Fragment merging without crystallography for CGRP receptor antagonists

Migraines are the third leading cause of disability worldwide. Although the pathology is complex, blocking the interaction of calcitonin gene-related peptide (CGRP) with its receptor, thereby decreasing vasodilation, has proven successful in the clinic. However, some of the early small molecule antagonists were discontinued due to hepatotoxicity. In a recent J. Med. Chem. paper, Naohide Morita, Isao Azumaya, and collaborators at Kissei Pharmaceutical and Toho University describe a new class of inhibitors.

 

CGRP binds at the interface of a heterodimeric receptor comprised of the calcitonin receptor-like receptor (CLR) and receptor activity-modifying protein 1 (RAMP1). To find hits, the researchers screened a library of 2500 fragments (which could be up to 350 Da) at 500 µM against the extracellular CLR/RAMP1 domains using SPR. This yielded 565 hits, which were clustered based on similarity, and 250 were chosen for dose-response studies, leading to 38 confirmed hits. Competition studies with a known CGRP antagonist whittled this number down to just four, with compound 1 being chosen for further study due to ease of analog synthesis.

 

Compound 1 was confirmed as a binder using isothermal titration calorimetry (ITC). Unfortunately, co-crystallography with CLR/RAMP1 was unsuccessful, so the researchers turned to docking using information from known small molecule inhibitors. This work suggested that compound 1 binds to the CGRP receptor but does not interact with RAMP1, a conclusion further supported by mutagenesis studies.

 

To find fragments that bind RAMP1, the researchers performed a second fragment screen, again using SPR. This time the fragments were chosen from those in the first set that had not been tested in dose-response studies, supplemented with several hundred more selected based on structures of known CGRP antagonists. Of 784 fragments screened, 114 were taken into dose-response studies, leading to 8 hits. Compound 2 was the most potent, and mutagenesis studies suggested it interacted with RAMP1.

 

Crystallography of compound 2 was also unsuccessful, but docking, supported by NMR studies, suggested a possible binding mode. Compounds 1 and 2 were merged to yield compound 3, which had a satisfying 2000-fold improvement in potency compared to compound 1. Compound 3 also showed cell activity.

 

Compound 3 contains three stereocenters, so the researchers sought to simplify the molecule. They also needed to improve potency and metabolic stability. Multiparameter optimization ultimately led to compound 15, with picomolar(!) affinity for the receptor, subnanomolar activity in cells, and good pharmacokinetic properties. A standard model for migraine is inhibition of facial blood flow in marmosets, and compound 15 was active. The compound was also clean in tests for hepatotoxicity.

 

Although no further development of compound 15 is reported, this is a nice case study in fragment merging. As the researchers note, it is also one of just a handful of examples that succeeded in the absence of crystallographic data (we wrote about another one here). Hopefully this will further embolden researchers to pursue fragment merging and linking without direct structural information.