Lapchak Paul A, Lara Jacqueline M, Boitano Paul D
Department of Neurology, Cedars-Sinai Medical Center, Advanced Health Sciences Pavilion, Suite 8318, 127 S. San Vicente Blvd., Los Angeles, CA, 90048, USA.
Department of Neurosurgery, Cedars-Sinai Medical Center, Advanced Health Sciences Pavilion, Suite 8318, 127 S. San Vicente Blvd., Los Angeles, CA, 90048, USA.
Transl Stroke Res. 2017 Apr 12. doi: 10.1007/s12975-017-0533-7.
Tissue plasminogen activator (tPA) is currently used in combination with endovascular procedures to enhance recanalization and cerebral reperfusion and is also currently administered as standard-of-care thrombolytic therapy to patients within 3-4.5 h of an ischemic stroke. Since tPA is not neuroprotective or cytoprotective, adjuvant therapy with a neuroprotective or an optimized cytoprotective compound is required to provide the best care to stroke victims to maximally promote clinical recovery. In this article, we describe the use of a sensitive standardized protease assay with CHSO-D-hexahydrotyrosine-Gly-Arg-p-nitroanilide•AcOH, a chromogenic protease substrate that is cleaved to 4-nitroaniline (p-nitroaniline) and measured spectrophotometrically at 405 nm (OD), and how the assay can be used as an effective screening assay to study drug-tPA interactions. While we focus on two compounds of interest in our drug development pipeline, the assay is broadly applicable to all small molecule neuroprotective or cytoprotective compounds currently being discovered and developed worldwide. In this present study, we found that the specific tPA inhibitor, plasminogen activator inhibitor-1 (PAI-1; 0.25 μM), significantly (p < 0.0001) inhibited 4-nitroaniline release, by 97.74% during the 10-min duration of the assay, which is indicative of tPA protease inhibition. In addition, two lead chromone cytoprotective candidates, 2-(3',4',5'-trihydroxyphenyl)chromen-4-one (3',4',5'-trihydroxyflavone) (CSMC-19) and 3-hydroxy-2-[3-hydroxy-4-(pyrrolidin-1-yl)phenyl]benzo[h]chromen-4-one (CSMC-140), also significantly (p < 0.05) reduced 4-nitroaniline accumulation, but to a lesser extent. The reduction was 68 and 45%, respectively, at 10 μM, and extrapolated IC values were 4.37 and >10 μM for CSMC-19 and CSMC-140, respectively. Using bonafide 4-nitroaniline, we then demonstrated that the reduction of 4-nitroaniline detection was not due to drug-4-nitroaniline quenching of signal detection at OD. In conclusion, the results suggest that high concentrations of both cytoprotectives reduced 4-nitroaniline production in vitro, but the inhibition only occurs with concentrations 104-1025-fold that of EC values in an efficacy assay. Thus, CSMC-19 and CSMC-140 should be further developed and evaluated in embolic stroke models in the absence or presence of a thrombolytic. If necessary, they could be administered once effective tPA thrombolysis has been confirmed to avoid the possibility that the chromone will reduce the efficacy of tPA in patients. Stroke investigator developing new cytoprotective small molecules should consider adding this sensitive assay to their development and screening repertoire to assess possible drug-tPA interactions in vitro as a de-risking step.
组织型纤溶酶原激活剂(tPA)目前与血管内手术联合使用,以增强再通和脑再灌注,并且目前也作为缺血性中风患者在3 - 4.5小时内的标准护理溶栓治疗药物。由于tPA没有神经保护或细胞保护作用,因此需要用神经保护或优化的细胞保护化合物进行辅助治疗,以便为中风患者提供最佳护理,最大程度地促进临床恢复。在本文中,我们描述了使用一种灵敏的标准化蛋白酶检测方法,该方法使用CHSO - D - 六氢酪氨酸 - 甘氨酸 - 精氨酸 - 对硝基苯胺•乙酸(一种生色蛋白酶底物,可裂解为4 - 硝基苯胺(对硝基苯胺)并在405nm处进行分光光度法测量(OD)),以及该检测方法如何用作研究药物 - tPA相互作用的有效筛选检测方法。虽然我们在药物开发流程中重点关注两种感兴趣的化合物,但该检测方法广泛适用于目前在全球范围内发现和开发的所有小分子神经保护或细胞保护化合物。在本研究中,我们发现特异性tPA抑制剂纤溶酶原激活剂抑制剂 - 1(PAI - 1;0.25μM)在检测的10分钟内显著(p < 0.0001)抑制了4 - 硝基苯胺的释放,抑制率达97.74%,这表明tPA蛋白酶受到抑制。此外,两种主要的色酮细胞保护候选物,2 - (3',4',5' - 三羟基苯基)色原酮 - 4 - 酮(3',4',5' - 三羟基黄酮)(CSMC - 19)和3 - 羟基 - 2 - [3 - 羟基 - 4 - (吡咯烷 - 1 - 基)苯基]苯并[h]色原酮 - 4 - 酮(CSMC - 140),也显著(p < 0.05)减少了4 - 硝基苯胺的积累,但程度较小。在10μM时,减少率分别为68%和45%,CSMC - 19和CSMC - 140的外推IC值分别为4.37μM和>10μM。然后,我们使用纯正的4 - 硝基苯胺证明,4 - 硝基苯胺检测的减少不是由于药物 - 4 - 硝基苯胺对OD处信号检测的淬灭。总之,结果表明两种细胞保护剂的高浓度在体外均降低了4 - 硝基苯胺的产生,但这种抑制仅在浓度比疗效检测中的EC值高104 - 1025倍时才会发生。因此,CSMC - 19和CSMC - 140应在有无溶栓剂的栓塞性中风模型中进一步开发和评估。如有必要,可在确认tPA溶栓有效后给药,以避免色酮降低tPA对患者疗效的可能性。开发新型细胞保护小分子的中风研究人员应考虑将这种灵敏的检测方法纳入其开发和筛选方法中,以在体外评估可能的药物 - tPA相互作用,作为降低风险的一步。