Article(id=1210516655071957781, tenantId=1146029695717560320, journalId=1189982191388893191, issueId=1210516638089212895, articleNumber=null, orderNo=null, doi=10.16438/j.0513-4870.2022-0442, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=research-article, receivedDate=1650211200000, receivedDateStr=2022-04-18, revisedDate=1652198400000, revisedDateStr=2022-05-11, acceptedDate=null, acceptedDateStr=null, onlineDate=1766539260881, onlineDateStr=2025-12-24, pubDate=1662912000000, pubDateStr=2022-09-12, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1766539260881, onlineIssueDateStr=2025-12-24, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1766539260881, creator=13701087609, updateTime=1766539260881, updator=13701087609, issue=Issue{id=1210516638089212895, tenantId=1146029695717560320, journalId=1189982191388893191, year='2022', volume='57', issue='9', pageStart='1', pageEnd='2888', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1766539256832, creator=13701087609, updateTime=1766539546411, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1210517852726096743, tenantId=1146029695717560320, journalId=1189982191388893191, issueId=1210516638089212895, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1210517852726096744, tenantId=1146029695717560320, journalId=1189982191388893191, issueId=1210516638089212895, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=2696, endPage=2708, ext={EN=ArticleExt(id=1210516655684326205, articleId=1210516655071957781, tenantId=1146029695717560320, journalId=1189982191388893191, language=EN, title=Recent progress of targeted small molecular CDK9 degraders based on PROTAC technology, columnId=1190335348648547107, journalTitle=Acta Pharmaceutica Sinica, columnName=Reviews, runingTitle=null, highlight=null, articleAbstract=

CDKs proteins are a kind of cell cycle protein-dependent kinases, which serve as important roles in controlling cell division and transcriptional stages. Among them, CDK9, as a key regulator responsible for the transcriptional elongation of cells, drives the development of various malignant cells and is considered as an important target in the field of anti-tumor drug development. However, the CDK family proteins feature high conservativeness and similarity in structure, leading to the poor selectivity and severe side effects for traditional small-molecular CDK9 inhibitors, which has limited their clinical applications. In view of this, there is an urgent need to investigate CDK9 targets through a novel strategy. The PROTAC is an emerging drug discovery strategy that the degrader could specifically recognize the target protein through indirect linkage with ubiquitin ligases and ultimately eliminate the target protein through the ubiquitination degradation system. This paper provides a brief overview of the structure and function of CDK9 protein, its relationship with the poor prognosis of clinical diseases, as well as the currently reported small molecular inhibitors. The latest research progress on the targeted degradation of CDK9 protein based on PROTAC technology is highlighted. Finally, the development prospects of this target protein in this novel technology field are summarized and prospected, aiming to provide a reference for the development of antitumor drugs in this direction.

, correspAuthors=Wei HOU, authorNote=null, correspAuthorsNote=null, copyrightStatement=Copyright ©2022 Acta Pharmaceutica Sinica. All rights reserved., copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, authorCompany=null, fund=null, authors=null, authorsList=Jin-xiu LI, He-wei DONG, Wei HOU), CN=ArticleExt(id=1210516658368680948, articleId=1210516655071957781, tenantId=1146029695717560320, journalId=1189982191388893191, language=CN, title=基于PROTAC技术的靶向CDK9小分子降解剂的研究进展, columnId=1190335349655180086, journalTitle=药学学报, columnName=综述, runingTitle=null, highlight=null, articleAbstract=

CDKs蛋白是一种细胞周期蛋白依赖性激酶, 它们在控制细胞分裂及转录阶段发挥着重要的作用。其中, CDK9作为一种负责细胞转录延伸阶段的关键调控因子, 驱动着各种恶性肿瘤细胞的发生, 被认为是抗肿瘤药物研发领域的重要靶标。然而, 由于CDK家族蛋白结构的高度保守性及相似性, 导致传统小分子CDK9抑制剂的选择性较差, 存在严重的不良反应而限制了其临床应用。鉴于此, 当前迫切需要一种全新策略来研究CDK9靶点。蛋白降解靶向嵌合体(PROTAC) 技术是一种新兴的药物研发策略, 通过靶蛋白与泛素连接酶的间接性链接, 特异性地识别靶蛋白并通过降解系统来消除目标蛋白。本文对CDK9蛋白的结构功能、与临床疾病预后不良产生的关系及明星小分子抑制剂进行简要概述, 重点讨论了近几年基于PROTAC技术靶向降解CDK9蛋白的最新研究进展, 并对该靶点蛋白在这一新型技术领域内的发展前景进行了总结和展望, 旨在为该方向的抗肿瘤药物研发提供参考。

, correspAuthors=侯卫, authorNote=null, correspAuthorsNote=
*侯卫, Tel: 15958024381, E-mail:
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InhibitorCompanyDiseaseClinical trialClinical batch number
Flavopiridol (1)National Cancer InstituteLymphomaNCT00445341
P276-00 (2)PiramalMelanomaNCT00835419
Dinaciclib (3)Merck Sharp & Dohme CorpChronic lymphocytic leukemia (CLL)NCT01580228
Seliciclib (4)Cedars-Sinai Medical CenterCushing diseaseNCT03774446
SNS-032 (5)Sunesis PharmaceuticalsB-lymphoid malignanciesNCT00446342
AZD4573 (6)AstraZenecaAdvanced haematological malignanciesNCT04630756
RGB286638 (7)AgennixHematological malignanciesNCT04630756
Atuveciclib (8)BayerLeukemiaNCT02345382
BAY-1251152 (9)BayerHematologic neoplasmsNCT02745743
), ArticleFig(id=1210516663372484793, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1210516655071957781, language=CN, label=Table 1, caption=

CDK9 inhibitors that have been reported in clinical trials

, figureFileSmall=null, figureFileBig=null, tableContent=
InhibitorCompanyDiseaseClinical trialClinical batch number
Flavopiridol (1)National Cancer InstituteLymphomaNCT00445341
P276-00 (2)PiramalMelanomaNCT00835419
Dinaciclib (3)Merck Sharp & Dohme CorpChronic lymphocytic leukemia (CLL)NCT01580228
Seliciclib (4)Cedars-Sinai Medical CenterCushing diseaseNCT03774446
SNS-032 (5)Sunesis PharmaceuticalsB-lymphoid malignanciesNCT00446342
AZD4573 (6)AstraZenecaAdvanced haematological malignanciesNCT04630756
RGB286638 (7)AgennixHematological malignanciesNCT04630756
Atuveciclib (8)BayerLeukemiaNCT02345382
BAY-1251152 (9)BayerHematologic neoplasmsNCT02745743
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基于PROTAC技术的靶向CDK9小分子降解剂的研究进展
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李金秀 , 董何伟 , 侯卫 *
药学学报 | 综述 2022,57(9): 2696-2708
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药学学报 | 综述 2022, 57(9): 2696-2708
基于PROTAC技术的靶向CDK9小分子降解剂的研究进展
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李金秀, 董何伟, 侯卫*
作者信息
  • 浙江工业大学药学院, 浙江 杭州 310014

通讯作者:

*侯卫, Tel: 15958024381, E-mail:
Recent progress of targeted small molecular CDK9 degraders based on PROTAC technology
Jin-xiu LI, He-wei DONG, Wei HOU*
Affiliations
  • College of Pharmaceutical Science, Zhejiang University of Technology, Hangzhou 310014, China
出版时间: 2022-09-12 doi: 10.16438/j.0513-4870.2022-0442
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CDKs蛋白是一种细胞周期蛋白依赖性激酶, 它们在控制细胞分裂及转录阶段发挥着重要的作用。其中, CDK9作为一种负责细胞转录延伸阶段的关键调控因子, 驱动着各种恶性肿瘤细胞的发生, 被认为是抗肿瘤药物研发领域的重要靶标。然而, 由于CDK家族蛋白结构的高度保守性及相似性, 导致传统小分子CDK9抑制剂的选择性较差, 存在严重的不良反应而限制了其临床应用。鉴于此, 当前迫切需要一种全新策略来研究CDK9靶点。蛋白降解靶向嵌合体(PROTAC) 技术是一种新兴的药物研发策略, 通过靶蛋白与泛素连接酶的间接性链接, 特异性地识别靶蛋白并通过降解系统来消除目标蛋白。本文对CDK9蛋白的结构功能、与临床疾病预后不良产生的关系及明星小分子抑制剂进行简要概述, 重点讨论了近几年基于PROTAC技术靶向降解CDK9蛋白的最新研究进展, 并对该靶点蛋白在这一新型技术领域内的发展前景进行了总结和展望, 旨在为该方向的抗肿瘤药物研发提供参考。

细胞周期蛋白依赖性激酶9  /  蛋白降解靶向嵌合体  /  抑制剂  /  抗肿瘤  /  降解剂

CDKs proteins are a kind of cell cycle protein-dependent kinases, which serve as important roles in controlling cell division and transcriptional stages. Among them, CDK9, as a key regulator responsible for the transcriptional elongation of cells, drives the development of various malignant cells and is considered as an important target in the field of anti-tumor drug development. However, the CDK family proteins feature high conservativeness and similarity in structure, leading to the poor selectivity and severe side effects for traditional small-molecular CDK9 inhibitors, which has limited their clinical applications. In view of this, there is an urgent need to investigate CDK9 targets through a novel strategy. The PROTAC is an emerging drug discovery strategy that the degrader could specifically recognize the target protein through indirect linkage with ubiquitin ligases and ultimately eliminate the target protein through the ubiquitination degradation system. This paper provides a brief overview of the structure and function of CDK9 protein, its relationship with the poor prognosis of clinical diseases, as well as the currently reported small molecular inhibitors. The latest research progress on the targeted degradation of CDK9 protein based on PROTAC technology is highlighted. Finally, the development prospects of this target protein in this novel technology field are summarized and prospected, aiming to provide a reference for the development of antitumor drugs in this direction.

cyclin-dependent kinases 9  /  proteolysis-targeting chimera  /  inhibitor  /  antitumor  /  degradation
李金秀, 董何伟, 侯卫. 基于PROTAC技术的靶向CDK9小分子降解剂的研究进展. 药学学报, 2022 , 57 (9) : 2696 -2708 . DOI: 10.16438/j.0513-4870.2022-0442
Jin-xiu LI, He-wei DONG, Wei HOU. Recent progress of targeted small molecular CDK9 degraders based on PROTAC technology[J]. Acta Pharmaceutica Sinica, 2022 , 57 (9) : 2696 -2708 . DOI: 10.16438/j.0513-4870.2022-0442
细胞的异常增殖和分裂是癌症产生的重要标志[1]。尤其是对于一些细胞周期调控因子来说, 细胞周期的失调与细胞抗凋亡能力的增强, 是导致肿瘤发生的重要原因[2]。因此, 通过控制细胞周期治疗癌症的方法被认为是具有前景的抗肿瘤策略。
作为控制细胞周期的关键酶和调节因子, 蛋白依赖性激酶CDKs参与细胞增殖、转录及神经元迁移和分化、DNA修复[3]、细胞凋亡等过程[4]。有证据表明[5], CDK9蛋白作为细胞转录延伸阶段的关键调控因子, 其异常激活会使细胞周期失调, 导致一些短寿命抗凋亡蛋白表达增强(如Mcl-1)。因此, CDK9被认为是抗肿瘤药物研发的重要靶点, 通过调节CDK9激酶活性来阻断转录阶段抗凋亡蛋白的表达, 从而促进肿瘤细胞的凋亡, 这一结果极大激发了研究者们对CDK9抑制剂开发的兴趣。
过去20年, CDK靶向抗癌药物层出不穷。2015年, 首个CDK抑制剂palbociclib被FDA获批上市[6]。截止到目前, 关于CDK9小分子抑制剂也在不断突破, 取得了一些令人兴奋的成果。但由于CDK家族蛋白的ATP结合位点具有很高的同源性[7], 在不同肿瘤中的表达情况也存在差异, 导致开发出的大部分CDK9抑制剂选择性差, 不良反应大等限制了其在临床上的进一步应用, 例如出现严重的超急性肿瘤溶解综合征等[8, 9]。为了克服CDK9抑制剂选择性差的难题, 进一步深入对CDK9靶点的认识, 迫切需要一种全新的策略对CDK9药物进行靶向设计。
蛋白降解靶向嵌合体(PROTAC) 技术是一种新兴的药物开发策略, 已成为新药研发领域最热门的技术之一[10]。这一概念最初是在2001年由Crews提出[11], 能够利用机体内天然存在的蛋白降解系统对靶蛋白进行降解而非抑制靶蛋白功能。PROTAC是一种异双功能分子, 主要是由3部分组成(图 1), 一端是与靶蛋白特异性结合的“弹头”, 另一端是连接E3泛素连接酶的配体, 中间是由linker连接而成, 通过E3泛素连接酶募集靶蛋白进行泛素化标记, 然后利用体内的降解系统对目标蛋白进行降解[12, 13]
目前, 已有多种靶向蛋白降解剂进入了临床试验阶段, 其中, 由Arvinas公司研发用于治疗前列腺癌的雄激素受体降解剂ARV-110在2019年首次进入临床试验[14], 是第一种进入临床研究的降解剂, 目前处于临床Ⅱ期阶段。研究表明, ARV-110作为口服降解剂是安全有效的[15], 去年, 该公司开发出的治疗乳腺癌的雌激素受体ARV-471也进入了临床Ⅱ期试验, 良好的临床数据给靶向药物带来了全新的设计思路。
CDK9作为极具潜力的药物靶点, 引起了研究人员的广泛关注。然而, 大部分的CDK9小分子抑制剂因其缺乏选择性而阻碍了在临床中的应用[16, 17]。近年来, PROTAC技术的出现为靶向CDK9的药物研发带来了新的希望。传统小分子抑制剂通过连续不断地占据“ATP结合口袋”的作用模式来抑制靶蛋白的功能, 从而发挥治疗疾病的目的。而PROTAC技术利用细胞内的蛋白酶体系统, 与靶蛋白瞬时结合即可诱导多种蛋白的降解, 并消除该蛋白的所有功能, 在某种程度上可以提高对CDK9靶蛋白的高效性和特异性。重要的是, 新的研究表明[18], CDKs蛋白之间的表面形状各不相同, 以及暴露的赖氨酸残基分布对泛素化及蛋白酶体降解具有重要影响, 这些差异为进一步指导设计PROTAC选择性CDK蛋白降解剂提供了契机。因此, 越来越多的研究者把目光转移到这项新技术当中, 近几年, 已有多个基于PROTAC技术研发的靶向CDK9蛋白小分子降解剂被报道。
近期, Mallareddy等[19]对目前开发的CDK9降解剂也进行了概述, 但全文并没有对CDK9降解剂的结构设计及构效关系进行详细分析, 不够系统和全面。本文从CDK9的结构和功能出发, 简要分析了CDK9活性的上调与临床疾病中存在的预后关系, 重点从药物的构效关系方面详细介绍了近些年关于CDK9蛋白降解剂的研究进展, 并对CDK9靶点蛋白在降解技术领域的前景进行了总结和展望。
CDKs家族有多种成员。目前, 根据其作用机制主要被分为两种, 一种是负责细胞周期的调控, 包含CDK1、CDK2、CDK4和CDK6; 另一种是作为细胞转录过程的调节剂, 包含CDK7、CDK8、CDK9[20]、CDK12-13和CDK19[21]。还有一些具有多种功能但未被具体定义的亚型: CDK5、CDK10、CDK11、CDK14~18、CDK20[22]。1994年, 研究者首次发现并分离出CDK9蛋白, 证明其主要功能是负责参与促进细胞转录过程阶段的延长[23]
研究表明[24], CDK9几乎存在于所有的哺乳动物细胞中。由于细胞中存在不同的启动子而被鉴定出两种亚型: CDK42和CDK55, CDK55在N端比CDK42多出117个氨基酸残基, 主要富含甘氨酸和脯氨酸。两者在人类癌细胞系和组织中都表达, 但是在组织中分布的位置、调节方式、表达情况却有所差异。因CDK55表达机制和功能尚未明确, 所以目前的研究以CDK42为主。据报道[25], CDK9的结构和其他激酶类似, 主要是由α螺旋构成的C端和β折叠、α螺旋共同构成的N端两大部分组成的激酶域, 而中间部分是ATP结合口袋, 具有高度保守性, 决定着与CDK9蛋白结合的特异性, 在细胞后期的转录阶段起着关键作用。
研究报道[7], CDK9主要是通过磷酸化RNA聚合酶Ⅱ的C末端CTD结构域来精确调节细胞的转录延伸过程。在细胞中, CDK9单体不稳定易分解, 所以需要借助伴侣蛋白(CDC37、HSP70和HSP90) 从而形成一种蛋白瞬时复合物后, 再与细胞周期蛋白CyclinT1、T2a、T2b或K结合形成蛋白复合物CDK9T, 即正性转录因子P-TEFb, CDK9T环上的第186位苏氨酸残基发生磷酸化, 从而活化P-TEFb。RNA聚合酶Ⅱ的C末端CTD结构域磷酸化位点有很多, 丝氨酸是主要的磷酸化位点, 分别由CDK7和CDK9共同参与调节[26, 27]。CDK7蛋白先通过磷酸化Ser5来激活RNA的转录, 但由于负转录延伸因子NELF和敏感性诱导因子DSIF停留在RNA聚合酶Ⅱ的近端, 阻断其转录过程, 此时, 激活的P-TEFb会使NELF、DSIF及RNA聚合酶Ⅱ的CTD结构域上的2位丝氨酸进行磷酸化, 从而驱动细胞内RNA链转录延长。因此, 通过抑制CDK9激酶活性来阻断细胞的转录过程, 使细胞内抗凋亡蛋白的表达水平下降, 从而导致肿瘤细胞的凋亡(图 2)。
研究发现[28, 29], CDK9是位于与肿瘤细胞密切相关的抗凋亡蛋白及关键调控因子的上游位置。研究表明, CDK9与多种疾病的发生密切相关, 如慢性淋巴细胞白血病[30]、艾滋病[31]、胃癌[32]等。近期发现, CDK9的活性上调是导致临床疾病中预后不良的主要因素[5, 33], 对各种癌症的预防和复发起着关键作用。因此, 本文主要对近几年CDK9与临床疾病中的预后关系进行简要概述。
近年来, 三阴性乳腺癌在全球范围内的高发率引起了人们极大的关注。对于三阴性乳腺癌患者而言, 手术前的新辅助化疗(NACT) 可以减小乳腺肿瘤的大小, 但其残留会使乳腺癌患者的复发率增加, 其判断临床结局的预后标志物尚不清楚。然而, 研究表明[34], CDK9在乳腺癌患者中经常失调而导致基因组不稳定。因此, Schlafstein等[35]为了确定NACT后CDK9的表达与预后不良之间的关联, 选取了67名乳腺癌患者样本, 对患者预后治疗中CDK9表达的高低与3年后总生存率(OS) 之间的关系进行分析, 结果发现CDK9高表达组与超过3年的总生存率的改善密切相关, 3年内CDK9的高表达对总生存率存在不利影响, 而3年后的总生存率却表现出增加的趋势, 这说明CDK9的高表达是长期临床结局的有利预后因素。同时, CDK9的低表达导致自发DNA损伤增加和遗传不稳定性, 该研究推测CDK9的低表达可能对于残留的乳腺癌患者具有严重的影响, 导致预后更差。虽然该项研究的分析样本有限, 但这些工作证明了CDK9作为一种新型预后标志物, 为临床中乳腺癌患者开展积极的辅助治疗及预后效果提供了重要的信息。
骨肉瘤是一种较常见的恶性肿瘤, 其药物化疗提高了患者的生存期[36], 但是该病的复发性和转移性是需要解决的问题[37]。研究报道, Ma等[5]通过免疫组化的方法, 对CDK9在骨肉瘤患者中的表达与患者进行新辅助治疗的临床预后关系进行了研究。在70例患者样本中, CDK9低表达患者的生存期明显长于高表达的肿瘤患者, 当使用新型ATP竞争性CDK9抑制剂LDC000067进行治疗时可以显著降低pS2 RNAP Ⅱ和MCL-1的水平, 有效抑制骨肉瘤细胞的克隆形成且诱导细胞凋亡。重要的是, CDK9的表达与新辅助化疗后肿瘤坏死百分比呈负相关水平, 反应较差的患者中CDK9的表达明显更高, 且其他临床病理学特征中显示无预后关系, 这一发现证实了CDK9是骨肉瘤患者生存的独立预测因子, 也是对骨肉瘤患者有效的治疗靶标。
因此, 作为一个有潜力的治疗靶点, CDK9成为了一种新型的预后标志物, 与多种临床疾病的不良预后高度相关。尤其是近些年, CDK9作为一种预后标志物在大量临床研究中得到证实, 除了上述疾病外, 还有胰腺癌[38]、卵巢癌[39]等。
CDK9是一种DNA转录调节因子, 在基因沉默方面也发挥着一定的作用。2018年, 来自Zhang等[40]的一项新研究, 发现抑制CDK9可以重新激活在表观遗传上被癌症沉默的基因。这种重新激活恢复了肿瘤抑制基因的表达并增强了抗癌免疫反应, 研究者通过遗传学实验鉴定出CDK9是一种有效的抑制剂蛋白靶标, 且在体内外都表现出广泛的抗癌活性。这是首次发现这种特定的激酶与哺乳动物中的基因沉默相关联, 这一发现为科学家们确定用于基因沉默的表观遗传癌症治疗药物提供了新的靶标。
最新研究报道[41], CDK9作为新型标志物, 在转录延伸过程还具有MYC依赖性合成致死作用。研究表明[42, 43], CDK9是MYC基因驱动肿瘤发生所必需的调节因子。在MYC过表达的肿瘤细胞中, MYC可通过特异性招募P-TEFb复合物促进细胞的转录延伸, 这使得CDK9抑制剂能够抑制MYC过表达的B细胞淋巴瘤和肝癌细胞的增殖[44], 这一发现表明CDK9抑制剂可以对其他MYC激活的靶标发挥协同作用。因此, CDK9被认为是一种新型合成致死性的生物标志物, 有望与其他抗癌药物联用来治疗临床中的疾病, 为后续临床中的抗肿瘤免疫领域提供了一种有前景的治疗策略。
近几年使用PROTAC技术研发出的降解剂大部分还处于临床前研究阶段, 所以与一些疾病的预后关系还有待进一步探索。
截止目前为止, 已有一些CDK9小分子抑制剂被广泛研究(图 3), 但因选择性差导致的不良反应限制了其在临床上的应用。
为了获得高选择性的CDK9抑制剂, 科学家们付出了大量努力, 目前已有多个药物进入临床试验(表 1)。根据抑制剂的母核结构可以分为黄酮类(flavopiridol、P276-00)、吡唑并嘧啶类(dinaciclib)、嘌呤类(seliciclib)、胺基噻唑类(SNS-032)、吡唑类(AZD4573、RGB286638) 和其他类(atuveciclib、BAY-1251152)。但大部分化合物由于临床的不良反应而进展缓慢, 例如抑制剂1被证实具有很强的抗肿瘤活性, 但在治疗慢性淋巴细胞白血病患者研究的Ⅱ期试验显示, 100%的患者出现不良反应。抑制剂3在Ⅱ期临床研究中, 超过75%的患者有不良反应[45, 46]。目前, 只有P276-00黄酮类化合物进入Ⅲ期临床, 其安全性和有效性仍有待进一步检验。
近期, 卞金磊团队针对目前临床研究中的CDK9抑制剂及结构设计策略进行了系统的综述[47], 本文不再对靶向CDK9抑制剂的研究进展进行详细阐述。
由于CDKs家族蛋白之间的同源性及ATP结合口袋在结构上的相似性, 致使亚型选择性的CDK抑制剂的开发存在着巨大挑战。然而, PROTAC技术因不同于传统小分子“占据ATP结合口袋”的作用模式, 且CDKs之间的表面结构以及赖氨酸残基的分布又各不相同, 这些差异为指导设计选择性的CDK小分子降解剂(PROTAC) 提供了理论基础[18], 该技术的出现有望突破CDK9抑制剂选择性差的瓶颈。因此, 靶向CDK9蛋白的PROTAC小分子引起了研究人员极大的兴趣。尤其在近几年, 关于CDK9降解剂的报道相继而出, 为基于CDK9靶点的药物研发提供了新的思路。
2017年, Natarajan团队首次报道了[18]一种通过化学手段的诱导而具有选择性降解CDK9的氨基吡唑类化合物。作者基于共晶体结构分析[48], 氨基吡唑中的3个氮原子会与CDK蛋白上的残基发生相互作用。因此, 建立了氨基吡唑小分子抑制剂库, 并从中发现苯环的对位有取代基时仍能保持活性。作者以该位置出发设计合成了抑制剂11和抑制剂12 (图 4)。在HCT116细胞中的蛋白印迹实验显示, 两个化合物对CDK5和CDK9的选择性优于CDK2。因此, 作者通过将抑制剂12与沙利度胺连接构建降解剂13, 这是CDK9药物研发领域内第一个意义上的CDK9降解剂。结果显示降解剂13只选择性地降解CDK9蛋白而对CDK2、CDK5、AKT、FAK和IKKβ等激酶水平没有明显的变化, 该团队推测其原因可能是高浓度的降解剂13在空间结构上不能与其他蛋白形成三元复合物, 或者是缺少可以泛素化的近端赖氨酸残基。虽然具体的机制还尚不明确, 但这也进一步证实了通过PROTAC策略能够提高对靶蛋白的选择性, 改变传统小分子抑制剂存在的弊端。此外, 细胞机制研究表明, 抑制剂12和降解剂13都可以使受CDK9活性调节的促生存蛋白Mcl-1呈现剂量依赖性下降, 但是降解剂13诱导其下降的效果更为显著(下降比例达到56%~65%), 与传统抑制剂相比, 小分子诱导的降解作用展现出更具有潜力的效果。降解剂13是第一个报道的具有选择性降解CDK9作用的PROTAC分子, 这些工作为靶向CDK9药物研发打开了大门, 也为后续的研究奠定了基础。
为了进一步提高CDK9的降解活性, 2021年7月, Natarajan团队[49]在此基础上又合成了一系列氨基吡唑类的PROTAC小分子库来进一步探索连接链的长度和类型对降解活性的影响。经过初步筛选得到了降解剂15, 它以剂量和时间依赖性地选择性降解CDK9 (DC50 = 158 ± 6 nmol·L-1), 当在浓度为1 μmol·L-1时, 可特异性地完全降解CDK9, 这对实现高选择性地靶向降解CDK9迈出了重要一步。但当在15的基础上将连接链长度减少或增加2个碳原子时CDK9降解效果均降低(DC50 ~1 μmol·L-1)。重要的是, 当PEG接头替换成烷基接头或者在酰胺键的任意一侧改变长度时都会失去CDK9降解效果。这些研究表明了连接链的长度和原子组成对CDK9的降解具有关键作用。虽然激酶抑制实验发现降解剂15对CDK2/5/9的抑制活性相似, 但它只对CDK9有选择性的降解作用, 这一结果与之前的研究相似, 都是归因于不同蛋白之间赖氨酸残基的分布存在差异性, 也表明PROTAC技术比传统小分子抑制剂具有较高的选择性优势。有研究表明[50-52], Mcl-1和Bcl-xL的失活可以强烈诱导细胞的凋亡, 且Bcl-xL抑制剂的抗增殖作用与Mcl-1因子的凋亡密切相关。因此, 作者进一步将15与Bcl-xL抑制剂进行联合用药, 结果发现它们对胰腺癌细胞能够发挥强烈的协同抑制作用, 进一步的体内研究还在进行中, 其结果值得期待。
为了改进目前CDK9抑制剂可逆性抑制的现状, 获得高效快速降解CDK9的降解剂。2018年, Gray团队[53]利用他们自己开发的一种小分子介导蛋白降解的策略, 成功将多靶点抑制剂16转化成高选择性的CDK9降解剂17。作者基于抑制剂16与CDK2共晶结构设计得到该分子, 与已报道的母体抑制剂16对CDK靶标的抑制活性相比[54], 发现降解剂17仍能保持纳摩尔的抑制作用且保持相似的激酶选择性。在MOLT4细胞中孵育6 h后, 在5 μmol·L-1浓度以下时呈现出对CDK9的浓度依赖性降解, 但当浓度进一步提高时CDK9降解将减少, 这种现象与文献[55]中报道的“hook”效应一致, 但是该情况在PROTAC技术中的作用机制还尚不明确, 未来还需要在该方面做更深入的研究。此外, 作者又发现了一种新的CDK9抑制剂18, 对CDK9的选择性远高于抑制剂16。因此, 作者以此为骨架, 通过链长及连接链类型的改变设计了一系列新的CDK9降解剂, 但结果发现基于18的降解剂抗增殖效果很差且都不能完全降解CDK9。其中, 1920表现出较有潜力的抗增殖作用, 但当与17以相同的浓度作用于MOLT4细胞时, 17在6 h即可达到完全降解而20在24 h才能达到完全降解的效果。为何以抑制剂18衍生的降解剂效果不佳呢?这有待进一步研究。作者进一步对CDK9激酶活性在转录延伸阶段的作用机制进行了探究, 结果显示17能够减少RNA Pol Ⅱ的延伸, 以浓度和时间依赖性方式抑制Ser2的磷酸化, Ser2的缺失高度依赖于CRBN的存在, 证实了CDK9激酶活性在细胞转录过程中的重要作用, 展示了PROTAC降解技术对CDK9靶点疾病治疗的潜力。值得注意的是, 虽然降解剂17与传统的小分子抑制剂1618都可以使CDK9诱导的细胞凋亡水平显著降低, 但当药物被洗脱之后, 只有被降解剂17处理过的细胞仍处于增殖抑制状态, 显示出CDK9降解剂在细胞中具有持久的药效学作用。因此, 这也表明了PROTAC技术比传统的小分子抑制剂更具有治疗优势。特别一提的是, 该降解剂被首次证实也是一种新型的抗病毒药物[56], 显示出浓度依赖性的抗人巨细胞病毒(HCMV) 活性, 这些工作表明该分子确实是一种较有潜力的化合物, 其各方面的实用价值值得进一步研究。
为了进一步改进CDK9降解剂的降解效果, 卞金磊等[57]首次设计合成了一系列基于汉黄芩素类的靶向CDK9的新型PROTAC化合物。他们首先通过汉黄岑素与CDK9激酶的晶体复合物发现, 汉黄芩素结构中的黄酮骨架上C-8位可以在引入取代的情况下保持活性, 这给研究者提供了新的思路。因此, 作者以该位置为出发点, 通过使用不同长度的烷基链(22a~22d) 和引入三氮唑基团(23a~23d) 得到两个系列的PROTAC分子(图 5)。在MCF-7细胞中分别测试了它们对CDK9/5两种蛋白的水平影响, 结果发现三氮唑结构的修饰要明显优于烷基链系列化合物的降解活性, 且该系列降解剂只显示出对CDK9具有选择性。这表明三氮唑基团的引入明显增强了CDK9与E3连接酶配体的蛋白之间的相互作用, 使降解效果得到提高。与汉黄岑素相比, 烷基链系列部分降解剂对CDK9的亲和力有所损失(IC50 > 40 μmol·L-1), 但三氮唑系列降解剂仍表现出中等强度的抑制效果, 其中, 降解剂23c对CDK9具有较强的亲和力(IC50 = 523 ± 12 nmol·L-1) 及降解效果。有意思的是, 作者也发现降解剂23c对CDK9具有高度选择性, 对CKD2、CDK4、CDK5、CDK7、CDK8都没有降解活性, 进一步解释了该现象原因, 高浓度的降解剂由于空间位阻或者没有近端的赖氨酸残基被泛素化而无法与其他蛋白形成三元复合物, 这与Natarajan团队得到的结果一致。汉黄岑素作为一种新型骨架, 为今后基于CDK9降解剂的药物研发设计提供了新的参考和思路。
鉴于先前报道的靶向CDK9的降解剂都是通过使用非选择性CDK9抑制剂作为配体获得, 2021年, 卞金磊团队[58]首次使用选择性CDK9抑制剂24进行结构修饰获得一系列PROTAC分子(图 6), 并实现了体内外靶向CDK9的降解。该团队通过分子对接, 发现抑制剂24的磺酰亚胺基和B环位置可以暴露在溶剂区。因此, 他们通过PEG或三唑烷基接头与24的磺酰亚胺基和B环位置连接设计合成了两个系列降解剂, 经过生物学评估发现, 磺酰亚胺基位置的改变比B环改造更具有潜力。与抑制剂24相比, 经磺酰亚胺基修饰得到的降解剂活性对CDK9激酶均表现出纳摩尔的抑制活性(8~96 nmol·L-1), 而B环修饰得到的降解剂活性均降低且处于微摩尔水平(1~10 μmol·L-1)。因此, 作者在磺酰亚氨基的基础上, 进一步通过改变酰胺键一侧链长长度、增加氧原子或引入三氮唑基团, 筛选出了最具有潜力的降解剂25c, 而其他结构的修饰没有显著差异。目前, 虽然对于降解剂的结构修饰带来的影响因素有很多, 存在较大的偶然性, 但这至少表明了链长的改变对于降解剂的结果具有重要影响。降解剂25c在MV4-11细胞系中显示出最强的抗增殖效果, 比抑制剂24的细胞活性高20倍, 且具有更强的诱导MV4-11细胞凋亡能力, 推测这种提高的抗增殖活性是由酶活性及抗凋亡能力增强引起, 表明将抑制剂转化成PROTAC技术的思路是可行的。蛋白印迹实验中, 当作用浓度为250 nmol·L-1时, 降解剂25c以时间依赖性的方式降解CDK9, 且最快在1 h内就能够明显观察到CDK9的降解, 达到最好的降解效果(DC50 = 7.62 nmol·L-1)。值得一提的是, 作者还进行了初步的体内药效评价, 在MV4-11异种移植模型中, 单剂量为5 mg·kg-1的静脉注射后, 发现25c的半衰期为1.3 h, 肿瘤组织内的蛋白质印迹结果显示静脉注射25c (20 mg·kg-1) 可在3 h内有效降解CDK9, 这些工作表明了降解剂25c是一种极具潜力的先导化合物。这是首次关于CDK9降解剂的体内报道, 虽然只展示了初步的体内效果, 进一步的成药性及体内抑瘤效果如何有待进一步研究, 但这为治疗急性白血病(AML) 的药物研发提供了一种新的设计策略。
为了提高三阴性乳腺癌(TNBC) 的靶向治疗和探究相关细胞周期蛋白的转录调控机制, 2021年9月, 中国科学院上海药物研究所陈小华及黄锐敏团队[59]报道了用于首次治疗TNBC的靶向CDK9高效降解剂。他们基于先前报道的CDK9抑制剂及降解剂, 发现化合物中含氮的杂环骨架及苄胺基团部分在与CDK9蛋白赖氨酸残基形成氢键过程中起着重要作用。因此, 通过分子对接筛选出符合条件的4种配体[60-62], 通过与CRBN连接得到一系列降解剂, 但是结果发现这些降解剂在不同细胞中的抑制活性都不理想(IC50 > 20 μmol·L-1), 进一步以配体262829为例, 通过对苯环上连接点、链长和连接链类型进行研究, 设计合成了一系列降解剂, 结果显示在TNBC细胞中, 苯环上的4号连接位点比其他位点具有更好的细胞活性(图 7)。同时, 当具有相同的链长及原子组成时, 配体连接位点的改变对细胞活性产生更大的影响。通过筛选发现以配体29为母核, 以苯环上的4号位点设计出的降解剂具有最好的抗增殖活性(IC50 < 1 μmol·L-1)。因此, 作者以配体29作为CDK9配体, 通过链长及原子组成的进一步优化设计得到了不同的降解剂。结果发现, 当用氧原子替代连接链中的氨基时, 细胞活性将提高4~5倍。当连接链中缩短一个亚甲基时, 细胞活性将减弱。因此, 作者保留了连接链中的酰胺键, 通过引入1个亚甲基, 在TNBC细胞中的活性提高了10倍, 得到了纳摩尔降解活性的分子32。但是当增加两个亚甲基时细胞活性明显下降, 这表明连接链中的链长及原子组成对降解剂的抗增殖效果极其重要。基于以上探索, 作者进一步将沙利度胺替换成来那度胺, 但发现E3连接酶配体对细胞活性影响并不大, 其中, 具有中等链长的降解剂33最有潜力。但意想不到的是, 当把链中的氧原子进一步替换成亚甲基时细胞活性提高了3倍。同时, 在保留连接链中酰胺基的情况下, 作者发现引入了哌嗪环的降解剂34与降解剂32具有相当的抗增殖活性, 这可能是哌嗪环的引入增强了蛋白之间的相互作用。基于以上大量的工作最终获得了最具潜力的降解剂32~34, 降解剂32比之前抑制剂抗增殖活性提高60倍。蛋白印迹实验显示, 这些降解剂以500 nmol·L-1的浓度孵育在TNBC细胞中, 8 h内基本都能完全降解, 而降解剂32在2 h内即可达到对CDK9的完全降解, 体现了该系列降解剂的高效性。进一步通过降解剂32 (500 nmol·L-1) 与不含沙利多胺的化合物(5 μmol·L-1) 及单独的沙度利胺片段、蛋白酶体之间的竞争实验证明了降解剂32是通过与CDK9及E3连接酶的结合实现对CDK9的高效降解, 这正是PROTAC技术核心所在, 是传统小分子抑制剂不具备的。RNA测序分析实验表明降解剂32可以下调CDK9转录水平的下游靶标基因包括MYC和MCL-1, 诱导TNBC肿瘤细胞的凋亡, 这也进一步证实PROTAC技术对CDK9降解的可行性。但降解剂32在初步的PK实验中显示出较低的血浆暴露量, 这可能与较差的水溶性有关。为了提高水溶性, 作者在降解剂34的基础上引入了游离羟基得到降解剂35, 如预期一样, 35与降解剂32达到相似的降解效果, 且PK实验显示出具有潜力的成药性和水溶性的提升。肿瘤组织内的蛋白印迹显示, 降解剂3235分别使CDK9蛋白减少26%和54%。在MDA-MB-231异种移植的小鼠模型中发现, 降解剂35分别以2.5 mg·kg-1和5 mg·kg-1的剂量每天给药2次, 结果均达到50%左右的抑瘤率。该项研究是在TNBC治疗中首次关于靶向CDK9降解剂进行详细的体内药效学评估和对CDK9降解剂的类药性质优化, 也表明了在转录水平中靶向降解CDK9是一种有效策略, 为后续TNBC临床前的评价奠定了基础。
2019年12月, Zhou等[63]基于CDK2降解剂, 设计合成了一种双重降解剂, 能够同时有效地降解CDK2和CDK9蛋白, 展现出潜在的治疗用途。作者基于CDK抑制剂36[64]37[65]分别与CDK2的晶体结构, 设计出两个系列的PROTAC分子, 采用同样的链长设计及原子组成, 结果发现两个系列化合物的降解效果存在较大差异(图 8)。在人前列腺癌PC-3细胞中孵育12 h后, 基于抑制剂36的降解剂38在1 μmol·L-1时仅对CDK2有降解效果, 当浓度提高到5 μmol·L-1时可同时降解CDK2和CDK9。而基于抑制剂37的部分降解剂在1 μmol·L-1时就可实现对CDK2和CDK9的双重降解, 当链长增加时则只对CDK9进行选择性降解, 这表明了链长可能会改变降解剂的降解效果和选择性。进一步通过浓度筛选得到降解剂39具有最强的降解能力, 在PC-3细胞中孵育24 h后, 发现对CDK2和CDK9的DC50分别为62和33 nmol·L-1, 且CDK9在4 h内达到快速降解(降解率 > 80%)。有趣的是, 选择性CDK9降解剂表现出较弱的抗增殖效果, 而双重降解剂39比其他降解剂抑制活性高出4~20倍, 这与降解效果保持一致。最后, 作者又通过将39结构中的泊马度胺替换成来那度胺和沙利度胺得到降解剂4041, 但细胞活性都弱于39, 这表明配体的选择对降解活性具有重要影响。同时, 39可以通过延长PC3细胞的S期和G2/M来抑制细胞的增殖, 且可以在多种癌细胞中降低CDK2/9活性。该研究证明了39是一种双靶标降解剂, 也进一步表明了PROTAC技术具有多靶点特性的巨大潜力, 这些工作为靶向CDK2/9的癌症治疗提供了一种新的途径和方法。
以上关于CDK9降解剂的设计都是基于CRBN作为弹头配体, 目前也只有CRBN的配体成功应用于降解CDK9靶点蛋白中, 含其他配体的CDK9降解剂至今还未见报道。近来Nieto-Jimenez等[66]通过探究连接酶和靶标之间的关系, 评估在某种肿瘤中特异性使用连接酶配体会产生治疗优势, 观察到MDM2连接酶可作为CDK9靶标的弹头配体发挥作用, 这也为靶向CDK9降解剂的研发提供了一种新的选择。未来关于CDK9靶点的E3连接酶配体设计还有待进一步研究, 希望能够为靶向CDK9蛋白的降解剂药物研发提供更多可能性。
CDK9作为治疗抗癌药物的重要靶标, 近年来已受到越来越多的关注, 从靶蛋白的发现到药物的开发都取得了很大的进展(图 9)。作为CDKs家族成员之一, CDK9在细胞转录方面扮演着重要的角色。从过去到现在, 基于不同母核结构的设计, 已有多个CDK9抑制剂被开发出来, 但因其选择性差[67]和脱靶效应带来的不良反应而限制了其在临床上的研究[8, 9]。然而, 当前PROTAC技术因其独特的优势实现了对CDK9的高选择性, 以一个全新的视角使该领域内的药物研发重焕生机。尤其是在近几年, CDK9作为一个热门靶标在PROTAC技术领域内得到越来越多的研究。近来, 由陈小华及黄锐敏团队报道[54]的一种高选择性CDK9降解剂, 不论在扩大成药性空间或是药理学方面都显示出巨大的潜力, 实现了对CDK9体内外的快速降解, 这无疑给该领域的研究者们带来了更大的动力。
随着PROTAC技术的不断深入, 与传统的小分子抑制剂相比, 该技术能够攻克许多小分子抑制剂难以解决的问题, 凸显出较大的优势潜力: ①改变了传统小分子抑制剂的药理学作用模式, 扩大了蛋白靶标的作用范围。传统的药物能否成药通常取决于是否可以设计成能够结合空腔或者口袋的小分子来抑制活性。而PROTAC技术是通过与靶蛋白发挥瞬时结合的模式, 不论是否为活性位点只需有结合作用即可诱导相关蛋白被降解[68, 69], 比传统的抑制剂有更多的靶点选择, 也为那些“不可成药”的靶点如转录因子、支架蛋白等提供了更多的治疗机会; ②具有更高的催化特性。小分子抑制剂大多数是一个以高浓度的依赖方式调节着蛋白的功能[70], 一般需要强结合力才能与靶蛋白的ATP结合位点进行作用, 而降解剂只需要催化量的药物就能诱导靶蛋白的降解。这种亚化学计量活性的模式避免了传统小分子抑制剂因其高剂量药物带来的毒副作用; ③具有更高的选择性。Crew团队[71]通过以抑制剂foretinib为弹头, 与不同的E3连接酶连接设计出的PROTACs分子中发现, 抑制剂foretinib能够同时靶向133种激酶, 而以VHL和CRBN为E3连接酶设计出的PROTACs分别只能降解36和62种激酶, 这极大凸显出PROTACs技术比传统抑制剂具有更高的靶标选择性优势。尤其是对于同源蛋白家族来说, 多项研究表明[18, 57], PROTAC技术对CDKs蛋白的结合和降解具有更高的选择性, 很大程度上改变了传统小分子CDKs抑制剂选择性差的缺陷, 表明了PROTAC策略在靶向CDK9抗肿瘤药物研发中的可行性和有效性; ④具有持久的药效学作用[53]。相比于传统小分子单一的抑制作用, PROTAC诱导靶蛋白降解后可以重新恢复其功能, 继续结合下一个靶蛋白进行降解, 使药物效力得到很大提高。
总的来说, 关于靶向CDK9降解剂的研究在近几年得到迅速发展, 给该领域的药物研发注入了新的活力。但就目前形势来说还处于研究阶段的初期, 且研究机制不够深入, 目前也存在一定的不足[53]: ①靶蛋白配体及E3连接酶配体的选择对CDK9降解剂的效果尤为重要[59], 但部分降解剂因其配体的选择或链长设计的不合理而达不到理想的降解效果; ②缺乏对降解剂在体内疗效的报道。因降解剂具有较大的分子量, 特别关注它们在细胞中的渗透性或者体内的生物利用度效果如何, 但基于以上报道中除了开发出的降解剂21c初步的体内效果及最新降解剂27d之外, 其他降解剂均没有进一步的详细报道体内效果, 这也是关于CDK9降解剂药物研发领域需要不断探索的地方。
PROTAC降解技术为新药研发打开了新篇章, 也给各界药物研发企业带来了前所未有的机遇。相信随着PROTAC技术的不断深入和成熟, 未来会有更多具有良好抗肿瘤活性CDK9降解剂的出现, 为深入对CDK9靶点的药物研发奠定理论基础。
作者贡献: 李金秀负责文章的框架构建及文章内容撰写、图片制作、文献整理及文章修改; 董何伟负责部分内容的撰写、图片制作及文章修改; 侯卫(通讯作者) 负责文章的思路整理、文章修改和检查, 以及提出重要指导意见。
利益冲突: 本文不存在利益冲突。
  • 浙江省自然科学基金资助项目(LY22H300001)
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2022年第57卷第9期
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doi: 10.16438/j.0513-4870.2022-0442
  • 接收时间:2022-04-18
  • 首发时间:2025-12-24
  • 出版时间:2022-09-12
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  • 收稿日期:2022-04-18
  • 修回日期:2022-05-11
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    浙江工业大学药学院, 浙江 杭州 310014

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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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