J Cachexia Sarcopenia Muscle. 2026 Aug;17(4):
e70328
Md Rameez Moin,
Shyamal Pal,
Shubhrajyoti Das,
Pallavi Awasthi,
Anushka Talukdar,
Akhilesh Kumar,
Shruti Suhas Varode,
Nikhil Nikolas,
Shamima Khatoon,
Madhav Nilkanth Mugale,
Rajdeep Guha,
Sabyasachi Sanyal,
Atul Goel.
BACKGROUND: Skeletal muscle atrophy is a frequent comorbidity of metabolic disorders and chronic diseases, and despite its high prevalence, no pharmacological therapy is available, representing a major unmet clinical need. Adiponectin and its receptors are key regulators of skeletal muscle metabolism, mitochondrial function and myogenesis, yet clinical translation has been hindered by the lack of receptor-selective agonists with favourable pharmacological and safety profiles. Here, we report the identification and characterization of CDRI-1709S, the first small-molecule AdipoR1-selective agonist and evaluate its myogenic and anti-atrophy efficacy.
METHODS: A PGC-1α luciferase reporter-based screen in AdipoR1/AdipoR2-transfected, AdipoR-low HEK293T cells identified CDRI-1709S as an AdipoR1 agonist. Adiponectin-associated signalling events were evaluated by immunoblotting in AdipoR1/2-overexpressing HEK293T cells and AdipoR-abundant C2C12 myotubes, with receptor specificity confirmed using RNA interference. Myogenic potential was assessed by morphometric analysis and immune detection of myogenic factors. Fibre-type composition and metabolic capacity were evaluated using immunoblotting and extracellular flux analysis. Anti-atrophy effects were examined in vitro using various assault-induced models of myotube atrophy, and in vivo using rat models of dexamethasone (Dex) and sciatic nerve denervation-induced muscle atrophy.
RESULTS: CDRI-1709S selectively activated AdipoR1 with high potency (EC50: 414.7pM) and, at a pharmacologically relevant concentration (100 nM), induced rapid adiponectin-associated signalling, including phosphorylation of AMPK, AKT and p38-MAPK, along with upregulation of its downstream skeletal muscle metabolic targets PGC-1α, GLUT4 and UCP3 in an AdipoR1-dependent manner (p < 0.05). CDRI-1709S promoted C2C12 myoblast differentiation into mature myotubes, accompanied by increased expression of MyoD and myogenin (p < 0.05). Treated myotubes were protected against cytokine-, Dex- and nutrient-deprivation-induced atrophy through suppression of atrogenes Atrogin-1 and MuRF-1 (p < 0.01), restoration of myogenic markers (p < 0.05) and prevention of Dex-induced fibre-type switching toward glycolytic MyHC-IIB, with concomitant induction of slow (MyHC-I) and fast (MyHC-IIA) oxidative fibres (p < 0.05). CDRI-1709S also reversed Dex-mediated impairments in oxidative and glycolytic capacity (p < 0.05). Oral administration of CDRI-1709S (10 mg/kg/day) in Dex- and denervation-induced rat models restored atrogene expression, myogenic markers, local adiponectin signalling and myofibrillar architecture to normalcy (p < 0.05 to p < 0.0001). CDRI-1709S prevented Dex-induced enrichment of glycolytic fibres and preserved oxidative fibre composition (p < 0.05). The structural/molecular improvements translated into significant functional enhancements, including toe-spread reflex in denervated limbs (p < 0.05) and increased grip strength (p < 0.0001) plus prolonged wire-hang duration (p < 0.01) in Dex-treated animals.
CONCLUSION: CDRI-1709S is the first AdipoR1-selective small-molecule agonist that induced myogenesis and robustly ameliorated skeletal muscle atrophy, establishing the proof-of-concept for AdipoR1-targeting as a promising therapeutic strategy for sarcopenia and skeletal muscle atrophy.
Keywords: AdipoR1 agonist; adiponectin; muscle fibre‐type; muscle function improvement; skeletal muscle atrophy