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钾通道调节剂的药理学剖析:偏头痛新治疗机遇展望

Pharmacological Profiling of K Channel Modulators: An Outlook for New Treatment Opportunities for Migraine.

作者信息

Dyhring Tino, Jansen-Olesen Inger, Christophersen Palle, Olesen Jes

机构信息

Saniona A/S, 2600 Glostrup, Denmark.

Danish Headache Center, Department of Neurology, University of Copenhagen, 2600 Glostrup, Denmark.

出版信息

Pharmaceuticals (Basel). 2023 Feb 1;16(2):225. doi: 10.3390/ph16020225.

Abstract

Migraine is a highly disabling pain disorder with huge socioeconomic and personal costs. It is genetically heterogenous leading to variability in response to current treatments and frequent lack of response. Thus, new treatment strategies are needed. A combination of preclinical and clinical data indicate that ATP-sensitive potassium (K) channel inhibitors could be novel and highly effective drugs in the treatment of migraine. The subtype Kir6.1/SUR2B is of particular interest and inhibitors specific for this cranio-vascular K channel subtype may qualify as future migraine drugs. Historically, different technologies and methods have been undertaken to characterize K channel modulators and, therefore, a head-to-head comparison of potency and selectivity between the different K subtypes is difficult to assess. Here, we characterize available K channel activators and inhibitors in fluorescence-based thallium-flux assays using HEK293 cells stably expressing human Kir6.1/SUR2B, Kir6.2/SUR1, and Kir6.2/SUR2A K channels. Among the openers tested, levcromakalim, Y-26763, pinacidil, P-1075, ZM226600, ZD0947, and A-278637 showed preference for the K channel subtype Kir6.1/SUR2B, whereas BMS-191095, NN414, and VU0071306 demonstrated preferred activation of the Kir6.2/SUR1 subtype. In the group of K channel blockers, only Rosiglitazone and PNU-37783A showed selective inhibition of the Kir6.1/SUR2B subtype. PNU-37783A was stopped in clinical development and Rosiglitazone has a low potency for the vascular K channel subtype. Therefore, development of novel selective K channel blockers, having a benign side effect profile, are needed to clinically prove inhibition of Kir6.1/SUR2B as an effective migraine treatment.

摘要

偏头痛是一种极具致残性的疼痛疾病,会带来巨大的社会经济成本和个人代价。它具有遗传异质性,导致对当前治疗的反应存在差异且常常缺乏疗效。因此,需要新的治疗策略。临床前和临床数据相结合表明,ATP敏感性钾(K)通道抑制剂可能是治疗偏头痛的新型高效药物。亚型Kir6.1/SUR2B尤其值得关注,针对这种颅脑血管K通道亚型的特异性抑制剂可能成为未来的偏头痛治疗药物。从历史上看,人们采用了不同的技术和方法来表征K通道调节剂,因此,很难评估不同K亚型之间效力和选择性的直接比较。在这里,我们使用稳定表达人Kir6.1/SUR2B、Kir6.2/SUR1和Kir6.2/SUR2A K通道的HEK293细胞,在基于荧光的铊通量测定中表征现有的K通道激活剂和抑制剂。在所测试的开放剂中,利克溴脲、Y-26763、匹那地尔、P-1075、ZM226600、ZD0947和A-278637对K通道亚型Kir6.1/SUR2B表现出偏好,而BMS-191095、NN414和VU0071306则表现出对Kir6.2/SUR1亚型的优先激活。在K通道阻滞剂组中,只有罗格列酮和PNU-37783A对Kir6.1/SUR2B亚型表现出选择性抑制。PNU-37783A已停止临床开发,罗格列酮对血管K通道亚型的效力较低。因此,需要开发具有良好副作用特征的新型选择性K通道阻滞剂,以在临床上证明抑制Kir6.1/SUR2B是一种有效的偏头痛治疗方法。

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