Discovery of Piragliatin—First Glucokinase Activator Studied in Type 2 Diabetic Patients
作者:Ramakanth Sarabu、Fred T. Bizzarro、Wendy L. Corbett、Mark T. Dvorozniak、Wanping Geng、Joseph F. Grippo、Nancy-Ellen Haynes、Stanley Hutchings、Lisa Garofalo、Kevin R. Guertin、Darryl W. Hilliard、Marek Kabat、Robert F. Kester、Wang Ka、Zhenmin Liang、Paige E. Mahaney、Linda Marcus、Franz M. Matschinsky、David Moore、Jagdish Racha、Roumen Radinov、Yi Ren、Lida Qi、Michael Pignatello、Cheryl L. Spence、Thomas Steele、John Tengi、Joseph Grimsby
DOI:10.1021/jm3008689
日期:2012.8.23
Glucokinase (GK) activation as a potential strategy to treat type 2 diabetes (T2D) is well recognized. Compound 1, a glucokinase activator (GKA) lead that we have previously disclosed, caused reversible hepatic lipidosis in repeat-dose toxicology studies. We hypothesized that the hepatic lipidosis was due to the structure-based toxicity and later established that it was due to the formation of a thiourea metabolite, 2. Subsequent SAR studies of 1 led to the identification of a pyrazine-based lead analogue 3, lacking the thiazole moiety. In vivo metabolite identification studies, followed by the independent synthesis and profiling of the cyclopentyl keto- and hydroxyl- metabolites of 3, led to the selection of piragliatin, 4, as the clinical lead. Piragliatin was found to lower pre- and postprandial glucose levels, improve the insulin secretory profile, increase beta-cell sensitivity to glucose, and decrease hepatic glucose output in patients with T2D.