Abstract:
Cardiovascular diseases are the world’s leading cause of death. Accounting for 83 % of all cardiovascular disease-related deaths, ischemic heart disease (IHD) and ischemic stroke (IS) are the main contributors to the high mortality rate of this disease group. In the secondary prevention of IHD and IS patients, platelet aggregation inhibitors play a pivotal role. Although therapy with platelet aggregation inhibitors significantly reduces mortality, they can rarely cause severe side effects, most notably bleeding. The atypical chemokine receptor 3 (ACKR3) has been discussed in recent scientific findings as a possible modulator of platelet aggregation. ACKR3 belongs to the family of G protein-coupled receptors but atypically recruits β-arrestin instead of a G protein. Biological experiments have demonstrated that the activation of this receptor results in platelet degranulation, quantified by a reduction in P-selectin expression, and consequently to a notable reduction in platelet aggregation. Despite the existence of a few agonists, no ACKR3 agonist with high antiplatelet activity has been identified so far. Two scaffolds of compounds were developed as a part of this work. The two scaffolds were divided into sections, then systematic derivatizations were performed, and their ability to modulate ACKR3 was evaluated. The first scaffold A, which was based on a virtual screening of the ACKR3 receptor, resulted in the first-in-class superagonists 32 (EC50 = 3.4 µM, Emax = 161 %, P-sel. expr. red. = 76 %) and 31 (EC50 = 3.5 µM, Emax = 164 %, P-sel. expr. red. = 97 %). Optimization efforts of scaffold B, based on a weak literature compound, yielded two highly active ACKR3 platelet modulators, compound 118 (EC50 = 0.111 µM, P-sel. expr. red. = 95 %) and 122 (EC50 = 0.069 µM, P-sel. expr. red. = 80 %). Both compounds exhibited high β-arrestin recruitment potency, strong selectivity, and low toxicity. In summary, in this study, the first ACKR3 platelet aggregation inhibitors were developed, synthesized, and comprehensively characterized.