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Sphingosine 1-Phosphate Receptor Modulators and Drug Discovery

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Sphingosine 1-Phosphate Receptor Modulators and Drug Discovery Invited Review Biomol Ther 25(1), 80-90 (2017) Sphingosine 1-Phosphate Receptor Modulators and Drug Discovery Soo-Jin Park and Dong-Soon Im* Molecular Inflammation Research Center for Aging Intervention (MRCA) and College of Pharmacy, Pusan National University, Busan 46241, Republic of Korea Abstract Initial discovery on sphingosine 1-phosphate (S1P) as an intracellular second messenger was faced unexpectedly with roles of S1P as a first messenger, which subsequently resulted in cloning of its G protein-coupled receptors, S1P1-5. The molecular iden- tification of S1P receptors opened up a new avenue for pathophysiological research on this lipid mediator. Cellular and molecular in vitro studies and in vivo studies on gene deficient mice have elucidated cellular signaling pathways and the pathophysiological meanings of S1P receptors. Another unexpected finding that fingolimod (FTY720) modulates S1P receptors accelerated drug discovery in this field. Fingolimod was approved as a first-in-class, orally active drug for relapsing multiple sclerosis in 2010, and its applications in other disease conditions are currently under clinical trials. In addition, more selective S1P receptor modulators with better pharmacokinetic profiles and fewer side effects are under development. Some of them are being clinically tested in the contexts of multiple sclerosis and other autoimmune and inflammatory disorders, such as, psoriasis, Crohn’s disease, ulcerative colitis, polymyositis, dermatomyositis, liver failure, renal failure, acute stroke, and transplant rejection. In this review, the authors discuss the state of the art regarding the status of drug discovery efforts targeting S1P receptors and place emphasis on potential clinical applications. Key Words: Sphingosine 1-phosphate, G protein-coupled receptor, Fingolimod, FTY720, Drug discovery, S1P agonist GPCR IN DRUG DISCOVERY include Claritin a H1 histamine receptor antagonist, Cozaar an AT1 angiotensin receptor antagonist, Neurontin a GABAB G protein-coupled receptors (GPCRs) constitute the larg- γ-aminobutyric acid receptor agonist, Plavix a P2Y12 ADP re- est superfamily of receptors for signaling molecules, ligands, ceptor antagonist, Singulair a CysLT1 leukotriene D4 receptor and currently comprise some 865 receptors (Im, 2002, 2013; antagonist, Zantac a H2 histamine receptor antagonist, and Fredriksson et al., 2003; Kihara et al., 2015). GPCRs are also Zyprexa a mixed D2/D1/5-HT2 dopamine/serotonin receptors known as 7TM receptors, because they have seven trans- antagonist. About 55 GPCRs have been cloned and identified membrane domains. These receptors may signal though G as receptors for intercellular lipid mediators, and recent studies proteins but they also initiate signals via other entities (Dav- have unearthed their functional roles under both physiological enport et al., 2013). Many ligands, including hormones, au- and pathological conditions (Im, 2004, 2009, 2013). Further- tacoids, neurotransmitters, and very small molecules to large more, the number of drug discovery studies being conducted proteins can bind and activate GPCRs, and their activations on GPCRs have increased in many fields including cancer, lead to a multitude of physiological processes (Howard et al., cardiac dysfunction, central nervous system disorders, inflam- 2001; Overington et al., 2006; Im, 2013). matory diseases, metabolic disorders, and obesity, (Im, 2004, GPCRs represent a major drug target in all clinical areas. 2009; Mutoh et al., 2012; Pyne et al., 2012; Choi and Chun, Currently, about 40% of drugs on the market target GPCRs 2013; Makide et al., 2014; Proia and Hla, 2015). Here, we and regulate their activities positively or negatively, because summarize current knowledge on one specific aspect of drug a variety of GPCRs offer selectivity and specificity for many discovery involving interactions between GPCRs and the in- human diseases (Im, 2013). Examples of their applications tercellular lipid mediator, sphingosine 1 phosphate (S1P). Open Access https://doi.org/10.4062/biomolther.2016.160 Received Jul 22, 2016 Revised Oct 6, 2016 Accepted Oct 27, 2016 Published Online Jan 1, 2017 This is an Open Access article distributed under the terms of the Creative Com- mons Attribution Non-Commercial License (http://creativecommons.org/licens- *Corresponding Author es/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, E-mail: [email protected] and reproduction in any medium, provided the original work is properly cited. Tel: +82-51-510-2817, Fax: +82-51-513-6754 Copyright © 2017 The Korean Society of Applied Pharmacology www.biomolther.org 80 Park and Im. S1P Receptor Modulators and Drug Discovery SPHINGOSINE 1-PHOSPHATE AND ITS GPCRs disease-modifying drug to treat relapses of multiple sclerosis (Kihara et al., 2015). Multiple sclerosis is a demyelinating dis- S1P is a bioactive lysophospholipid metabolite that can act ease that damages axonal myelin sheaths in the brain and as an intercellular lipid mediator (Moolenaar and Hla, 2012). spinal cord. The primary action mechanism of fingolimod is to Initially, S1P was reported to be a second messenger that reduce lymphocyte egress from secondary lymphoid organ, mediates increases in intracellular calcium levels as a result thymus, and bone marrow, resulting in lymphopenia (Adachi of PDGF and IgE signaling (Olivera and Spiegel, 1993; Choi and Chiba, 2008). Thereby, lymphopenia contributes to inhibit et al., 1996). However, S1P was also unexpectedly found to axon myelin sheath damage. function as an intercellular first messenger like autacoids. The Fingolimod is a unique drug in two respects. First, fingolimod presence of S1P GPCRs in the plasma membrane was sug- is a prodrug (Fig. 1). In vivo fingolimod is phosphorylated by gested by the pertussis toxin sensitivity in S1P-induced actions sphingosine kinases (SK1 and SK2) and then phosphorylated (Bunemann et al., 1995; Goodemote et al., 1995; Im et al., fingolimod acts as an agonist on four S1P receptor subtypes 1997; Okajima et al., 1997; van Koppen et al., 1996). The dis- (S1P1, S1P3, S1P4 and S1P5) (Billich et al., 2003). Second, covery of S1P1 (formerly known as Edg-1) in 1998 along with effects of fingolimod on lymphocyte egress involve not ago- four other S1P2-5 receptors represents a milestone in sphingo- nistic but rather functional antagonistic activity against S1P1 lipid biology (An et al., 1997; Lee et al., 1998; Lynch and Im, (Fig. 1) (Matloubian et al., 2004). Both S1P and fingolimod- 1999; Okamoto et al., 1999; Im et al., 2000; Van Brocklyn et phosphate have been reported to induce lymphopenia via the al., 2000; Yamazaki et al., 2000), and leads to the identifica- agonistic activation of S1P1 and subsequent internalization of tion of a variety of biological functions mediated by interactions S1P1 in the lymphocytes (Brinkmann et al., 2004; Thangada between S1P and S1P receptors (Sanchez and Hla, 2004). In et al., 2010). In fact, the absence of S1P1 on the cell surface particular, S1P regulates the response and function of various blocks re-circulation of lymphocytes from secondary lymphoid cellular and organ systems, such as, cell differentiation, cell organs to blood, because lymphocytes egress by chemotactic migration, cell proliferation, immune response, trafficking of T response to S1P concentration gradient (high in blood and low and B cells, and vascular stability (Gardell et al., 2006; Huwiler in lymph node) through S1P1 (Brinkmann et al., 2004; Chiba, and Pfeilschifter, 2008). S1P receptors exhibit overlapping or 2009). In the case of S1P1 agonist like S1P, internalized S1P1 distinct expression patterns in various cells and tissues, and recycled back to the cell surface within several hours. Howev- as a result, the various cellular functions of S1P have been er, in the case of S1P1 modulators like fingolimod-phosphate, assigned to S1P receptor subtypes. Furthermore, because internalized S1P1 undergoes proteosomal degradation, result- S1P plays critical roles in autoimmune diseases, cancer, and ing in long-time absence of S1P1 until de novo synthesized diseases related to the cardiovascular, immune, nervous, and (Oo et al., 2007). This kind of functional antagonism of fingo- reproductive systems, S1P receptors become important treat- limod means it has a long action time, which can sometimes ment targets (Kihara et al., 2015). In addition, the discovery of be disadvantageous (Subei and Cohen, 2015). The immune S1P receptors made the screening and development of S1P modulatory action of fingolimod has also been reported in agonists and antagonists accessible. Furthermore, discover- autoimmune diseases other than multiple sclerosis, such as ies of S1P receptor subtype-selective agonists or antagonists spontaneous autoimmnune polyneuropathy and experimental could provide novel therapeutic candidates (Im, 2010). autoimmune neuritis (Kim et al., 2009; Zhang et al., 2009a). The discovery that fingolimod (also known as FTY720) is Other applications of fingolimod have also been suggested, an agonist of four S1P receptor subtypes by researchers in im- such as, for the treatment of ischemia/reperfusion injury, which mune therapeutics field accelerated the drug discovery in this is the cellular damage that results from ischemia and re-sup- area. Fingolimod has been approved as a first-in-class drug ply of blood to infarcted tissues. In fact, it has been estimated targeting S1P1 and several selective S1P receptor modulators that systemic inflammatory response after ischemia/reperfu-
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