Emory University, Department of Chemistry, Atlanta, GA 30322, USA.
Expert Opin Ther Pat. 2012 Nov;22(11):1337-52. doi: 10.1517/13543776.2012.728587. Epub 2012 Sep 26.
The NMDA receptor is a ligand-gated ion channel that plays a critical role in higher level brain processes and has been implicated in a range of neurological and psychiatric conditions. Although initial studies for the use of NMDA receptor antagonists in neuroprotection were unsuccessful, more recently, NMDA receptor antagonists have shown clinical promise in other indications such as Alzheimer's disease, Parkinson's disease, pain and depression. Based on the clinical observations and more recent insights into receptor pharmacology, new modulatory approaches are beginning to emerge, with potential therapeutic benefit.
The article covers the known pharmacology and important features regarding NMDA receptors and their function. A discussion of pre-clinical and clinical relevance is included, as well. The subsequent patent literature review highlights the current state of the art targeting the receptor since the last review in 2010.
The complex nature of the NMDA receptor structure and function is becoming better understood. As knowledge about this receptor increases, it opens up new opportunities for targeting the receptor for many therapeutic indications. New strategies and advances in older technologies will need to be further developed before clinical success can be achieved. First-in-class potentiators and subunit-selective agents form the basis for most new strategies, complemented by efforts to limit off-target liability and fine-tune on-target properties.
NMDA 受体是一种配体门控离子通道,在大脑的高级活动中起着关键作用,与一系列神经和精神疾病有关。尽管最初使用 NMDA 受体拮抗剂进行神经保护的研究并不成功,但最近,NMDA 受体拮抗剂在其他适应症(如阿尔茨海默病、帕金森病、疼痛和抑郁)方面显示出了临床应用前景。基于临床观察和最近对受体药理学的了解,新的调节方法开始出现,并具有潜在的治疗益处。
本文涵盖了 NMDA 受体及其功能的已知药理学和重要特征。还包括了临床前和临床相关性的讨论。随后的专利文献综述突出了自 2010 年上次综述以来针对该受体的最新技术水平。
NMDA 受体结构和功能的复杂性正逐渐被理解。随着对该受体的了解不断增加,为许多治疗适应症靶向该受体提供了新的机会。在取得临床成功之前,需要进一步开发新的策略和改进旧技术。大多数新策略以首创增效剂和亚单位选择性药物为基础,同时努力限制脱靶毒性并微调靶标特性。