Small molecule Parkin activators to treat Alzheimer's Disease - Alzheimer’s disease (AD) affects an estimated 21-35 million worldwide; this number will double in the next
decade. AD results from the degeneration and death of hippocampal and entorhinal cortex neurons in the brain,
which are critical for learning and memory. Patients in end stage AD require round-the-clock care. Ultimately
fatal with no cure available, AD is the sixth-leading cause of death in the US. Current therapies have serious
side effects and cannot prevent neuronal death and disease progression, leading to efforts to identify novel
therapeutics that stop AD progression. One target for such therapy is the mitochondrion. Mitochondrial damage
and the appearance of autophagic vacuoles correlate with AD onset, and evidence suggests that mitophagy, a
regulatory form of autophagic degradation mediated by the ubiquitin E3 ligase Parkin and the kinase PINK1, is
overwhelmed and cannot prevent accumulation of damaged mitochondria in AD-affected neurons. Dysfunctional
mitochondria in the axons of AD-linked neurons diminish energy production and release harmful reactive oxygen
species; in these neurons, dysfunctional mitochondria accumulate due to inadequate mitophagy. Thus,
therapeutic intervention in this compromised Parkin and PINK1-mediated mitophagy pathway is a promising
strategy to improve mitochondrial integrity, preventing AD progression. Supporting this notion, overexpression
of Parkin in an AD mouse model ameliorates AD-related symptoms, with improved mitochondrial integrity.
Notably, the key factor of the mitophagy pathway, Parkin, is known to exist in an auto-inhibited ‘off’ state in
cytosol, with very low basal level enzymatic activity. Its auto-inhibition is mediated by multiple intramolecular
interactions, and point mutations that specifically disrupt these interactions activate Parkin activity and promote
its translocation to dysfunctional mitochondria. The therapeutic hypothesis driving the current application is that
small molecules that relieve auto-inhibitory interactions within Parkin can be used to selectively activate Parkin
activity and facilitate mitochondrial health. Parkin activators are expected to prevent neuronal death induced by
defective mitophagy, thereby hindering the progression of AD. It is proposed in this Phase II application to initiate
preclinical development of selected small molecule activators of Parkin, identified in Phase I and shown to relieve
auto-inhibition of Parkin, augmenting mitophagy in cells. This will be accomplished by performing lead
optimization of selected Parkin activators, performing ADME/DMPK analyses (in vitro and in vivo) on compounds
of interest, and demonstrating efficacy of optimized compounds in cellular and animal models of AD-related
neurodegeneration. The ultimate commercial goal is the development of a novel small molecule agonist that can
be used to treat neurological diseases with mitochondrial dysfunction.