Bisphosphonates: The first 40 years

R-Aminophosphonic acids are broadly defined as analogues of amino acids in which the carboxylic group is replaced by a phosphonic acid or related group (usually phosphonous or phosphinic acids). This results in the presence of the characteristic N C P scaffold (Scheme 1). The biological activity and natural occurrence of these compounds (often called R-aminophosphonates) were discovered half a century ago. Since then, the chemistry and biology of this class of compounds have been developed into a distinct branch of phosphorus chemistry. It is generally acknowledged that R-aminophosphonates possess a broad capability of influencing physiologic and pathologic processes, with applications ranging from agrochemistry to medicine. In some cases, these compounds have been commercialized. A number of excellent reviews on various aspects of their activity in natural systems have been published. 12 The mode of action of aminophosphonates primarily involves the inhibition of enzymes of different class and origin. Despite its long history, this area of research remains intensively explored and frequently delivers new promising lead compounds in medicinal chemistry. The N C P molecular fragment and its chemistry offer many possibilities for structural modifications, which have resulted in broad biological relevance (Scheme 1). Often, R-aminophosphonic and phosphinic acids are considered simple analogues of their natural counterparts, carboxylic acids. Although carboxylic and phosphonic acid groups differ in shape (tetrahedral at phosphorus versus planar at carbon), acidity (with phosphonic acid being significantly more acidic), and steric bulk (the phosphorus atom has a much larger atomic radius than carbon), they frequently exhibit similar properties, with the phosphonic acid being recognized by enzymes or receptors as false substrates or inhibitors. However, the tetrahedral geometry of substituents around the phosphorus moiety causes it to resemble the high-energy transition state (TS) of ester and amide bond hydrolyses. The tetrahedral transition state is believed to be specifically stabilized in enzyme active sites, which has inspired numerous studies on their applications in regulating the activity of proteases. This approach has been most successful in the case of metalloproteases, which have an organophosphorus moiety in their active sites that facilitates the chelation of metal ions. This approach has resulted in the development of many potent inhibitors of various enzymes, such as the antihypertensive drug fosinopril, an angiotensin I converting enzyme (ACE) inhibitor. Recently, the N C P scaffold has been used to construct extended transition state analogues of amide bond synthesis or hydrolysis to find potent inhibitors of enzymes such as glutamine synthetase or urease. Reactive peptidyl phosphonate diaryl esters have been successfully used to covalently modify members of the serine hydrolase superfamily. This approach exploits their ability to phosphonylate the hydroxyl residue of the active-site serine of these enzymes. They act as competitive, irreversible inhibitors, which, after the formation of an initial enzyme substrate complex, bind to the active site via a transesterification reaction and thus block its catalytic function. The activity and selectivity of the interactions of inhibitors with target enzymes can be adjusted by structural optimization of the S1 residues and/or by the development of an extended peptide chain. Finally, aminomethylenebisphosphonic acids form a separate class of medicinally important compounds bearing the N C P skeleton. They are hydrolytically stable analogues of pyrophosphate characterized by a common P C P fragment in which a carbon phosphorus bond replaces an oxygen phosphorus bond. Their primary medical application is in combating osteoporosis. They exhibit very high affinity to bone tissue, being rapidly adsorbed at the bone surface, and they regulate the bone remodeling process. Because the action of bisphosphonates is limited to osseous tissue, they have also been used to deliver conjugated chemotherapeutic agents to bone. Likely because of their strong chelating properties, bisphosphonates also exhibit inhibitory properties toward a wide variety of metalloenzymes. In this Perspective, we present the key features of theN C P molecular fragment that govern the activity of the molecules that incorporate it. A general overview of known modes of action and target enzyme classes is briefly presented. Recent representative medicinal chemistry projects are described and discussed, including the achievements of our research group on leucine aminopeptidase and urease. Particular attention is given to the molecular aspects of the N C P mechanism of action and to the rational design of new compounds based on threedimensional structures. The potential future applications of this class of compounds are also discussed.

Remarkable potential of the α-aminophosphonate/phosphinate structural motif in medicinal chemistry.

The profound effects of the bisphosphonates on calcium metabolism were discovered over 30 years ago, and they are now well established as the major drugs used for the treatment of bone diseases associated with excessive resorption. Their principal uses are for Paget disease of bone, myeloma, bone metastases, and osteoporosis in adults, but there has been increasing and successful application in pediatric bone diseases, notably osteogenesis imperfecta. Bisphosphonates are structural analogues of inorganic pyrophosphate but are resistant to enzymatic and chemical breakdown. Bisphosphonates inhibit bone resorption by selective adsorption to mineral surfaces and subsequent internalization by bone-resorbing osteoclasts where they interfere with various biochemical processes. The simpler, non-nitrogen-containing bisphosphonates (eg, clodronate and etidronate) can be metabolically incorporated into nonhydrolysable analogues of adenosine triphosphate (ATP) that may inhibit ATP-dependent intracellular enzymes. In contrast, the more potent, nitrogen-containing bisphosphonates (eg, pamidronate, alendronate, risedronate, ibandronate, and zoledronate) inhibit a key enzyme, farnesyl pyrophosphate synthase, in the mevalonate pathway, thereby preventing the biosynthesis of isoprenoid compounds that are essential for the posttranslational modification of small guanosine triphosphate (GTP)-binding proteins (which are also GTPases) such as Rab, Rho, and Rac. The inhibition of protein prenylation and the disruption of the function of these key regulatory proteins explains the loss of osteoclast activity. The recently elucidated crystal structure of farnesyl diphosphate reveals how bisphosphonates bind to and inhibit at the active site via their critical nitrogen atoms. Although bisphosphonates are now established as an important class of drugs for the treatment of many bone diseases, there is new knowledge about how they work and the subtle but potentially important differences that exist between individual bisphosphonates. Understanding these may help to explain differences in potency, onset and duration of action, and clinical effectiveness.

https://pediatrics.aappublications.org/content/pediatrics/119/Supplement_2/S150.full.pdf

Bisphosphonates: Mode of Action and Pharmacology

Human Vgamma2Vdelta2 T cells play important roles in mediating immunity against microbial pathogens and have potent anti-tumor activity. Vgamma2Vdelta2 T cells recognize the pyrophosphorylated isoprenoid intermediates (E)-4-hydroxy-3-methyl-but-2-enyl pyrophosphate (HMBPP), an intermediate in the foreign 2-C-methyl-d-erythritol 4-phosphate (MEP) pathway, and isopentenyl pyrophosphate (IPP), an intermediate in the self-mevalonate pathway. Infection with bacteria and protozoa using the MEP pathway leads to the rapid expansion of Vgamma2Vdelta2 T cells to very high numbers through preferential recognition of HMBPP. Activated Vgamma2Vdelta2 T cells produce proinflammatory cytokines and chemokines, kill infected cells, secrete growth factors for epithelial cells, and present antigens to alphabeta T cells. Vgamma2Vdelta2 T cells can also recognize high levels of IPP in certain tumors and in cells treated with pharmacological agents, such as bisphosphonates and alkylamines, that block farnesyl pyrophosphate synthase. Activated Vgamma2Vdelta2 T cells are able to kill most tumor cells because of recognition by T-cell receptor and natural killer receptors. The ubiquitous nature of the antigens converts essentially all Vgamma2Vdelta2 T cells to memory cells at an early age. Thus, primary infections with HMBPP-producing bacteria are perceived by Vgamma2Vdelta2 T cells as a repeat infection. Extensive efforts are underway to harness these cells to treat a variety of cancers and to provide microbial immunity.

Nonpeptide antigens, presentation mechanisms, and immunological memory of human Vγ2Vδ2 T cells: discriminating friend from foe through the recognition of prenyl pyrophosphate antigens

The discovery and development of the bisphosphonates (BPs) as a major class of drugs for the treatment of bone diseases has been a fascinating journey that is still not over. In clinical medicine, several BPs are established as the treatments of choice for various diseases of excessive bone resorption, including Paget's disease of bone, myeloma and bone metastases, and osteoporosis. Bisphosphonates are chemically stable analogues of inorganic pyrophosphate, and are resistant to breakdown by enzymatic hydrolysis. Bisphosphonates inhibit bone resorption by being selectively taken up and adsorbed to mineral surfaces in bone, where they interfere with the action of the bone-resorbing osteoclasts. Bisphosphonates are internalized by osteoclasts and interfere with specific biochemical processes. Bisphosphonates can be classified into at least two groups with different molecular modes of action. The simpler non-nitrogen-containing bisphosphonates (such as clodronate and etidronate) can be metabolically incorporated into nonhydrolyzable analogues of adenosine triphosphate (ATP) that may inhibit ATP-dependent intracellular enzymes. The more potent, nitrogen-containing bisphosphonates (such as pamidronate, alendronate, risedronate, ibandronate, and zoledronate) are not metabolized in this way but can inhibit enzymes of the mevalonate pathway, thereby preventing the biosynthesis of isoprenoid compounds that are essential for the posttranslational modification of small GTP-binding proteins (which are also GTPases) such as rab, rho, and rac. The inhibition of protein prenylation and the disruption of the function of these key regulatory proteins explain the loss of osteoclast activity and induction of apoptosis. The key target for bisphosphonates is farnesyl pyrophosphate synthase (FPPS) within osteoclasts, and the recently elucidated crystal structure of this enzyme reveals how BPs bind to and inhibit at the active site via their critical N atoms. In conclusion, bisphosphonates are now established as an important class of drugs for the treatment of many bone diseases, and their mode of action is being unraveled. As a result their full therapeutic potential is gradually being realized.

Bisphosphonates from bench to bedside

γδ T cells are the first line of defense against many infectious organisms and are also involved in tumor cell surveillance and killing. They are stimulated by a broad range of small, phosphorus-containing antigens (phosphoantigens) as well as by the bisphosphonates commonly used in bone resorption therapy, such as pamidronate and risedronate. Here, we report the activation of γδ T cells by a broad range of bisphosphonates and develop a pharmacophore model for γδ T cell activation, in addition to using a comparative molecular similarity index analysis (CoMSIA) approach to make quantitative relationships between γδ T cell activation by bisphosphonates and their three-dimensional structures. The CoMSIA analyses yielded R2 values of ∼0.8−0.9 and q2 values of ∼0.5−0.6 for a training set of 45 compounds. Using an external test set, the activities (IC50 values) of 16 compounds were predicted within a factor of 4.5, on average. The CoMSIA fields consisted of ∼40% hydrophobic, ∼40% electrostatic, and ∼20% steric ...

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Alison Colantino

Papers

Quantitative Structure-Activity Relationships for γδ T Cell Activation by Bisphosphonates