Druggability & Clinical Context
Druggability
Low
Score: 0.34
Druggability Analysis
Structural Tractability0.70
Key Metrics
PDB Structures:
4
Known Drugs:
1
Approved:
0
In Clinical Trials:
0
Drug Pipeline (1 compounds)
Therapeutic Areas:Major depressive disorder Anxiety disorders Post-traumatic stress disorder (PTSD) Chronic stress-related neurodegeneration Cognitive decline and dementia Neuroinflammation HPA axis-mediated disorders
Druggability Rationale: CRH (Corticotropin-Releasing Hormone) represents a challenging but promising neurotherapeutic target with low druggability, primarily due to its complex stress-response signaling mechanism. While antalarmin demonstrates initial proof-of-concept as a CRH receptor antagonist, the limited structural data and complex receptor dynamics suggest significant medicinal chemistry optimization would be required to develop clinically effective neurodegeneration therapeutics. The presence of AlphaFold structural predictions and multiple PDB structures provides a computational foundation for rational drug design, though translating these insights into selective, blood-brain barrier-penetrant small molecules remains a substantial scientific challenge.
Mechanism: CRH receptor antagonist blocking stress hormone signaling
Drug Pipeline (1 compounds)
Known Drugs:Antalarmin (clinical_trial) — stress-related disorders
Structural Data:PDB (4) ✓AlphaFold ✓Cryo-EM ✓
Binding Pocket Analysis:The CRH-R1 receptor contains an extracellular ligand-binding domain characteristic of class B GPCRs, with multiple high-resolution structures revealing a shallow peptide-recognition surface rather than a classic deep pocket; known antagonists like Antalarmin occupy an allosteric or partially-overlapping site distinct from the native CRH N-terminal binding region.
Selectivity & Safety Considerations
Selectivity is a primary concern due to CRH receptor subtypes (CRH-R1 and CRH-R2) with distinct CNS and peripheral roles; selective CRH-R1 antagonism is preferred to avoid compensatory peripheral stress responses. Off-target GPCR cross-reactivity represents a significant risk, requiring careful structure-activity relationship optimization.
Clinical Trials (10)
Relevant trials from ClinicalTrials.gov
By Phase
NA: 1 · PHASE2: 2 · PHASE3: 2 · PHASE4: 1 · Unknown: 4
Unknown
NCT05040048
n=220
Alzheimer's Disease, Parkinson's Disease
Interventions: Clinical, biological and imaging assessm
Sponsor: Institut National de la Santé Et de la Recherche Médicale, F
PHASE2
NCT00064792
n=23
Smith-Lemli-Opitz Syndrome
Interventions: Simvastatin Susp., OraPlus
Sponsor: Forbes Porter, M.D.
Unknown
NCT06459024
n=4000
Acute Myeloid Leukemia, in Relapse, Acute Myeloid Leukemia Refractory
Interventions: Registration into the STREAM platform
Sponsor: Istituto Romagnolo per lo Studio dei Tumori Dino Amadori IRS
PHASE3
NCT01603628
n=384
Pediatrics, Muscle Spasticity, Cerebral Palsy
Interventions: botulinum toxin Type A, Normal Saline (Placebo)
Sponsor: Allergan
PHASE2
NCT01227980
n=70
Alcohol-Related Disorders, Alcohol Dependence, Alcoholism
Interventions: Pexacerfont, Placebo
Sponsor: National Institute on Alcohol Abuse and Alcoholism (NIAAA)
PHASE3
NCT00088166
n=200
Brain Edema, Brain Tumor
Interventions: hCRF, placebo hCRF
Sponsor: Celtic Pharma Development Services
NA
NCT06389305
n=213
B-cell Acute Lymphoblastic Leukemia, Acute Lymphoblastic Leukemia, in Relapse, Refractory Acute Lymphoid Leukemia
Interventions: peripheral blood lymphocytes, CIK cell
Sponsor: Beijing GoBroad Hospital
Unknown
NCT00507104
n=100
Traumatic Brain Injury, Subarachnoid Hemorrhage, Hypopituitarism
Sponsor: University of Erlangen-Nürnberg Medical School