Muscarinic receptor activators as novel antipsychotic agents

描述（由申请人提供）：最近的临床研究表明，激活毒蕈碱乙酰胆碱受体（mAChR）的药物在减少精神分裂症以及AD和其他神经退行性疾病患者的精神病症状方面具有稳健的疗效。有证据表明，胆碱能药物的抗精神病作用可能是由M1 mAChR亚型介导的。然而，之前开发的用于选择性激活M1受体的化合物缺乏对M1的真正特异性。这导致了患者中M2和M3激活引起的不良反应的问题，并且使得不可能明确确定这些化合物的行为和临床作用是否由M1或其他mAChR亚型介导。尽管多个工业和学术实验室做出了重大努力，但仍不可能开发出临床上有用的、作用于正构乙酰胆碱（ACh）结合位点的高选择性M1激动剂。这可能是由于mAChR亚型之间ACh位点的高度保守性。近年来，我们已经非常成功地建立了一类新的化合物，作为G蛋白偶联受体的变构增效剂，可以提供直接作用的激动剂的关键优势。与激动剂不同，这些化合物不直接激活受体，而是作用于变构位点以增强对内源性激动剂的反应。通常，这些化合物倾向于对预期受体更具选择性，因为它们不与高度保守的神经递质结合位点相互作用。另一个重大突破发生在其他实验室发现了一类新的M1激动剂，它们与受体上的异位位点而不是ACh结合位点相互作用。与传统激动剂不同，这些化合物相对于其他mAChR亚型对M1具有高度特异性，并提供了令人兴奋的新工具，以明确确定被认为对抗精神病活性重要的mAChR激动剂的生理和行为效应是否由M1介导。在拟议的研究中，我们将利用自动化技术和高通量筛选M1的变构增效剂，我们已经开发了识别新型化合物，作为这种受体的高选择性变构增效剂。此外，我们将沿着使用这些化合物和新的选择性异位位点M1激动剂，一种新的M4变构增效剂和一组小鼠，其中特定的mAChR亚型已被删除，以测试抗精神病药-M1介导的毒蕈碱激动剂的相似特征，并确定M1的变构增效剂是否具有与M1相似的电生理和行为效应激动剂

DESCRIPTION (provided by applicant): Recent clinical studies reveal that agents that activate muscarinic acetylcholine receptors (mAChRs) have robust efficacy in reducing psychotic symptoms in patients with schizophrenia as well as AD and other neurodegenerative disorders. Evidence suggests that the antipsychotic effects of cholinergic agents may be mediated by the M1 mAChR subtype. However, previous compounds developed to selectively activate M1 receptors lack true specificity for M1. This has resulted in problems with adverse effects due to M2 and M3 activation in patients and has made it impossible to definitively determine whether the behavioral and clinical effects of these compounds are mediated by M1 or other mAChR subtypes. Despite major efforts by multiple industry and academic laboratories, it has been impossible to develop clinically useful highly selective M1 agonists that act the orthosteric acetylcholine (ACh) binding site. This is likely due to the high degree of conservation of the ACh site between mAChR subtypes. In recent years we have been highly successful in establishing a new class of compounds that act as allosteric potentiators of G protein-coupled receptors that may provide key advantages to direct-acting agonists. Unlike agonists, these compounds do not directly activate the receptor but act at an allosteric site to potentiate the response to the endogenous agonist. In general, these compounds tend to be more selective for the intended receptor because they do not interact with the highly conserved neurotransmitter binding site. Another major breakthrough occurred when other laboratories discovered a novel class of M1 agonists that interact with an ectopic site on the receptor rather than the ACh binding site. Unlike traditional agonists, these compounds are highly specific for M1 relative to other mAChR subtypes and provide exciting new tools to definitively determine whether the physiological and behavioral effects of mAChR agonists thought to be important for antipsychotic activity are mediated by M1. In the proposed studies, we will take advantage of automated technologies and a high throughput screen for allosteric potentiators of M1 that we have developed to identify novel compounds that act as highly selective allosteric potentiators of this receptor. In addition, we will use these compounds along with the new selective ectopic site M1 agonists, a novel M4 allosteric potentiator and a panel of mice in which specific mAChR subtypes have been deleted to test the hypothesis that the antipsychotic-like profile of muscarinic agonists is mediated by M1 and to determine whether allosteric potentiators of M1 have electrophysiological and behavioral effects that are similar to those of M1 agonists.