IntroductionInhibitors of bone resorption can preserve bone mass and maintain normal bone architecture, thereby preventing fractures in later life (1).The bone-resorption process requires secretion of protons by the osteoclasts (2). This allows the dissolution of the bone mineral and the maintenance of the acidic environment required by proteolytic enzymes to degrade the bone matrix (3). Protons are extruded by a proton pump belonging to the class of vacuolar-type H + -ATPases (V-H + -ATPases (4) that is present in high concentration on the ruffled border (apical surface) of the resorbing osteoclast.The osteoclast V-H + -ATPase therefore represents a previously unexploited molecular target for the design of novel agents for reducing osteoclast activity. However, since V-H + -ATPase is an ubiquitous component of eukaryotic organisms and is the major electrogenic pump of endomembranes (5), the selective inhibition of the osteoclast V-H + -ATPase must be achieved in order to afford novel drugs that may constitute useful and safe agents for the treatment of osteoporosis and related osteopenic diseases.Bafilomycin A 1 , a potent and specific inhibitor of V-H + -ATPases (6), inhibits bone resorption both in vitro (7) and in vivo (8). However, since bafilomycin is not selective for any particular type of V-H + -ATPases, when administered to animals it inhibits all the essential V-H + -ATPases leading to systemic alteration of cellular physiology and to unacceptable toxicity (9). Recently, a novel class of small molecules endowed with potent osteoclast V-H + -ATPase inhibitory activity has been discovered (10), whose optimization resulted in (2Z,4E)-5-(5,6-dichloro-2-indolyl)-2-methoxy-N-(1,2,2,6,6-pentamethylpiperidin-4-yl)-2,4-pentadienamide (SB 242784; Figure 1) (11). The in vitro V-H + -ATPase inhibitory profile of SB 242784 has been reported previously (11). SB 242784 was a low-nanomolar inhibitor (IC 50 = 26.3 nM) of the bafilomycin-sensitive (vacuolar) Mg 2+ -ATPase in membrane preparations of osteoclasts obtained from egg-laying hens. In addition, SB 242784 was a very potent inhibitor of bone resorption (IC 50 = 3.4 nM) in an assay measuring the collagen fragments released from bone slices after a 48-hour incubation with human osteoclasts.In this paper we characterize further the biochemical and pharmacological actions of SB 242784 and demonstrate that it is highly selective for the V-H + -ATPase of human osteoclasts when compared with V-H + -ATPases from a number of other human tissues. Most importantly, we show that oral administration of SB 242784 reduces the retinoid-induced hypercalcemia in thyroparathyroidectomized (TPTX) rats and prevents the A potent and selective inhibitor of the osteoclastic V-H + -ATPase, (2Z,4E)-5-(5,6-dichloro-2-indolyl)-2-methoxy-N-(1,2,2,6,6-pentamethylpiperidin-4-yl) -2,4-pentadienamide (SB 242784), was evaluated in two animal models of bone resorption. SB 242784 completely prevented retinoid-induced hypercalcemia in thyroparathyroidectomized (TPTX) rats when administered orally ...