Ponatinib (AP24534) inhibits MEKK3-KLF signaling and prevents formation and progression of cerebral cavernous malformations

Sci Adv. 2018 Nov 7;4(11):eaau0731. doi: 10.1126/sciadv.aau0731. eCollection 2018 Nov.

Abstract

Cerebral cavernous malformation (CCM) is a common cerebrovascular disease that can occur sporadically or be inherited. They are major causes of stroke, cerebral hemorrhage, and neurological deficits in the younger population. Loss-of-function mutations in three genes, CCM1, CCM2, and CCM3, have been identified as the cause of human CCMs. Currently, no drug is available to treat CCM disease. Hyperactive mitogen-activated protein kinase kinase Kinase 3 (MEKK3) kinase signaling as a consequence of loss of CCM genes is an underlying cause of CCM lesion development. Using a U.S. Food and Drug Administration-approved kinase inhibitor library combined with virtual modeling and biochemical and cellular assays, we have identified a clinically approved small compound, ponatinib, that is capable of inhibiting MEKK3 activity and normalizing expression of downstream kruppel-like factor (KLF) target genes. Treatment with this compound in neonatal mouse models of CCM can prevent the formation of new CCM lesions and reduce the growth of already formed lesions. At the ultracellular level, ponatinib can normalize the flattening and disorganization of the endothelium caused by CCM deficiency. Collectively, our study demonstrates ponatinib as a novel compound that may prevent CCM initiation and progression in mouse models through inhibition of MEKK3-KLF signaling.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Cells, Cultured
  • Disease Progression
  • Endothelium, Vascular / drug effects
  • Endothelium, Vascular / metabolism
  • Endothelium, Vascular / pathology
  • Gene Expression Regulation / drug effects*
  • Imidazoles / pharmacology*
  • Intellectual Disability / drug therapy*
  • Intellectual Disability / metabolism
  • Intellectual Disability / pathology
  • KRIT1 Protein / physiology*
  • Kruppel-Like Transcription Factors / genetics
  • Kruppel-Like Transcription Factors / metabolism*
  • MAP Kinase Kinase Kinase 3 / genetics
  • MAP Kinase Kinase Kinase 3 / metabolism*
  • Mice
  • Mice, Inbred C57BL
  • Mice, Knockout
  • Microfilament Proteins / physiology*
  • Micrognathism / drug therapy*
  • Micrognathism / metabolism
  • Micrognathism / pathology
  • Mutation
  • Protein Kinase Inhibitors / pharmacology
  • Pyridazines / pharmacology*
  • Ribs / abnormalities*
  • Ribs / metabolism
  • Ribs / pathology
  • Signal Transduction
  • Zebrafish

Substances

  • Imidazoles
  • KRIT1 Protein
  • Krit1 protein, mouse
  • Kruppel-Like Transcription Factors
  • Microfilament Proteins
  • Protein Kinase Inhibitors
  • Pyridazines
  • erythroid Kruppel-like factor
  • osmosensing scaffold for MEKK3 protein, mouse
  • ponatinib
  • MAP Kinase Kinase Kinase 3
  • Map3k3 protein, mouse

Supplementary concepts

  • Cerebral Cavernous Malformations 2