Discovery of Novel Nonsteroidal SGRMs of Sulfonamide-2-Oxo-Tetrahydroquinoline Derivatives by Carbonyl Migration

Glucocorticoids (GCs) are limited by severe side effects, driving the development of selective glucocorticoid receptor modulators (SGRMs) with improved therapeutic profiles. We previously development the SGRM lead <b>B53</b>, which suffered from poor metabolic stability. In this study, structure-guided optimization of <b>B53</b> yielded 43 novel sulfonamide derivatives. Among them, <b>D8</b>, which contained 2-oxo-tetrahydroquinoline by carbonyl migration form <b>B53</b>, manifests an excellent SGRM with remarkable transrepression potency (IC_50NF-κB = 0.9 nM) superior to dexamethasone (IC_{50 NF-κB} = 5.0 nM). Besides, <b>D8</b> exhibits a significantly higher specificity for GR over AR, MR, and PR and exhibited less adverse effects on osteoprotegerin. Furthermore, <b>D8</b> demonstrated improved metabolic stability and optimized binding mode within the GR LBD. <i>In vivo</i>, oral administration of <b>D8</b> significantly alleviated dermatitis and autoimmune hepatitis in mouse models, underscoring its therapeutic potential and validating our design strategy.