靶向电压门控KCNQ/M钾通道的调节剂对神经精神疾病的潜在治疗作用

1980年David Brown博士首次发现了M型乙酰胆碱受体激动剂可以抑制一种钾通道电流,并将其命名为M型钾电流（IM）十八年后科学家们克隆了导致新生儿癫痫的KCNQ2和KCNQ3突变基因,并且证明KCNQ2和KCNQ3亚基异源组装介导M型钾通道电流。电压门控KCNQ2/3钾通道（亦称M通道）功能降低可导致神经元的过度兴奋,诱发癫痫及慢性疼痛。因此,研发激活KCNQ2/3通道功能的开放剂可用于治疗癫痫和疼痛等神经疾病。著名的KCNQ通道开放剂瑞替加滨retigabine（商品名Potiga）于2011年被美国食品与药品监督管理局批准治疗癫痫。我们最近参与研发了一类新型的KCNQ2/3特异性开放剂—吡唑并[1,5-a]嘧啶酮类化合物。在动物模型上,该开放剂具有抗癫痫和镇痛的效果。最近的研究工作提示,KCNQ通道开放剂还对抑郁症、焦虑症和精神分裂症等动物模型有效,而KCNQ通道抑制剂可以提高动物的学习与记忆能力。目前的研究进展提示,电压门控KCNQ/M通道是治疗神经精神类疾病的靶点,靶向该通道的调节剂对多种神经精神疾病具有潜在的治疗价值。

Targeting voltage-gated Kv7/KCNQ/M-channel for therapeutic potential of neuropsychiatric disorders

M-type potassium current （IM） was initially isolated from sympathetic neurons in 1980 and named as it was inhibited by muscarine. In 1998, the molecular identity of M-current was revealed to be heterotetramers of KCNQ2 and KCNQ3 subunits, whose mutations cause neonatal epilepsy. Reduction of voltage-gated KCNQ2/3 K＋ channel （M-channel） activity leads to neuronal byperexcitability that defines the fundamental mechanism of neurological disorders such as epilepsy and pain. Thus, suppression of neuronal hyperexcitability by activation of KCNQ2/3 channels serves the basis for development of the channel openers for treatment of epilepsy and pain. The well-known KCNQ opener is retigabine （Potiga） that was approved by FDA as an antiepileptic drug in 2011. Recent studies also provide evidence that KCNQ2/3 channel openers are effective in animal models of bipolar disorder, anxiety and schizophrenia, whereas KCNQ2/3 inhibitors, on the other hand, are indicated for improvement of learning and memory in animal models. We recently designed and validated a novel series of pyrazolo [1,5-a]pyrimidin-7（4H）-ones （PPOs） that selectively activate KCNQ2/3 and show antiepileptic and analgesic activity in vivo. Up to date, all the progress made enforces the view that targeting voltage-gated KCNQ/M-channel may provide therapeutic potential for treatment of neuropsychiatric disorders.