Discovery of 2-(cyclopropanecarboxamido)-N-(5-((1-(4-fluorobenzyl)piperidin-4-yl)methoxy)pyridin-3-yl)isonicotinamide as a potent dual AChE/GSK3β inhibitor for the treatment of Alzheimer's disease: Significantly increasing the level of acetylcholine in the brain without affecting that in intestine

Eur J Med Chem. 2021 Nov 5:223:113663. doi: 10.1016/j.ejmech.2021.113663. Epub 2021 Jun 22.

Abstract

Acetylcholinesterase (AChE) inhibitors are currently the first-line drugs approved by the FDA for the treatment of Alzheimer's disease (AD). However, a short effective-window limits their therapeutic benefits. Clinical studies have confirmed that the combination of AChE inhibitors and neuroprotective agents exhibits better anti-AD effects. We have previously reported that the dual AChE/GSK3β (Glycogen synthase kinase 3β) modulators have both neuroprotective effects and cognitive impairment-improvement effects. In this study, we characterized a new backbone of the AChE/GSK3β inhibitor 11c. It was identified as a highly potent AChE inhibitor and was found superior to donepezil, the first-line drug for the treatment of AD. In vivo studies confirmed that 11c significantly inhibited the activity of AChE in the brain but had little effect on the activity of AChE in the intestine. This advantage of 11c was expected to reduce the peripheral side effects caused by donepezil. Furthermore, biomarker studies have shown that 11c also improved the levels of acetylcholine and synaptophysin in the brain and exhibited neuroprotective effects. Preliminary in vivo and in vitro research results underline the exciting potential of compound 11c in the treatment of AD.

Keywords: AChE; Acetylcholine; Alzheimer's disease; GSK3β; Neuroprotection.

MeSH terms

  • Acetylcholine / metabolism*
  • Acetylcholinesterase / chemistry*
  • Acetylcholinesterase / metabolism
  • Alzheimer Disease / drug therapy
  • Animals
  • Binding Sites
  • Blood-Brain Barrier / drug effects
  • Blood-Brain Barrier / metabolism
  • Brain / drug effects
  • Brain / metabolism*
  • Cholinesterase Inhibitors / chemistry*
  • Cholinesterase Inhibitors / metabolism
  • Cholinesterase Inhibitors / pharmacology
  • Cholinesterase Inhibitors / therapeutic use
  • Drug Design
  • Glycogen Synthase Kinase 3 beta / antagonists & inhibitors*
  • Glycogen Synthase Kinase 3 beta / metabolism
  • Humans
  • Intestines / drug effects
  • Mice
  • Mice, Inbred ICR
  • Molecular Dynamics Simulation
  • Neuroprotective Agents / chemistry
  • Neuroprotective Agents / metabolism
  • Neuroprotective Agents / pharmacology
  • Neuroprotective Agents / therapeutic use
  • Niacinamide / chemistry*
  • Niacinamide / metabolism
  • Niacinamide / pharmacology
  • Niacinamide / therapeutic use
  • Protein Kinase Inhibitors / chemistry
  • Protein Kinase Inhibitors / metabolism
  • Protein Kinase Inhibitors / pharmacology
  • Structure-Activity Relationship
  • Up-Regulation / drug effects

Substances

  • Cholinesterase Inhibitors
  • Neuroprotective Agents
  • Protein Kinase Inhibitors
  • Niacinamide
  • Glycogen Synthase Kinase 3 beta
  • Acetylcholinesterase
  • Acetylcholine