E2511, a novel small compound TrkA biased positive allosteric modulator, reinnervates cholinergic neuron and activates cholinergic functions in non‐clinical studies

Abstract Background Cholinergic innervation is particularly vulnerable in many neurodegenerative diseases associated with cognitive dysfunction, and loss of cholinergic neurons in Alzheimer’s disease (AD) is pathogenic event observed from early stage correlated with cognitive impairment. Nerve growth factor (NGF) plays a major role in the maintenance and function of cholinergic neurons, and a decrease in trophic signalling by NGF‐Tropomyosin receptor kinase A (TrkA) contributes to cholinergic neurodegeneration and cognitive decline during the course of AD. The activation of NGF‐induced trophic signal could be a promising therapy for the neurodegenerative diseases including AD, reinnervating and maintaining cholinergic neurons to functional status. E2511 was identified as a novel small compound TrkA biased positive allosteric modulator that can enhance specific trophic signal of NGF signal without induction of NGF‐like adverse effect via direct binding to TrkA in primary neuron culture and animal model. We present evidence that E2511 induced functional restoration of cholinergic neuron in animal model and rats. Method The trophic effect of E2511 on cholinergic neurons was assessed by biochemical studies such as western blotting and immunohistochemistry in human Tau P301S transgenic mice (Tau tg mice) following once‐daily oral administrations of E2511 for 3 months. E2511 TrkA downstream trophic effects on acetylcholine (ACh) were evaluated in cerebrospinal fluid (CSF) collected from cisterna magna in normal SD rats treated with once‐daily oral E2511 for 14 days, using an original LCMS method. Result Chronic administration of E2511 demonstrated reinnervative effects on cholinergic presynapses as well as a correlation with improvement of the number of cholinergic neurons in Tau tg mice. In SD rats, CSF ACh increased in a dose‐dependent manner at exposures associated with cholinergic reinnervation, with changes also correlating with increases in choline acetyltransferase mRNA level. These results suggest that CSF ACh may be a useful marker to establish the E2511 effective dose in humans. Conclusion E2511 functionally reinnervates cholinergic neuronal network in the Tau tg mice. CSF ACh increased in a dose‐related manner in SD rats. CSF ACh may be used as a pharmacodynamic marker to establish the dose showing the reinnervative effect of E2511 in clinical studies.