NADPH oxidase 1 is a novel pharmacological target for the development of an antiplatelet drug without bleeding side effects

FASEB J. 2020 Oct;34(10):13959-13977. doi: 10.1096/fj.202001086RRR. Epub 2020 Aug 26.

Abstract

Growing evidence supports a central role of NADPH oxidases (NOXs) in the regulation of platelets, which are circulating cells involved in both hemostasis and thrombosis. Here, the use of Nox1-/- and Nox1+/+ mice as experimental models of human responses demonstrated a critical role of NOX1 in collagen-dependent platelet activation and pathological arterial thrombosis, as tested in vivo by carotid occlusion assays. In contrast, NOX1 does not affect platelet responses to thrombin and normal hemostasis, as assayed in tail bleeding experiments. Therefore, as NOX1 inhibitors are likely to have antiplatelet effects without associated bleeding risks, the NOX1-selective inhibitor 2-acetylphenothiazine (2APT) and a series of its derivatives generated to increase inhibitory potency and drug bioavailability were tested. Among the 2APT derivatives, 1-(10H-phenothiazin-2-yl)vinyl tert-butyl carbonate (2APT-D6) was selected for its high potency. Both 2APT and 2APT-D6 inhibited collagen-dependent platelet aggregation, adhesion, thrombus formation, superoxide anion generation, and surface activation marker expression, while responses to thrombin or adhesion to fibrinogen were not affected. In vivo administration of 2APT or 2APT-D6 led to the inhibition of mouse platelet aggregation, oxygen radical output, and thrombus formation, and carotid occlusion, while tail hemostasis was unaffected. Differently to in vitro experiments, 2APT-D6 and 2APT displayed similar potency in vivo. In summary, NOX1 inhibition with 2APT or its derivative 2APT-D6 is a viable strategy to control collagen-induced platelet activation and reduce thrombosis without deleterious effects on hemostasis. These compounds should, therefore, be considered for the development of novel antiplatelet drugs to fight cardiovascular diseases in humans.

Keywords: NADPH oxidase; free radical; hemostasis; oxidative stress; platelet; redox; thrombosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Carotid Artery Thrombosis / drug therapy*
  • Carotid Artery Thrombosis / prevention & control
  • Cells, Cultured
  • Collagen / metabolism
  • Enzyme Inhibitors / adverse effects
  • Enzyme Inhibitors / pharmacology*
  • Enzyme Inhibitors / therapeutic use
  • Female
  • Fibrinogen / metabolism
  • Hemorrhage / etiology
  • Humans
  • Mice
  • Mice, Inbred C57BL
  • NADPH Oxidase 1 / antagonists & inhibitors*
  • Phenothiazines / adverse effects
  • Phenothiazines / pharmacology*
  • Phenothiazines / therapeutic use
  • Platelet Adhesiveness / drug effects
  • Platelet Aggregation / drug effects
  • Platelet Aggregation Inhibitors / adverse effects
  • Platelet Aggregation Inhibitors / pharmacology*
  • Platelet Aggregation Inhibitors / therapeutic use
  • Reactive Oxygen Species / metabolism
  • Thrombin / metabolism

Substances

  • 2-acetylphenothiazine
  • Enzyme Inhibitors
  • Phenothiazines
  • Platelet Aggregation Inhibitors
  • Reactive Oxygen Species
  • Fibrinogen
  • Collagen
  • NADPH Oxidase 1
  • NOX1 protein, mouse
  • Thrombin