Department of Pharmacology, University of Michigan School of Medicine, Ann Arbor, MI, USA.
Nat Rev Drug Discov. 2018 Nov;17(11):789-803. doi: 10.1038/nrd.2018.135. Epub 2018 Sep 28.
G protein-coupled receptors (GPCRs) are the largest class of drug targets, largely owing to their druggability, diversity and physiological efficacy. Many drugs selectively target specific subtypes of GPCRs, but high specificity for individual GPCRs may not be desirable in complex multifactorial disease states in which multiple receptors may be involved. One approach is to target G protein subunits rather than the GPCRs directly. This approach has the potential to achieve broad efficacy by blocking pathways shared by multiple GPCRs. Additionally, because many GPCRs couple to multiple G protein signalling pathways, blocking specific G protein subunits can 'bias' GPCR signals by inhibiting only a subset of these signals. Molecules that target G protein α or βγ-subunits have been developed and show strong efficacy in multiple preclinical disease models and biased inhibition of G protein signalling. In this Review, we discuss the development and characterization of G protein α and βγ-subunit ligands and the preclinical evidence that this exciting new approach has potential for therapeutic efficacy in a number of indications, such as pain, thrombosis, asthma and heart failure.
G 蛋白偶联受体(GPCRs)是最大的药物靶点类别之一,主要归因于它们的可成药性、多样性和生理功效。许多药物选择性地靶向特定的 GPCR 亚型,但在涉及多种受体的复杂多因素疾病状态下,对单个 GPCR 的高特异性可能并不理想。一种方法是靶向 G 蛋白亚基而不是直接靶向 GPCR。这种方法有可能通过阻断多个 GPCR 共享的途径来实现广泛的疗效。此外,由于许多 GPCR 与多种 G 蛋白信号通路偶联,因此阻断特定的 G 蛋白亚基可以通过仅抑制这些信号的一部分来“偏向”GPCR 信号。已经开发出针对 G 蛋白α或βγ亚基的分子,并在多种临床前疾病模型中显示出强大的疗效,并对 G 蛋白信号的偏向性抑制。在这篇综述中,我们讨论了 G 蛋白α和βγ亚基配体的开发和表征,以及这一令人兴奋的新方法在许多适应症(如疼痛、血栓形成、哮喘和心力衰竭)中具有治疗疗效的临床前证据。