The polygenic nature of neurological and psychiatric syndromes and the significant impact of environmental factors on the underlying developmental, homeostatic, and neuroplastic mechanisms suggest that an efficient therapy for these disorders should be a complex one. Pharmacological interventions with drugs selectively influencing the epigenetic landscape (epidrugs) allow one to hit multiple targets, therefore, assumably addressing a wide spectrum of genetic and environmental mechanisms of central nervous system (CNS) disorders.
Epigenetic Modification/ Pathway (Figure 2) |
Target Domain and Mechanism of Action |
Abbreviation | Examples of Approved Compounds |
Primary Target Pathology |
---|---|---|---|---|
DNA methylation | DNA methyltransferase inhibitors |
DNMTis | 5-azacytidine, decitabine [21], hydralazine [22], and procainamide [23] |
myeloid neoplasms, malaria, and cardiovascular diseases |
DNA demethylation | Ten-eleven translocation (TET) proteins inhibitors |
TETis | - | |
Histone acetylation | Histone acetyltransferase inhibitors |
HATis | anacardic acid, curcumin, garcinol, catechin, and thiazole + bistubstrate inhibitors [24] |
antimicrobial therapy, anti-inflammatory therapy, and cancer |
Histone deacetylation | Histone deacetylases inhibitors |
HDACis | vorinostat, panobinostat (withdrawn by FDA in 2022), romidepsin (withdrawn by FDA in 2021), belinostat, chidamide (tucidinostat) [25], entinostat (granted breakthrough therapy status by the FDA in 2013), valproic acid, magnesium salt of valproic acid, phenylbutyric acid [2], nicotinamide (affirmed as GRAS (Generally Recognized as Safe) by the FDA in 2005 as a direct human food ingredient) [26], and carbamazepine [27] |
lymphomas, myeloid neoplasms, other types of cancer, epilepsy, and dietary supplement |
Histone methylation | Histone methyltransferase inhibitors |
HMTis | - | |
Lysine-specific histone methyltransferases inhibitors |
HKMTis | phenelzine [28], tranylcypromine [29], and tazemetostat [30] |
major depression, anxiety, and epithelioid sarcoma | |
Histone demethylation | Histone demethylase inhibitors |
HDMis | deferiprone [31] and deferasirox [32] |
treatment of iron overload in thalassemia and major or long-term blood transfusions |
Lysine-specific histone demethylases inhibitors |
LSDis/ KDMis |
- | ||
Protein arginine methylation |
Protein arginine methyltransferase inhibitors |
PRMTis | - | |
Protein arginine citrullination (deamination) |
Protein arginine deiminase inhibitors |
PADis | streptomycin and methotrexate [33] |
antimicrobial therapy, chemotherapy agent, and immune system suppressant |
Phosphorylation | Histone kinase inhibitors | - | ruxolitinib, pacritinib, pazopanib, vandetanib, lapatinib, and erlotinib [25] |
myelofibrosis, atopic dermatitis, vitiligo, renal cell carcinoma, soft tissue sarcoma, medullary thyroid cancer, breast cancer, non-small cell lung cancer, and pancreatic cancer |
Ubiquitination/ deubiquitination |
Inhibitors of ubiquitin signaling modulators (proteasome, target E1, E3, or DUB modulators) | - | bortezomib, carfizomib, ixazomib, thalidomide, lenalidomide, and pomalidomide [34] |
multiple myeloma, mantel cell lymphoma, and myelodysplastic syndromes |
Poly(ADP-ribosyl)ation (PARylation) |
Poly(ADP-ribose) polymerase (PARP1) inhibitors | PARPis | olaparib, niraparib, rucaparib, and talazoparib [35] |
different types of cancer |
Others | Inhibitors of proteins binding to acetylated histones |
PAHis | - | |
Bromodomain and Extra terminal motif proteins (BETs) inhibitors |
BETis | dinaciclib (granted orphan drug status by the FDA in 2011) [36] |
different types of cancer | |
Inhibitors of proteins binding to methylated histones |
PMHis | - | ||
Regulation by non-coding RNA | ncRNAs | patisiran, givosiran, and pegatanib [37] |
familial amyloid polyneuropathy, hepatic porphyria, and macular degeneration |
Epidrug Cluster | Instances | Some PK/PD Features | Representative Preclinical and Clinical Studies |
---|---|---|---|
First-generation DNMTis | 5-azacytidine 5-aza-dioxycytidine |
antimetabolites | potentiation of neurotoxic effects in the culture of dopamine neurons [43] |
Second-generation DNMTis | hydralazine zebularine RG108 procainamide |
selective inhibition of DNMT isoforms and inhibition of DNMTs and cytidine deaminase |
interference with β-amyloid production [44]; enhancement of neurotoxicity [45]; and suppression of apoptosis in motor neurons [46] |
First-generation HDACis |
trichostatin A vorinostat (SAHA) romidepsin |
reversible binding to Zn2+ in the HDAC catalytic center selective for HDAC I, II class enzymes |
prevention of stress-related behavioral changes in mice [47,48] |
Second-generation HDACis |
belinostat panobinostat benzamides (e.g., MS-275) carboxylic acid derivatives (e.g., valproic acid) |
improved bioavailability and less toxicity | adjuvant therapy for glioma [49]; prevention of stress-related behavioral changes in mice, antidepressant effect [50,51]; and reduction in anxiety and panic attacks in humans [52,53,54] |
HATis | exifone | genome stabilization | neuroprotection [55] |
HMTis | tazemetostat JNJ-64619178 |
duality of action: the effect is determined by the position of the methylated lysine |
therapy for glioma [56] |
LSDis | tranylcypromine ORY-1001 | FAD-dependent inhibition (similar to inhibition of homologous LSD1 and LSD2 monoamine oxidase MAO) | change in Bdnf transcription, antidepressant effect in mice [57]; and alteration of Bdnf transcription and memory suppression [58,59] |
BETis | RVX-208 JQ-1 diazepine derivatives |
high-affinity BET inhibitors (antitumor and expression-regulating ApoA1 and HDL activity) |
positive effect on neurogenesis in vitro, modulation of memory and learning mechanisms in mice [60,61]; and improving cognitive performance in humans [62] |
This entry is adapted from the peer-reviewed paper 10.3390/cells12111464