Rational design of potent human transthyretin amyloid disease inhibitors

• Published in: Nature structural & molecular biology Vol. 7; no. 4; pp. 312 - 321
• Main Authors: Sacchettini, James C, Klabunde, Thomas, Petrassi, H. Michael, Oza, Vibha B, Raman, Prakash, Kelly, Jeffery W
• Format: Journal Article
• Language: English
• Published: United States Nature Publishing Group 01.04.2000
• Subjects: Amino Acid Sequence; Amyloid Neuropathies - drug therapy; Anti-inflammatory agents; Anti-Inflammatory Agents, Non-Steroidal - chemistry; Anti-Inflammatory Agents, Non-Steroidal - metabolism; Anti-Inflammatory Agents, Non-Steroidal - pharmacology; Anti-Inflammatory Agents, Non-Steroidal - therapeutic use; Benzofurans - chemistry; Benzofurans - metabolism; Benzofurans - pharmacology; Benzofurans - therapeutic use; Binding Sites; Cardiomyopathies - drug therapy; Crystallography, X-Ray; Dicarboxylic Acids - chemistry; Dicarboxylic Acids - metabolism; Dicarboxylic Acids - pharmacology; Dicarboxylic Acids - therapeutic use; Diclofenac - chemistry; Diclofenac - metabolism; Diclofenac - pharmacology; Diclofenac - therapeutic use; Drug Design; Flurbiprofen - chemistry; Flurbiprofen - metabolism; Flurbiprofen - pharmacology; Flurbiprofen - therapeutic use; Humans; Hydrogen Bonding; Models, Molecular; Molecular Sequence Data; Nonsteroidal anti-inflammatory drugs; ortho-Aminobenzoates - chemistry; ortho-Aminobenzoates - metabolism; ortho-Aminobenzoates - pharmacology; ortho-Aminobenzoates - therapeutic use; Oxazines - chemistry; Oxazines - metabolism; Oxazines - pharmacology; Oxazines - therapeutic use; Prealbumin - antagonists & inhibitors; Prealbumin - chemistry; Prealbumin - metabolism; Protein Structure, Quaternary; Stilbenes - chemistry; Stilbenes - metabolism; Stilbenes - pharmacology; Stilbenes - therapeutic use; Structure-Activity Relationship; Thermodynamics; transthyretin
• ISSN: 1072-8368; 1545-9993; 2331-365X; 1545-9985
• DOI: 10.1038/74082

The human amyloid disorders, familial amyloid polyneuropathy, familial amyloid cardiomyopathy and senile systemic amyloidosis, are caused by insoluble transthyretin (TTR) fibrils, which deposit in the peripheral nerves and heart tissue. Several nonsteroidal anti-inflammatory drugs and structurally similar compounds have been found to strongly inhibit the formation of TTR amyloid fibrils in vitro. These include flufenamic acid, diclofenac, flurbiprofen, and resveratrol. Crystal structures of the protein-drug complexes have been determined to allow detailed analyses of the protein-drug interactions that stabilize the native tetrameric conformation of TTR and inhibit the formation of amyloidogenic TTR. Using a structure-based drug design approach ortho-trifluormethylphenyl anthranilic acid and N-(meta-trifluoromethylphenyl) phenoxazine 4, 6-dicarboxylic acid have been discovered to be very potent and specific TTR fibril formation inhibitors. This research provides a rationale for a chemotherapeutic approach for the treatment of TTR-associated amyloid diseases.