Adgrg6 (Gpr126) is an adhesion (B2) class G protein-coupled receptor (aGPCR) with conserved roles in myelination of the vertebrate peripheral nervous system (PNS) (reviewed in Langenhan et al., 2016; Patra et al., 2014). In homozygous loss-of-function adgrg6 zebrafish and mouse mutants, peripheral myelination is severely impaired: Schwann cells associate with axons, but are unable to generate the myelin sheath, and show reduced expression of the myelin basic protein (mbp) gene (Glenn and Talbot, 2013; Mogha et al., 2013; Monk et al., 2009; Monk et al., 2011). Targeted disruption of Adgrg6 in the mouse results in additional abnormal phenotypes, including limb and cardiac abnormalities, axon degeneration and embryonic lethality (Monk et al., 2011; Patra et al., 2013; Waller-Evans et al., 2010). In humans, mutations in ADGRG6 are causative for congenital contracture syndrome 9, a severe type of arthrogryposis multiplex congenita (Ravenscroft et al., 2015). Peripheral nerves from affected individuals have reduced expression of myelin basic protein, suggesting that the function of ADGRG6 in myelination is evolutionarily conserved from teleosts to humans (Ravenscroft et al., 2015). Human ADGRG6 variants have also been proposed to underlie some paediatric musculoskeletal disorders, including adolescent idiopathic scoliosis (Karner et al., 2015) (and references within).

In zebrafish, homozygous loss-of-function adgrg6 mutants exhibit an inner ear defect in addition to deficiencies in myelination (Geng et al., 2013; Monk et al., 2009). In the otic vesicle, the epithelial projections that prefigure formation of the semicircular canal ducts overgrow and fail to fuse, resulting in morphological defects and ear swelling. Analysis of the zebrafish adgrg6 mutant ear shows a dramatic alteration in the expression of genes coding for several extracellular matrix (ECM) components and ECM-modifying enzymes (Geng et al., 2013) (Figure 1A). Notably, transcripts coding for core proteins of the chondroitin sulphate proteoglycan Versican, normally transiently expressed in the outgrowing projections and then down-regulated once projection fusion has occurred, remain highly expressed in the overgrown and unfused projections of adgrg6 mutants (Geng et al., 2013). Although Adgrg6 (Gpr126) mRNA is known to be expressed in the mouse ear (Patra et al., 2013), a role in otic development in the mammal has yet to be determined.

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Like all aGPCR members, the zebrafish Adgrg6 receptor consists of a long extracellular domain (ECD), a seven-pass transmembrane domain (7TM), and a short intracellular domain (reviewed in Langenhan et al., 2016) (Figure 1B). The ECD includes a GPCR autoproteolysis-inducing (GAIN) domain, which incorporates the GPCR proteolytic site (GPS) and the conserved Stachel sequence (Liebscher et al., 2014; Patra et al., 2014). Proteolysis at the GPS results in two fragments, an N-terminal fragment (NTF) and a C-terminal fragment (CTF), which can remain associated with one another, or may dissociate, the NTF binding to cell surface or extracellular matrix ligands (Patra et al., 2014; Petersen et al., 2015). Dissociation of the NTF triggers binding of the Stachel sequence to the 7TM domain, thereby activating the CTF (Liebscher et al., 2014). This feature provides a variety of CTF-dependent or -independent signalling capabilities that orchestrate cell adhesion and other cell-cell or cell-matrix interactions. For example, during Schwann cell development and terminal differentiation, the Adgrg6 NTF promotes radial sorting of axons, whereas the CTF is thought to signal through a stimulatory Gα subunit (Gα_s), leading to elevated cAMP levels and activated protein kinase A (PKA) to induce transcription of downstream target genes, such as egr2 and oct6 (Petersen et al., 2015). Compounds that act to raise intracellular cAMP levels, such as the phosphodiesterase inhibitor 3-isobutyl-1-methylxanthine (IBMX) and the adenylyl cyclase activator forskolin, can rescue phenotypic defects in both the inner ear and PNS in adgrg6 mutants (Geng et al., 2013; Monk et al., 2009).

Despite the enormous importance of GPCRs as drug targets (Hauser et al., 2017; Sriram and Insel, 2018; Wootten et al., 2018), adhesion class GPCRs remain poorly characterised, representing a valuable untapped resource as targets of future therapeutics (Hamann et al., 2015; Monk et al., 2015). The identification of specific modulators of aGPCR activity is an essential step for understanding the mechanism of aGPCR function and to inform the design of new drugs. Recent successful approaches include the use of Stachel sequence peptides as aGPCR agonists (Demberg et al., 2017), or synthetic monobodies directed against domains within the NTF (Salzman et al., 2017). A promising alternative approach lies in the potential of unbiased whole-animal screening of small molecules. In recent years, zebrafish have emerged as an important tool for in vivo phenotypic screening for new therapeutics (Brady et al., 2016) and for understanding biological mechanisms (Baxendale et al., 2017; Richter et al., 2017). Zebrafish have many advantages for drug discovery: they are a vertebrate species whose embryos can fit into individual wells of a multiwell plate, facilitating high-throughput analysis; they generate large numbers of offspring; they can absorb compounds directly added to the water, and whole-organism screening enables toxicity, absorption, metabolism and excretion of compounds to be assayed early in the screening pipeline.

To date, over one hundred drug screens using different zebrafish disease models have been conducted, some identifying lead compounds that have subsequently been tested in mammalian model systems or entered clinical trials (Chowdhury et al., 2013; Griffin et al., 2017; North et al., 2007; Owens et al., 2008) (reviewed in Baxendale et al., 2017). Two screens have been performed to identify compounds that promote myelination in the central nervous system (Buckley et al., 2010; Early et al., 2018). These studies used live imaging of Tg(olig2:GFP) or Tg(mbp:eGFP) fluorescent transgenic lines to screen for small molecules that increase progenitor or myelinating oligodendrocyte cell number. While elegant in design, and successful in identifying hit compounds, these screens required the use of sophisticated and costly high-resolution imaging platforms and relied on detailed quantitative assays for cell number, techniques that are not available to all labs and are potentially limiting in scalability and throughput.

In this study, we have developed an in vivo drug screening assay based on semi-automated in situ hybridisation (ISH) to identify modulators of the Adgrg6 pathway. We have used the otic expression of versican b (vcanb) as an easily-scored qualitative readout to identify compounds that can reduce vcanb overexpression back to normal levels in a hypomorphic mutant allele for adgrg6, tb233c. We used expression of mbp in the posterior lateral line ganglion of adgrg6^tb233c mutants as a secondary screening assay, with the aim of identifying chemical classes capable of rescuing the expression of both genes, which may thus represent agonists of the Adgrg6 signalling pathway. To identify ligands that potentially bind directly to Adgrg6, we then tested hit compounds for their ability to rescue a strong loss-of-function adgrg6 allele, fr24, which predicts a severely truncated protein. Several compounds were unable to rescue adgrg6^fr24 mutants, including a group with similar structures from the gedunin family of compounds. Compounds able to rescue both alleles include colforsin, a known activator of adenylyl cyclase, demonstrating proof-of-principle that our screen can identify compounds that restore GPCR pathway activity downstream of the receptor. These alternative assays for both down-regulation and up-regulation of gene expression, combined with a comparison of rescue in both weak and strong alleles, have facilitated selection of a strong cohort of hit compounds that can be differentiated by the different screens used. Our approach is scalable and can be used to screen additional compound collections. In parallel, chemoinformatics analysis of the compound libraries and identified hits has enabled classification and prioritisation of selected hit compounds.

Adhesion GPCRs are critical regulators of development and disease, driving cell-cell and cell-ECM communications to elicit internal responses to extrinsic cues. This study set out to identify positive modulators of the Adgrg6 signalling pathway, a key regulator of myelination and inner ear development in the zebrafish embryo. Use of a whole-animal phenotypic (mutant rescue) screen gave the potential to identify compounds affecting the entire Adgrg6 pathway in the correct cellular context. We have used a simple in situ hybridisation approach to assay vcanb expression in the inner ear of adgrg6 mutants, exploiting an easily identifiable phenotype that could be scored manually. Following our primary screen of 3120 small molecules, we tested 89 hit compounds in a counter screen for rescue of the myelination defect in adgrg6 mutant embryos. We identified 41 compounds that can both rescue vcanb expression in the inner ear and mbp expression in Schwann cells of adgrg6 hypomorphic mutants, suggesting these are Adgrg6 pathway-specific modulators. Further analysis of a strong adgrg6 allele, fr24, identified a subset of 19 compounds that are potential direct interactors of the Adgrg6 receptor. This analysis, combined with chemoinformatics analysis of the identified hit compounds, has identified clusters of compounds acting at different levels of the Adgrg6 pathway.

An optimal drug screening assay design identifies the maximum number of hit compounds with the minimum number of false positives and false negatives. Chemical screening assays using zebrafish range from simple morphology screens (Yu et al., 2008) through to high-tech, automated methods for quantitative image analysis (Early et al., 2018) or behavioural analysis (Bruni et al., 2016; Rennekamp et al., 2016) (reviewed in Kalueff et al., 2016). We used an in situ hybridisation screen to analyse gene expression changes, as this has the advantages of being scalable to different sized projects and relatively inexpensive to perform—with results that are stable and reproducible. Spatial resolution of staining patterns can be accurately scored: expression pattern screens have recently been used to identify small molecules that can induce subtle differences in gene expression domains along the pronephros (Poureetezadi et al., 2016) and in the somites (Richter et al., 2017). Although quantification of gene expression levels is less reliable with an enzymatic reaction compared with a fluorescent signal, we utilised the strong contrast between the high vcanb expression in the ear of adgrg6 mutant fish compared with the low expression in a small dorsal region of the wild-type ear at four dpf to produce a robust scoring system for our phenotype rescue.

Relatively few zebrafish screens have been undertaken to identify compounds that can increase myelination (Buckley et al., 2010; Early et al., 2018) or restore myelination in neuropathy models (Zada et al., 2016), which is in part due to the complex distribution of glial cells in both the CNS and PNS. Performing the primary screen using an ear marker, vcanb, enabled us to bypass the difficulties of scoring and quantification of mbp staining on a large scale; instead, mbp expression was used as a counter screen on a limited number of cherry-picked hits. Contrary to the primary assays, which screened for down-regulation of vcanb expression, the counter screen assayed for up-regulation of mbp expression, enabling the identification of 21 false-positive compounds that down-regulate the expression of both genes (presumably by inhibiting transcription).

Determining the false-negative rate for any screen is difficult. In our assay we used only one concentration of compound (25 µM), so it is likely that some of the compounds that were toxic or showed no effect at 25 µM—and thus eliminated from our screen—would be effective at lower or higher concentrations, respectively. One possibility would be to run a parallel screen at a lower or higher concentration or use an alternative protocol with shorter incubation times, an approach that has recently proved successful at identifying different compounds influencing segmentation in zebrafish (Richter et al., 2017). Here, the compounds were found to be most active in the range of 10–50 µM, supporting our choice of 25 µM for the primary screen. However, increasing the number of replicates with different drug concentrations or assay conditions has significant implications on the cost and time taken to complete the screen, reducing the number of compounds analysed and the potential hits identified. An alternative method is to use a structural network to select and prioritise candidate compounds that have a similar structure to hit compounds and test these at different concentrations. Using this approach, we identified (±)-Bay K 8644 as an additional hit from the pyridine cluster when tested at a higher concentration. Our minimum estimate for the false-negative rate is 5%, based on the seven compounds (out of a total of 155) that were duplicated in both libraries and had a significantly different score after retesting, being classified as a hit in one library but not in the other. It is possible that this is due to differences in chemical purity from the different suppliers. Other false-negative compounds could include those that are unable to penetrate into the ear. Neomycin, for example, is toxic to the superficial hair cells of the lateral line system, but is ineffective on inner ear hair cells unless microinjected into the ear (Buck et al., 2012). Other compounds that we will have missed could include myelination-specific compounds, as the primary assay scored for the ear phenotype only. Given that several compounds were positive hits for the rescue of vcanb in the ear and negative for mbp, it is likely that tissue-specific functions of Adgrg6 are mediated through different downstream pathways or are stimulated by different ligands.

Our positive control compound, IBMX, was identified independently through our screen as a category A hit. The hit compound colforsin was found to be more potent and less toxic than the related control compound forskolin, and had the highest score in every assay, showing full rescue of the strong fr24 allele. Both these observations highlight the robustness of the assay and the consistency of the scoring process. In total, the final number of hit compounds identified was similar in both the compound libraries screened, with 42 compounds identified from the Spectrum library (2.1%) and 27 compounds from the Tocris library (2.4%). These hit rates are comparable to those found in other similar screens (Baxendale et al., 2012; Vettori et al., 2017; Wiley et al., 2017).

Chemoinformatics analysis and visualisation of the results provided additional context to the identified hit compounds. The polar scatter plot displayed an initial overview of the results and allowed the identification of six different structurally-related clusters of active compounds with similar structure. The compound network focused the analysis on highly detailed similarity relationships inside each compound cluster, yielding a wealth of structure-activity relationship information that could prove very useful for any future optimisation of the identified hit compounds. Seven of the 41 hit compounds that rescued vcanb and mbp expression are Ca²⁺-channel modulators. Six of these (nifedipine, cilnidipine, nitrendipine, nimodipine, efonidipine, niguldipine) belong to the chemical group of dihydropyridines (cluster 1), and initial investigations into compounds with similar structures identified four additional compounds in this class. Several dihydropyridines are known to have neuroprotective effects in mammalian models. Nimodipine, for example, has been shown to trigger remyelination in a mouse model of multiple sclerosis and to improve repair in peripheral nerve crush injuries in rats (Schampel et al., 2017; Tang et al., 2015), and some compounds have shown promise at clearing toxic proteins in animal models of neurodegeneration, including felodipine (Siddiqi et al., 2019) and nilvadipine (Paris et al., 2011). As dihydropyridines have been reported to inhibit cAMP phosphodiesterases (Sharma et al., 1997), protection of cAMP from degradation might be another mechanism whereby these molecules exert their ameliorating action on the adgrg6 mutant phenotype.

Phenotypic screens are advantageous for assessing models of multifactorial pathological conditions, such as hereditary neuropathies and cancer (reviewed in Baxendale et al., 2017). However, one of the challenges for phenotypic screening is the identification of the specific target for any hit compound, as multiple pathways and different cell types can contribute to a positive read-out in the screening assay. Our aim was to identify compounds that could potentially interact directly with the Adgrg6 receptor. We were able to separate hit compounds into different groups based on their ability to rescue otic phenotypes caused by missense (tb233c) and nonsense (fr24) mutations. In total, we found 19 hits that could rescue vcanb expression and mbp expression in the tb233c allele, but were unable to rescue the fr24 allele. We hypothesise that the fr24 allele is unable to produce the full-length Adgrg6 protein including the CTF, and therefore any compounds that interact directly with the receptor would not be able to rescue any CTF-dependent function in this strong allele. Further analysis will be needed to determine whether any of these compounds can bind directly to the Adgrg6 receptor, for example by assessing stimulation of cAMP and direct binding in in vitro assays. However, this approach of using a combination of null and hypomorphic alleles in zebrafish whole-organism screening with the aim of identifying target-specific compounds is particularly exciting and one that the advent of CRISPR/Cas9 technology is placed to take full advantage of, since it is now possible to generate designer mutations in the zebrafish through homology-directed repair (Hruscha et al., 2013; Hwang et al., 2013; Komor et al., 2016).

It is of interest to note that one of the main groups of compounds identified as potential interactors of the receptor in the fr24 screen is a cluster of gedunin derivatives (cluster 2). One of these compounds, deoxygedunin, has previously been identified as a TrkB agonist that has neuroprotective properties (Nie et al., 2015), can promote axon regeneration after nerve injury (English et al., 2013), and, interestingly, has been found to protect the vestibular ganglion from degeneration in mice mutant for BDNF (Jang et al., 2010). More recently, gedunin derivatives, including 3-α-DOG, have been shown to act as partial agonists for the closely related aGPCR, ADGRG1 (formerly GPR56) (Stoveken et al., 2018), a key regulator of myelination in both the CNS and PNS (Ackerman et al., 2015; Ackerman et al., 2018; Giera et al., 2015; Salzman et al., 2016). While further work will be necessary to determine if gedunin-type molecules can also bind and activate zebrafish Adgrg6 by interacting directly, these studies set a precedent for this type of interaction.

GPCRs can be modulated by the membrane lipid cholesterol, where interactions with the 7TM domain can provide plasticity for the receptors by altering their stability and structure (Huang et al., 2018; Prasanna et al., 2016). In addition, cholesterol can activate the hedgehog signalling pathway directly by binding to the extracellular domain of the GPCR Smoothened (Huang et al., 2018; Luchetti et al., 2016). Although cholesterol was not identified as a hit in our primary screen, we did identify two cholesterol-lowering drugs, ezetimibe (Altmann et al., 2004) and rosuvastatin (Istvan and Deisenhofer, 2001), as putative modulators of the Adgrg6 pathway. Whether these act by altering the activity of Adgrg6 through altering cholesterol levels remains to be determined.

In addition to the dihydropyridines (cluster 1) and the tetranortriterpenoid (gedunin-derived) compounds (cluster 2), there are also clusters of steroid hormones (danazol, hydroxyprogesterone, pregnenalone succinate, hydrocortisone hemisuccinate) and flavonoid compounds (baicalein, tangeritin, nobiletin, dimethylnobiletin, hexamethylquercetagetin). The flavonoids are a group of molecules with wide ranging activities, including anti-cancer (Ma et al., 2015) and neuroprotective properties (reviewed in Braidy et al., 2017). All four O-methylated flavonoids that rescued vcanb and mbp expression in tb233c mutants were also able to rescue fr24 allele in our assay, suggesting that they act downstream of the Adgrg6 receptor.

Our screen identified 28 compounds that down-regulated vcanb expression, but did not rescue mbp expression, which may provide useful tools to manipulate semicircular canal formation in vivo. Versican and other chondroitin sulphate proteoglycans (CSPGs) are associated with a number of human pathologies; Versican overexpression has been shown to be strongly involved in inflammation, cancer progression and the development of lung disorders (reviewed in Andersson-Sjöland et al., 2015; Ricciardelli et al., 2009; Wight et al., 2017). CSPGs and hyaluronan are components of the inhibitory scar that forms at the site of injury after CNS damage, preventing axon regeneration (Silver and Miller, 2004). In addition, CSPGs have been shown to inhibit the ability of oligodendrocytes to remyelinate axons, a process that is reversed by reduction of CSPG levels (Keough et al., 2016; Pendleton et al., 2013). Whether the down-regulation of CSPGs to promote remyelination occurs via a similar mechanism to that involved in Adgrg6-regulated projection fusion remains to be determined. However, it is of interest that a key regulator of myelination, Adgrg1, has also been recently shown to reduce fibronectin deposition and inhibit cell-ECM signalling to prevent metastatic melanoma growth (Millar et al., 2018).

In conclusion, our data show that vcanb expression in the adgrg6^tb233c mutant ear provides a robust, easy-to-use screening tool to identify drugs that target the Adgrg6 pathway. In combination with the different alleles available for adgrg6 in zebrafish, this in vivo platform provides an excellent opportunity to find hit compounds that may be specific for Adgrg6 in counter screens. These may provide a starting point for the development of therapeutic approaches towards human diseases where ADGRG6 or myelination is affected. We have identified groups of structurally-related compounds that can rescue adgrg6 mutant defects, including those that are likely to act downstream of the Adgrg6 pathway, and others that are candidates for interacting with the Adgrg6 receptor. The chemical analysis and structural comparison of the compounds shown to be putative Adgrg6 receptor agonists will contribute to the elucidation of the physical properties responsible for ligand binding and will provide further insight on the underlying mechanism of Adgrg6 signalling.

All data generated or analysed during this study are included in the manuscript and supporting files. Source data files have been provided for Table 1 and Figure 1-figure supplement 1, Figure 3, Figure 7 and Figure 7-figure supplements. Links to interactive files are given in the manuscript and in a supplementary file.

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Author details

1. Elvira Diamantopoulou

   Bateson Centre and Department of Biomedical Science, University of Sheffield, Sheffield, United Kingdom

   Contribution

   Data curation, Formal analysis, Validation, Investigation, Visualization, Writing—original draft, Writing—review and editing

   Contributed equally with

   Sarah Baxendale

   Competing interests

   No competing interests declared

   "This ORCID iD identifies the author of this article:" 0000-0002-9336-7965

2. Sarah Baxendale

   Bateson Centre and Department of Biomedical Science, University of Sheffield, Sheffield, United Kingdom

   Contribution

   Conceptualization, Data curation, Formal analysis, Supervision, Funding acquisition, Validation, Investigation, Visualization, Writing—original draft, Project administration, Writing—review and editing

   Contributed equally with

   Elvira Diamantopoulou

   Competing interests

   No competing interests declared

   "This ORCID iD identifies the author of this article:" 0000-0002-6760-9457

3. Antonio de la Vega de León

   Information School, University of Sheffield, Sheffield, United Kingdom

   Contribution

   Data curation, Formal analysis, Validation, Visualization, Writing—review and editing, Chemoinformatics analysis

   Competing interests

   No competing interests declared

   "This ORCID iD identifies the author of this article:" 0000-0003-0927-2099

4. Anzar Asad

   Bateson Centre and Department of Biomedical Science, University of Sheffield, Sheffield, United Kingdom

   Contribution

   Data curation, Validation, Investigation, Visualization, Writing—review and editing

   Competing interests

   No competing interests declared

5. Celia J Holdsworth

   Bateson Centre and Department of Biomedical Science, University of Sheffield, Sheffield, United Kingdom

   Contribution

   Investigation

   Competing interests

   No competing interests declared

6. Leila Abbas

   Bateson Centre and Department of Biomedical Science, University of Sheffield, Sheffield, United Kingdom

   Contribution

   Conceptualization, Investigation

   Competing interests

   No competing interests declared

7. Valerie J Gillet

   Information School, University of Sheffield, Sheffield, United Kingdom

   Contribution

   Visualization, Writing—review and editing, Chemoinformatics analysis

   Competing interests

   No competing interests declared

   "This ORCID iD identifies the author of this article:" 0000-0002-8403-3111

8. Giselle R Wiggin

   Sosei Heptares, Cambridge, United Kingdom

   Contribution

   Conceptualization, Supervision, Writing—review and editing

   Competing interests

   No competing interests declared

   "This ORCID iD identifies the author of this article:" 0000-0003-4436-9208

9. Tanya T Whitfield

   Bateson Centre and Department of Biomedical Science, University of Sheffield, Sheffield, United Kingdom

   Contribution

   Conceptualization, Formal analysis, Supervision, Funding acquisition, Writing—original draft, Project administration, Writing—review and editing

   For correspondence

   t.whitfield@sheffield.ac.uk

   Competing interests

   Reviewing editor, eLife

   "This ORCID iD identifies the author of this article:" 0000-0003-1575-1504

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