An Introduction to Phosphodiesterase Type 5 (PDE5) and Phosphodiesterase Type 6 (PDE6)
Phosphodiesterase type 5 (PDE5) and phosphodiesterase type 6 (PDE6) are crucial enzymes involved in cellular signaling pathways with significant implications in human health and disease [
1,
2,
3]. PDE5, predominantly found in smooth muscle cells of the vasculature and corpus cavernosum, plays a pivotal role in the regulation of cyclic guanosine monophosphate (cGMP) levels [
4]. PDE5 inhibitors cause vasodilation in the penis and lung by blocking the breakdown of cyclic guanosine monophosphate (cGMP) which results in prolongation of the action of mediators of vasodilation including nitric oxide (NO) [
5]. Clinically, inhibitors of PDE5, such as sildenafil, tadalafil, and vardenafil, are widely prescribed for the treatment of erectile dysfunction, pulmonary hypertension, and other cardiovascular conditions [
6]. However, despite their therapeutic efficacy, PDE5 inhibitors are associated with a notable side effect profile, notably visual disturbances, attributed to off-target effects on PDE6 [
7]. PDE6, primarily expressed in rod and cone photoreceptor cells of the retina, serves as a key mediator in the visual transduction cascade [
8].
In general, the essential biological function of phosphodiesterase (PDE) type enzymes is to regulate the cytoplasmic levels of intracellular second messengers, 3’,5’-cyclic guanosine monophosphate (cGMP) and/or 3’,5’-cyclic adenosine monophosphate (cAMP) [
7]. PDE targets have 11 isoenzymes. Of these enzymes [
7], PDE5 (
Figure 1) has attracted a special attention over the years after its recognition as being the target enzyme in treating erectile dysfunction. Due to the amino acid sequence and the secondary structural similarity of PDE6 and PDE11 with the catalytic domain of PDE5, first-generation PDE5 inhibitors (i.e. sildenafil and vardenafil) are also competitive inhibitors of PDE6 and PDE11 [
9]. Thus, inhibition of PDE6 by PDE5 inhibitors can disrupt phototransduction processes, leading to transient visual changes, including altered color perception and sensitivity to light [
9]. Understanding the distinct roles of PDE5 and PDE6 in cellular signaling pathways is essential for elucidating the mechanisms underlying both the therapeutic effects and adverse reactions associated with PDE5 inhibitors [
8]. Moreover, it underscores the importance of developing strategies to enhance binding selectivity towards PDE5 while minimizing off-target interactions with PDE6, thereby mitigating visual disturbances and improving the overall safety profile of these drugs [
8].
Specifically, the amino acid sequence of the catalytic domain of PDE5 is listed in italics in fasta format as below,
>3SHY_1|Chain A|cGMP-specific 3’,5’-cyclic phosphodiesterase|Homo sapiens (9606)
MGSSHHHHHHSSGLVPRGSHMEETRELQSLAAAVVPSAQTLKITDFSFSDFELSDLETALCTIRMFTDLNLVQNFQMKHEVLCRWILSVKKNYRKNVAYHNWRHAFNTAQCMFAALKAGKIQNKLTDLEILALLIAALSHDLDHRGVNNSYIQRSEHPLAQLYCHSIMEHHHFDQCLMILNSPGNQILSGLSIEEYKTTLKIIKQAILATDLALYIKRRGEFFELIRKNQFNLEDPHQKELFLAMLMTACDLSAITKPWPIQQRIAELVATEFFDQGDRERKELNIEPTDLMNREKKNKIPSMQVGFIDAICLQLYEALTHVSEDCFPLLDGCRKNRQKWQALAEQQ
and the amino acid sequence of the entire PDE5 is listed in italics in fasta format as below,
>PDE5A_(UniProtKB ID: O76074)_cGMP-specific 3’,5’-cyclic phosphodiesterase
MERAGPSFGQQRQQQQPQQQKQQQRDQDSVEAWLDDHWDFTFSYFVRKATREMVNAWFAERVHTIPVCKEGIRGHTESCSCPLQQSPRADNSAPGTPTRKISASEFDRPLRPIVVKDSEGTVSFLSDSEKKEQMPLTPPRFDHDEGDQCSRLLELVKDISSHLDVTALCHKIFLHIHGLISADRYSLFLVCEDSSNDKFLISRLFDVAEGSTLEEVSNNCIRLEWNKGIVGHVAALGEPLNIKDAYEDPRFNAEVDQITGYKTQSILCMPIKNHREEVVGVAQAINKKSGNGGTFTEKDEKDFAAYLAFCGIVLHNAQLYETSLLENKRNQVLLDLASLIFEEQQSLEVILKKIAATIISFMQVQKCTIFIVDEDCSDSFSSVFHMECEELEKSSDTLTREHDANKINYMYAQYVKNTMEPLNIPDVSKDKRFPWTTENTGNVNQQCIRSLLCTPIKNGKKNKVIGVCQLVNKMEENTGKVKPFNRNDEQFLEAFVIFCGLGIQNTQMYEAVERAMAKQMVTLEVLSYHASAAEEETRELQSLAAAVVPSAQTLKITDFSFSDFELSDLETALCTIRMFTDLNLVQNFQMKHEVLCRWILSVKKNYRKNVAYHNWRHAFNTAQCMFAALKAGKIQNKLTDLEILALLIAALSHDLDHRGVNNSYIQRSEHPLAQLYCHSIMEHHHFDQCLMILNSPGNQILSGLSIEEYKTTLKIIKQAILATDLALYIKRRGEFFELIRKNQFNLEDPHQKELFLAMLMTACDLSAITKPWPIQQRIAELVATEFFDQGDRERKELNIEPTDLMNREKKNKIPSMQVGFIDAICLQLYEALTHVSEDCFPLLDGCRKNRQKWQALAEQQEKMLINGESGQAKRN
and the amino acid sequences of four (, , and ) subunits of PDE6 (
Figure 2) are also listed in italics in fasta format as below:
>PDE6A_(UniProtKB ID: P16499)_Human Retinal Rod cGMP-specific 3’,5’-cyclic phosphodiesterase subunit alpha
MGEVTAEEVEKFLDSNIGFAKQYYNLHYRAKLISDLLGAKEAAVDFSNYHSPSSMEESEIIFDLLRDFQENLQTEKCIFNVMKKLCFLLQADRMSLFMYRTRNGIAELATRLFNVHKDAVLEDCLVMPDQEIVFPLDMGIVGHVAHSKKIANVPNTEEDEHFCDFVDILTEYKTKNILASPIMNGKDVVAIIMAVNKVDGSHFTKRDEEILLKYLNFANLIMKVYHLSYLHNCETRRGQILLWSGSKVFEELTDIERQFHKALYTVRAFLNCDRYSVGLLDMTKQKEFFDVWPVLMGEVPPYSGPRTPDGREINFYKVIDYILHGKEDIKVIPNPPPDHWALVSGLPAYVAQNGLICNIMNAPAEDFFAFQKEPLDESGWMIKNVLSMPIVNKKEEIVGVATFYNRKDGKPFDEMDETLMESLTQFLGWSVLNPDTYESMNKLENRKDIFQDIVKYHVKCDNEEIQKILKTREVYGKEPWECEEEELAEILQAELPDADKYEINKFHFSDLPLTELELVKCGIQMYYELKVVDKFHIPQEALVRFMYSLSKGYRKITYHNWRHGFNVGQTMFSLLVTGKLKRYFTDLEALAMVTAAFCHDIDHRGTNNLYQMKSQNPLAKLHGSSILERHHLEFGKTLLRDESLNIFQNLNRRQHEHAIHMMDIAIIATDLALYFKKRTMFQKIVDQSKTYESEQEWTQYMMLEQTRKEIVMAMMMTACDLSAITKPWEVQSQVALLVAAEFWEQGDLERTVLQQNPIPMMDRNKADELPKLQVGFIDFVCTFVYKEFSRFHEEITPMLDGITNNRKEWKALADEYDAKMKVQEEKKQKQQSAKSAAAGNQPGGNPSPGGATTSKSCCIQ
>PDE6B_(UniProtKB ID: P35913)_Human Retinal Rod cGMP-specific 3’,5’-cyclic phosphodiesterase subunit beta
MSLSEEQARSFLDQNPDFARQYFGKKLSPENVAAACEDGCPPDCDSLRDLCQVEESTALLELVQDMQESINMERVVFKVLRRLCTLLQADRCSLFMYRQRNGVAELATRLFSVQPDSVLEDCLVPPDSEIVFPLDIGVVGHVAQTKKMVNVEDVAECPHFSSFADELTDYKTKNMLATPIMNGKDVVAVIMAVNKLNGPFFTSEDEDVFLKYLNFATLYLKIYHLSYLHNCETRRGQVLLWSANKVFEELTDIERQFHKAFYTVRAYLNCERYSVGLLDMTKEKEFFDVWSVLMGESQPYSGPRTPDGREIVFYKVIDYVLHGKEEIKVIPTPSADHWALASGLPSYVAESGFICNIMNASADEMFKFQEGALDDSGWLIKNVLSMPIVNKKEEIVGVATFYNRKDGKPFDEQDEVLMESLTQFLGWSVMNTDTYDKMNKLENRKDIAQDMVLYHVKCDRDEIQLILPTRARLGKEPADCDEDELGEILKEELPGPTTFDIYEFHFSDLECTELDLVKCGIQMYYELGVVRKFQIPQEVLVRFLFSISKGYRRITYHNWRHGFNVAQTMFTLLMTGKLKSYYTDLEAFAMVTAGLCHDIDHRGTNNLYQMKSQNPLAKLHGSSILERHHLEFGKFLLSEETLNIYQNLNRRQHEHVIHLMDIAIIATDLALYFKKRAMFQKIVDESKNYQDKKSWVEYLSLETTRKEIVMAMMMTACDLSAITKPWEVQSKVALLVAAEFWEQGDLERTVLDQQPIPMMDRNKAAELPKLQVGFIDFVCTFVYKEFSRFHEEILPMFDRLQNNRKEWKALADEYEAKVKALEEKEEEERVAAKKVGTEICNGGPAPKSSTCCIL
>PDE6G_(UniProtKB ID: P18545)_Human Retinal rod rhodopsin-sensitive cGMP 3’,5’-cyclic phosphodiesterase subunit gamma
MNLEPPKAEFRSATRVAGGPVTPRKGPPKFKQRQTRQFKSKPPKKGVQGFGDDIPGMEGLGTDITVICPWEAFNHLELHELAQYGII
>PDE6D_(UniProtKB ID: O43924)_Human Retinal rod rhodopsin-sensitive cGMP 3’,5’-cyclic phosphodiesterase subunit delta
MSAKDERAREILRGFKLNWMNLRDAETGKILWQGTEDLSVPGVEHEARVPKKILKCKAVSRELNFSSTEQMEKFRLEQKVYFKGQCLEEWFFEFGFVIPNSTNTWQSLIEAAPESQMMPASVLTGNVIIETKFFDDDLLVSTSRVRLFYV
To further account for the molecular and structural characterizations of PDE6, the amino acid sequences of , and subunits of PDE6 are also listed in italics in fasta format as below:
>6MZB_1|Chain A[auth B]|Rod cGMP-specific 3’,5’-cyclic phosphodiesterase subunit beta|Bos taurus (9913)
MSLSEGQVHRFLDQNPGFADQYFGRKLSPEDVANACEDGCPEGCTSFRELCQVEESAALFELVQDMQENVNMERVVFKILRRLCSILHADRCSLFMYRQRNGVAELATRLFSVQPDSVLEDCLVPPDSEIVFPLDIGVVGHVAQTKKMVNVQDVMECPHFSSFADELTDYVTRNILATPIMNGKDVVAVIMAVNKLDGPCFTSEDEDVFLKYLNFGTLNLKIYHLSYLHNCETRRGQVLLWSANKVFEELTDIERQFHKAFYTVRAYLNCDRYSVGLLDMTKEKEFFDVWPVLMGEAQAYSGPRTPDGREILFYKVIDYILHGKEDIKVIPSPPADHWALASGLPTYVAESGFICNIMNAPADEMFNFQEGPLDDSGWIVKNVLSMPIVNKKEEIVGVATFYNRKDGKPFDEQDEVLMESLTQFLGWSVLNTDTYDKMNKLENRKDIAQDMVLYHVRCDREEIQLILPTRERLGKEPADCEEDELGKILKEVLPGPAKFDIYEFHFSDLECTELELVKCGIQMYYELGVVRKFQIPQEVLVRFLFSVSKGYRRITYHNWRHGFNVAQTMFTLLMTGKLKSYYTDLEAFAMVTAGLCHDIDHRGTNNLYQMKSQNPLAKLHGSSILERHHLEFGKFLLSEETLNIYQNLNRRQHEHVIHLMDIAIIATDLALYFKKRTMFQKIVDESKNYEDRKSWVEYLSLETTRKEIVMAMMMTACDLSAITKPWEVQSKVALLVAAEFWEQGDLERTVLDQQPIPMMDRNKAAELPKLQVGFIDFVCTFVYKEFSRFHEEILPMFDRLQNNRKEWKALADEYEAKVKALEEDQKKETTAKKVGTEICNGGPAPRSSTCRIL
>6MZB_2|Chain B[auth A]|Rod cGMP-specific 3’,5’-cyclic phosphodiesterase subunit alpha|Bos taurus (9913)
MGEVTAEEVEKFLDSNVSFAKQYYNLRYRAKVISDLLGPREAAVDFSNYHALNSVEESEIIFDLLRDFQDNLQAEKCVFNVMKKLCFLLQADRMSLFMYRARNGIAELATRLFNVHKDAVLEECLVAPDSEIVFPLDMGVVGHVALSKKIVNVPNTEEDEHFCDFVDTLTEYQTKNILASPIMNGKDVVAIIMVVNKVDGPHFTENDEEILLKYLNFANLIMKVFHLSYLHNCETRRGQILLWSGSKVFEELTDIERQFHKALYTVRAFLNCDRYSVGLLDMTKQKEFFDVWPVLMGEAPPYAGPRTPDGREINFYKVIDYILHGKEDIKVIPNPPPDHWALVSGLPTYVAQNGLICNIMNAPSEDFFAFQKEPLDESGWMIKNVLSMPIVNKKEEIVGVATFYNRKDGKPFDEMDETLMESLTQFLGWSVLNPDTYELMNKLENRKDIFQDMVKYHVKCDNEEIQTILKTREVYGKEPWECEEEELAEILQGELPDADKYEINKFHFSDLPLTELELVKCGIQMYYELKVVDKFHIPQEALVRFMYSLSKGYRRITYHNWRHGFNVGQTMFSLLVTGKLKRYFTDLEALAMVTAAFCHDIDHRGTNNLYQMKSQNPLAKLHGSSILERHHLEFGKTLLRDESLNIFQNLNRRQHEHAIHMMDIAIIATDLALYFKKRTMFQKIVDQSKTYETQQEWTQYMMLDQTRKEIVMAMMMTACDLSAITKPWEVQSKVALLVAAEFWEQGDLERTVLQQNPIPMMDRNKADELPKLQVGFIDFVCTFVYKEFSRFHEEITPMLDGITNNRKEWKALADEYETKMKGLEEEKQKQQAANQAAAGSQHGGKQPGGGPASKSCCVQ
>6MZB_3|Chains C, D|Retinal rod rhodopsin-sensitive cGMP 3’,5’-cyclic phosphodiesterase subunit gamma|Bos taurus (9913)
MNLEPPKAEIRSATRVMGGPVTPRKGPPKFKQRQTRQFKSKPPKKGVQGFGDDIPGMEGLGTDITVICPWEAFNHLELHELAQYGII
Background on Currently Available PDE5 Inhibitors and Their Action Mechanisms
Phosphodiesterase type 5 (PDE5) inhibitors represent a class of drugs with diverse clinical applications and profound therapeutic significance [
1,
2,
3]. Primarily known for their efficacy in the management of erectile dysfunction (ED), PDE5 inhibitors, including sildenafil (Viagra,
Figure 1), tadalafil (Cialis), and vardenafil (Levitra), exert their effects by selectively inhibiting the enzymatic activity of PDE5. By blocking the degradation of cyclic guanosine monophosphate (cGMP), PDE5 inhibitors prolong the vasodilatory effects initiated by nitric oxide (NO) release upon sexual stimulation [
7]. This results in enhanced blood flow to the corpus cavernosum of the penis, facilitating erectile function [
5]. Beyond their use in ED, PDE5 inhibitors have demonstrated efficacy in the treatment of pulmonary arterial hypertension (PAH) by promoting vasodilation and inhibiting pulmonary vascular remodeling [
15]. Furthermore, emerging research suggests potential applications of PDE5 inhibitors in various other conditions, including benign prostatic hyperplasia (BPH) and Raynaud’s phenomenon [
16].
At the molecular level, PDE5 inhibitors bind directly to the catalytic site of PDE5 (
Figure 1), preventing the hydrolysis of cGMP to guanosine monophosphate (GMP). From the amino acid sequence point of view, the binding between PDE5 inhibitor (e.g., Sildenafil) and PDE5’s catalytic site is located between sequence position number 536 and 860 (
Figure 3). This binding between PDE5 inhibitor (e.g., Sildenafil) leads to an accumulation of cGMP within smooth muscle cells, resulting in prolonged relaxation and vasodilation. Additionally, the inhibition of PDE5 in other tissues, such as the pulmonary vasculature, contributes to the therapeutic effects observed in PAH [
7]. However, the non-selective nature of some PDE5 inhibitors can lead to off-target interactions with other phosphodiesterase isoforms, notably PDE6 in the retina, resulting in visual disturbances. Understanding the molecular mechanisms underlying PDE5 inhibitor action is crucial for optimizing their therapeutic benefits while minimizing adverse effects [
19,
20].
A GIBAC-Based Selectivity Strategy for the Design of Non-PDE6-Binding PDE5 Inhibitors
On August 11, 2022, the concept of a general intermolecular binding affinity calculator (GIBAC) was for the first time proposed in an MDPI preprint [
38] and defined as below:
where
represents the molecular system described either in strings (e.g., amino acid sequences, strings of SMILES to represent small molecules [
39,
40]), or in graphs to describe PTMs (e.g., glycosylated proteins) and PEMs (e.g., insulin icodec of Novo Nordisk [
41,
42,
43]).
On October 19, 2023, the concept of GIBAC (Equation
1) was for the first time updated, including its inception, definition (Equation
1), construction, practical applications, technical challenges and limitations, and future directions [
37,
44]. As defined in [
37], a real GIBAC (Equation
1) is able to meet the criteria listed as below:
a real GIBAC needs to take genetic variations into account; and
a real GIBAC needs to work even without structural information; and
for a real GIBAC, a variety of factors need to be taken into account, such as temperature, pH [
45,
46], site-specific protonation states (e.g., side chain pK
a of protein) [
47,
48], post-translational modifications (PTMs) [
49,
50,
51], post-expression modifications (PEMs) [
52,
53], buffer conditions [
54], et cetera; and
a real GIBAC requires a general forcefield for all types of molecules [
55]; and
a real GIBAC requires a universal notation system for accurate and flexible description of all molecular types and drug modalities [
56,
57]; and
a real GIBAC is able to be used the other way around, i.e., to be used as a search engine for therapeutic candidate(s). With such a GIBAC-based search engine, a list of therapeutic candidates can be retrieved and ranked according to drug-target Kd value(s), with input parameters including drug target(s) and a desired drug-target Kd value or a range of it.
As mentioned above, the binding between PDE5 inhibitor (e.g., sildenafil) and PDE5’s catalytic domain is located between sequence position number 536 and 860 (
Figure 3) of PDE5. From
Figure 4, it can been seen that the three amino acid sequences (PDE5, PDE6A and PDE6B) do possess a certain degree of sequence homology. Yet, the three sequences are also different from one another, especially for the region which corresponds to the catalytic domain of PDE5, i.e., the region between sequence position number 536 and 860 (
Figure 3) of PDE5. Thus, from a structural and biophysical point of view, it is conceivable to design non-PDE6-binding PDE5 inhibitors, which selectively targets PDE5, binds to its binding pocket as shown in
Figure 1, and does not target PDE6 at all, i.e., ∆G (kcal/mol)
or ∆G (kcal/mol)
[
37].
In practice, the design of non-PDE6-binding PDE5 inhibitors is equivalent to a matter of the construction of a mini GIBAC based on experimental structures of PDE5 and its inhibitor(s) using currently available AI algorithms as listed in [
37]. Specifically, the construction of a mini GIBAC based on experimental structures of PDE5 and its inhibitor(s) needs at least four key ingredients: data, algorithm, knowledge and computational power, e.g.,
experimental structures of PDE5 and its inhibitor(s);
experimental structures of PDE6 and its inhibitor(s);
PDE5-related computational structural data from AlphaFold database [?];
PDE6-related computational structural data from AlphaFold database [?];
synthetic (both apo and complex) PDE5-related structural data generators [?];
synthetic (both apo and complex) PDE6-related structural data generators [?];
feature extraction using a comprehensive structural biophysical analysis [
29,
30], including structural biophysics and interfacial geometrics [
25,
58] underlying the complex structures of PDE5 (or PDE6) and its inhibitors.
molecular docking & dynamics simulation tools [??].
synthetic K
d data generators [
36];
side chain placement and energy minimization algorithms [?] to incorporate structural information of PTMs [
49,
50,
51] and PEMs [
52,
53,
59] into structural models.