Discovery and Optimization of Non-bile Acid FXR Agonists as Preclinical Candidates for the Treatment of Nonalcoholic Steatohepatitis

J Med Chem. 2020 Nov 12;63(21):12748-12772. doi: 10.1021/acs.jmedchem.0c01065. Epub 2020 Oct 13.

Abstract

Farnesoid X receptor (FXR) plays a key role in bile acid homeostasis, inflammation, fibrosis, and metabolism of lipid and glucose and becomes a promising therapeutic target for nonalcoholic steatohepatitis (NASH) or other FXR-dependent diseases. The phase III trial results of obeticholic acid demonstrate that the FXR agonists emerge as a promising intervention in patients with NASH and fibrosis, but this bile acid-derived FXR agonist brings severe pruritus and an elevated risk of cardiovascular disease for patients. Herein, we reported our efforts in the discovery of a series of non-bile acid FXR agonists, and 36 compounds were designed and synthesized based on the structure-based drug design and structural optimization strategies. Particularly, compound 42 is a highly potent and selective FXR agonist, along with good pharmacokinetic profiles, high liver distribution, and preferable in vivo efficacy, indicating that it is a potential candidate for the treatment of NASH or other FXR-dependent diseases.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Binding Sites
  • Chemical and Drug Induced Liver Injury / drug therapy
  • Chemical and Drug Induced Liver Injury / pathology
  • Chenodeoxycholic Acid / analogs & derivatives*
  • Chenodeoxycholic Acid / chemistry
  • Chenodeoxycholic Acid / metabolism
  • Chenodeoxycholic Acid / pharmacokinetics
  • Chenodeoxycholic Acid / therapeutic use
  • Drug Design
  • Drug Evaluation, Preclinical
  • Half-Life
  • Humans
  • Liver / drug effects
  • Liver / pathology
  • Male
  • Mice
  • Mice, Inbred C57BL
  • Molecular Docking Simulation
  • Non-alcoholic Fatty Liver Disease / drug therapy
  • Non-alcoholic Fatty Liver Disease / pathology
  • Rats
  • Rats, Sprague-Dawley
  • Receptors, Cytoplasmic and Nuclear / agonists*
  • Receptors, Cytoplasmic and Nuclear / metabolism
  • Structure-Activity Relationship

Substances

  • Receptors, Cytoplasmic and Nuclear
  • obeticholic acid
  • farnesoid X-activated receptor
  • Chenodeoxycholic Acid