Large library docking identifies positive allosteric modulators of the calcium-sensing receptor

作者：Fangyu Liu, Cheng-Guo Wu, Chia‐Ling Tu, Isabella Glenn, Justin Meyerowitz, Anat Levit, Jiankun Lyu, Zhiqiang Cheng, Olga O. Tarkhanova, Yurii S. Moroz, John J. Irwin, Wenhan Chang, Brian K. Shoichet, Georgios Skiniotis · 发表于：Science · 年份：2024 · DOI：10.1126/science.ado1868 · 被引用次数：47 · 研究领域：Protein Kinase Regulation and GTPase Signaling、Nitric Oxide and Endothelin Effects、Molecular Sensors and Ion Detection

Positive allosteric modulator (PAM) drugs enhance the activation of the calcium-sensing receptor (CaSR) and suppress parathyroid hormone (PTH) secretion. Unfortunately, these hyperparathyroidism-treating drugs can induce hypocalcemia and arrhythmias. Seeking improved modulators, we docked libraries of 2.7 million and 1.2 billion molecules against the CaSR structure. The billion-molecule docking found PAMs with a 2.7-fold higher hit rate than the million-molecule library, with hits up to 37-fold more potent. Structure-based optimization led to nanomolar leads. In ex vivo organ assays, one of these PAMs was 100-fold more potent than the standard of care, cinacalcet, and reduced serum PTH levels in mice without the hypocalcemia typical of CaSR drugs. As determined from cryo-electron microscopy structures, the PAMs identified here promote CaSR conformations that more closely resemble the activated state than those induced by the established drugs.