The shifting landscape of KATP channelopathies and the need for 'sharper' therapeutics

Future Med Chem. 2016 May;8(7):789-802. doi: 10.4155/fmc-2016-0005. Epub 2016 May 10.

Abstract

ATP-sensitive potassium (KATP) channels play fundamental roles in the regulation of endocrine, neural and cardiovascular function. Small-molecule inhibitors (e.g., sulfonylurea drugs) or activators (e.g., diazoxide) acting on SUR1 or SUR2 have been used clinically for decades to manage the inappropriate secretion of insulin in patients with Type 2 diabetes, hyperinsulinism and intractable hypertension. More recently, the discovery of rare disease-causing mutations in KATP channel-encoding genes has highlighted the need for new therapeutics for the treatment of certain forms of neonatal diabetes mellitus, congenital hyperinsulinism and Cantu syndrome. Here, we provide a high-level overview of the pathophysiology of these diseases and discuss the development of a flexible high-throughput screening platform to enable the development of new classes of KATP channel modulators.

Keywords: Cantu syndrome; KATP channels; chemical chaperone; diabetes; high-throughput screening; insulin; pancreas; thallium flux; trafficking.

Publication types

  • Review
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adenine Nucleotides / pharmacology
  • Adenine Nucleotides / therapeutic use
  • Animals
  • Cardiomegaly / drug therapy
  • Cardiomegaly / metabolism
  • Channelopathies / drug therapy*
  • Channelopathies / metabolism
  • Diabetes Mellitus, Type 2 / drug therapy
  • Diabetes Mellitus, Type 2 / metabolism
  • Humans
  • Hyperinsulinism / congenital
  • Hyperinsulinism / drug therapy
  • Hypertrichosis / drug therapy
  • Hypertrichosis / metabolism
  • Hypoglycemic Agents / pharmacology
  • Hypoglycemic Agents / therapeutic use
  • Ion Channel Gating
  • KATP Channels / antagonists & inhibitors
  • KATP Channels / metabolism*
  • Osteochondrodysplasias / drug therapy
  • Osteochondrodysplasias / metabolism
  • Protein Transport

Substances

  • Adenine Nucleotides
  • Hypoglycemic Agents
  • KATP Channels

Supplementary concepts

  • Cantu syndrome