Small molecule antagonist of leukocyte function associated antigen-1 (LFA-1): structure-activity relationships leading to the identification of 6-((5S,9R)-9-(4-cyanophenyl)-3-(3,5-dichlorophenyl)-1-methyl-2,4-dioxo-1,3,7-triazaspiro[4.4]nonan-7-yl)nicotinic acid (BMS-688521).
Watterson, S.H., Xiao, Z., Dodd, D.S., Tortolani, D.R., Vaccaro, W., Potin, D., Launay, M., Stetsko, D.K., Skala, S., Davis, P.M., Lee, D., Yang, X., McIntyre, K.W., Balimane, P., Patel, K., Yang, Z., Marathe, P., Kadiyala, P., Tebben, A.J., Sheriff, S., Chang, C.Y., Ziemba, T., Zhang, H., Chen, B.C., DelMonte, A.J., Aranibar, N., McKinnon, M., Barrish, J.C., Suchard, S.J., Murali Dhar, T.G.(2010) J Med Chem 53: 3814-3830
- PubMed: 20405922 
- DOI: https://doi.org/10.1021/jm100348u
- Primary Citation of Related Structures:  
3M6F - PubMed Abstract: 
Leukocyte function-associated antigen-1 (LFA-1), also known as CD11a/CD18 or alpha(L)beta(2), belongs to the beta(2) integrin subfamily and is constitutively expressed on all leukocytes. The major ligands of LFA-1 include three intercellular adhesion molecules 1, 2, and 3 (ICAM 1, 2, and 3). The interactions between LFA-1 and the ICAMs are critical for cell adhesion, and preclinical animal studies and clinical data from the humanized anti-LFA-1 antibody efalizumab have provided proof-of-concept for LFA-1 as an immunological target. This article will detail the structure-activity relationships (SAR) leading to a novel second generation series of highly potent spirocyclic hydantoin antagonists of LFA-1. With significantly enhanced in vitro and ex vivo potency relative to our first clinical compound (1), as well as demonstrated in vivo activity and an acceptable pharmacokinetic and safety profile, 6-((5S,9R)-9-(4-cyanophenyl)-3-(3,5-dichlorophenyl)-1-methyl-2,4-dioxo-1,3,7-triazaspiro-[4.4]nonan-7-yl)nicotinic acid (2e) was selected to advance into clinical trials.
Organizational Affiliation: 
Bristol-Myers Squibb Research and Development, P.O. Box 4000, Princeton, New Jersey 08543, USA. scott.watterson@bms.com