Discovery of a CNS penetrant small molecule SMN2 splicing modulator with improved tolerability for spinal muscular atrophy

Sci Rep. 2020 Oct 15;10(1):17472. doi: 10.1038/s41598-020-74346-9.

Abstract

Spinal muscular atrophy (SMA) is a motor neuron disease, typically resulting from loss-of-function mutations in the survival motor neuron 1 (SMN1) gene. Nusinersen/SPINRAZA, a splice-switching oligonucleotide that modulates SMN2 (a paralog of SMN1) splicing and consequently increases SMN protein levels, has a therapeutic effect for SMA. Previously reported small-molecule SMN2 splicing modulators such as risdiplam/EVRYSDI and its analog SMN-C3 modulate not only the splicing of SMN2 but also that of secondary splice targets, including forkhead box protein M1 (FOXM1). Through screening SMA patient-derived fibroblasts, a novel small molecule, designated TEC-1, was identified that selectively modulates SMN2 splicing over three secondary splice targets. TEC-1 did not strongly affect the splicing of FOXM1, and unlike risdiplam, did not induce micronucleus formation. In addition, TEC-1 showed higher selectively on galactosylceramidase and huntingtin gene expression compared to previously reported compounds (e.g., SMN-C3) due to off-target effects on cryptic exon inclusion and nonsense-mediated mRNA decay. Moreover, TEC-1 significantly ameliorated the disease phenotype in an SMA murine model in vivo. Thus, TEC-1 may have promising therapeutic potential for SMA, and our study demonstrates the feasibility of RNA-targeting small-molecule drug development with an improved tolerability profile.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Alternative Splicing*
  • Animals
  • Azo Compounds / pharmacology
  • Cell Differentiation
  • Drug Discovery
  • Fibroblasts / metabolism
  • Forkhead Box Protein M1 / genetics
  • Genetic Therapy
  • Heterozygote
  • Humans
  • Induced Pluripotent Stem Cells / cytology
  • Male
  • Mice
  • Muscular Atrophy, Spinal / drug therapy*
  • Muscular Atrophy, Spinal / genetics*
  • Oligonucleotides / genetics
  • Oligonucleotides / pharmacology*
  • Phenotype
  • Pyrimidines / pharmacology
  • Survival of Motor Neuron 1 Protein / genetics
  • Survival of Motor Neuron 2 Protein / genetics

Substances

  • Azo Compounds
  • FOXM1 protein, human
  • Forkhead Box Protein M1
  • Foxm1 protein, mouse
  • Oligonucleotides
  • Pyrimidines
  • SMN1 protein, human
  • SMN2 protein, human
  • SMN2 protein, mouse
  • Smn1 protein, mouse
  • Survival of Motor Neuron 1 Protein
  • Survival of Motor Neuron 2 Protein
  • nusinersen
  • Risdiplam