Novel treatment of posttraumatic stress disorder

描述（由申请人提供）：本申请“创伤后应激障碍的新治疗”解决了对创伤后应激障碍（PTSD）的有效治疗的迫切需要。由创伤经历激活的关键神经信号级联由兴奋性神经递质谷氨酸启动。NMDA受体（谷氨酸受体亚型）的激活导致神经元型一氧化氮合酶（nNOS）的随后激活，并最终导致信号分子一氧化氮（NO）的产生增加。这些事件触发异常的突触可塑性， 创伤后应激障碍的发生和维持突触后密度蛋白95（PSD 95）将nNOS靶向NMDA受体，因此是nNOS的NMDA受体活化所需的。Lai博士是该项目的主要研究者，他首先证明了小分子抑制剂IC 87201在体外破坏了nNOS和PSD 95之间的功能性蛋白质-蛋白质相互作用，并在体内减弱了NMDA受体依赖性痛觉过敏。由Shekhar博士（Anagin的创始人）领导的临床前团队现在已经证明，IC 87201和相关的类似物ZL 006即使在恐惧条件反射发生后（即创伤后）也能阻止条件反射恐惧的长期编码。与NMDA受体拮抗剂不同，这些蛋白质相互作用抑制剂是有效的，不会损害运动或记忆。因此，信号区室化的中断代表了开发具有较少副作用的焦虑症新疗法的创新方法。我们组建了一个具有协同和互补专业知识的合作团队，将药物发现（Lai），新型临床前应激和记忆模型（Shekhar和Hohmann）开发，先导化合物（Thakur）的化学优化和目标验证（Lai和Hohmann）的广泛经验结合起来，以开展两个特定目标下的工作。本提案的目的1将描述我们的先导抑制剂的药代动力学特征和口服疗效。然后，目标2将使用传统的药物药物化学方法来设计和开发与母体化合物相比具有改善的溶解度和效力的备用化学系列。这项SBIR I期研究的结果将为进一步优化和临床前开发nNOS靶向抑制剂作为II期PTSD的新型治疗方法奠定基础。这些研究有望验证信号蛋白区室化的破坏作为药物开发的创新和可行的方法。开发具有有限副作用特征的新型化学结构的有效药物疗法有望降低不断上升的医疗保健成本，并减轻创伤后应激障碍患者不必要的痛苦。

DESCRIPTION (provided by applicant): The present application "Novel Treatment for Posttraumatic Stress Disorder" addresses the critical need for efficacious treatments for posttraumatic stress disorder (PTSD). A key neural signaling cascade activated by a trauma experience is initiated by the excitatory neurotransmitter glutamate. Activation of the NMDA receptor, a glutamate receptor subtype, results in subsequent activation of the enzyme neuronal nitric oxide synthase (nNOS) and, ultimately, an increase in the production of the signaling molecule nitric oxide (NO). These events trigger aberrant synaptic plasticity that is implicated in the initiation and maintenance of PTSD. Postsynaptic density protein 95 (PSD95) targets nNOS to the NMDA receptor and is, therefore, required for NMDA receptor activation of nNOS. Dr. Lai, Principal investigator for this project, first showed that the small molecule inhibitor IC87201 disrupts the functional protein-protein interaction between nNOS and PSD95 in vitro and attenuates NMDA receptor dependent hyperalgesia in vivo. Our preclinical team, led by Dr. Shekhar (Founder of Anagin), has now shown that IC87201 and a related analog, ZL006, block the long-term encoding of conditioned fear even after a fear conditioning session has occurred (i.e. post-trauma). Unlike NMDA receptor antagonists, these protein interaction inhibitors are efficacious without impairing motor movement or memory. Thus, disruption of signal compartmentalization represents an innovative approach to develop novel treatments for anxiety disorders with fewer side-effects. We have assembled a collaborative team with synergistic and complementary expertise to unite extensive combined experience in drug discovery (Lai), development of novel preclinical stress and memory models (Shekhar and Hohmann), chemical optimization of lead compounds (Thakur) and target validation (Lai and Hohmann) to conduct work proposed under two Specific Aims. Aim 1 of this proposal will characterize the pharmacokinetic profile and oral efficacy of our lead inhibitors. Aim 2 will then use a traditional drug medicinal chemistry approach to design and develop a back up chemical series with improved solubility and potency compared to the parent compounds. Results from this SBIR Phase I study will lay the foundation for further lead optimization and preclinical development of nNOS targeting inhibitors as novel treatments for PTSD in Phase II. These studies are expected to validate the disruption of signal protein compartmentalization as an innovative and feasible approach to drug development. The development of effective pharmacotherapies with novel chemical structures that possess limited side- effect profiles is expected to drive down escalating health care costs and alleviate unnecessary suffering in PTSD patients.