Identification of small molecule dimethyoxyphenyl piperazine inhibitors of alpha-synuclein fibril growth

Alpha-synuclein (asyn) fibril accumulation is the defining feature of Parkinson disease and is a target for disease-modifying treatments. One therapeutic strategy to reduce fibril accumulation is inhibition of asyn fibril growth. We developed a sensitive fluorescence-based fibril growth assay to screen for small molecule inhibitors. After validating the inhibition assay using a previously identified inhibitor, epigallocatechin-3-gallate, we identified compound 1 as a lead for inhibition of fibril growth. We analysed structure-activity relationships with analogs of 1 to optimize inhibition potency. Our results identified two dimethoxyphenyl piperazine analogs with more potent inhibition of in-vitro assembled fibrils, which were further validated with orthogonal assays including kinetic measurements of fibril concentration with Thioflavin T. These analogs also inhibited the growth of asyn fibrils amplified from Lewy Body Disease brain tissue, further validating the inhibitor screening assay. Molecular docking studies indicate that these compounds can bind to the fibril ends, suggesting a potential capping mechanism through which these compounds inhibit the sequential association of monomeric asyn required for fibril growth.