Idiopathic pulmonary fibrosis (IPF)
is a progressive lung disease,
and its incidence rate is rapidly rising. However, effective therapies
for the treatment of IPF are still lacking. Phosphodiesterase 4 (PDE4)
inhibitors were reported to be potential anti-fibrotic agents, but
their clinical use was hampered by side effects like emesis and nausea.
Herein, structure-based hit-to-lead optimizations of natural mangostanin
resulted in the novel and orally active PDE4 inhibitor 18a with potent inhibitory affinity (IC50 = 4.2 nM), favorable
physico-chemical properties, and a different binding pattern from
roflumilast. Emetic activity tests on dogs demonstrated that 18a cannot cause emesis even at an oral dose of 10 mg/kg,
whereas rolipram had severe emetic effects at an oral dose of 1 mg/kg.
Finally, the oral administration of 18a (10 mg/kg) exhibited
comparable anti-pulmonary fibrosis effects with pirfenidone (150 mg/kg)
in a bleomycin-induced IPF rat model, indicating its potential as
a novel anti-IPF agent with improved safety.