Structure-based design of subtype-selective psychedelic analogs.
Li, H., Tang, L., Zhang, J., Meng, B., Cao, D., Chen, Y., Yu, J., Wang, H., Liu, Z.J., Wang, S., Cheng, J.(2026) Nat Commun 17
- PubMed: 42754591 Search on PubMedSearch on PubMed Central
- DOI: https://doi.org/10.1038/s41467-026-77658-y
- Primary Citation Related Structures: 
9WPQ, 9WPX, 9WQ5, 9WQ6, 9WQA, 9WQB - PubMed Abstract: 
Classical psychedelics exert hallucinogenic and therapeutic effects primarily through activation of serotonin 2 A receptor (5-HT 2A R), offering promise as transformative treatments for neuropsychiatric disorders. However, their concurrent activation of 5-HT 2B R-associated with cardiac valvulopathy-raises serious safety concerns, underscoring the need for subtype-selective psychedelics. To address this, we determine the cryo-EM structure of 5-HT 2A R and perform a comparative structural analysis of the orthosteric binding pockets (OBPs) of 5-HT 2A R and 5-HT 2B R. Guided by key residue differences, we develop a trigonal pharmacophore model to inform the design of 5-HT 2A R-selective agonists that avoid 5-HT 2B R activation. Using this model, we design and synthesize two compound series that selectively activate 5-HT 2A R while antagonizing 5-HT 2B R. Molecular basis of subtype selectivity is confirmed by five additional cryo-EM structures of receptor-ligand complexes. Selected compounds also exhibit antidepressant-like efficacy in animal models. Our findings provide a strategy for the development of safer, subtype-selective psychedelic analogs with therapeutic potential.
- iHuman Institute, ShanghaiTech University, Shanghai, China.
Organizational Affiliation: 

