M1-positive allosteric modulators lacking agonist activity provide the optimal profile for enhancing cognition

Neuropsychopharmacology. 2018 Jul;43(8):1763-1771. doi: 10.1038/s41386-018-0033-9. Epub 2018 Mar 14.

Abstract

Highly selective positive allosteric modulators (PAMs) of the M1 subtype of muscarinic acetylcholine receptor have emerged as an exciting new approach for improving cognitive function in patients suffering from Alzheimer's disease and schizophrenia. However, excessive activation of M1 is known to induce seizure activity and have actions in the prefrontal cortex (PFC) that could impair cognitive function. We now report a series of pharmacological, electrophysiological, and behavioral studies in which we find that recently reported M1 PAMs, PF-06764427 and MK-7622, have robust agonist activity in cell lines and agonist effects in the mouse PFC, and have the potential to overactivate the M1 receptor and disrupt PFC function. In contrast, structurally distinct M1 PAMs (VU0453595 and VU0550164) are devoid of agonist activity in cell lines and maintain activity dependence of M1 activation in the PFC. Consistent with the previously reported effect of PF-06764427, the ago-PAM MK-7622 induces severe behavioral convulsions in mice. In contrast, VU0453595 does not induce behavioral convulsions at doses well above those required for maximal efficacy in enhancing cognitive function. Furthermore, in contrast to the robust efficacy of VU0453595, the ago-PAM MK-7622 failed to improve novel object recognition, a rodent assay of cognitive function. These findings suggest that in vivo cognition-enhancing efficacy of M1 PAMs can be observed with PAMs lacking intrinsic agonist activity and that intrinsic agonist activity of M1 PAMs may contribute to adverse effects and reduced efficacy in improving cognitive function.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Allosteric Regulation
  • Animals
  • CHO Cells
  • Cholinergic Agents / pharmacology*
  • Cricetulus
  • Excitatory Postsynaptic Potentials / drug effects
  • Excitatory Postsynaptic Potentials / physiology
  • Male
  • Mice, Inbred C57BL
  • Nootropic Agents / pharmacology*
  • Prefrontal Cortex / drug effects
  • Prefrontal Cortex / physiology
  • Pyramidal Cells / drug effects
  • Pyramidal Cells / physiology
  • Rats
  • Rats, Sprague-Dawley
  • Receptor, Muscarinic M1 / agonists
  • Receptor, Muscarinic M1 / genetics
  • Receptor, Muscarinic M1 / metabolism*
  • Recognition, Psychology / drug effects
  • Tissue Culture Techniques

Substances

  • Cholinergic Agents
  • Nootropic Agents
  • Receptor, Muscarinic M1