4.7 Review

The pharmacology of the TMEM16A channel: therapeutic opportunities

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Polymodal Control of TMEM16x Channels and Scramblases

Emilio Agostinelli et al.

Summary: The TMEM16A/anoctamin-1 calcium-activated chloride channel plays a vital role in controlling vascular tone and epithelial ion transport. It is a founding member of a protein family with diverse functions, and its regulation is influenced by calcium signaling as well as various other cellular factors.

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Zafirlukast inhibits the growth of lung adenocarcinoma via inhibiting TMEM16A channel activity

Sai Shi et al.

Summary: Lung cancer has the highest mortality rate among cancers worldwide and lacks effective treatments. Through screening of marketed drugs, we identified Zafirlukast (ZAF), a drug approved for asthma treatment, as an inhibitor of the TMEM16A channel. ZAF demonstrated the ability to inhibit the proliferation and migration of lung adenocarcinoma cells and showed promising results in mouse models. It represents a potential therapeutic option for lung adenocarcinoma.

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Inhibition mechanism of the chloride channel TMEM16A by the pore blocker 1PBC

Andy K. M. Lam et al.

Summary: In this study, the authors used cryo-EM and electrophysiology to reveal the mechanism of TMEM16A inhibition by the pore blocker 1PBC. They found that 1PBC binds to a pocket located externally to the neck region of the channel, stabilizing an open-like conformation and affecting the gating mechanism. These findings provide important insights for the design of new and potent TMEM16A modulators.

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The Ca2+-gated channel TMEM16A amplifies capillary pericyte contraction and reduces cerebral blood flow after ischemia

Nils Korte et al.

Summary: A small increase in cytoplasmic calcium concentration in pericytes activates chloride efflux through the TMEM16A channel, leading to depolarization of the cell and opening of voltage-gated calcium channels. Inhibition of TMEM16A slows down ischemia-induced increase in calcium concentration, reduces pericyte death, and improves cerebrovascular reperfusion in a rodent stroke model. Altered TMEM16A expression is implicated in poor patient recovery from ischemic stroke, suggesting its potential as a therapeutic target.

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Chloride transport modulators as drug candidates

Alan S. Verkman et al.

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TMEM16A channel upregulation in arterial smooth muscle cells produces vasoconstriction during diabetes

M. Dennis Leo et al.

Summary: This study demonstrates the involvement of TMEM16A channels in vascular dysfunction during type 2 diabetes. Higher levels of TMEM16A message, protein, and currents were observed in smooth muscle cells of resistance-size arteries during T2D. Arteries from T2D mice showed increased vasoconstriction compared to non-diabetic mice, a response that was abolished in TMEM16A smKO mice. Additionally, a decrease in Akt2 function was found to stimulate TMEM16A expression in arterial smooth muscle cells, leading to vasoconstriction during T2D.

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Xuan Zhang et al.

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Identification of evodiamine and rutecarpine as novel TMEM16A inhibitors and their inhibitory effects on peristalsis in isolated Guinea-pig ileum

Zhijun Zhao et al.

Summary: In this study, evodiamine and rutecarpine extracted from Evodia rutaecarpa were identified as novel TMEM16A inhibitors with inhibitory effects on intestinal peristalsis. They suppressed TMEM16A Cl- currents and significantly decreased peristalsis in isolated guinea-pig ileum, supporting the regulatory effect of TMEM16A modulators on gastrointestinal motility.

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The Ca2+-activated chloride channel ANO1/TMEM16A: An emerging therapeutic target for epithelium-originated diseases?

Yani Liu et al.

Summary: ANO1 gene encodes a Ca2+ activated Cl- channel critical for physiological functions, with abnormal expression or dysfunction linked to various diseases. The lack of specific modulators hinders the validation of ANO1 as a therapeutic target.

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Anoctamin 1 antagonism potentiates conventional tocolytic-mediated relaxation of pregnant human uterine smooth muscle

Shunsuke Hyuga et al.

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TMEM16A Protein: Calcium-Binding Site and its Activation Mechanism

Wanying Ji et al.

Summary: This review discusses the calcium sensing sites and activation properties of TMEM16A, helping to understand the structure-function relationship of TMEM16A and providing insights for molecular design targeting the TMEM16A channel.

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Mechanism of pore opening in the calcium-activated chloride channel TMEM16A

Andy K. M. Lam et al.

Summary: The anion channel TMEM16A is activated by intracellular Ca2+ in a highly cooperative process. Authors combine electrophysiology and autocorrelation analysis to observe the sampling of intermediate conformations during gating.

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Specific PIP2 binding promotes calcium activation of TMEM16A chloride channels

Zhiguang Jia et al.

Summary: The study demonstrates that specific binding of PIP2 to TMEM16A can lead to spontaneous opening of the permeation pathway in the Ca2+-bound state, predicting an activated state consistent with mutagenesis and functional data. This provides a basis for understanding the interplay of multiple signals in controlling TMEM16A channel function.

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A small molecule inhibitor of the chloride channel TMEM16A blocks vascular smooth muscle contraction and lowers blood pressure in spontaneously hypertensive rats

Onur Cil et al.

Summary: Pharmacological inhibition of TMEM16A can effectively reduce blood pressure in vascular smooth muscle cells in vitro and produce significant effects in spontaneously hypertensive rats.

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Coronary hypercontractility to acidosis owes to the greater activity of TMEM16A/ANO1 in the arterial smooth muscle cells

Pengmei Guo et al.

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Summary: ANO1, also known as TMEM16A, is the molecular basis of calcium-activated chloride channels widely expressed in mammalian cells. It could be a potential new drug target for the treatment of cancer, pain, diarrhea, hypertension, and asthma.

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Theaflavin binds to a druggable pocket of TMEM16A channel and inhibits lung adenocarcinoma cell viability

Sai Shi et al.

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Emerging Modulators of TMEM16A and Their Therapeutic Potential

Anqi Hao et al.

Summary: Calcium-activated chloride channels (CaCCs) rely on calcium activation to function, with TMEM16A identified as the molecular basis of CaCCs. TMEM16A is widely expressed in various cells and controls basic physiological functions, but abnormal function may lead to various diseases.

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An outer-pore gate modulates the pharmacology of the TMEM16A channel

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Summary: Research has found that TMEM16A channels are sensitive to the extracellular modulator A9C in the presence of intracellular Ca2+, but insensitive when intracellular Ca2+ is omitted. This conclusion highlights a critical site for pharmacological intervention and reveals an aspect of Ca2+ gating in the TMEM16A channel.

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