Puay-Wah Phuan1, Jung-Ho Son2, Joseph-Anthony Tan3, Clarabella Li2, Ilaria Musante4, Lorna Zlock5, Dennis W Nielson6, Walter E Finkbeiner5, Mark J Kurth2, Luis J Galietta4, Peter M Haggie3, Alan S Verkman3. 1. Department of Medicine, University of California, San Francisco, CA 94143-0521, USA; Department of Physiology, University of California, San Francisco, CA 94143-0521, USA. Electronic address: Puay-wah.Phuan@ucsf.edu. 2. Department of Chemistry, University of California, Davis, CA 95616-5270, USA. 3. Department of Medicine, University of California, San Francisco, CA 94143-0521, USA; Department of Physiology, University of California, San Francisco, CA 94143-0521, USA. 4. Telethon Institute for Genetics and Medicine (TIGEM), Pozzuoli, Italy. 5. Department of Pathology University of California, San Francisco, CA 94143-0521, USA. 6. Department of Pediatrics, University of California, San Francisco, CA 94143-0521, USA.
Abstract
BACKGROUND: Current modulator therapies for some cystic fibrosis-causing CFTR mutants, including N1303K, have limited efficacy. We provide evidence here to support combination potentiator (co-potentiator) therapy for mutant CFTRs that are poorly responsive to single potentiators. METHODS: Functional synergy screens done on N1303K and W1282X CFTR, in which small molecules were tested with VX-770, identified arylsulfonamide-pyrrolopyridine, phenoxy-benzimidazole and flavone co-potentiators. RESULTS: A previously identified arylsulfonamide-pyrrolopyridine co-potentiator (ASP-11) added with VX-770 increased N1303K-CFTR current 7-fold more than VX-770 alone. ASP-11 increased by ~65% of the current of G551D-CFTR compared to VX-770, was additive with VX-770 on F508del-CFTR, and activated wild-type CFTR in the absence of a cAMP agonist. ASP-11 efficacy with VX-770 was demonstrated in primary CF human airway cell cultures having N1303K, W1282X and G551D CFTR mutations. Structure-activity studies on 11 synthesized ASP-11 analogs produced compounds with EC50 down to 0.5 μM. CONCLUSIONS: These studies support combination potentiator therapy for CF caused by some CFTR mutations that are not effectively treated by single potentiators.
BACKGROUND: Current modulator therapies for some cystic fibrosis-causing CFTR mutants, including N1303K, have limited efficacy. We provide evidence here to support combination potentiator (co-potentiator) therapy for mutant CFTRs that are poorly responsive to single potentiators. METHODS: Functional synergy screens done on N1303K and W1282XCFTR, in which small molecules were tested with VX-770, identified arylsulfonamide-pyrrolopyridine, phenoxy-benzimidazole and flavone co-potentiators. RESULTS: A previously identified arylsulfonamide-pyrrolopyridine co-potentiator (ASP-11) added with VX-770 increased N1303K-CFTR current 7-fold more than VX-770 alone. ASP-11 increased by ~65% of the current of G551D-CFTR compared to VX-770, was additive with VX-770 on F508del-CFTR, and activated wild-type CFTR in the absence of a cAMP agonist. ASP-11 efficacy with VX-770 was demonstrated in primary CF human airway cell cultures having N1303K, W1282X and G551D CFTR mutations. Structure-activity studies on 11 synthesized ASP-11 analogs produced compounds with EC50 down to 0.5 μM. CONCLUSIONS: These studies support combination potentiator therapy for CF caused by some CFTR mutations that are not effectively treated by single potentiators.
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