Discovery of Novel GPVI Receptor Antagonists by Structure-Based Repurposing

Inappropriate platelet aggregation creates a cardiovascular risk that is largely managed with thienopyridines and aspirin. Although effective, these drugs carry risks of increased bleeding and drug ‘resistance’, underpinning a drive for new antiplatelet agents. To discover such drugs, one strategy is to identify a suitable druggable target and then find small molecules that modulate it. A good and unexploited target is the platelet collagen receptor, GPVI, which promotes thrombus formation. To identify inhibitors of GPVI that are safe and bioavailable, we docked a FDA-approved drug library into the GPVI collagen-binding site in silico. We now report that losartan and cinanserin inhibit GPVI-mediated platelet activation in a selective, competitive and dose-dependent manner. This mechanism of action likely underpins the cardioprotective effects of losartan that could not be ascribed to its antihypertensive effects. We have, therefore, identified small molecule inhibitors of GPVI-mediated platelet activation, and also demonstrated the utility of structure-based repurposing.

[1]  M. Gawaz,et al.  The GPVI-Fc Fusion Protein Revacept Improves Cerebral Infarct Volume and Functional Outcome in Stroke , 2013, PloS one.

[2]  Harold J. Ting,et al.  Characterization of the In Vivo Antiplatelet Activity of the Antihypertensive Agent Losartan , 2012, Journal of cardiovascular pharmacology and therapeutics.

[3]  John B. O. Mitchell,et al.  Hierarchical virtual screening for the discovery of new molecular scaffolds in antibacterial hit identification , 2012, Journal of The Royal Society Interface.

[4]  M. Holinstat,et al.  Newer agents in antiplatelet therapy: a review , 2012, Journal of blood medicine.

[5]  C. Ward,et al.  Pathologic shear triggers shedding of vascular receptors: a novel mechanism for down-regulation of platelet glycoprotein VI in stenosed coronary vessels. , 2012, Blood.

[6]  D. Mozaffarian,et al.  Heart disease and stroke statistics--2012 update: a report from the American Heart Association. , 2012, Circulation.

[7]  P. Passmore,et al.  The renin-angiotensin system and antihypertensive drugs in Alzheimer's disease: current standing of the angiotensin hypothesis? , 2012, Journal of Alzheimer's disease : JAD.

[8]  Á. Chamorro,et al.  Terutroban versus aspirin in patients with cerebral ischaemic events (PERFORM): a randomised, double-blind, parallel-group trial , 2011, The Lancet.

[9]  M. Gawaz,et al.  Novel Antiplatelet Drug Revacept (Dimeric Glycoprotein VI-Fc) Specifically and Efficiently Inhibited Collagen-Induced Platelet Aggregation Without Affecting General Hemostasis in Humans , 2011, Circulation.

[10]  T. Mizushima Drug discovery and development focusing on existing medicines: drug re-profiling strategy. , 2011, Journal of biochemistry.

[11]  Ruili Huang,et al.  The NCGC Pharmaceutical Collection: A Comprehensive Resource of Clinically Approved Drugs Enabling Repurposing and Chemical Genomics , 2011, Science Translational Medicine.

[12]  Mark McGann,et al.  FRED Pose Prediction and Virtual Screening Accuracy , 2011, J. Chem. Inf. Model..

[13]  P. D. de Groot,et al.  Synergism between platelet collagen receptors defined using receptor-specific collagen-mimetic peptide substrata in flowing blood. , 2010, Blood.

[14]  K. Ono,et al.  Structural basis for platelet antiaggregation by angiotensin II type 1 receptor antagonist losartan (DuP-753) via glycoprotein VI. , 2010, Journal of medicinal chemistry.

[15]  A. Michelson Antiplatelet therapies for the treatment of cardiovascular disease , 2010, Nature Reviews Drug Discovery.

[16]  Ruben Abagyan,et al.  Structure-based discovery of novel chemotypes for adenosine A(2A) receptor antagonists. , 2010, Journal of medicinal chemistry.

[17]  Vincent B. Chen,et al.  Correspondence e-mail: , 2000 .

[18]  M. Franchini,et al.  New antiplatelet agents: why they are needed. , 2009, European journal of internal medicine.

[19]  K. Dickstein,et al.  Effects of high-dose versus low-dose losartan on clinical outcomes in patients with heart failure (HEAAL study): a randomised, double-blind trial , 2009, The Lancet.

[20]  M. Bousser,et al.  Effect of the Thromboxane Prostaglandin Receptor Antagonist Terutroban on Arterial Thrombogenesis after Repeated Administration in Patients Treated for the Prevention of Ischemic Stroke , 2009, Cerebrovascular Diseases.

[21]  M. Bouabdelli,et al.  Design and humanization of a murine scFv that blocks human platelet glycoprotein VI in vitro , 2009, The FEBS journal.

[22]  A. Siegbahn,et al.  Genetic variation of CYP2C19 affects both pharmacokinetic and pharmacodynamic responses to clopidogrel but not prasugrel in aspirin-treated patients with coronary artery disease , 2009, European heart journal.

[23]  A. Feher,et al.  The genetics of antiplatelet drug resistance , 2009, Clinical genetics.

[24]  G. Stoll,et al.  Molecular mechanisms of thrombus formation in ischemic stroke: novel insights and targets for treatment. , 2008, Blood.

[25]  Xu Shen,et al.  Design and synthesis of cinanserin analogs as severe acute respiratory syndrome coronavirus 3CL protease inhibitors. , 2008, Chemical & pharmaceutical bulletin.

[26]  S. Allender,et al.  Coronary heart disease statistics. , 2008 .

[27]  E. Kremmer,et al.  EXP3179 Inhibits Collagen-Dependent Platelet Activation via Glycoprotein Receptor-VI Independent of AT1-Receptor Antagonism: Potential Impact on Atherothrombosis , 2007, Arteriosclerosis, thrombosis, and vascular biology.

[28]  G. Stoll,et al.  Targeting Platelets in Acute Experimental Stroke: Impact of Glycoprotein Ib, VI, and IIb/IIIa Blockade on Infarct Size, Functional Outcome, and Intracranial Bleeding , 2007, Circulation.

[29]  K. Horii,et al.  Structural basis for platelet collagen responses by the immune-type receptor glycoprotein VI. , 2006, Blood.

[30]  B. Shoichet Screening in a spirit haunted world. , 2006, Drug discovery today.

[31]  W. Ouwehand,et al.  Gain‐ and loss‐of‐function mutants confirm the importance of apical residues to the primary interaction of human glycoprotein VI with collagen , 2006, Journal of thrombosis and haemostasis : JTH.

[32]  J. Backman,et al.  Polymorphisms of COX-1 and GP VI associate with the antiplatelet effect of aspirin in coronary artery disease patients , 2006, Thrombosis and Haemostasis.

[33]  P. Burton,et al.  A genomewide linkage study of 1,933 families affected by premature coronary artery disease: The British Heart Foundation (BHF) Family Heart Study. , 2005, American journal of human genetics.

[34]  A. Maree,et al.  Cyclooxygenase‐1 haplotype modulates platelet response to aspirin , 2005, Journal of thrombosis and haemostasis : JTH.

[35]  Christian Drosten,et al.  Cinanserin Is an Inhibitor of the 3C-Like Proteinase of Severe Acute Respiratory Syndrome Coronavirus and Strongly Reduces Virus Replication In Vitro , 2005, Journal of Virology.

[36]  Brian K. Shoichet,et al.  Virtual screening of chemical libraries , 2004, Nature.

[37]  T. Ashburn,et al.  Drug repositioning: identifying and developing new uses for existing drugs , 2004, Nature Reviews Drug Discovery.

[38]  J. Gibbins Platelet adhesion signalling and the regulation of thrombus formation , 2004, Journal of Cell Science.

[39]  J. Laragh,et al.  Outcomes in hypertensive patients at high cardiovascular risk treated with regimens based on valsartan or amlodipine: the VALUE randomised trial , 2004, The Lancet.

[40]  U. Heinzmann,et al.  Soluble glycoprotein VI dimer inhibits platelet adhesion and aggregation to the injured vessel wall in vivo , 2004, FASEB journal : official publication of the Federation of American Societies for Experimental Biology.

[41]  Richard W Farndale,et al.  Identification of the primary collagen-binding surface on human glycoprotein VI by site-directed mutagenesis and by a blocking phage antibody. , 2004, Blood.

[42]  G. Pelle,et al.  Improved endothelial function by the thromboxane A2 receptor antagonist S 18886 in patients with coronary artery disease treated with aspirin. , 2003, Journal of the American College of Cardiology.

[43]  Jonas Boström,et al.  Assessing the performance of OMEGA with respect to retrieving bioactive conformations. , 2003, Journal of molecular graphics & modelling.

[44]  M. Nieminen,et al.  Effects of losartan on cardiovascular morbidity and mortality in patients with isolated systolic hypertension and left ventricular hypertrophy: a Losartan Intervention for Endpoint Reduction (LIFE) substudy. , 2002, JAMA.

[45]  Steven Snapinn,et al.  Cardiovascular morbidity and mortality in patients with diabetes in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol , 2002, The Lancet.

[46]  R H Myers,et al.  Genetic and Environmental Contributions to Platelet Aggregation: The Framingham Heart Study , 2001, Circulation.

[47]  Juan Gómez,et al.  Efecto del losartán sobre la activación de plaquetas humanaspor tromboxano A 2 , 2000 .

[48]  J. A. Rodríguez-Feo,et al.  [Effect of losartan on human platelet activation by thromboxane A2]. , 2000, Revista espanola de cardiologia.

[49]  S. Watson,et al.  Glycoprotein VI is the collagen receptor in platelets which underlies tyrosine phosphorylation of the Fc receptor gamma-chain. , 1997, FEBS letters.

[50]  S. Watson,et al.  Glycoprotein VI is the collagen receptor in platelets which underlies tyrosine phosphorylation of the Fc receptor γ‐chain , 1997 .

[51]  M. Turner,et al.  The Fc receptor γ‐chain and the tyrosine kinase Syk are essential for activation of mouse platelets by collagen , 1997, The EMBO journal.

[52]  R. Tsien,et al.  A new generation of Ca2+ indicators with greatly improved fluorescence properties. , 1985, The Journal of biological chemistry.