SUN-190 GFB-887, a small molecule inhibitor of TRPC5, protects against podocyte injury and attenuates proteinuria in models of FSGS

Abstract

Focal segmental glomerulosclerosis (FSGS) is a rare podocytopathy with a high likelihood of progression to end stage renal disease. The Ca2+-permeable transient receptor potential canonical 5 (TRPC5) channel is a critical mediator of proteinuria in FSGS. Activation of the TRPC5 pathway in podocytes culminates in activation of Rac1, which is the primary driver of proteinuria in many forms of familial and sporadic FSGS. Inhibition of TRPC5 channel activity has been shown to protect against proteinuria and podocyte loss in AT1R transgenic and Dahl salt-sensitive rats. We performed high throughput screening of a structurally diverse compound collection followed by lead optimization for the development of several potent TRPC5 inhibitors. We characterized TRPC5 inhibitors in vitrousing a mouse podocyte cell line and podocyte injury models derived from human inducible pluripotent stem cells (hiPSC), and in two in vivomodels of FSGS, the unilaterally nephrectomized deoxycorticosterone acetate (DOCA)-salt rat model and the puromycin aminonucleoside nephrosis (PAN) rat model Here we report the identification of GFB-887, a potent, selective and orally bioavailable small molecule inhibitor of TRPC5. Potency and selectivity across TRP channels were determined using FLIPR based assays and electrophysiology. We show that TRPC5 inhibition protects against loss of stress fibers induced by protamine sulfate, a known activator of TRPC5, and restores stress fibers in podocytes after knockdown of synaptopodin. We further show that inhibition of TRPC5 suppresses pathogenic podocyte motility in a scratch assay. Finally, we demonstrate that inhibition of TRPC5 attenuates proteinuria in hypertension-induced FSGS in DOCA-salt rat model without altering blood pressure, and in non-hypertensive FSGS in the PAN rat model suggesting direct glomerular protection in vivo. We have identified GFB-887 as a new selective small molecule inhibitor of TRPC5 for the treatment of proteinuria in FSGS