Discovery of TD-0212, an Orally Active Dual Pharmacology AT<sub>1</sub> Antagonist and Neprilysin Inhibitor (ARNI)
作者:R. Murray McKinnell、Paul Fatheree、Seok-Ki Choi、Roland Gendron、Keith Jendza、Brooke Olson Blair、Joe Budman、Craig M. Hill、Laxminarayan G. Hegde、Cecile Yu、Donavon McConn、Sharath S. Hegde、Daniel G. Marquess、Uwe Klein
DOI:10.1021/acsmedchemlett.8b00462
日期:2019.1.10
structures of losartan (an AT1 antagonist) and thiorphan (a NEP inhibitor) led to the discovery of a novel series of orally active, dual AT1 antagonist/NEP inhibitors (ARNIs) exemplified by compound 35 (TD-0212). In models of renin-dependent and -independent hypertension, 35 produced blood pressure reductions similar to omapatrilat and combinations of AT1 receptor antagonists and NEP inhibitors. Upper airway
相对于ACE抑制剂,诸如omapatrilat的药物对血管紧张素转换酶(ACE)和中性溶酶(NEP)的双重抑制产生了优越的降压功效,但由于缓激肽升高,导致危及生命的血管性水肿的风险更高。我们假设用单个分子双重双重AT1(血管紧张素II 1型受体)阻滞和NEP抑制将产生与omapatrilat相似的降压功效,而没有血管性水肿的风险,因为ACE(缓激肽代谢中的限速酶)将保持不受抑制。氯沙坦(一种AT1拮抗剂)和硫羟西芬(一种NEP抑制剂)的结构融合导致发现了一系列新型的口服活性双重AT1拮抗剂/ NEP抑制剂(ARNIs),以化合物35(TD-0212)为例。在肾素依赖性和非依赖性高血压模型中,35名患者的血压降低与omapatrilat相似,并且AT1受体拮抗剂和NEP抑制剂联合使用。在大鼠气管血浆外渗(TPE)模型中评估了上呼吸道血管性水肿的风险。与omapatrilat不同的是,在降压剂