A combination treatment based on drug repurposing demonstrates mutation-agnostic efficacy in pre-clinical retinopathy models

Nat Commun. 2024 Jul 15;15(1):5943. doi: 10.1038/s41467-024-50033-5.

Abstract

Inherited retinopathies are devastating diseases that in most cases lack treatment options. Disease-modifying therapies that mitigate pathophysiology regardless of the underlying genetic lesion are desirable due to the diversity of mutations found in such diseases. We tested a systems pharmacology-based strategy that suppresses intracellular cAMP and Ca2+ activity via G protein-coupled receptor (GPCR) modulation using tamsulosin, metoprolol, and bromocriptine coadministration. The treatment improves cone photoreceptor function and slows degeneration in Pde6βrd10 and RhoP23H/WT retinitis pigmentosa mice. Cone degeneration is modestly mitigated after a 7-month-long drug infusion in PDE6A-/- dogs. The treatment also improves rod pathway function in an Rpe65-/- mouse model of Leber congenital amaurosis but does not protect from cone degeneration. RNA-sequencing analyses indicate improved metabolic function in drug-treated Rpe65-/- and rd10 mice. Our data show that catecholaminergic GPCR drug combinations that modify second messenger levels via multiple receptor actions provide a potential disease-modifying therapy against retinal degeneration.

MeSH terms

  • Animals
  • Bromocriptine / pharmacology
  • Bromocriptine / therapeutic use
  • Calcium / metabolism
  • Cyclic AMP / metabolism
  • Cyclic Nucleotide Phosphodiesterases, Type 6 / genetics
  • Cyclic Nucleotide Phosphodiesterases, Type 6 / metabolism
  • Disease Models, Animal*
  • Dogs
  • Drug Repositioning*
  • Drug Therapy, Combination
  • Female
  • Humans
  • Leber Congenital Amaurosis / drug therapy
  • Leber Congenital Amaurosis / genetics
  • Male
  • Mice
  • Mice, Inbred C57BL
  • Mice, Knockout
  • Mutation
  • Receptors, G-Protein-Coupled / genetics
  • Receptors, G-Protein-Coupled / metabolism
  • Retinal Cone Photoreceptor Cells / drug effects
  • Retinal Cone Photoreceptor Cells / metabolism
  • Retinal Cone Photoreceptor Cells / pathology
  • Retinal Degeneration / drug therapy
  • Retinal Degeneration / genetics
  • Retinitis Pigmentosa* / drug therapy
  • Retinitis Pigmentosa* / genetics
  • cis-trans-Isomerases / genetics
  • cis-trans-Isomerases / metabolism

Substances

  • Cyclic Nucleotide Phosphodiesterases, Type 6
  • Receptors, G-Protein-Coupled
  • Bromocriptine
  • cis-trans-Isomerases
  • retinoid isomerohydrolase
  • Cyclic AMP
  • Calcium