In an effort to find novel chemical series as antifibrinolytic agents, we explore α-phenylsulfonyl-α-spiropiperidines bearing different zinc-binding groups (ZBGs) to target those metalloproteinases involved in the fibrinolytic process: MMP3 and MMP10. Surprisingly, all these new chemical series were inactive against these metalloproteinases; however, several new molecules retained the antifibrinolytic activity in a phenotypic functional assay using thromboelastometry and human whole blood. Further optimization led to compound 38 as a potent antifibrinolytic agent in vivo, three times more efficacious than the current standard-of-care (tranexamic acid, TXA) at 300 times lower dose. Finally, in order to decipher the underlying mode-of-action leading to this phenotypic response, an affinity-based probe 39 was successfully designed to identify the target involved in this response: a potentially unknown mechanism-of-action in the fibrinolytic process.

中文翻译：

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表型筛选发现新型化学系列作为高效抗出血药

为了找到新的化学系列作为抗纤维蛋白溶解剂，我们探索了带有不同锌结合基团（ZBGs）的α-苯基磺酰基-α-螺哌啶，以靶向那些参与纤维蛋白溶解过程的金属蛋白酶：MMP3和MMP10。出乎意料的是，所有这些新化学系列均对这些金属蛋白酶没有活性。然而，在使用血栓弹力测定法和人全血的表型功能测定中，一些新分子保留了抗纤维蛋白溶解活性。进一步的优化导致化合物38在体内作为一种有效的抗纤维蛋白溶解剂，在低300倍剂量的情况下，其功效比目前的护理标准（氨甲环酸，TXA）高三倍。最后，为了破译导致这种表型反应的潜在作用方式，使用了基于亲和力的探针成功设计了39种抗体来识别参与此反应的靶标：纤溶过程中潜在的未知作用机制。