Targeting GNE Myopathy: A Dual Prodrug Approach for the Delivery of N-Acetylmannosamine 6-Phosphate

J Med Chem. 2019 Sep 12;62(17):8178-8193. doi: 10.1021/acs.jmedchem.9b00833. Epub 2019 Aug 20.

Abstract

ProTides comprise an important class of prodrugs currently marketed and developed as antiviral and anticancer therapies. The ProTide technology employs phosphate masking groups capable of providing more favorable druglike properties and an intracellular activation mechanism for enzyme-mediated release of a nucleoside monophosphate. Herein, we describe the application of phosphoramidate chemistry to 1,3,4-O-acetylated N-acetylmannosamine (Ac3ManNAc) to deliver ManNAc-6-phosphate (ManNAc-6-P), a critical intermediate in sialic acid biosynthesis. Sialic acid deficiency is a hallmark of GNE myopathy, a rare congenital disorder of glycosylation (CDG) caused by mutations in GNE that limit the production of ManNAc-6-P. Synthetic methods were developed to provide a library of Ac3ManNAc-6-phosphoramidates that were evaluated in a series of studies for their potential as a treatment for GNE myopathy. Prodrug 12b showed rapid activation in a carboxylesterase (CPY) enzymatic assay and favorable ADME properties, while also being more effective than ManNAc at increasing sialic acid levels in GNE-deficient cell lines. These results provide a potential platform to address substrate deficiencies in GNE myopathy and other CDGs.

MeSH terms

  • Animals
  • CHO Cells
  • Caco-2 Cells
  • Cell Survival / drug effects
  • Cells, Cultured
  • Cricetulus
  • Distal Myopathies / drug therapy*
  • Distal Myopathies / metabolism
  • Distal Myopathies / pathology
  • Dose-Response Relationship, Drug
  • Drug Delivery Systems*
  • Hexosamines / chemical synthesis
  • Hexosamines / chemistry
  • Hexosamines / pharmacology*
  • Humans
  • Molecular Structure
  • N-Acetylneuraminic Acid / analysis
  • Phosphotransferases (Alcohol Group Acceptor) / antagonists & inhibitors*
  • Phosphotransferases (Alcohol Group Acceptor) / deficiency
  • Phosphotransferases (Alcohol Group Acceptor) / metabolism
  • Prodrugs / chemical synthesis
  • Prodrugs / chemistry
  • Prodrugs / pharmacology*
  • Structure-Activity Relationship
  • Sugar Phosphates / chemical synthesis
  • Sugar Phosphates / chemistry
  • Sugar Phosphates / pharmacology*

Substances

  • Hexosamines
  • N-acetylmannosamine 6-phosphate
  • Prodrugs
  • Sugar Phosphates
  • Phosphotransferases (Alcohol Group Acceptor)
  • N-acylmannosamine kinase
  • N-Acetylneuraminic Acid

Supplementary concepts

  • Distal myopathy, Nonaka type