DAAO Inhibitors for the treatment of Schizophrenia

描述（由申请人提供）：累积证据表明，通过甘氨酸调节位点的NMDA受体的变构激活为精神分裂症的治疗提供了新的治疗潜力。d -丝氨酸是甘氨酸调节部位的一种内源性激动剂，在临床研究中已被证明对治疗阳性、阴性和精神分裂症的认知症状有效。尽管临床数据非常鼓舞人心，但d -丝氨酸的临床开发可能会面临障碍，因为要达到疗效需要高剂量（每天约2克）。这主要是由于d -氨基酸氧化酶（DAAO）对外周给药的d -丝氨酸的大量代谢，d -氨基酸氧化酶是一种在肝脏、肾脏和大脑中表达的黄酶。daao介导的d -丝氨酸代谢不仅限制了d -丝氨酸的生物利用度，而且有可能通过生成过氧化氢诱导肾毒性。因此，我们假设阻断daao介导的d -丝氨酸代谢可以大大降低药效所需的剂量，同时防止过氧化氢诱导的外周毒性。为此，我们发现在精神分裂症动物模型中，d -丝氨酸和DAAO抑制剂共同施用可显著增加血浆和脑中的d -丝氨酸水平，并增强d -丝氨酸的体内效力。拟议研究的目标是通过实施一项战略研究计划，将我们的发现转化为创新的治疗方法，该研究计划包括以下内容：（目标1）对苯并异唑衍生物和其他类别的融合双环化合物进行先导优化研究，以建立SAR（结构-活性关系），并确定有效的、选择性的、无毒的、代谢稳定的药物类DAAO抑制剂；（目的2）评估目的1中确定的强效药物样DAAO抑制剂对d -丝氨酸口服生物利用度的影响；（目的3）评估目的2中鉴定的DAAO抑制剂对d -丝氨酸减轻苯环利定（PCP）诱导的小鼠脉冲前抑制（PPI）缺陷的能力的影响；（目的4）评估目的3中鉴定的DAAO抑制剂对d -丝氨酸减轻精神分裂症遗传小鼠模型中PPI缺陷的能力的影响。在这个项目完成后，我们期望确定临床前候选DAAO抑制剂，这可能导致一种真正的新型抗精神病药物用于治疗精神分裂症。

DESCRIPTION (provided by applicant): Cumulative evidence suggests that allosteric activation of the NMDA receptor through the glycine modulatory site provides new therapeutic potential for the treatment of schizophrenia. D-Serine, an endogenous agonist at the glycine modulatory site, has been shown to be effective at treating positive, negative, and cognitive symptoms of schizophrenia in clinical studies. Despite the highly encouraging clinical data, clinical development of D-serine will likely face obstacles because of the high dosages required for efficacy (approximately 2 grams per day). This is primarily due to the substantial metabolism of peripherally administered D-serine by D-amino acid oxidase (DAAO), a flavoenzyme expressed in the liver, kidneys, and brain. DAAO-mediated metabolism of D-serine not only limits D-serine bioavailability but also has the potential to induce kidney toxicity through the generation of hydrogen peroxide. Therefore, we hypothesize that blockade of DAAO-mediated D-serine metabolism could substantially lower the dosages required for efficacy while preventing hydrogen peroxide-induced peripheral toxicity. To this end, we found that co-administration of D-serine and a DAAO inhibitor significantly increases plasma and brain levels of D-serine and enhances in vivo potency of D-serine in an animal model of schizophrenia. The goal of the proposed research is to translate our findings into innovative therapeutics by conducting a strategic research plan that consists of the following: (Aim 1) Perform lead optimization studies on benzoisoxazole derivatives and other classes of fused bicyclic compounds to establish SAR (structure-activity relationships) and identify potent, selective, non-toxic, and metabolically stable drug-like DAAO inhibitors; (Aim 2) Assess the effects on D-serine oral bioavailability of potent drug-like DAAO inhibitors identified in Aim 1; (Aim 3) Assess the effect of DAAO inhibitors identified in Aim 2 on D-serine's ability to attenuate phencyclidine (PCP) induced prepulse inhibition (PPI) deficits in mice; (Aim 4) Assess the effects of DAAO inhibitors identified in Aim 3 on D-serine's ability to attenuate PPI deficits in a genetic mouse model of schizophrenia. Upon completion of this project, we expect to identify preclinical candidate DAAO inhibitors that could lead to a truly novel antipsychotic drug for the treatment of schizophrenia.