T-cell acute lymphoblastic leukemia (T-ALL) is an aggressive form of blood cancer. It is a type of a broader category of leukemia called acute lymphoblastic leukemia (ALL). T-cell acute lymphoblastic leukemia accounts for approximately 12% - 15% of ALL cases in children and nearly 25% of cases in adults (
1). One of the targets to limit the proliferation of these cells is the inhibition of inosine monophosphate dehydrogenase by reducing the synthesis of DNA nucleotides (
2). Inosine monophosphate dehydrogenase (IMPDH) is one of the most important enzymes in the life cycle of lymphocytes, catalyzing the NAD-dependent conversion of inosine 5’-monophosphate to xanthine monophosphate, which is the rate-limiting step in de novo guanine nucleotide biosynthesis (
3). The proliferation of T- and B-lymphocytes mainly depends on the presence of a large number of guanine nucleotides. Therefore, the enzyme is upregulated in these cells to support this activity (
4).
Lymphocytes cannot use the salvage pathway to provide purines for their life cycle, and they only rely on the de novo synthesis of purines. Consequently, inhibiting IMPDH is one of the best choices to suppress their proliferation. The synthesis of enzyme antagonists is a subject of many studies on treating immune system disorders, such as graft-versus-host disease (GvHD) and cancers (
5). One of the well-known active ingredients that inhibit IMPDH is mycophenolic acid, which is found in the formulation of various medicines, such as mycophenolate mofetil (
Figure 1).
This medicine is commonly used as immunosuppressive in the prophylaxis of allograft rejection in transplant recipients (
6-
8) and autoimmune diseases, such as Crohn’s (
9), lupus (
10), and anticancer agents (
11). Mycophenolic acid reduces the guanosine triphosphate (GTP) pool resulting in a cycle arrest mainly in G0/G1 phase, although some blockage in the S phase has also been reported (
12,
13). However, a high dose of MPA, more than 1 g/day, is needed to prevent transplant rejection in patients, and this dose might cause many serious side effects, including anemia (
14), gastrointestinal bleeding (
15), progressive multifocal leukoencephalopathy (
16), and flashing.
Proteolysis-targeting chimera is a bifunctional molecule with two attached parts via a linker, the head has a ligand to recognize the targeted protein to be degraded, and the other has an E3 ligase ligand (
17). The proximity of the protein and E3 ligase can induce the ubiquitination of the protein in lysine, serine, or threonine residues (
18) and leads to degradation through the ubiquitin-proteasome system (UPS). After that, the PROTAC is intact and ready to target another protein. Therefore, in a sub-stoichiometric amount, a biological response is achieved with less total drug concentration (
17). Selectivity, longer-acting activity, and less off-target side effects of this technology in comparison with the traditional inhibition of proteins make it a promising approach to drug discovery (
19). Since the first introduction by Crews and coworkers in 2001, the PROTACs have been broadly applied for degrading various proteins, such as Sirtuin 2 (
20), bromodomain and extra-terminal (BET) (
21), TANK-binding kinase 1 (TBK1) (
22), B-cell lymphoma 6 (BCL6) (
23), and estrogen-related receptor α (
24). To use the advantages of the PROTAC technique, we have synthesized novel compounds to degrade the IMPDH by the proteasome system. By this means, alkynylated MPA was coupled with pomalidomide-derived azide via click reaction. In other compounds, MPA and pomalidomide-derived azides were synthesized and attached by different lengths of alkynylated glycol linkers through a copper-catalyzed click cycloaddition reaction. The versatile ligands were chosen to strengthen the interaction and minimize the proximity of E3 ligase and IMPDH (
Figure 2).
On the other hand, the presence of triazole moiety in the framework of a molecule generally provides some advantages, including increasing water solubility, strengthening interaction with receptors through the addition of hydrogen bond acceptor to structure, raising the rigidity of PROTACs to fix the molecule in a receptor (
20), and broad functional groups tolerance of click chemistry in the synthesis of PROTACs.