutic targets for this disease and the development of disease-modifying anti-osteoarthritic drugs is critically assessed. Some important recent research with regard to possible therapeutic targets in osteoarthritis drug discovery is highlighted. EXPERT OPINION: The concept that synovial macrophages and macrophage-produced cytokines, may play a role in driving inflammatory and destructive signalling pathways in osteoarthritis, is of importance for drug discovery in this disease, in spite of disappointing results from early studies of anti-cytokine strategies in osteoarthritis clinical trials. There is also an abundance of potential downstream therapeutic targets in osteoarthritis, including the matrix metalloproteinases, the aggrecanases, iNOS and elements of the Wnt pathway.     

Can we discover pharmacological promiscuity early in the drug discovery process?

The term 'pharmacological promiscuity' describes the activity of a single compound against multiple targets. When undesired, promiscuity is a major safety concern that needs to be detected as early as possible in the drug discovery process. The analysis of large datasets reveals that the majority of promiscuous compounds are characterized by recognizable molecular properties and structural motifs, the most important one being a basic center with a pK(a)(B)>6. These compounds interact with a small set of targets such as aminergic GPCRs; some of these targets attract surprisingly high hit rates. In this review, we discuss current trends in the assessment of pharmacological promiscuity and propose strategies to enable early detection and mitigation.     

Where do we stand in the field of anti-abuse drug discovery?

Drug abuse and addiction to licit and illicit drugs constitute an almost worldwide health and socioeconomic problem. This problem can be addressed in a number of ways. As far as pharmaceutical development and drug therapy is concerned, abuse-deterrent formulations (ADF), substitution therapies, antagonist therapies, aversion therapies, and diverse novel approaches can be considered. ADF (or tamper-resistant formulations) are an important step towards preventing the abuse of medically used drugs, such as strong opioid analgesics, and some drug treatments are well established, such as substitution therapy in opioid dependence with methadone and buprenorphine. Nevertheless, a large medical need remains, and drugs that effectively curb opioid or psychostimulant addiction by promoting abstinence and preventing relapse have yet to be developed. Many different targets and mechanisms are currently being considered in preclinical research, but apart from repurposing or reformulating already known drugs, very little clinical development is currently ongoing. It is hoped that at least a few of the investigated approaches (e.g., various glutamate and GABA receptor modulators, nociceptin/orphanin FQ peptide receptor agonists, or histamine H3 receptor antagonists) reach the stage of clinical development and eventually reach regulatory approval.     

The endoplasmic reticulum protein folding factory and its chaperones: new targets for drug discovery?

Cytosolic heat shock proteins have received significant attention as emerging therapeutic targets. Much of this excitement has been triggered by the discovery that HSP90 plays a central role in the maintenance and stability of multifarious oncogenic membrane receptors and their resultant tyrosine kinase activity. Numerous studies have dealt with the effects of small molecules on chaperone- and stress-related pathways of the endoplasmic reticulum (ER). However, unlike cytosolic chaperones, relatively little emphasis has been placed upon translational avenues towards targeting of the ER for inhibition of folding/secretion of disease-promoting proteins. Here, we summarise existing small molecule inhibitors and potential future targets of ER chaperone-mediated inhibition. Client proteins of translational relevance in disease treatment are outlined, alongside putative future disease treatment modalities based on ER-centric targeted therapies. Particular attention is paid to cancer and autoimmune disorders via the effects of the GRP94 inhibitor geldanamycin and its population of client proteins, overloading of the unfolded protein response, and inhibition of members of the IL-12 family of cytokines by celecoxib and non-coxib analogues.     

TAT-based drug delivery system – new directions in protein delivery for new hopes?

There has been great progress in the use of TAT-based drug delivery systems for the delivery of different macromolecules into cells in vitro and in vivo, thus circumventing the bioavailability barrier that is a problem for so many drugs. There are many advantages to using this system, such as the ability to deliver these cargoes into all types of cells in culture and into all organs in vivo. This system can even deliver cargoes into the brain across the blood–brain barrier. In addition, the ability to target specific intracellular sub-localizations such as the nuclei, the mitochondria and lysosomes further expands the possibilities of this drug delivery system to the development of sub-cellular organelle-targeted therapy. The therapeutic applications seem almost unlimited, and the use of the TAT-based delivery system has extended from proteins to a large variety of cargoes such as oligonucleotides, imaging agents, low molecular mass drugs, nanoparticles, micelles and liposomes. In this review the most recent advances in the use of the TAT-based drug delivery system will be described, mainly discussing TAT-mediated protein delivery and the use of the TAT system for enzyme replacement therapy.     

LCZ696: a new paradigm for the treatment of heart failure?

Introduction: Heart failure (HF) represents a significant healthcare issue because of its ever-increasing prevalence, poor prognosis and complex pathophysiology. Currently, blockade of the renin–angiotensin–aldosterone system (RAAS) is the cornerstone of treatment; however, the combination of RAAS blockade with inhibition of neprilysin (NEP), an enzyme that degrades natriuretic peptides, has recently emerged as a potentially superior treatment strategy.

Areas covered: Following the results of the recent Phase III Prospective Comparison of ARNI with ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure clinical trial in patients with chronic HF with reduced ejection fraction (HF-REF), this review focuses on LCZ696, a first-in-class angiotensin receptor NEP inhibitor. This drug consists of a supramolecular complex containing the angiotensin receptor inhibitor valsartan in combination with the NEP inhibitor prodrug, AHU377. Following oral administration, the LCZ696 complex dissociates and the NEP inhibitor component is metabolized to the active form (LBQ657). Aspects of the trial that might be relevant to clinical practice are also discussed.

Expert opinion: Speculation that LCZ696 will pass the scrutiny of regulatory agencies for HF-REF appears to be justified, and it is likely to become a core therapeutic component in the near future. Replication of the eligibility criteria and titration protocol used in the PARADIGM-HF trial would be valuable in clinical practice and may minimize the risk of adverse events. Although long-term data remain to be generated, the promising results regarding hypertension are likely to expedite acceptance of the drug for HF-REF.