# New Generation of Mitochondrial Uncouplers for the Treatment of Metabolic DIsorders

> **NIH NIH R43** · EQUATOR THERAPEUTICS, INC. · 2021 · $340,882

## Abstract

Project Summary/Abstract
Metabolic syndrome (MetS), a constellation of medical conditions that includes obesity, type 2 diabetes, fatty
liver, hypertension, cardiovascular disease, and dyslipidemia, creates a major burden for individuals and
society. MetS is caused by insulin resistance and obesity, and a drug that could reverse these two conditions
would transform its treatment. Unfortunately, no safe and effective medication with such properties exists.
Equator Therapeutics is developing a first-in-class drug that will increase the resting metabolic rate by
activating the native pathways for mitochondrial H+ leak and thermogenesis. This drug will correct the root
cause of metabolic disorders—the imbalance between excess caloric intake and limited energy expenditure—
and is expected to be highly effective at reversing obesity and insulin resistance. Until recently, development of
such drug was impossible due to a very limited understanding of the mechanisms of the mitochondrial H+ leak.
Instead, protonophores that indiscriminately increase H+ leak not only in mitochondria but all cell membranes,
were used, leading to undesirable side effects. In contrast, our drug will activate H+ leak specifically in
mitochondria via the physiologically regulated native H+ leak pathways mediated by uncoupling proteins and is
expected to be much safer. The development of this drug is enabled by our recent discoveries concerning the
molecular mechanisms of the mitochondrial H+ leak. In Specific Aim 1, we will identify a set of diverse
drug-like compounds that selectively activate a protein target natively responsible for the
mitochondrial H+ leak. Importantly, these compounds will have no protonophoric activity. We have selected a
library of ~67,000 small molecules with desirable chemical properties specific to our target. We will screen this
library for hits that increase mitochondrial H+ leak using new high-throughput mitochondrial assays consisting
of a primary screen and counter-screen to remove false positives. Compounds that pass both rounds of high-
throughput screening will be validated by direct measurement of the H+ current via our target protein using
mitochondrial patch-clamp electrophysiology. Additional patch-clamp studies in the plasma membrane will
further select only those of them that lack any protonophoric activity. In Specific Aim 2, we will determine the
effects of the novel activators of the native mitochondrial H+ leak pathways on the bioenergetics of
intact human cells in vitro. We will primarily focus on the ability of our compounds to stimulate uncoupled
respiration, the parameter reflecting their ability to activate mitochondrial H+ leak and thermogenesis in intact
cells. Other parameters such as the respiration capacity of the cell, activity of the glycolytic pathways, and the
intracellular ATP level will also be assessed. Finally, cytotoxicity assays will be performed. Successful
accomplishment of these aims will generate a set of che...

## Key facts

- **NIH application ID:** 10383829
- **Project number:** 1R43DK127880-01A1
- **Recipient organization:** EQUATOR THERAPEUTICS, INC.
- **Principal Investigator:** Liliya Gabelev Khasin
- **Activity code:** R43 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $340,882
- **Award type:** 1
- **Project period:** 2021-09-20 → 2023-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10383829

## Citation

> US National Institutes of Health, RePORTER application 10383829, New Generation of Mitochondrial Uncouplers for the Treatment of Metabolic DIsorders (1R43DK127880-01A1). Retrieved via AI Analytics 2026-06-11 from https://api.ai-analytics.org/grant/nih/10383829. Licensed CC0.

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