目的:P2X3受体,三聚体离子型嘌呤能受体,已成为难治性慢性咳嗽(RCC)的潜在治疗靶点。然而,Gefapixant/AF-219,唯一上市的P2X3受体拮抗剂,可能通过调节人P2X2/3(hP2X2/3)异源三聚体导致味觉障碍。因此,在RCC药物开发中,对hP2X3同源三聚体表现出强亲和力和对hP2X2/3异源三聚体表现出弱亲和力的化合物具有希望。这样的分子的一个实例是sivopixant/S-600918,一种临床II期RCC候选物,与Gefapixant相比具有降低的味觉紊乱发生率。Sivopixant及其类似物,(3-(4-([3-氯-4-异丙氧基苯基]氨基)-3-(4-甲基苄基)-2,6-二氧代-3,6-二氢-1,3,5-三嗪-1(2H)-基)丙酸(DDTPA),对hP2X3同源三聚体表现出高亲和力和高选择性,与hP2X2/3异源三聚体相比。药物位点的潜在机制及其高选择性仍不清楚。
方法:为了分析将该候选药物与其他P2X3受体抑制剂区分开的机制,我们使用了嵌合体构建的组合,位点共价占据,元动力学,诱变和全细胞记录。
结果:sivopixant/DDTPA对hP2X3受体的高亲和力和选择性是通过位于靠近上前庭的三对称位点确定的。hP2X2上半身结构域内仅四个氨基酸被hP2X3的氨基酸取代,使hP2X2/3异源三聚体对sivopixant/DDTPA的表观亲和力与hP2X3同源三聚体相似。
结论:从受体-配体识别的角度来看,我们已经阐明了新型RCC临床候选物的分子基础,\'咳嗽抑制特性和减少的副作用,为发现特异性靶向P2X3受体的新型药物提供了有希望的方法。
OBJECTIVE: The P2X3 receptor, a trimeric ionotropic purinergic receptor, has emerged as a potential therapeutic target for refractory chronic cough (RCC). Nevertheless, gefapixant/AF-219, the only marketed P2X3 receptor antagonist, might lead taste disorders by modulating the human P2X2/3 (hP2X2/3) heterotrimer. Hence, in RCC drug development, compounds exhibiting strong affinity for the hP2X3 homotrimer and a weak affinity for the hP2X2/3 heterotrimer hold promise. An example of such a molecule is sivopixant/S-600918, a clinical Phase II RCC candidate with a reduced incidence of taste disturbance compared to gefapixant. Sivopixant and its analogue, (3-(4-([3-chloro-4-isopropoxyphenyl]amino)-3-(4-methylbenzyl)-2,6-dioxo-3,6-dihydro-1,3,5-triazin-1(2H)-yl)propanoic acid (DDTPA), exhibit both high affinity and high selectivity for hP2X3 homotrimers, compared with hP2X2/3 heterotrimers. The mechanism underlying the druggable site and its high selectivity remains unclear.
METHODS: To analyse mechanisms that distinguish this drug candidate from other inhibitors of the P2X3 receptors we used a combination of chimera construction, site covalent occupation, metadynamics, mutagenesis and whole-cell recording.
RESULTS: The high affinity and selectivity of sivopixant/DDTPA for hP2X3 receptors was determined by the tri-symmetric site located close to the upper vestibule. Substitution of only four amino acids inside the upper body domain of hP2X2 with those of hP2X3, enabled the hP2X2/3 heterotrimer to exhibit a similar level of apparent affinity for sivopixant/DDTPA as the hP2X3 homotrimer.
CONCLUSIONS: From the receptor-ligand recognition perspective, we have elucidated the molecular basis of novel RCC clinical candidates\' cough-suppressing properties and reduced side effects, offering a promising approach to the discovery of novel drugs that specifically target P2X3 receptors.