In 1984, Japanese researchers led
by the biochemist Hiroyoshi Hidaka
described the first synthetic protein kinase inhibitors based on an
isoquinoline sulfonamide structure (Hidaka et al. Biochemistry, 1984
Oct 9; 23(21): 5036–41. doi: 10.1021/bi00316a032). These led
to the first protein kinase inhibitor approved for medical use (fasudil),
an inhibitor of the AGC subfamily Rho kinase. With potencies strong
enough to compete against endogenous ATP, the isoquinoline compounds
established the druggability of the ATP binding site. Crystal structures
of their protein kinase complexes, including with cAMP-dependent protein
kinase (PKA), showed interactions that, on the one hand, could mimic
ATP but, on the other hand, could be optimized for high potency binding,
kinase selectivity, and diversification away from adenosine. They
also showed the flexibility of the glycine-rich loop, and PKA became
a major prototype for crystallographic and nuclear magnetic resonance
(NMR) studies of protein kinase mechanism and dynamic activity control.
Since fasudil, more than 70 kinase inhibitors have been approved for
clinical use, involving efforts that progressively have introduced
new paradigms of data-driven drug discovery. Publicly available data
alone comprise over 5000 protein kinase crystal structures and hundreds
of thousands of binding data. Now, new methods, including artificial
intelligence techniques and expansion of protein kinase targeting
approaches, together with the expiration of patent protection for
optimized inhibitor scaffolds, promise even greater advances in drug
discovery. Looking back to the time of the first isoquinoline hinge
binders brings the current state-of-the-art into stark contrast. Appropriately
for this Perspective article, many of the milestone papers during
this time were published in Biochemistry (now ACS Biochemistry).