1. Discovery of BAY 2413555, First Selective Positive Allosteric Modulator of the M2 Receptor to Restore Cardiac Autonomic Balance.
- Author
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Vakalopoulos A, Basting D, Brechmann M, Teller H, Boultadakis Arapinis M, Straub A, Mittendorf J, Meininghaus M, Müller T, Nowak-Reppel K, Schäfer M, Wittwer M, Kullmann M, Terjung C, Lang D, Poethko T, Marquardt T, Freudenberger T, Mondritzki T, Hüser J, Heckmann M, and Tinel H
- Subjects
- Animals, Allosteric Regulation drug effects, Humans, Naphthyridines pharmacology, Naphthyridines chemistry, Male, Drug Discovery, Structure-Activity Relationship, Heart drug effects, Rats, Heart Rate drug effects, Autonomic Nervous System drug effects, Receptor, Muscarinic M2 metabolism, Receptor, Muscarinic M2 antagonists & inhibitors, Receptor, Muscarinic M2 agonists
- Abstract
Autonomic disbalance, i.e., sympathetic overactivation and parasympathetic withdrawal, is a causal driver of disease progression in heart failure. While sympatholytic drugs are established treatments, no drug therapy restoring vagal control of cardiac function is available. We report here the HTS-based discovery of a novel class of 1,8-naphthyridin-4(1H)-one carboxamides acting as positive allosteric modulators (PAMs) of the M2 muscarinic acetylcholine receptor (M2R). M2R is the main postsynaptic myocyte receptor regulating heart rate, electrical conduction, and contractile strength. Extensive optimization of the screening hit in terms of potency, permeation, metabolic stability, and solubility ultimately resulted in the discovery of the first-in-class clinical candidate BAY 2413555 ( 27 ). With an overall technical profile compatible with once-daily oral administration in a phase 1 study, no apparent effects on blood pressure, and a mechanism that largely preserves autonomic regulatory capacity, BAY 2413555 could be the tool to finally study the restoration of autonomic balance.
- Published
- 2024
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