Overactivation of the mineralocorticoid receptor (MR) is involved in many diseases, such as hypertension, kidney disease, and heart failure. Thus, MR antagonists (MRAs) are expected to be beneficial to patients with these diseases. In order to identify novel nonsteroidal MRAs that overcome the issues of already marketed steroidal MRAs, we searched for new compounds guided by our hypothesis that T-shaped compounds with a hydrophobic core structure, two polar functional groups at both extremities able to interact with MR, and a bulky substituent that can interfere with the folding of the C-terminal helix 12 may exhibit antagonist activity toward MR. We discovered that the novel 1,4-benzoxazin-3-one derivative 19 (apararenone: MT-3995) acted as a highly selective and potent nonsteroidal MRA. Apararenone exhibited a more potent antihypertensive and organ-protective activity than steroidal MRA eplerenone in a primary aldosteronism rat model obtained by infusing aldosterone in uninephrectomized rats.

中文翻译：

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发现 Apararenone (MT-3995) 作为一种高度选择性、有效的新型非甾体盐皮质激素受体拮抗剂

盐皮质激素受体 (MR) 的过度激活与许多疾病有关，例如高血压、肾病和心力衰竭。因此，预计 MR 拮抗剂 (MRA) 将对患有这些疾病的患者有益。为了确定能够克服已上市甾体 MRA 问题的新型非甾体 MRA，我们根据我们的假设寻找新的化合物，即具有疏水核心结构的 T 形化合物，两端的两个极性官能团能够与 MR 相互作用，并且可以干扰C-末端螺旋12折叠的庞大取代基可能表现出对MR的拮抗活性。我们发现新型 1,4-benzoxazin-3-one 衍生物19(apararenone: MT-3995) 作为一种高度选择性和有效的非甾体 MRA。在通过在未切除肾的大鼠中注入醛固酮获得的原发性醛固酮增多症大鼠模型中，Apararenone 表现出比甾体 MRA 依普利酮更有效的抗高血压和器官保护活性。