Discovery of Procognitive Antipsychotics by Combining Muscarinic M-1 Receptor Structure-Activity Relationship with Systems Response Profiles in Zebrafish Larvae

• Current antipsychotic drugs are notably ineffective at addressing the cognitive deficits associated with schizophrenia. N-Desmethylclozapine (NDMC), the major metabolite of clozapine, displays muscarinic M-1 receptor (M-1) agonism, an activity associated with improvement in cognitive functioning. Preclinical and clinical data support that M-1 agonism may be a desired activity in antipsychotic drugs. However, NDMC failed clinical phase II studies in acute psychotic patients. NDMC analogues were synthesized to establish a structure-activity relationship (SAR) at the M-1 receptor as an indication of potential procognitive properties. In vitro evaluation revealed a narrow SAR in which M-1 agonist activity was established by functionalization in the 4- and 8-positions in the tricyclic core. In vivo behavioral response profiles were used to evaluate antipsychotic efficacy and exposure in zebrafish larvae and peripheral side effect related M-1 activity in adult zebrafish. The NDMC analogue 13f demonstrated antipsychotic activity similar to clozapine including M-1 agonist activity. Cotreatment with trospium chloride, an M1 peripheral acting antagonist, counteracted peripheral side effects. Thus, the NDMC analogue 13f, in combination with a peripherally acting anticholinergic compound, could be suitable for further development as an antipsychotic compound with potential procognitive activity.

Ämnesord

NATURVETENSKAP  -- Biologi -- Biokemi och molekylärbiologi (hsv//swe)

NATURAL SCIENCES  -- Biological Sciences -- Biochemistry and Molecular Biology (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Medicinska och farmaceutiska grundvetenskaper -- Farmakologi och toxikologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Basic Medicine -- Pharmacology and Toxicology (hsv//eng)

Nyckelord

Zebrafish

antipsychotics

muscarinic agonist

structure-activity

relationship

N-desmethylclozapine

behavioral profiling

n-desmethylclozapine

allosteric modulation

drug

schizophrenia

clozapine

m1

identification

association

impairment

activation

Biochemistry & Molecular Biology

Pharmacology & Pharmacy

Neurosciences

& Neurology

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