COMPUTATIONAL DRUG DESIGN: New Tricks for Old Drugs When cheap drugs are needed fast, resistance to all known therapies, making SOIPPA (Sequence Order Independent
which was developed by Bourne and Lei
short-cut: repurposing existing drugs for
Xie, PhD, research scientist at UCSD. For
actions in the body, the same drug may be
searched for TB proteins with structurally
similar binding sites. Then Bourne’s team
“There’s a lot of evidence now that the
issue of PLoS Computational Biology.
virtually docked the drug into these TB pro-
so-called ‘magic bullet’—one-drug to specif-
ically bind to one receptor to treat one con-
had been co-crystallized with at least one
“There’s a computer cost associated with
dition—is the exception rather than the
rule,” says Philip E. Bourne, PhD, a profes-
identify new drugs (see “Dock This” in
ly “dock” drugs into receptors’ 3-D
ing old drugs, these same in silico
explain a drug’s side effects. The algo-
Virtual Docking: Focusing on Proteins In this network representation of the TB-drugome, red nodes are FDA approved drugs and blue nodes are binding sites on TB protein receptors. An edge is drawn between drug and receptor if the drug is believed to interact with the protein. Bourne's group hypothesizes that the highly connected drugs present the most opportunity for disrupting the normal functioning of TB. Courtesy of Philip Bourne. Reprinted from Kinnings, SL, et al., 2010, The Mycobacterium tuberculosis Drugome and Its Polypharmacological Implications, PLoS Computational Biology 6(11): e1000976. doi:10.1371/journal.pcbi.1000976. Published by Simbios, the NIH National Center for Physics-Based Simulation of Biological Structures
cluster in a couple of weeks,” Bourne says. Guilt by Association: Focusing on Ligands
interesting associations experimentally.
the need for 3-D protein structures, says
we’re very excited about,” Keiser says. Michael J. Keiser, PhD. Keiser is President
them,” Bourne says. For example, two drugs
experiments, it bound to this receptor 10
for Parkinson’s disease were unexpectedly
found to bind to an important TB enzyme. goals). His team builds structure-free pro-
files of the receptors. “We forget every-
ent TB proteins, which is a potential boon
the antidepressants Prozac and Paxil (which
for preventing drug resistance. If a drug
act on neurons) also act as weak beta block-
develop a mutation that escapes the drug,
receptor, located in heart muscle and blood
Bourne says. “So what you really want is
vessels. The finding may explain why some
people who stop taking these drugs experi-
ence changes in heart rate and blood pres-
In a 2009 paper in Nature, his team
sure (“SSRI discontinuation syndrome”).
drug-target space for TB—previously only
nine TB proteins had been investigated as
drugs based on their phenotypic similarities,
potential therapeutic targets, Bourne says. human protein targets looking for novel
for example gene expression or side effect
profiles. In a 2008 paper in Science,
cover potential drugs for other diseases as
well as to predict drug side effects. For
746 marketed drugs solely based on the side
effects listed on their inserts. They found
entire set [of ligands] rather than on a one-
more than 1000 pairs of side-effect related
sites for the breast cancer drug tamoxifen
by-one basis,” Keiser says. They identified
drugs, including a couple hundred pairs that
that help explain why it can cause cardiac
6928 drug-target pairs that were statistical-
were otherwise unalike. In tests of 20 of
ly likely to bind. When they tested 30 pre-
these, they verified 13 novel drug-target
interactions. For example, rabeprazole, a
proton pump inhibitor used to treat ulcers,
was found to bind neurologic targets, includ-
Going Forward: Complementary Approaches
based approaches don’t require 3-D struc-
tures, they are limited to protein targets
that are already known to bind to drugs.
only the first step in drug repurposing.
of new drug-target pairs to explore. If even
just a few prove effective, these could pro-
vide life-saving alternatives for devastat-
ing diseases such as drug-resistant TB. ■
Ignoring structures and focusing only on ligand binding, Keiser and his colleagues identified new targets (blue) to existing drugs (gold) The drugs' known targets (violet) connected to the drugs by gray lines. Node sizes increase with number of incident edges. Reprinted with per- mission from MacMillan Publishers Ltd, Keiser, M, et al., Predicting new molecular targets for known drugs, Nature (2009).
Patient Education Handout LUMBAR DISCOGRAPHY (Disc Stimulation) The discs of the spine may develop tears in the outside lining that holds the spongy, shock absorber part of the disc inside. The disc may then become painful causing pain due to nerves that grow into the disc where there should be none. Movement then causes severe back pain due to these new nerves being compressed.
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