Preclinical pharmacology of AZD9977: A novel mineralocorticoid receptor modulator separating organ protection from effects on electrolyte excretion.

Bibliographic Details
Title: Preclinical pharmacology of AZD9977: A novel mineralocorticoid receptor modulator separating organ protection from effects on electrolyte excretion.
Authors: Krister Bamberg, Ulrika Johansson, Karl Edman, Lena William-Olsson, Susanna Myhre, Anders Gunnarsson, Stefan Geschwindner, Anna Aagaard, Anna Björnson Granqvist, Frédéric Jaisser, Yufeng Huang, Kenneth L Granberg, Rasmus Jansson-Löfmark, Judith Hartleib-Geschwindner
Source: PLoS ONE, Vol 13, Iss 2, p e0193380 (2018)
Publisher Information: Public Library of Science (PLoS), 2018.
Publication Year: 2018
Collection: LCC:Medicine
LCC:Science
Subject Terms: Medicine, Science
More Details: Excess mineralocorticoid receptor (MR) activation promotes target organ dysfunction, vascular injury and fibrosis. MR antagonists like eplerenone are used for treating heart failure, but their use is limited due to the compound class-inherent hyperkalemia risk. Here we present evidence that AZD9977, a first-in-class MR modulator shows cardio-renal protection despite a mechanism-based reduced liability to cause hyperkalemia. AZD9977 in vitro potency and binding mode to MR were characterized using reporter gene, binding, cofactor recruitment assays and X-ray crystallopgraphy. Organ protection was studied in uni-nephrectomised db/db mice and uni-nephrectomised rats administered aldosterone and high salt. Acute effects of single compound doses on urinary electrolyte excretion were tested in rats on a low salt diet. AZD9977 and eplerenone showed similar human MR in vitro potencies. Unlike eplerenone, AZD9977 is a partial MR antagonist due to its unique interaction pattern with MR, which results in a distinct recruitment of co-factor peptides when compared to eplerenone. AZD9977 dose dependently reduced albuminuria and improved kidney histopathology similar to eplerenone in db/db uni-nephrectomised mice and uni-nephrectomised rats. In acute testing, AZD9977 did not affect urinary Na+/K+ ratio, while eplerenone increased the Na+/K+ ratio dose dependently. AZD9977 is a selective MR modulator, retaining organ protection without acute effect on urinary electrolyte excretion. This predicts a reduced hyperkalemia risk and AZD9977 therefore has the potential to deliver a safe, efficacious treatment to patients prone to hyperkalemia.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 1932-6203
Relation: http://europepmc.org/articles/PMC5825103?pdf=render; https://doaj.org/toc/1932-6203
DOI: 10.1371/journal.pone.0193380
Access URL: https://doaj.org/article/837696cf2e364f56bb14da55aad00b11
Accession Number: edsdoj.837696cf2e364f56bb14da55aad00b11
Database: Directory of Open Access Journals
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More Details
ISSN:19326203
DOI:10.1371/journal.pone.0193380
Published in:PLoS ONE
Language:English