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新型 M 型阳性变构调节剂 MK-7622 的临床前到人体转化药理学。

Preclinical to Human Translational Pharmacology of the Novel M Positive Allosteric Modulator MK-7622.

机构信息

Merck Research Laboratories, Merck & Co., Inc., Kenilworth, New Jersey (J.M.U., S.D.K., M.W., H.S.L., S.V.F., C.M., N.P., D.H., C.M., K.M., D.C.B.); MSD (Europe), Brussels, Belgium (C.C.); and Hammersmith Medicines Research, London, United Kingdom (S.W.)

Merck Research Laboratories, Merck & Co., Inc., Kenilworth, New Jersey (J.M.U., S.D.K., M.W., H.S.L., S.V.F., C.M., N.P., D.H., C.M., K.M., D.C.B.); MSD (Europe), Brussels, Belgium (C.C.); and Hammersmith Medicines Research, London, United Kingdom (S.W.).

出版信息

J Pharmacol Exp Ther. 2018 Jun;365(3):556-566. doi: 10.1124/jpet.117.245894. Epub 2018 Mar 21.

Abstract

The current standard of care for treating Alzheimer's disease is acetylcholinesterase inhibitors, which nonselectively increase cholinergic signaling by indirectly enhancing activity of nicotinic and muscarinic receptors. These drugs improve cognitive function in patients, but also produce unwanted side effects that limit their efficacy. In an effort to selectively improve cognition and avoid the cholinergic side effects associated with the standard of care, various efforts have been aimed at developing selective M muscarinic receptor activators. In this work, we describe the preclinical and clinical pharmacodynamic effects of the M muscarinic receptor-positive allosteric modulator, MK-7622. MK-7622 attenuated the cognitive-impairing effects of the muscarinic receptor antagonist scopolamine and altered quantitative electroencephalography (qEEG) in both rhesus macaque and human. For both scopolamine reversal and qEEG, the effective exposures were similar between species. However, across species the minimum effective exposures to attenuate the scopolamine impairment were lower than for qEEG. Additionally, there were differences in the spectral power changes produced by MK-7622 in rhesus versus human. In sum, these results are the first to demonstrate translation of preclinical cognition and target modulation to clinical effects in humans for a selective M muscarinic receptor-positive allosteric modulator.

摘要

目前治疗阿尔茨海默病的标准疗法是乙酰胆碱酯酶抑制剂,它通过间接增强烟碱型和毒蕈碱型受体的活性来非选择性地增加胆碱能信号。这些药物改善了患者的认知功能,但也产生了一些不良的副作用,限制了它们的疗效。为了有选择性地改善认知功能并避免与标准疗法相关的胆碱能副作用,人们一直在努力开发选择性 M 毒蕈碱受体激动剂。在这项工作中,我们描述了 M 毒蕈碱受体正变构调节剂 MK-7622 的临床前和临床药效学效应。MK-7622 减弱了毒蕈碱受体拮抗剂东莨菪碱对认知的损害作用,并改变了恒河猴和人类的定量脑电图(qEEG)。对于东莨菪碱的逆转和 qEEG,种间的有效暴露量相似。然而,在种间水平上,减轻东莨菪碱损伤的最小有效暴露量低于 qEEG。此外,MK-7622 在恒河猴和人类中产生的频谱功率变化也存在差异。总之,这些结果首次证明了选择性 M 毒蕈碱受体正变构调节剂在人类中的临床疗效与临床前认知和靶标调节的转化。

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