张雪, 冯雅煊, 张柳, 孙璐, 贺慧宁. 靶向蛋白降解技术在中枢神经系统疾病治疗中的应用进展J. 药学学报, 2025, 60(11): 3318-3329. DOI: 10.16438/j.0513-4870.2025-0804
引用本文: 张雪, 冯雅煊, 张柳, 孙璐, 贺慧宁. 靶向蛋白降解技术在中枢神经系统疾病治疗中的应用进展J. 药学学报, 2025, 60(11): 3318-3329. DOI: 10.16438/j.0513-4870.2025-0804
ZHANG Xue, FENG Ya-xuan, ZHANG Liu, SUN Lu, HE Hui-ning. Progress in targeted protein degradation for central nervous system diseases therapyJ. Acta Pharmaceutica Sinica, 2025, 60(11): 3318-3329. DOI: 10.16438/j.0513-4870.2025-0804
Citation: ZHANG Xue, FENG Ya-xuan, ZHANG Liu, SUN Lu, HE Hui-ning. Progress in targeted protein degradation for central nervous system diseases therapyJ. Acta Pharmaceutica Sinica, 2025, 60(11): 3318-3329. DOI: 10.16438/j.0513-4870.2025-0804

靶向蛋白降解技术在中枢神经系统疾病治疗中的应用进展

Progress in targeted protein degradation for central nervous system diseases therapy

  • 摘要: 中枢神经系统(central nervous system, CNS) 疾病药物研发面临血脑屏障(blood-brain barrier, BBB) 通透性低和以聚集状病理性蛋白为靶药物开发难度大等瓶颈。靶向蛋白降解技术(targeted protein degradation, TPD) 通过泛素-蛋白酶体系统或溶酶体途径选择性清除致病蛋白, 为CNS疾病治疗提供了新的策略。相较于传统小分子药物, 靶向蛋白降解药物采用事件驱动型作用机制, 可降解β-淀粉样蛋白等“不可成药”靶点, 且亚化学计量浓度即可生效, 有望显著降低CNS递送难度。其药效学与药代动力学的解耦特性进一步降低了脱靶风险, 尤其适用于CNS这一对药物安全性要求极高的治疗领域。目前已有3款用于CNS疾病治疗的靶向蛋白降解药物进入临床试验阶段。本综述详细阐述了基于不同降解系统的TPD技术在CNS疾病治疗中的应用进展, 系统地分析了各自技术的优势和局限性, 并对TPD应用于CNS疾病治疗面临的共性挑战和通用优化策略展开探讨, 以期为TPD技术在CNS疾病治疗中的深入应用提供新的启示。

     

    Abstract: The development of therapeutic interventions for central nervous system (CNS) diseases poses significant challenges. These challenges are primarily attributable to the limitations imposed by the blood-brain barrier (BBB) permeability and the inherent complexity of protein aggregates. Targeted protein degradation (TPD) technology selectively removes pathogenic proteins through the ubiquitin-proteasome system or lysosomal pathways, offering a new strategy for CNS treatment. In comparison with conventional small molecule drugs, TPD employs an event-driven mode of action, capable of degrading β-amyloid and other "undruggable" targets, and demonstrating efficacy at sub-chemometric doses. This is anticipated to markedly reduce the complexity of CNS delivery. The disconnecting of pharmacodynamics and pharmacokinetics further reduces the risk of off-targeting, making it particularly suitable for the CNS, a therapeutic area that requires a high degree of drug safety. Three CNS degraders have already entered clinical trials. This review comprehensively elaborates on the application progress of TPD technologies based on different degradation systems in the treatment of CNS diseases, systematically analyzes the advantages and limitations of each technology, and discusses the common challenges and general optimization strategies for TPD application in CNS disease therapy. The findings aim to provide new insights for the in-depth application of TPD technology in the treatment of CNS diseases.

     

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