Abstract

Rare, or orphan, diseases are conditions afflicting a small subset of people in a population. Although these disorders collectively pose significant health care problems, drug companies require government incentives to develop drugs for rare diseases due to extremely limited individual markets. Computer-aided drug repositioning, i.e., finding new indications for existing drugs, is a cheaper and faster alternative to traditional drug discovery offering a promising venue for orphan drug research. Structure-based matching of drug-binding pockets is among the most promising computational techniques to inform drug repositioning. In order to find new targets for known drugs ultimately leading to drug repositioning, we recently developed eMatchSite, a new computer program to compare drug-binding sites. In this study, eMatchSite is combined with virtual screening to systematically explore opportunities to reposition known drugs to proteins associated with rare diseases. The effectiveness of this integrated approach is demonstrated for a kinase inhibitor, which is a confirmed candidate for repositioning to synapsin Ia. The resulting dataset comprises 31,142 putative drug-target complexes linked to 980 orphan diseases. The modeling accuracy is evaluated against the structural data recently released for tyrosine-protein kinase HCK. To illustrate how potential therapeutics for rare diseases can be identified, we discuss a possibility to repurpose a steroidal aromatase inhibitor to treat Niemann-Pick disease type C. Overall, the exhaustive exploration of the drug repositioning space exposes new opportunities to combat orphan diseases with existing drugs. DrugBank/Orphanet repositioning data are freely available to research community at https://osf.io/qdjup/.

Highlights

  • Repositioning drugs to treat conditions for which they were not originally intended is an emerging strategy offering a faster and cheaper route to develop new treatments compared to traditional drug discovery.[1]

  • Rational repositioning of existing drugs is expected to play a major role in the development of treatments for orphan diseases

  • We demonstrate that combining eMatchSite with structure-based virtual screening enhances the accuracy of the detection of similar binding pockets

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Summary

INTRODUCTION

Repositioning drugs to treat conditions for which they were not originally intended is an emerging strategy offering a faster and cheaper route to develop new treatments compared to traditional drug discovery.[1]. Developed to treat hypertension and angina pectoris in the 1980s, it was later repurposed to erectile dysfunction and pulmonary arterial hypertension.[4] Other examples are amantadine and memantine. The former was introduced in the 1960s as a prophylactic agent in respiratory infections.[5] A few years later, a patient with Parkinson’s disease experienced a dramatic improvement in her symptoms during the daily administration of amantadine for influenza prophylaxis.[6] This anecdotal observation stimulated research on using amantadine and other members of the aminoadamantane class of molecules to treat neurological diseases. Structure-based virtual screening holds a significant promise to systematically explore the drug repositioning space at the Example of a validated candidate for repositioning systems level

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