Article
Author: Jiang, Tao  ; Glatthar, Ralf  ; André, Cédric  ; Boulay, Thomas  ; Pei, Wei  ; Han, Dong  ; Mutnick, Daniel  ; Betschart, Claudia  ; Hemmig, Rene  ; Feifel, Roland  ; Maginnis, Jillian  ; Michellys, Pierre-Yves  ; Ruzzante, Giulia  ; Deane, Jonathan  ; Syka, Peter  ; Zhang, Guobao  ; Hawtin, Stuart  ; Zipfel, Géraldine  ; Alper, Phil  ; Junt, Tobias  ; Faller, Michael  ; Knoepfel, Thomas  ; Cheng, Dai  ; Zink, Florence  ; Zhang, Yi 
Toll-like receptor (TLR) 7 and TLR8 are endosomal sensors of the innate immune system that are activated by GU-rich single stranded RNA (ssRNA). Multiple genetic and functional lines of evidence link chronic activation of TLR7/8 to the pathogenesis of systemic autoimmune diseases (sAID) such as Sjögren's syndrome (SjS) and systemic lupus erythematosus (SLE). This makes targeting TLR7/8-induced inflammation with small-molecule inhibitors an attractive approach for the treatment of patients suffering from systemic autoimmune diseases. Here, we describe how structure-based optimization of compound 2 resulted in the discovery of 34 (MHV370, (S)-N-(4-((5-(1,6-dimethyl-1H-pyrazolo[3,4-b]pyridin-4-yl)-3-methyl-4,5,6,7-tetrahydro-1H-pyrazolo[4,3-c]pyridin-1-yl)methyl)bicyclo[2.2.2]octan-1-yl)morpholine-3-carboxamide). Its in vivo activity allows for further profiling toward clinical trials in patients with autoimmune disorders, and a Phase 2 proof of concept study of MHV370 has been initiated, testing its safety and efficacy in patients with Sjögren's syndrome and mixed connective tissue disease.