ABSTRACT:The M 1 muscarinic acetylcholine receptor is thought to play an important role in memory and cognition, making it a potential target for the treatment of Alzheimer's disease (AD) and schizophrenia. Moreover, M 1 interacts with BACE1 and regulates its proteosomal degradation, suggesting selective M 1 activation could afford both palliative cognitive benefit as well as disease modification in AD. A key challenge in targeting the muscarinic acetylcholine receptors is achieving mAChR subtype selectivity. Our lab has previously reported the M 1 selective positive allosteric modulator ML169. Herein we describe our efforts to further optimize this lead compound by preparing analogue libraries and probing novel scaffolds. We were able to identify several analogues that possessed submicromolar potency, with our best example displaying an EC 50 of 310 nM. The new compounds maintained complete selectivity for the M 1 receptor over the other subtypes (M 2 −M 5 ), displayed improved DMPK profiles, and potentiated the carbachol (CCh)-induced excitation in striatal MSNs. Selected analogues were able to potentiate CCh-mediated nonamyloidogenic APPsα release, further strengthening the concept that M 1 PAMs may afford a disease-modifying role in the treatment of AD. KEYWORDS: Muscarinic, acetylcholine, positive allosteric modulator (PAM), ML169, Alzheimer's disease (AD), medium spiny neurons (MSNs), MLPCN T he muscarinic acetylcholine receptors (mAChRs) are members of the family A G-protein-coupled receptors (GPCRs) and comprise five subtypes (M 1 −M 5 ) that mediate a broad range of actions of the neurotransmitter acetylcholine (ACh, 1) in the central nervous system and other tissues (Figure 1) and play key roles in memory and attention mechanisms, motor control, nociception, regulation of sleepwake cycles, cardiovascular function, renal function, and GI function. 1 mAChR subtypes M 1 , M 3 , and M 5 are coupled to G q and stimulate phospholipase C and intracellular Ca 2+ release, while M 2 and M 4 are coupled to G i and block adenylyl cyclase. 2 Data from brain expression, cellular localization, and knockout mice have implicated that M 1 plays a vital role in both memory and cognition, 3 and numerous studies have shown efficacy in preclinical cognition models with selective M 1 activators. 4−7 Recently, studies have conclusively shown that M 1 interacts with BACE1 to regulate its protesomal degradation and that M 1 activation activates α-secretase, which leads to an increase in sAPPα thereby preventing the formation of Aβ via MAPK-and PKC-dependent pathways. 8 In addition, M 1 activation decreases τ phosphorylation; therefore, M 1 activation affects the major pathological hallmarks of AD. 8,9 Beyond the cholinergic and NMDA hypofunction hypotheses of schizophrenia where M 1 could play a critical therapeutic role, 10 BACE1 has also been linked to schizophrenia, via neuregulin 1; thus, the ability of M 1 activation to regulate BACE1 suggests that pharmacological agents that can selectivity activate M 1 represent a nove...