Antagonists of the EP3 receptor for prostaglandin e2 are novel antiplatelet agents that do not prolong bleeding

Jasbir Singh, Wayne Zeller, Nian Zhou, Georgeta Hategen, Rama Mishra, Alex Polozov, Peng Yu, Emmanuel Onua, Jun Zhang, David Zembower, Alex Kiselyov, José L. Ramírez, Gudmundur Sigthorsson, Jon Mar Bjornsson, Margret Thorsteinsdottir, Thorkell Andresson, Maria Bjarnadottir, Olafur Magnusson, Jean Etienne Fabre, Kari StefanssonMark E. Gurney

Research output: Contribution to journalArticlepeer-review

61 Scopus citations

Abstract

Myocardial infarction and stroke are caused by blood clots forming over a ruptured or denuded atherosclerotic plaque (atherothrombosis). Production of prostaglandin E2 (PGE2) by an inflamed plaque exacerbates atherothrombosis and may limit the effectiveness of current therapeutics. Platelets express multiple G-protein coupled receptors, including receptors for ADP and PGE2. ADP can mobilize Ca2+ and through the P 2Y12 receptor can inhibit cAMP production, causing platelet activation and aggregation. Clopidogrel (Plavix), a selective P 2Y12 antagonist, prevents platelets from clotting but thereby increases the risk of severe or fatal bleeding. The platelet EP 3 receptor for PGE2, like the P2Y12 receptor, also inhibits cAMP synthesis. However, unlike ADP, facilitation of platelet aggregation via the PGE2/EP3 pathway is dependent on co-agonists that can mobilize Ca2+. We used a ligand-based design strategy to develop peri-substituted bicylic acylsulfon- amides as potent and selective EP3 antagonists. We show that DG-041, a selective EP 3 antagonist, inhibits PGE2 facilitation of platelet aggregation in vitro and ex vivo. PGE2 can resensitize platelets to agonist even when the P2Y12 receptor has been blocked by clopidogrel, and this can be inhibited by DG-041. Unlike clopidogrel, DG-041 does not affect bleeding time in rats, nor is bleeding time further increased when DG-041 is co-administered with clopidogrel. This indicates that EP 3 antagonists potentially have a superior safety profile compared to P2Y12 antagonists and represent a novel class of antiplatelet agents.

Original languageEnglish (US)
Pages (from-to)115-126
Number of pages12
JournalACS chemical biology
Volume4
Issue number2
DOIs
StatePublished - Feb 20 2009

ASJC Scopus subject areas

  • Biochemistry
  • Molecular Medicine

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