Discovery of GBT440, an Orally Bioavailable R-State Stabilizer of Sickle Cell Hemoglobin

作者：Metcalf Brian; Chuang Chihyuan; Dufu Kobina; Patel Mira P; Silva Garcia Abel; Johnson Carl; Lu Qing; Partridge James R; Patskovska Larysa; Patskovsky Yury; Almo Steven C; Jacobson Matthew P; Hua Lan; Xu Qing; Gwaltney Stephen L II; Yee Calvin; Harris Jason; Morgan Bradley P; James Joyce; Xu Donghong; Hutchaleelaha Athiwat; Paulvannan Kumar; Oksenberg Donna; Li Zhe^*

来源：ACS Medicinal Chemistry Letters, 2017, 8(3): 321-326.

DOI：10.1021/acsmedchemlett.6b00491

• Sickle cell disease
• sickle cell hemoglobin
• allosteric modulator
• aldehyde
• Schiff-base formation
• oxygen affinity
• red blood cell partitioning

We report the discovery of a new potent allosteric effector of sickle cell hemoglobin, GBT440 (36), that increases the affinity of hemoglobin for oxygen and consequently inhibits its polymerization when subjected to hypoxic conditions. Unlike earlier allosteric activators that bind covalently to hemoglobin in a 2:1 stoichiometry, 36 binds with a 1:1 stoichiometry. Compound 36 is orally bioavailable and partitions highly and favorably into the red blood cell with a RBC/plasma ratio of similar to 150. This partitioning onto the target protein is anticipated to allow therapeutic concentrations to be achieved in the red blood cell at low plasma concentrations. GBT440 (36) is in Phase 3 clinical trials for the treatment of sickle cell disease (NCT03036813).

• 出版日期2017-3