Discovery of β-Arrestin–Biased Dopamine D ₂ Ligands for Probing Signal Transduction Pathways Essential for Antipsychotic Efficacy

Abstract

Elucidating the key signal transduction pathways essential for both antipsychotic efficacy and side-effect profiles is essential for developing safer and more effective therapies. Recent work has highlighted noncanonical modes of dopamine D 2 receptor (D 2 R) signaling via β-arrestins as being important for the therapeutic actions of both antipsychotic and antimanic agents. We thus sought to create unique D 2 R agonists that display signaling bias via β-arrestinergic signaling. Through a robust diversity-oriented modification of the scaffold represented by aripiprazole (1), we discovered UNC9975 (2), UNC0006 (3), and UNC9994 (4) as unprecedented β-arrestin-biased D 2 R ligands. These compounds also represent unprecedented β-arrestin-biased ligands for a G i -coupled G proteincoupled receptor (GPCR). Significantly, UNC9975, UNC0006, and UNC9994 are simultaneously antagonists of G i -regulated cAMP production and partial agonists for D 2 R/β-arrestin-2 interactions. Importantly, UNC9975 displayed potent antipsychotic-like activity without inducing motoric side effects in inbred C57BL/6 mice in vivo. Genetic deletion of β-arrestin-2 simultaneously attenuated the antipsychotic actions of UNC9975 and transformed it into a typical antipsychotic drug with a high propensity to induce catalepsy. Similarly, the antipsychotic-like activity displayed by UNC9994, an extremely β-arrestin-biased D 2 R agonist, in wild-type mice was completely abolished in β-arrestin-2 knockout mice. Taken together, our results suggest that β-arrestin signaling and recruitment can be simultaneously a significant contributor to antipsychotic efficacy and protective against motoric side effects. These functionally selective, β-arrestin-biased D 2 R ligands represent valuable chemical probes for further investigations of D 2 R signaling in health and disease.functional selectivity | ligand bias G protein-coupled receptors (GPCRs) signal not only via canonical pathways involving heterotrimeric large G proteins, but also via noncanonical G protein-independent interactions with other signaling proteins including, most prominently, β-arrestins (1-4). The process by which GPCR ligands differentially modulate canonical and noncanonical signal transduction pathways is a phenomenon known as "functional selectivity" (5, 6). Such functionally selective ligands preferentially engage either canonical or noncanonical GPCR pathways (7,8). Clearly, the discovery of ligands with discrete functional selectivity profiles will be extremely useful for elucidating the key signal transduction pathways essential for both the therapeutic actions and the side effects of drugs (6). Understanding which signaling pathways contribute to antipsychotic efficacy and side effects, for instance, will in turn enable the design of better antipsychotic drug candidates and, ultimately, lead to safer and more effective therapies for patients. However, only a small number of functionally selective GPCR ligands have been reported to date (5-9). In addition to the paucity of such ligands,...

Deletion of GSK3β in D2R-expressing neurons reveals distinct roles for β-arrestin signaling in antipsychotic and lithium action

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6′-Guanidinonaltrindole (6′-GNTI) Is a G Protein-biased κ-Opioid Receptor Agonist That Inhibits Arrestin Recruitment

“…Understanding which signaling pathways contribute to therapeutic efficacy and which contribute to side effects will enable the design of better drug candidates and lead to safer and more effective therapies. For example, several novel compounds exhibiting antipsychotic-like activity in vivo were shown recently to be antagonists at dopamine D2 receptor of G i -mediated inhibition of cAMP production but partial agonists for recruitment of arrestin3 to the dopamine D2 receptor (38). These functionally selective arrestin-biased ligands represent valuable chemical probes for investigation of the signaling pathways that are associated with antipsychotic efficacy and side effects.…”

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“…Indeed, such a biased ligand has been generated that shows functional selectivity to the b-arrestin pathway at the D2 receptor and has shown specificity in targeting the barr2 pathway. 26 It remains to be determined whether such newly identified biased ligands show clinical efficacy.…”