Heinrich Rueeger

Dynamics of Aβ Turnover and Deposition in Different β-Amyloid Precursor Protein Transgenic Mouse Models Following γ-Secretase Inhibition

Human β-amyloid precursor protein (APP) transgenic mice are commonly used to test potential therapeutics for Alzheimers disease. We have characterized the dynamics of β-amyloid (Aβ) generation and deposition following γ-secretase inhibition with compound LY-411575 [N2-[(2S)-2-(3,5-difluorophenyl)-2-hydroxyethanoyl]-N1-[(7S)-5-methyl-6-oxo-6,7-dihydro-5H-dibenzo[b,d]azepin-7-yl]-l-alaninamide]. Kinetic studies in preplaque mice distinguished a detergent-soluble Aβ pool in brain with rapid turnover (half-lives for Aβ40 and Aβ42 were 0.7 and 1.7 h) and a much more stable, less soluble pool. Aβ in cerebrospinal fluid (CSF) reflected the changes in the soluble brain Aβ pool, whereas plasma Aβ turned over more rapidly. In brain, APP C-terminal fragments (CTF) accumulated differentially. The half-lives for γ-secretase degradation were estimated as 0.4 and 0.1 h for C99 and C83, respectively. Three different APP transgenic lines responded very similarly to γ-secretase inhibition regardless of the familial Alzheimers disease mutations in APP. Amyloid deposition started with Aβ42, whereas Aβ38 and Aβ40 continued to turn over. Chronic γ-secretase inhibition lowered amyloid plaque formation to a different degree in different brain regions of the same mice. The extent was inversely related to the initial amyloid load in the region analyzed. No evidence for plaque removal below baseline was obtained. γ-Secretase inhibition led to a redistribution of intracellular Aβ and an elevation of CTFs in neuronal fibers. In CSF, Aβ showed a similar turnover as in preplaque animals demonstrating its suitability as marker of newly generated, soluble Aβ in plaque-bearing brain. This study supports the use of APP transgenic mice as translational models to characterize Aβ-lowering therapeutics.

Discovery of Cyclic Sulfone Hydroxyethylamines as Potent and Selective β-Site APP-Cleaving Enzyme 1 (BACE1) Inhibitors: Structure-Based Design and in Vivo Reduction of Amyloid β-Peptides

Structure-based design of a series of cyclic hydroxyethylamine BACE1 inhibitors allowed the rational incorporation of prime- and nonprime-side fragments to a central core template without any amide functionality. The core scaffold selection and the structure-activity relationship development were supported by molecular modeling studies and by X-ray analysis of BACE1 complexes with various ligands to expedite the optimization of the series. The direct extension from P1-aryl- and heteroaryl moieties into the S3 binding pocket allowed the enhancement of potency and selectivity over cathepsin D. Restraining the design and synthesis of compounds to a physicochemical property space consistent with central nervous system drugs led to inhibitors with improved blood-brain barrier permeability. Guided by structure-based optimization, we were able to obtain highly potent compounds such as 60p with enzymatic and cellular IC(50) values of 2 and 50 nM, respectively, and with >200-fold selectivity over cathepsin D. Pharmacodynamic studies in APP51/16 transgenic mice at oral doses of 180 μmol/kg demonstrated significant reduction of brain Aβ levels.

Design, synthesis and SAR of a series of 2-substituted 4-amino-quinazoline neuropeptide Y Y5 receptor antagonists.

The design of a novel series of NPY-Y5 receptor antagonists is described. Key elements for the design were the identification of weak Y5 hits from a Y1 program, results from a combinatorial approach and database mining. This led to the discovery of the quinazoline 4 and the aryl-sulphonamide moiety as major components of the pharmacophore for Y5 affinity. The synthesis and SAR towards CGP71683A is described.

A novel BACE inhibitor NB-360 shows a superior pharmacological profile and robust reduction of amyloid-β and neuroinflammation in APP transgenic mice

BackgroundAlzheimer’s disease (AD) is the most common form of dementia, the number of affected individuals is rising, with significant impacts for healthcare systems. Current symptomatic treatments delay, but do not halt, disease progression. Genetic evidence points to aggregation and deposition of amyloid-β (Aβ) in the brain being causal for the neurodegeneration and dementia typical of AD. Approaches to target Aβ via inhibition of γ-secretase or passive antibody therapy have not yet resulted in substantial clinical benefits. Inhibition of BACE1 (β-secretase) has proven a challenging concept, but recent BACE1inhibitors can enter the brain sufficiently well to lower Aβ. However, failures with the first clinical BACE1 inhibitors have highlighted the need to generate compounds with appropriate efficacy and safety profiles, since long treatment periods are expected to be necessary in humans.ResultsTreatment with NB-360, a potent and brain penetrable BACE-1 inhibitor can completely block the progression of Aβ deposition in the brains of APP transgenic mice, a model for amyloid pathology. We furthermore show that almost complete reduction of Aβ was achieved also in rats and in dogs, suggesting that these findings are translational across species and can be extrapolated to humans. Amyloid pathology may be an initial step in a complex pathological cascade; therefore we investigated the effect of BACE-1 inhibition on neuroinflammation, a prominent downstream feature of the disease. NB-360 stopped accumulation of activated inflammatory cells in the brains of APP transgenic mice. Upon chronic treatment of APP transgenic mice, patches of grey hairs appeared.ConclusionsIn a rapidly developing field, the data on NB-360 broaden the chemical space and expand knowledge on the properties that are needed to make a BACE-1 inhibitor potent and safe enough for long-term use in patients. Due to its excellent brain penetration, reasonable oral doses of NB-360 were sufficient to completely block amyloid-β deposition in an APP transgenic mouse model. Data across species suggest similar treatment effects can possibly be achieved in humans. The reduced neuroinflammation upon amyloid reduction by NB-360 treatment supports the notion that targeting amyloid-β pathology can have beneficial downstream effects on the progression of Alzheimer’s disease.

Macrocyclic BACE-1 inhibitors acutely reduce Aβ in brain after po application

A series of macrocyclic peptidic BACE-1 inhibitors was designed. While potency on BACE-1 was rather high, the first set of compounds showed poor brain permeation and high efflux in the MDRI-MDCK assay. The replacement of the secondary benzylamino group with a phenylcyclopropylamino group maintained potency on BACE-1, while P-glycoprotein-mediated efflux was significantly reduced and brain permeation improved. Several compounds from this series demonstrated acute reduction of Abeta in human APP-wildtype transgenic (APP51/16) mice after oral administration.

Structure based design, synthesis and SAR of cyclic hydroxyethylamine (HEA) BACE-1 inhibitors.

This Letter describes the de novo design of non-peptidic hydroxyethylamine (HEA) inhibitors of BACE-1 by elimination of P-gp contributing amide attachments. The predicted binding mode of the novel cyclic sulfone HEA core template was confirmed in a X-ray co-crystal structure. Inhibitors of sub-micromolar potency with an improved property profile over historic HEA inhibitors resulting in improved brain penetration are described.

The Bace-1 inhibitor CNP520 for prevention trials in Alzheimer's disease

The beta‐site amyloid precursor protein cleaving enzyme‐1 (BACE‐1) initiates the generation of amyloid‐β (Aβ), and the amyloid cascade leading to amyloid plaque deposition, neurodegeneration, and dementia in Alzheimers disease (AD). Clinical failures of anti‐Aβ therapies in dementia stages suggest that treatment has to start in the early, asymptomatic disease states. The BACE‐1 inhibitor CNP520 has a selectivity, pharmacodynamics, and distribution profile suitable for AD prevention studies. CNP520 reduced brain and cerebrospinal fluid (CSF) Aβ in rats and dogs, and Aβ plaque deposition in APP‐transgenic mice. Animal toxicology studies of CNP520 demonstrated sufficient safety margins, with no signs of hair depigmentation, retina degeneration, liver toxicity, or cardiovascular effects. In healthy adults ≥ 60 years old, treatment with CNP520 was safe and well tolerated and resulted in robust and dose‐dependent Aβ reduction in the cerebrospinal fluid. Thus, long‐term, pivotal studies with CNP520 have been initiated in the Generation Program.

Discovery of amino-1,4-oxazines as potent BACE-1 inhibitors.

New amino-1,4-oxazine derived BACE-1 inhibitors were explored and various synthetic routes developed. The binding mode of the inhibitors was elucidated by co-crystallization of 4 with BACE-1 and X-ray analysis. Subsequent optimization led to inhibitors with low double digit nanomolar activity in a biochemical and single digit nanomolar potency in a cellular assays. To assess the inhibitors for their permeation properties and potential to cross the blood-brain-barrier a MDR1-MDCK cell model was successfully applied. Compound 8a confirmed the in vitro results by dose-dependently reducing Aβ levels in mice in an acute treatment regimen.

THE BACE INHIBITOR NB-360 HAS EXCELLENT BRAIN PENETRATION AND EFFICACY ON AMYLOID-B LOAD IN ANIMAL MODELS

human APOE3 or APOE4) were treated with Bex, LG268 (a more selective RXR agonist), or vehicle control in 3 treatment paradigms: T1) 7-day oral gavage (5.75-6M); T2) 7-day hydrogel (5.75-6M); and T3) 30-day hydrogel (5-6M). Hydrogel provides a steady dosage of drug throughout the awake period of the mice. Brains were harvested, dissected, and homogenized by 3-step serial extraction.Results: In brain regions with lowAb levels at treatment, RXR agonists did not change soluble levels of Ab 42 and oAb in E3FAD or E4FAD mice. In brain regions with intermediate Ab levels, RXR agonist treatment induced an increase in soluble Ab 42 and oAb levels in E3FAD and E4FADmice. However, in the hippocampus of E4FADmice, with high Ab levels at treatment, RXR agonists induced a decrease in soluble Ab 42 and oAb levels and an increase in synaptic proteins. Importantly, total apoE levels were unaffected for all treatment groups, suggesting an alternate mechanism of action for RXR agonists. Our data further demonstrate that the beneficial effects of RXR agonists in E4FAD mice are mediated via: increased ABCA1 and ABCG1 expression, increased apoE4 association with lipoproteins, increased apoE/Ab complex levels, reduced oAb levels and enhanced synaptic viability. Conclusions: Collectively, our data demonstrate that RXR agonist efficacy is determined by the levels of Ab pathology at time of treatment, exhibiting no effect, or even an increase the levels of neurotoxic Ab in prevention paradigms where Ab levels are likely sub-pathological. However, in later stages of AD, RXR agonists may address the loss of function associated with APOE4 by increasing apoE4 lipidation and apoE4/Ab complex formation. Future studies are necessary to determine whether this pathway is relevant for APOE3 carriers with high Ab pathology, or if RXR agonists are an APOE4specific AD therapeutic.