Biased Agonist Pharmacochaperones of the AVP V2 Receptor May Treat Congenital Nephrogenic Diabetes Insipidus

• Published in: Journal of the American Society of Nephrology Vol. 20; no. 10; pp. 2190 - 2203
• Main Authors: JEAN-ALPHONSE, Frédéric, PERKOVSKA, Sanja, MENDRE, Christiane, FRANTZ, Marie-Céline, DURROUX, Thierry, MEJEAN, Catherine, MORIN, Denis, LOISON, Stéphanie, BONNET, Dominique, HIBERT, Marcel, MOUILLAC, Bernard
• Format: Journal Article
• Language: English
• Published: Washington, DC American Society of Nephrology 01.10.2009
• Subjects: Arginine Vasopressin - metabolism; Arrestin - antagonists & inhibitors; Arrestin - metabolism; Basic Research; Biochemistry, Molecular Biology; Biological and medical sciences; Cell Behavior; Cells, Cultured; Cellular Biology; Cyclic AMP - biosynthesis; Diabetes Insipidus, Nephrogenic - drug therapy; Glycosylation; Humans; Kidneys; Life Sciences; MAP Kinase Signaling System - drug effects; Medical sciences; Molecular Chaperones - pharmacology; Molecular Chaperones - therapeutic use; Molecular Networks; Nephrology. Urinary tract diseases; Pharmaceutical sciences; Pharmacology; Receptors, Vasopressin - agonists; Receptors, Vasopressin - physiology; Reproductive Biology; Sexual reproduction; Urinary system involvement in other diseases. Miscellaneous; Kidney disease; Agonist; Nephrology; Urinary system disease; Treatment; Congenital; Nephrogenic diabetes insipidus; Urology; Biological receptor
• ISSN: 1046-6673; 1533-3450
• DOI: 10.1681/asn.2008121289

X-linked congenital nephrogenic diabetes insipidus (cNDI) results from inactivating mutations of the human arginine vasopressin (AVP) V2 receptor (hV(2)R). Most of these mutations lead to intracellular retention of the hV(2)R, preventing its interaction with AVP and thereby limiting water reabsorption and concentration of urine. Because the majority of cNDI-hV(2)Rs exhibit protein misfolding, molecular chaperones hold promise as therapeutic agents; therefore, we sought to identify pharmacochaperones for hV(2)R that also acted as agonists. Here, we describe high-affinity nonpeptide compounds that promoted maturation and membrane rescue of L44P, A294P, and R337X cNDI mutants and restored a functional AVP-dependent cAMP signal. Contrary to pharmacochaperone antagonists, these compounds directly activated a cAMP signal upon binding to several cNDI mutants. In addition, these molecules displayed original functionally selective properties (biased agonism) toward the hV(2)R, being unable to recruit arrestin, trigger receptor internalization, or stimulate mitogen-activated protein kinases. These characteristics make these hV(2)R agonist pharmacochaperones promising therapeutic candidates for cNDI.