Table 1.
Small molecules targeting the unfolded protein response (UPR) pathway for amyotrophic lateral sclerosis (ALS) treatment.
Small molecule | Molecular target | Model | Experimental evidence | Stage | References |
---|---|---|---|---|---|
Salubrinal | Block eIF2α dephosphorylation | SOD1G93A mice | Alleviation of disease manifestations and delayed progression | Preclinical | Saxena et al. (2009) |
Caenorhabditis elegans/zebrafish expressing TDP-43G348C | Response to neurotoxicity through reduction of ER stress. Rescue of the motor phenotype | Vaccaro et al. (2013) | |||
Neuro2a cells expressing SOD1G85R/SOD1G93A | Protects cells by suppressing the UPR that propagates as a death signal | Oh et al. (2008) | |||
Arimoclomol | Coinducer of heat shock proteins | SOD1G93A mice | Improvement of muscle function and motor neuron(MN) survival | Fails phase III clinical trial | Kieran et al. (2004) |
Kalmar et al. (2008) | |||||
ALS patients | Phase III clinical trial for 245 patients with ALS | https://clinicaltrials.gov/ct2/show/NCT03491462 | |||
PRE-084 | Sigma-1 receptor agonist | SOD1G93A mice | Improvement of MN function | Preclinical | Mancuso et al. (2012) |
Functional preservation of MNs and an increase in the number of surviving MNs | Gaja-Capdevila et al. (2021) | ||||
Zebrafish expressing TDP-43G348C | Restoration of motor performance and mitochondrial respiration | Lasbleiz et al. (2022) | |||
Sephin1 | Selective inhibitor of GADD34 | SOD1G93A mice | Prevents motor deficits, motor neuron loss and molecular defects | Phase II clinical trial | Das et al. (2015) |
ALS patients | Treatment combining Riluzole and IFB-088 (sephin1) in bulbar-onset ALS | https://clinicaltrials.gov/ct2/show/NCT055080742 | |||
Guanabenz | Selective inhibitor of GADD34 | SOD1G93A mice | Attenuation of ER stress and mitochondrial stress. Delayed disease onset and extended lifespan in SOD1 G93A mice. | Phase II clinical trial | Jiang et al. (2014) |
Wang et al. (2014) | |||||
Caenorhabditis elegans/zebrafish expressing TDP-43G348C | Response to neurotoxicity through reduction of ER stress. | Vaccaro et al. (2013) | |||
Rescue of the motor phenotype | |||||
ALS patients | 200 patients within 18 months of onset of symptoms | Dalla Bella et al. (2021) | |||
GSK2606414 | Inhibit kinase domain of PERK | TDP-43 expressing Drosophila | Dramatic mitigation of TDP-43-induced climbing dysfunction | In vivo study | Kim et al. (2014) |
C9ORF72 expressing Drosophila | Inhibition of neurodegeneration in Drosophila | Zhang et al. (2018) | |||
Cyclopiazonic acid | Specific inhibitor of SERCA | Motor neuron cultures from SOD1G93A mice | Helps maintain cellular ER homeostasis by suppressing ER calcium uptake and inducing UPR | In vitro study | Lautenschlager et al. (2013) |