Proteostasis Regulators in Cystic Fibrosis: Current Development and Future Perspectives

J Med Chem. 2022 Apr 14;65(7):5212-5243. doi: 10.1021/acs.jmedchem.1c01897. Epub 2022 Apr 4.

Abstract

In cystic fibrosis (CF), the deletion of phenylalanine 508 (F508del) in the CF transmembrane conductance regulator (CFTR) leads to misfolding and premature degradation of the mutant protein. These defects can be targeted with pharmacological agents named potentiators and correctors. During the past years, several efforts have been devoted to develop and approve new effective molecules. However, their clinical use remains limited, as they fail to fully restore F508del-CFTR biological function. Indeed, the search for CFTR correctors with different and additive mechanisms has recently increased. Among them, drugs that modulate the CFTR proteostasis environment are particularly attractive to enhance therapy effectiveness further. This Perspective focuses on reviewing the recent progress in discovering CFTR proteostasis regulators, mainly describing the design, chemical structure, and structure-activity relationships. The opportunities, challenges, and future directions in this emerging and promising field of research are discussed, as well.

Publication types

  • Review

MeSH terms

  • Cystic Fibrosis Transmembrane Conductance Regulator* / drug effects
  • Cystic Fibrosis Transmembrane Conductance Regulator* / genetics
  • Cystic Fibrosis Transmembrane Conductance Regulator* / metabolism
  • Cystic Fibrosis* / drug therapy
  • Cystic Fibrosis* / genetics
  • Cystic Fibrosis* / metabolism
  • Humans
  • Mutant Proteins / drug effects
  • Mutant Proteins / genetics
  • Mutant Proteins / metabolism
  • Mutation
  • Protein Folding / drug effects
  • Proteostasis* / drug effects
  • Proteostasis* / physiology

Substances

  • Mutant Proteins
  • Cystic Fibrosis Transmembrane Conductance Regulator