Inhibition of Glycogen Phosphorylase in the Context of Type 2 Diabetes, with Focus on Recent Inhibitors Bound at the Active Site

Among the variety of approaches for pharmacological intervention in T2DM, the inhibition of GP with the aim of reducing hepatic glucose output is a validated and thoroughly investigated strategy. Both the academia and health companies participate in the search of potent inhibitors, that might be suitable for long-term treatment. As several inhibitory sites have been identified for GP, interest focuses mainly on structures that can bind at either the catalytic, the allosteric, or the new allosteric sites. Glucose-based motifs and azasugars that bind at the active site constitute the most populated class of GPis. During the last two years, significant progresses have been made, since newly proposed motifs have Ki values in the low micromolar and even sub- micromolar range. Without ignoring previously reported structures, new series based on β-D-glucopyranosyl-pyrimidine, D-glucopyranosylidene-spiro-isoxazoline and D-glucopyranosylidene-spirooxathiazole motifs appear promising. A representative from this last series, with a 2-naphthyl residue was identified as the most potent GPi to date (Ki = 0.16 μM). While no inhibition was found for sulfonium analogs, D-DAB remains the best inhibitor among five and six-membered iminosugars that showed inhibitory properties toward GP. A study of glucagoninduced glucose production in primary rat hepatocytes has suggested that amylo-1,6-glucosidase inhibitors in combination with GPis may lower glucose level in T2DM. Considering the limitations found for other potent GPis binding at other sites and the complexity of pharmacological development, the potential of glucose-based GPis is still not established firmly and more tests with cells, tissues, animals are required to better establish the risks and merits of these structures, as antidiabetic drugs. Further studies might also confirm other directions where glucose-based GPis could be useful.