Discovery of Compound A – a selective activator of the glucocorticoid receptor with anti-inflammatory and anti-cancer activity

Ekaterina Lesovaya _, Alexander Yemelyanov, Amanda C. Swart, Pieter Swart, Guy Haegeman and Irina Budunova

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Oncotarget. 2015; 6:30730-30744. https://doi.org/10.18632/oncotarget.5078

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Ekaterina Lesovaya1, Alexander Yemelyanov2, Amanda C. Swart3, Pieter Swart3, Guy Haegeman4, Irina Budunova5

1Department of Chemical Carcinogenesis, N.N. Blokhin Russian Cancer Research Center, Moscow, Russia

2Pulmonary Division, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

3Department of Biochemistry, Stellenbosch University, Stellenbosch, South Africa

4LEGEST, University of Ghent, Ghent, Belgium

5Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

Correspondence to:

Irina Budunova, e-mail: i-budunova@northwestern.edu

Keywords: Review, compound A, selective glucocorticoid receptor activator (SEGRA), inflammation, cancer, autoimmune diseases

Received: June 05, 2015     Accepted: September 19, 2015     Published: October 02, 2015


Glucocorticoids are among the most effective anti-inflammatory drugs, and are widely used for cancer therapy. Unfortunately, chronic treatment with glucocorticoids results in multiple side effects. Thus, there was an intensive search for selective glucocorticoid receptor (GR) activators (SEGRA), which retain therapeutic potential of glucocorticoids, but with fewer adverse effects. GR regulates gene expression by transactivation (TA), by binding as homodimer to gene promoters, or transrepression (TR), via diverse mechanisms including negative interaction between monomeric GR and other transcription factors. It is well accepted that metabolic and atrophogenic effects of glucocorticoids are mediated by GR TA. Here we summarized the results of extensive international collaboration that led to discovery and characterization of Compound A (CpdA), a unique SEGRA with a proven “dissociating” GR ligand profile, preventing GR dimerization and shifting GR activity towards TR both in vitro and in vivo. We outlined here the unusual story of compound’s discovery, and presented a comprehensive overview of CpdA ligand properties, its anti-inflammatory effects in numerous animal models of inflammation and autoimmune diseases, as well as its anti-cancer effects. Finally, we presented mechanistic analysis of CpdA and glucocorticoid effects in skin, muscle, bone, and regulation of glucose and fat metabolism to explain decreased CpdA side effects compared to glucocorticoids. Overall, the results obtained by our and other laboratories underline translational potential of CpdA and its derivatives for treatment of inflammation, autoimmune diseases and cancer.

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