Development of NLRP3 inflammasome inhibitors towards Alzheimer's disease

The novel coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndromecoronavirus 2 (SARS-CoV-2). One of the pathologies associated with COVID-19 is pneumonia that quickly leadsto acute respiratory distress syndrome (ARDS)/acute lung injury (ALI) and ultimately patient death. Recentstudies suggested a critical role of the NLRP3 inflammasome, a multiprotein platform that tightly regulates theinnate immune response, in the development of ARDS/ALI in COVID-19. Dysregulation of the NLRP3inflammasome is responsible for the excessive production of pro-inflammatory interleukin (IL)-1β and IL-18, whchis involved in the uncontrolled inflammatory responses and cytokine storm. Therefore, development of NLRP3inhibitors (NLRP3is) represents a novel approach to mitigating ARDS/ALI in COVID-19 patients. Recently, wedeveloped novel small molecule NLRP3is that blocks the assembly and activation of the NLRP3 inflammasome,resulting in inhibition of IL-1β production both in vitro and in vivo. Studies in animal models of neurodegenerativedisorders demonstrated target engagement and in vivo efficacy, thus providing proof-of-concept for furtherdeveloping NLRP3is as therapeutics. Notably, our studies in experimental autoimmune encephalomyelitis (EAE),a mouse model of multiple sclerosis in which excessive inflammation is one of the prominent pathologies, showedthat the lead inhibitor reduced the severity of EAE both preventively and therapeutically. Treatment with this leadcompound also substantially reduced the type 17-helper T (Th17) cells that produce IL-17, indicating its potentialin restraining uncontrolled inflammation. The central hypothesis of this proposal is that aberrant activation ofNLRP3 inflammasome contributes to the induction of cytokine storm and development of ARDS/ALI in COVID-19, and its pharmacological inhibition with NLRP3is will prevent and reduce ARDS. With the current R01 support(R01AG058673), we have successfully developed selective NLRP3is from novel chemical scaffolds andidentified lead compounds with improved inhibitory potency and druggability. We also identified compounds asnon-selective NLRP3is to reduce the production of multiple pro-inflammatory cytokines including IL-1β, IL-6 andTNF-alpha. The goal of this supplement project is to test selective and non-selective NLRP3is as potentialtreatments for ARDS in COVID-19. Two specific aims are proposed in this application. In Aim 1, analogs basedon the newly identified chemical scaffolds will be designed and synthesized to identify candidates for in vivostudies. In Aim 2, the top candidate inhibitors will be studied to confirm the therapeutic efficacy to mitigate lunginjury in a mouse model of ARDS. The proposed research is highly significant because successful developmentof novel NLRP3is may provide promising candidates with translational potential for clinical management ofCOVID-19.