Discovery of a Novel Series of Potent, Selective, Orally Available, and Brain-Penetrable C1s Inhibitors for Modulation of the Complement Pathway

J Med Chem. 2023 May 11;66(9):6354-6371. doi: 10.1021/acs.jmedchem.3c00348. Epub 2023 Apr 25.

Abstract

A novel series of non-amidine-based C1s inhibitors have been explored. Starting from high-throughput screening hit 3, isoquinoline was replaced with 1-aminophthalazine to enhance C1s inhibitory activity while exhibiting good selectivity against other serine proteases. We first disclose a crystal structure of a complex of C1s and a small-molecule inhibitor (4e), which guided structure-based optimization around the S2 and S3 sites to further enhance C1s inhibitory activity by over 300-fold. Improvement of membrane permeability by incorporation of fluorine at the 8-position of 1-aminophthalazine led to identification of (R)-8 as a potent, selective, orally available, and brain-penetrable C1s inhibitor. (R)-8 significantly inhibited membrane attack complex formation induced by human serum in a dose-dependent manner in an in vitro assay system, proving that selective C1s inhibition blocked the classical complement pathway effectively. As a result, (R)-8 emerged as a valuable tool compound for both in vitro and in vivo assessment.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Brain / metabolism
  • Complement Activation*
  • Complement C1s* / chemistry
  • Complement C1s* / metabolism
  • Humans
  • Serine Endopeptidases / metabolism

Substances

  • Complement C1s
  • Serine Endopeptidases