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Repurposing Approved Drugs as Inhibitors of Kv7.1 and Nav1.8 to Treat Pitt Hopkins Syndrome

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Abstract

Purpose

Pitt Hopkins Syndrome (PTHS) is a rare genetic disorder caused by mutations of a specific gene, transcription factor 4 (TCF4), located on chromosome 18. PTHS results in individuals that have moderate to severe intellectual disability, with most exhibiting psychomotor delay. PTHS also exhibits features of autistic spectrum disorders, which are characterized by the impaired ability to communicate and socialize. PTHS is comorbid with a higher prevalence of epileptic seizures which can be present from birth or which commonly develop in childhood. Attenuated or absent TCF4 expression results in increased translation of peripheral ion channels Kv7.1 and Nav1.8 which triggers an increase in after-hyperpolarization and altered firing properties.

Methods

We now describe a high throughput screen (HTS) of 1280 approved drugs and machine learning models developed from this data. The ion channels were expressed in either CHO (KV7.1) or HEK293 (Nav1.8) cells and the HTS used either 86Rb+ efflux (KV7.1) or a FLIPR assay (Nav1.8).

Results

The HTS delivered 55 inhibitors of Kv7.1 (4.2% hit rate) and 93 inhibitors of Nav1.8 (7.2% hit rate) at a screening concentration of 10 μM. These datasets also enabled us to generate and validate Bayesian machine learning models for these ion channels. We also describe a structure activity relationship for several dihydropyridine compounds as inhibitors of Nav1.8.

Conclusions

This work could lead to the potential repurposing of nicardipine or other dihydropyridine calcium channel antagonists as potential treatments for PTHS acting via Nav1.8, as there are currently no approved treatments for this rare disorder.

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ACKNOWLEDGMENTS AND DISCLOSURES

The work at Icagen was funded by the Pitt Hopkins Research Foundation. SE kindly acknowledges NIH funding R43GM122196 and R44GM122196-02A1 “Centralized assay datasets for modelling support of small drug discovery organizations” from NIH/ NIGMS which supported development of Assay Central. We also kindly thank Dr. Alex Clark for assistance with Assay Central and Dr. Mary Lingerfelt, Dr. Aaron McMurtray and Dr. Kimberly Goodspeed for discussions. S.E. is owner, and K.M.Z., are employees of Collaborations Pharmaceuticals Inc. J.G. was an intern at Collaborations Pharmaceuticals Inc. A.G., B.A. and Z.L. are employees of Icagen. Models are available from authors upon request.

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Authors and Affiliations

  1. Collaborations Pharmaceuticals, Inc., 840 Main Campus Drive, Lab 3510, Raleigh, North Carolina, 27606, USA

    Sean Ekins, Jacob Gerlach & Kimberley M. Zorn

  2. Icagen, Inc., 4222 Emperor Blvd, Durham, North Carolina, 27703, USA

    Brett M. Antonio, Zhixin Lin & Aaron Gerlach

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  1. Sean Ekins
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Correspondence to Sean Ekins.

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Ekins, S., Gerlach, J., Zorn, K.M. et al. Repurposing Approved Drugs as Inhibitors of Kv7.1 and Nav1.8 to Treat Pitt Hopkins Syndrome. Pharm Res 36, 137 (2019). https://doi.org/10.1007/s11095-019-2671-y

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