The autotaxin-lysophosphatidic acid (ATX-LPA) signaling pathway plays a role in a variety of autoimmune diseases, such as rheumatoid arthritis or neurodegeneration. A link to the pathogenesis of glaucoma is suggested by an overactive ATX-LPA axis in aqueous humor samples of glaucoma patients. Analysis of such samples suggests that the ATX-LPA axis contributes to the fibrogenic activity and resistance to aqueous humor outflow through the trabecular meshwork. In order to inhibit or modulate this pathway, we developed a new series of ATX-inhibitors containing novel bicyclic and spirocyclic structural motifs. A potent lead compound (IC50 against ATX: 6 nM) with good in vivo PK, favorable in vitro property, and safety profile was generated. This compound leads to lowered LPA levels in vivo after oral administration. Hence, it was suitable for chronic oral treatment in two rodent models of glaucoma, the experimental autoimmune glaucoma (EAG) and the ischemia/reperfusion models. In the EAG model, rats were immunized with an optic nerve antigen homogenate, while controls received sodium chloride. Retinal ischemia/reperfusion (I/R) was induced by elevating the intraocular pressure (IOP) in one eye to 140 mmHg for 60 min, followed by reperfusion, while the other untreated eye served as control. Retinae and optic nerves were evaluated 28 days after EAG or 7 and 14 days after I/R induction. Oral treatment with the optimized ATX-inhibitor lead to reduced retinal ganglion cell (RGC) loss in both glaucoma models. In the optic nerve, the protective effect of ATX inhibition was less effective compared to the retina and only a trend to a weakened neurofilament distortion was detectable. Taken together, these results provide evidence that the dysregulation of the ATX-LPA axis in the aqueous humor of glaucoma patients, in addition to the postulated outflow impairment, might also contribute to RGC loss. The observation that ATX-inhibitor treatment in both glaucoma models did not result in significant IOP increases or decreases after oral treatment indicates that protection from RGC loss due to inhibition of the ATX-LPA axis is independent of an IOP lowering effect.
自动税脂酶-溶磷脂酸(ATX-LPA)信号通路在多种自身免疫性疾病中发挥作用,如类风湿性关节炎或神经退行性疾病。在青光眼患者的房水样本中发现ATX-LPA轴过度活跃,暗示了其与青光眼发病机制的联系。对这些样本的分析表明,ATX-LPA轴促进了纤维生成活性,并通过小梁网状结构对房水流出的抵抗。为了抑制或调节这一通路,我们开发了一系列含有新颖的双环和螺环结构基元的ATX抑制剂。一种有效的前导化合物(对ATX的IC50:6 nM)具有良好的体内PK、有利的体外特性和安全性概况。这种化合物在口服后能降低体内LPA水平。因此,它适用于两种青光眼啮齿动物模型的慢性口服治疗,即实验性自身免疫性青光眼(EAG)和缺血/再灌注模型。在EAG模型中,大鼠接种视神经抗原匀浆,而对照组接受氯化钠。通过将一只眼的眼压升至140 mmHg,保持60分钟,然后再灌注,诱导视网膜缺血/再灌注(I/R),而另一只未处理的眼睛作为对照。在EAG后的第28天或I/R诱导后的第7和第14天评估视网膜和视神经。优化的ATX抑制剂口服治疗可减少两种青光眼模型中视网膜神经节细胞(RGC)的丢失。在视神经中,ATX抑制的保护作用比在视网膜中效果较弱,只能观察到神经丝蛋白变形减弱的趋势。综上所述,这些结果表明,在青光眼患者的房水中ATX-LPA轴的失调,除了假设的流出障碍外,可能也导致RGC的丢失。在两种青光眼模型中使用ATX抑制剂治疗后,未观察到口服治疗后眼压显著增加或减少的情况,这表明由于抑制ATX-LPA轴而保护RGC免受损失的效果与降低眼压的效果无关。