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  • Repurposing antimalarial am...
    McAnally, Danielle; Siddiquee, Khandaker; Gomaa, Ahmed; Szabo, Andras; Vasile, Stefan; Maloney, Patrick R; Divlianska, Daniela B; Peddibhotla, Satyamaheshwar; Morfa, Camilo J; Hershberger, Paul; Falter, Rebecca; Williamson, Robert; Terry, David B; Farjo, Rafal; Pinkerton, Anthony B; Qi, Xiaping; Quigley, Judith; Boulton, Michael E; Grant, Maria B; Smith, Layton H

    PloS one, 09/2018, Letnik: 13, Številka: 9
    Journal Article

    Neovascularization is the pathological driver of blinding eye diseases such as retinopathy of prematurity, proliferative diabetic retinopathy, and wet age-related macular degeneration. The loss of vision resulting from these diseases significantly impacts the productivity and quality of life of patients, and represents a substantial burden on the health care system. Current standard of care includes biologics that target vascular endothelial growth factor (VEGF), a key mediator of neovascularization. While anti-VGEF therapies have been successful, up to 30% of patients are non-responsive. Therefore, there is a need for new therapeutic targets, and small molecule inhibitors of angiogenesis to complement existing treatments. Apelin and its receptor have recently been shown to play a key role in both developmental and pathological angiogenesis in the eye. Through a cell-based high-throughput screen, we identified 4-aminoquinoline antimalarial drugs as potent selective antagonists of APJ. The prototypical 4-aminoquinoline, amodiaquine was found to be a selective, non-competitive APJ antagonist that inhibited apelin signaling in a concentration-dependent manner. Additionally, amodiaquine suppressed both apelin-and VGEF-induced endothelial tube formation. Intravitreal amodaiquine significantly reduced choroidal neovascularization (CNV) lesion volume in the laser-induced CNV mouse model, and showed no signs of ocular toxicity at the highest doses tested. This work firmly establishes APJ as a novel, chemically tractable therapeutic target for the treatment of ocular neovascularization, and that amodiaquine is a potential candidate for repurposing and further toxicological, and pharmacokinetic evaluation in the clinic.