1. Design and Synthesis of Clinical Candidate PF-06852231 (CVL-231): A Brain Penetrant, Selective, Positive Allosteric Modulator of the M 4 Muscarinic Acetylcholine Receptor.
- Author
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Butler CR, Popiolek M, McAllister LA, LaChapelle EA, Kramer M, Beck EM, Mente S, Brodney MA, Brown M, Gilbert A, Helal C, Ogilvie K, Starr J, Uccello D, Grimwood S, Edgerton J, Garst-Orozco J, Kozak R, Lotarski S, Rossi A, Smith D, O'Connor R, Lazzaro J, Steppan C, and Steyn SJ
- Subjects
- Allosteric Regulation drug effects, Humans, Animals, Structure-Activity Relationship, Rats, Cricetulus, CHO Cells, Muscarinic Agonists pharmacology, Muscarinic Agonists chemical synthesis, Muscarinic Agonists chemistry, Schizophrenia drug therapy, Schizophrenia metabolism, Receptor, Muscarinic M4 metabolism, Receptor, Muscarinic M4 agonists, Drug Design, Brain metabolism, Brain drug effects
- Abstract
Selective activation of the M
4 muscarinic acetylcholine receptor subtype offers a novel strategy for the treatment of psychosis in multiple neurological disorders. Although the development of traditional muscarinic activators has been stymied due to pan-receptor activation, muscarinic receptor subtype selectivity can be achieved through the utilization of a subtype of a unique allosteric site. A major challenge in capitalizing on this allosteric site to date has been achieving a balance of suitable potency and brain penetration. Herein, we describe the design of a brain penetrant series of M4 selective positive allosteric modulators (PAMs), ultimately culminating in the identification of 21 ( PF-06852231, now CVL-231/emraclidine), which is under active clinical development as a novel mechanism and approach for the treatment of schizophrenia.- Published
- 2024
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