PDE9

PDE9A is a high-affinity, cGMP-specific phosphodiesterase that hydrolyzes cGMP and shows much higher affinity for cGMP than cAMP[1]. Mechanistically, PDE9A controls natriuretic-peptide-linked cGMP signaling rather than nitric-oxide-stimulated cGMP in cardiac myocytes and muscle[2]. Therefore, PDE9A differs from PDE5A, because PDE5A regulates nitric-oxide-generated cGMP, while PDE9A can regulate cGMP signaling independent of nitric oxide synthase activity[2]. In disease models, PDE9A is expressed in mammalian heart, including humans, and is upregulated by hypertrophy and cardiac failure[2]. Selective PDE9A inhibition protected against pathological responses to neurohormones and sustained pressure-overload stress, and reversed pre-established heart disease independent of nitric oxide synthase activity[2]. In brain, PDE9A regulates a compartmentalized cGMP pool independent of neuronal nitric oxide synthase and nitric oxide signaling[3]. For experimental applications, PF-04447943 is a selective brain-penetrant PDE9A inhibitor that improved rodent cognition assays but did not improve cognition in a 12-week Alzheimer’s disease trial[4][5]. In sickle cell disease research, PF-04447943 was tested in a phase Ib randomized placebo-controlled study, and IMR-687 reduced vessel occlusion in the Townes-HbSS mouse model[6][7].