Biased β-Agonists Favoring Gs over β-Arrestin for Individualized Treatment of Obstructive Lung Disease

Journal of Personalized Medicine

Stephen B. Liggett¹  Donghwa Kim¹  William A. Goddard²  Alina Tokmakova³ 

[1] Department of Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL 33612, USA;Materials and Process Simulation Center, California Institute of Technology, Pasadena, CA 91125, USA;Program in Biophysics, University of California, San Francisco, CA 94102, USA;

关键词: β₂-adrenergic receptor;    tachyphylaxis;    G protein;    desensitization;    airway smooth muscle;    G-protein-coupled receptor kinases;   

DOI  :  10.3390/jpm12030331

来源: DOAJ

【 摘 要 】

Signals from G-protein-coupled receptors (GPCRs) are the most frequently targeted pathways of currently prescribed therapeutics. Rather than being a simple switch, it is now evident that a given receptor can directly initiate multiple signals, and biasing to achieve signal selectivity based on agonist structure is possible. Biased agonists could direct therapeutically favorable pathways while avoiding counterproductive or adverse reaction pathways. For obstructive lung diseases, β₂-adrenergic receptor (β₂AR) agonists act at these receptors on airway smooth muscle (ASM) cells to open the airways by relaxing ASM, improving airflow and morbidity. However, these receptors signal to the G protein Gs (increasing cAMP and promoting relaxation), but also to β-arrestin (promoting desensitization and a loss of effectiveness). Indeed, β-agonist use is associated with adverse events in asthma pathogenesis and clinical outcomes which are related to desensitization. β-agonists favoring Gs coupling over β-arrestin binding would provide a means of tailoring bronchodilator therapy. In this review, we show how combinatorial methods with a 40 million compound agnostic library led to a new class of biased β-agonists that do not desensitize, providing an opportunity to personalize therapy in patients who experience poor efficacy or adverse effects from traditional balanced agonists.

【 授权许可】

Unknown