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Published February 23, 2022 | Published
Journal Article Open

Biased β-Agonists Favoring Gs over β-Arrestin for Individualized Treatment of Obstructive Lung Disease

Abstract

Signals from G-protein-coupled receptors (GPCRs) are the most frequently targeted pathways of currently prescribed therapeutics. Rather than being a simple switch, it is now evident that a given receptor can directly initiate multiple signals, and biasing to achieve signal selectivity based on agonist structure is possible. Biased agonists could direct therapeutically favorable pathways while avoiding counterproductive or adverse reaction pathways. For obstructive lung diseases, β₂-adrenergic receptor (β₂AR) agonists act at these receptors on airway smooth muscle (ASM) cells to open the airways by relaxing ASM, improving airflow and morbidity. However, these receptors signal to the G protein Gs (increasing cAMP and promoting relaxation), but also to β-arrestin (promoting desensitization and a loss of effectiveness). Indeed, β-agonist use is associated with adverse events in asthma pathogenesis and clinical outcomes which are related to desensitization. β-agonists favoring Gs coupling over β-arrestin binding would provide a means of tailoring bronchodilator therapy. In this review, we show how combinatorial methods with a 40 million compound agnostic library led to a new class of biased β-agonists that do not desensitize, providing an opportunity to personalize therapy in patients who experience poor efficacy or adverse effects from traditional balanced agonists.

Additional Information

© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Received: 25 January 2022 / Revised: 14 February 2022 / Accepted: 17 February 2022 / Published: 22 February 2022. We thank Lauren K. Lujan and Hannah R. Strzelinski and our other collaborators for data generation for the original paper and Himeshkumar N. Patel for assistance in manuscript preparation. This research was funded by National Institutes of Health, grant number HL114471, HL142992, HL045967, and HL155532. Author Contributions. Conceptualization, investigation, formal analysis, writing-original draft preparation, writing-review and editing, A.T., D.K., W.A.G.III and S.B.L. All authors have read and agreed to the published version of the manuscript. The authors declare no conflict of interest.

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Created:
August 22, 2023
Modified:
October 23, 2023