N-[6-(4-butanoyl-5-methyl-1H-pyrazol-1-yl)pyridazin-3-yl]-5-chloro-1-[2-(4-methylpiperazin-1-yl)-2-oxoethyl]-1H-indole-3-carboxamide (SAR216471), a novel intravenous and oral, reversible, and directly acting P2Y12 antagonist.

In the search of a potential backup for clopidogrel, we have initiated a HTS campaign designed to identify novel reversible P2Y12 antagonists. Starting from a hit with low micromolar binding activity, we report here the main steps of the optimization process leading to the identification of the preclinical candidate SAR216471. It is a potent, highly selective, and reversible P2Y12 receptor antagonist and by far the most potent inhibitor of ADP-induced platelet aggregation among the P2Y12 antagonists described in the literature. SAR216471 displays potent in vivo antiplatelet and antithrombotic activities and has the potential to differentiate from other antiplatelet agents.

5-Chlorothiophene-2-carboxylic acid [(S)-2-[2-methyl-3-(2-oxopyrrolidin-1-yl)benzenesulfonylamino]-3-(4-methylpiperazin-1-yl)-3-oxopropyl]amide (SAR107375), a selective and potent orally active dual thrombin and factor Xa inhibitor.

Compound 15 (SAR107375), a novel potent dual thrombin and factor Xa inhibitor resulted from a rational optimization process. Starting from compound 14, with low factor Xa and modest anti-thrombin inhibitory activities (IC50's of 3.5 and 0.39 µM, respectively), both activities were considerably improved, notably through the incorporation of a neutral chlorothiophene P1 fragment and tuning of P2 and P3-P4 fragments. Final optimization of metabolic stability with microsomes led to the identification of 15, which displays strong activity in vitro vs factor Xa and thrombin (with Ki's of 1 and 8 nM, respectively). In addition 15 presents good selectivity versus related serine proteases (roughly 300-fold), including trypsin (1000-fold), and is very active (0.39 µM) in the thrombin generation time (TGT) coagulation assay in human platelet rich plasma (PRP). Potent in vivo activity in a rat model of venous thrombosis following iv and, more importantly, po administration was also observed (ED50 of 0.07 and 2.8 mg/kg, respectively). Bleeding liability was reduced in the rat wire coil model, more relevant to arterial thrombosis, with 15 (blood loss increase of 2-fold relative to the ED80 value) compared to rivaroxaban 2 and dabigatran etexilate 1a.

SAR131675, a potent and selective VEGFR-3-TK inhibitor with antilymphangiogenic, antitumoral, and antimetastatic activities.

SAR131675 is a potent and selective VEGFR-3 inhibitor. It inhibited VEGFR-3 tyrosine kinase activity and VEGFR-3 autophosphorylation in HEK cells with IC(50) values of 20 and 45 nmol/L, respectively. SAR131675 dose dependently inhibited the proliferation of primary human lymphatic cells, induced by the VEGFR-3 ligands VEGFC and VEGFD, with an IC(50) of about 20 nmol/L. SAR131675 was found to be highly selective for VEGFR-3 versus 107 receptors, enzymes, ion channels, and 65 kinases. However, it was moderately active on VEGFR-2 with a VEGFR-3/VEGFR-2 ratio of about 10. SAR131675 had no antiproliferative activity on a panel of 30 tumors and primary cells, further showing its high specificity and indicating that SAR131675 is not a cytotoxic or cytostatic agent. SAR131675 was very well tolerated in mice and showed a potent antitumoral effect in several orthotopic and syngenic models, including mammary 4T1 carcinoma and RIP1.Tag2 tumors. Interestingly, it significantly reduced lymph node invasion and lung metastasis, showing its antilymphangiogenic activity in vivo. Moreover, treatment of mice before resection of 4T1 primary tumors was sufficient to prevent metastasis. Tumor-associated macrophages (TAM) play an important role in tumor growth and metastasis. The expression of VEGFR-3 on TAMs has been recently described. F4/80 immunostaining clearly showed that SAR131675 significantly reduced TAM infiltration and aggregation in 4T1 tumors. Taken together, SAR131675 is the first highly specific VEGFR-3-TK inhibitor described to date, displaying significant antitumoral and antimetastatic activities in vivo through inhibition of lymphangiogenesis and TAM invasion.

Activation of the UNC5B receptor by Netrin-1 inhibits sprouting angiogenesis.

Netrins are secreted molecules with roles in axonal growth and angiogenesis. The Netrin receptor UNC5B is required during embryonic development for vascular patterning, suggesting that it may also contribute to postnatal and pathological angiogenesis. Here we show that unc5b is down-regulated in quiescent adult vasculature, but re-expressed during sprouting angiogenesis in matrigel and tumor implants. Stimulation of UNC5B-expressing neovessels with an agonist (Netrin-1) inhibits sprouting angiogenesis. Genetic loss of function of unc5b reduces Netrin-1-mediated angiogenesis inhibition. Expression of UNC5B full-length receptor also triggers endothelial cell repulsion in response to Netrin-1 in vitro, whereas a truncated UNC5B lacking the intracellular signaling domain fails to induce repulsion. These data show that UNC5B activation inhibits sprouting angiogenesis, thus identifying UNC5B as a potential anti-angiogenic target.

Lesion progression in apoE-deficient mice: implication of chemokines and effect of the AT1 angiotensin II receptor antagonist irbesartan.

We recently described that a treatment with the angiotensin AT1 receptor antagonist irbesartan inhibits atherosclerotic lesion development, macrophage accumulation, and monocyte chemoattractant protein-1 (MCP-1) as well as the chemokine KC expression in apolipoprotein E-deficient (apoE-deficient) mice. The present study addresses whether these and other chemokines are expressed not only during the initiation but also during the development of atherosclerotic lesions and whether irbesartan can inhibit the expression of these chemokines during lesion progression. The time course of lesion development was assessed in apoE-deficient mice aged 1 to 9 months and the relative expression of chemokines was quantified by RT-PCR. Significant lesion formation already appeared in 3-month-old apoE-deficient mice, and progressed further to the age of 9 months. The expression of MCP-1 and KC (the mouse homologue of Groalpha), was induced at 1 month in apoE-deficient as compared with wild type (C57/Bl6) mice, and was observed before any detectable histologic changes. MCP-1 and KC expression remained high during lesion progression. The expression of macrophage inflammatory protein-2 (MIP-2, the mouse Grobeta/gamma homologue) and macrophage inflammatory protein-1alpha (MIP-1alpha) was increased in lesions from 4-month-old mice onward, whereas Regulated upon Activation of Normal T-cells Expressed and Secreted (RANTES) was significantly induced in 6- to 9-month-old mice only. Irbesartan (50 mg/kg/d) administered from the age of 3 months onward significantly reduced the progression of the lesions as well as the expression of the chemokines. A short-term treatment with irbesartan significantly inhibited the expression of MCP-1 and KC, suggesting that activation of the renin-angiotensin system is involved in up-regulation of these chemokines and that this effect represents a potential mechanism by which irbesartan inhibits plaque development and progression.

Deficiency of survivin in transgenic mice exacerbates Fas-induced apoptosis via mitochondrial pathways.

BACKGROUND & AIMS: Survivin is an inhibitor of apoptosis protein (IAP), which also is crucial for mitosis and cell cycle progression. IAPs participate in regulating Fas ligand-induced hepatic apoptosis. The aim was to study the contribution of survivin to hepatic apoptosis by generating transgenic mice lacking survivin. METHODS: The survivin gene was inactivated in mice by homologous recombination in embryonic stem cells. Survivin+/- and survivin+/+ mice were generated and injected with the Fas agonistic antibody Jo2. RESULTS: In 3 genetic backgrounds, survivin-/- embryos died before 4.5 days post coitum. Survivin+/- mice appeared normal, but liver lysates revealed baseline low-level activation of procaspase-8, Bid, procaspase-9, and procaspase-3, with accumulation of Bax, and release of cytochrome c, indicating a proapoptotic state. Intraperitoneal injection of low-dose Jo2 had no effect on survivin+/+ mice at 2 hours. However, in survivin+/- mice, Jo2 caused hemorrhagic necrosis of the liver, associated with prominent activation of the apoptotic pathway via the mitochondria, and up-regulation of hepatocellular expression of survivin in the cytosol, nuclei, and mitochondria. Isolated mitochondria from survivin+/- livers had more defects in oxidative phosphorylation after C(2)-ceramide exposure. CONCLUSIONS: Absence of survivin is incompatible with life. Although Jo2 induces expression of survivin, diminished baseline levels render the liver more sensitive to Fas, possibly due to functional effects on the mitochondria. This is the first in vivo documentation that survivin modulates caspase activation and that Fas-mediated hepatic apoptosis is regulated by survivin via mitochondrial pathways.