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Can worm drugs open airways via TMEM16A?

Open paper intelligence

A >500k-compound screen found niclosamide and nitazoxanide are potent TMEM16A antagonists that fully bronchodilate airways and resist pathways that blunt β-agonists.

Source

Drug Repurposing: The Anthelmintics Niclosamide and Nitazoxanide Are Potent TMEM16A Antagonists That Fully Bronchodilate Airways

Miner K, Labitzke K, Liu B, et al. · Frontiers in pharmacology · 2019

doi.org/10.3389/fphar.2019.00051Read the full paper ↗113 citationscc by

What they did

Screened over half a million compounds for TMEM16A antagonism, characterized niclosamide/nitazoxanide pharmacology, and tested bronchodilation in mouse tracheal rings and human small airways under harsh contractile/inflammatory conditions.

What they found

~40% of severe asthma patients respond poorly to β-agonists. Niclosamide and nitazoxanide blocked TMEM16A and provided robust bronchodilation, offering a complementary mechanism for poorly controlled asthma/COPD.

The limits

What it doesn't show

In vitro/ex vivo potency is not the same as proven clinical asthma benefit; safety/dosing for inhaled or systemic airway use needs dedicated trials.

Key terms

TMEM16A
Calcium-activated chloride channel (CaCC) involved in airway smooth-muscle contraction and mucus biology.
Niclosamide
Approved anthelmintic repositioned here as a potent TMEM16A antagonist.
Nitazoxanide
Approved antiparasitic likewise identified as a TMEM16A antagonist bronchodilator.
β-agonist desensitization
Use- and inflammation-related pathways that blunt β2-agonist bronchodilation.
Drug repurposing
Finding new indications for already-approved medicines.
ASM
Airway smooth muscle whose excitation-contraction coupling involves TMEM16A.

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Poor β-agonist response is framed as about:

Common questions

What unmet need is cited?

~40% of severe asthma patients show poor β-agonist responsiveness.

Screen scale?

Over half a million compounds.

Key hits?

Niclosamide and nitazoxanide (and related compounds).

Functional airway result?

Robust bronchodilation of mouse tracheal rings and human small airways.