Bitopic muscarinic agonists and antagonists and uses thereof: a patent evaluation of US20160136145A1.

INTRODUCTION: Bitopic M ligands, that is, ligands that interact both with the ortho- and allosteric binding sites of the M receptor subtypes, hold great potential as novel selective for muscarinic acetylcholine (M) ligands for several therapeutic applications. Areas covered: The patent application describes a set of compounds based on the neurotransmitter acetylcholine applying the Schulman-model for M ligands comprising heterocyclic (often quaternary) amines and a benzene ring (often as benzoic acid esters) to act as bitopic ligands. The compounds claimed hold functional selectivity and are supposed to be therapeutically applied as neuromuscular blocking agents, in asthma as well as CNS diseases. In vitro evaluations of selected compounds supported bitopic binding and some degree of functional selectivity was observed - albeit no selectivity was observed in binding studies. Expert opinion: The quaternary amine structure of the compounds claimed will prohibit penetration into the CNS and their ester structure will lead to significant metabolic instability which will hamper therapeutic applications for many indications. Furthermore, high affinity and subtype selectivity with regard to binding affinity which is observed for bitopic and allosteric ligands in the current literature is not observed for the compounds described in the patent.