Discovery of the Soluble Guanylate Cyclase Activator Runcaciguat (BAY 1101042)

Hahn, Michael G.; Lampe, Thomas; Sheikh, Sherif El; Griebenow, Nils; Woltering, Elisabeth; Schlemmer, Karl‐Heinz; Dietz, Lisa; Gerisch, Michael; Wunder, Frank; Becker-Pelster, Eva-Maria; Mussack, Thomas; Tinel, Hanna; Knorr, Andreas; Kern, Armin; Lang, Dieter; Hueser, Joerg; Schomber, Tibor; Bénardeau, Agnès; Eitner, Frank; Truebel, Hubert; Mittendorf, Joachim; Kumar, Vijay; Akker, F. van den; Schaefer, Martina; Geiss, Volker; Sandner, Peter; Stasch, Johannes‐Peter

doi:10.1021/acs.jmedchem.0c02154

Cited by 43 publications

(40 citation statements)

References 30 publications

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“…In addition to NO, which is a natural agonist of sGC, the artificial activator runcaciguat (BAY60-2770, Bayer AG, Wuppertal, Germany) was tested. Runcaciguat activates sGC in its haem-free configuration of NO ( Figure 3 A) [ 18 ]. This pharmacological activation of sGC provided additional information about its function.…”

Section: Resultsmentioning

confidence: 99%

Age Impairs Soluble Guanylyl Cyclase Function in Mouse Mesenteric Arteries

Zhong

Boral

et al. 2021

IJMS

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Endothelial dysfunction (ED) comes with age, even without overt vessel damage such as that which occurs in atherosclerosis and diabetic vasculopathy. We hypothesized that aging would affect the downstream signalling of the endothelial nitric oxide (NO) system in the vascular smooth muscle (VSM). With this in mind, resistance mesenteric arteries were isolated from 13-week (juvenile) and 40-week-old (aged) mice and tested under isometric conditions using wire myography. Acetylcholine (ACh)-induced relaxation was reduced in aged as compared to juvenile vessels. Pretreatment with L-NAME, which inhibits nitrix oxide synthases (NOS), decreased ACh-mediated vasorelaxation, whereby differences in vasorelaxation between groups disappeared. Endothelium-independent vasorelaxation by the NO donor sodium nitroprusside (SNP) was similar in both groups; however, SNP bolus application (10−6 mol L−1) as well as soluble guanylyl cyclase (sGC) activation by runcaciguat (10−6 mol L−1) caused faster responses in juvenile vessels. This was accompanied by higher cGMP concentrations and a stronger response to the PDE5 inhibitor sildenafil in juvenile vessels. Mesenteric arteries and aortas did not reveal apparent histological differences between groups (van Gieson staining). The mRNA expression of the α1 and α2 subunits of sGC was lower in aged animals, as was PDE5 mRNA expression. In conclusion, vasorelaxation is compromised at an early age in mice even in the absence of histopathological alterations. Vascular smooth muscle sGC is a key element in aged vessel dysfunction.

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Section: Resultsmentioning

confidence: 99%

Age Impairs Soluble Guanylyl Cyclase Function in Mouse Mesenteric Arteries

Zhong

Boral

et al. 2021

IJMS

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“…Studies examining the nuances of the pathogenesis and pathophysiology of DR and DME have elucidated many promising novel therapeutic targets. EPO signaling in tissue repair, cGMP activation, and activation of antioxidant gene transcription are promising therapeutic targets that can modify disease progression and can be utilized at earlier disease stages (Brines et al, 2008(Brines et al, , 2015Nakagami, 2016;Evans and Lawrenson, 2017;Hahn et al, 2021). Capitalizing on Arg1 and Arg2 activity in the disease pathogenesis of DM also shows therapeutic potential.…”

Section: Discussionmentioning

confidence: 99%

“…Another novel therapeutic approach targeting early stages of DR and DME is NO/cyclic GMP (cGMP) modulator drug therapy, which capitalizes on the various roles of NO signaling in DR pathogenesis. Runcaciguat, a novel cGMP activator, is undergoing clinical trials to assess its efficacy in both diabetic nephropathy and DR (Hahn et al, 2021). Although clinical trials with antioxidant and radical scavenging molecules have failed to show sufficient protection from DR progression, strategies for activating tissue antioxidant mechanisms have shown great therapeutic promise in retinopathies involving oxidative stress (Nakagami, 2016;Evans and Lawrenson, 2017).…”

Section: The Needmentioning

confidence: 99%

Novel Therapeutics for Diabetic Retinopathy and Diabetic Macular Edema: A Pathophysiologic Perspective

2022

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Diabetic retinopathy (DR) and diabetic macular edema (DME) are retinal complications of diabetes that can lead to loss of vision and impaired quality of life. The current gold standard therapies for treatment of DR and DME focus on advanced disease, are invasive, expensive, and can trigger adverse side-effects, necessitating the development of more effective, affordable, and accessible therapies that can target early stage disease. The pathogenesis and pathophysiology of DR is complex and multifactorial, involving the interplay between the effects of hyperglycemia, hyperlipidemia, hypoxia, and production of reactive oxygen species (ROS) in the promotion of neurovascular dysfunction and immune cell polarization to a proinflammatory state. The pathophysiology of DR provides several therapeutic targets that have the potential to attenuate disease progression. Current novel DR and DME therapies under investigation include erythropoietin-derived peptides, inducers of antioxidant gene expression, activators of nitric oxide/cyclic GMP signaling pathways, and manipulation of arginase activity. This review aims to aid understanding of DR and DME pathophysiology and explore novel therapies that capitalize on our knowledge of these diabetic retinal complications.

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“…Oxidative stress does not only impair NO binding to the sGC enzyme thereby interrupting NO/sGC/cGMP signaling, but also limits the effects of sGC stimulators like BAY-747. Therefore, another class of sGC modulating compounds known as sGC activators, which activate oxidized and heme free sGC and restore sGC signaling under oxidative stress conditions [ 29 ] might be a more effective alternative to sGC stimulators. In the future, head-to-head comparisons of sGC stimulators and sGC activators are needed to fully exploit the treatment opportunities of cGMP increase by sGC agonists in DMD.…”

Section: Discussionmentioning

confidence: 99%

Assessing the Use of the sGC Stimulator BAY-747, as a Potential Treatment for Duchenne Muscular Dystrophy

Krishnan

Nordlohne

Dietz

et al. 2021

IJMS

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Duchenne muscular dystrophy (DMD) is a severe and progressive muscle wasting disorder, affecting one in 3500 to 5000 boys worldwide. The NO-sGC-cGMP pathway plays an important role in skeletal muscle function, primarily by improving blood flow and oxygen supply to the muscles during exercise. In fact, PDE5 inhibitors have previously been investigated as a potential therapy for DMD, however, a large-scale Phase III clinical trial did not meet its primary endpoint. Since the efficacy of PDE5i is dependent on sufficient endogenous NO production, which might be impaired in DMD, we investigated if NO-independent sGC stimulators, could have therapeutic benefits in a mouse model of DMD. Male mdx/mTRG2 mice aged six weeks were given food supplemented with the sGC stimulator, BAY-747 (150 mg/kg of food) or food alone (untreated) ad libitum for 16 weeks. Untreated C57BL6/J mice were used as wild type (WT) controls. Assessments of the four-limb hang, grip strength, running wheel and serum creatine kinase (CK) levels showed that mdx/mTRG2 mice had significantly reduced skeletal muscle function and severe muscle damage compared to WT mice. Treatment with BAY-747 improved grip strength and running speed, and these mice also had reduced CK levels compared to untreated mdx/mTRG2 mice. We also observed increased inflammation and fibrosis in the skeletal muscle of mdx/mTRG2 mice compared to WT. While gene expression of pro-inflammatory cytokines and some pro-fibrotic markers in the skeletal muscle was reduced following BAY-747 treatment, there was no reduction in infiltration of myeloid immune cells nor collagen deposition. In conclusion, treatment with BAY-747 significantly improves several functional and pathological parameters of the skeletal muscle in mdx/mTRG2 mice. However, the effect size was moderate and therefore, more studies are needed to fully understand the potential treatment benefit of sGC stimulators in DMD.

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Discovery of the Soluble Guanylate Cyclase Activator Runcaciguat (BAY 1101042)

Cited by 43 publications

References 30 publications

Age Impairs Soluble Guanylyl Cyclase Function in Mouse Mesenteric Arteries

Age Impairs Soluble Guanylyl Cyclase Function in Mouse Mesenteric Arteries

Novel Therapeutics for Diabetic Retinopathy and Diabetic Macular Edema: A Pathophysiologic Perspective

Assessing the Use of the sGC Stimulator BAY-747, as a Potential Treatment for Duchenne Muscular Dystrophy

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