GAT1508, a selective neuronal GIRK1/2 activator, exhibits superior antiepileptic efficacy and synergizes with cannabidiol

Abstract

G protein-gated inwardly rectifying potassium (GIRK; Kir3) channels are key regulators of neuronal excitability and represent promising therapeutic targets for epilepsy. Here, we characterize GAT1508, a urea-based small-molecule activator selectively targeting neuronal GIRK1/2 heterotetramers, and compare its efficacy with previously described urea compounds ML297 and GiGA1. In a pentylenetetrazole (PTZ)-induced seizure model, GAT1508 demonstrated robust antiseizure activity, outperforming both ML297 and GiGA1 and achieving efficacy comparable to valproic acid. Electrophysiological studies using two-electrode voltage clamp in Xenopus oocytes revealed that GAT1508, unlike ML297 and GiGA1, selectively activates GIRK1/2 channels without significant activation of cardiac GIRK1/4 channels, suggesting reduced risk of cardiovascular side effects. Structural and computational analyses indicate that enhanced stabilization of GAT1508 compared to ML297 within the GIRK1/2 binding pocket promotes both ion permeation and channel gating through coordinated interactions with key residues. Furthermore, GAT1508, like the two other urea drugs, exhibited synergistic activation of GIRK channels when combined with G{beta}{gamma}-mediated pathways and significantly potentiated the antiseizure effects of cannabidiol (CBD) in both hippocampal slice recordings and in vivo seizure models. These findings establish GAT1508 as a potent and selective GIRK1/2 activator and support a novel combination therapeutic strategy for epilepsy based on convergent GIRK channel modulation.