RT Journal Article SR Electronic T1 Position 5.46 of the serotonin 5-HT2A receptor contributes to a species-dependent variation for the 5-HT2C agonist (R)-9-ethyl-1,3,4,10b-tetrahydro-7-trifluoromethylpyrazino[2,1-a]isoindol-6(2H)-one: impact on selectivity and toxicological evaluation JF Molecular Pharmacology JO Mol Pharmacol FD American Society for Pharmacology and Experimental Therapeutics SP mol.109.059204 DO 10.1124/mol.109.059204 A1 Keith J Miller A1 Ginger Y Wu A1 Jeffrey G Varnes A1 Paul Levesque A1 Julia Li A1 Danshi Li A1 Jeffrey A Robl A1 Karen A Rossi A1 Dean A Wacker YR 2009 UL http://molpharm.aspetjournals.org/content/early/2009/09/18/mol.109.059204.abstract AB Successful development of 5-HT2C agonists requires selectivity vs. the highly homologous 5-HT2A receptor as agonism at this receptor can result in significant adverse events. (R)-9-ethyl-1,3,4,10b-tetrahydro-7-trifluoromethylpyrazino[2,1-a]isoindol-6(2H)-one (compound 1) is a potent 5-HT2C agonist exhibiting selectivity over the human 5-HT2A receptor. Evaluation of the compound at the rat 5-HT2A receptor however, revealed potent binding and agonist functional activity. The physiological consequence of this higher potency was the observation of a significant increase in blood pressure in conscious telemeterized rats, which could be prevented by ketanserin. Docking of compound 1 in a homology model of the 5-HT2A receptor indicated a possible binding mode in which the ethyl group at the 9-position of the molecule was oriented toward position 5.46 of the 5-HT2A receptor. Within the human 5-HT2A receptor position 5.46 is S242 however in the rat 5-HT2A receptor it is A242, suggesting that the potent functional activity in this species resulted from the absence of the steric bulk provided by the -OH moiety of the Ser in the human isoform. We confirmed this hypothesis utilizing site directed mutagenesis both through the mutation of the human receptor S242→A as well as the rat receptor A242→S followed by radioligand binding and second messenger studies. Additionally we attempted to define the space allowed by the alanine by evaluating compounds with larger substitutions at the 9-position. The data indicate position 5.46 contributed to the species difference in 5-HT2A receptor potency observed for a pyrazinoisoindolone compound resulting in the observation of a significant cardiovascular safety signal.The American Society for Pharmacology and Experimental Therapeutics