Leukotrienes inhibition

Oxime derivatives of heterocyclic compounds, such as pyrrole and quinoline, were proposed as anti-inflammatory agents, probably due to their ability to inhibit the biosynthesis of leukotrienes . Inhibition of 5-lipogenase by oximes of biphenyl sulfides , and by 0-aIkylcarboxylate oximes of indole " , were suggested as key leads for the development of efficient anti-inflammatory drugs. 

These properties could be separated and MK0886 had no effect on isolated, purified 5-LO, although in intact leukocyte preparations it inhibited LTs at low nM IC50 values (3-5 nM) (167). Thus, a novel mode of action of leukotriene inhibition had been discovered, which was then exploited to find new inhibitors. Indeed, it further helped the understanding of the mechanism of 5-LO activation. 

Analog (20) (180) was similar in preclinical leukotriene inhibition but somewhat superior in monkey pharmacokinetics to MK0591 (R. Bell, unpublished observations, 1994). Reported SAR trends for structures related to... 

Most of the drugs such as epinephrine and albuterol used to treat asthma attacks are bronchodilators—substances that expand the bronchial passages Newer drugs are designed to either inhibit the enzyme 5 lipoxygenase which acts on arachidomc acid m the first stage of leukotriene biosynthesis or to block leukotriene receptors... 

Allergy. Figure 3 Leukotriene LT receptor antagonists inhibit the response of target cells to leukotrienes and relieve symptoms of allergic asthma bronchiale. 

Aspirin sensitive asthma, affecting about 10% of all asthmatics, is a nonallergic response to aspirin and other agents that inhibit cyclooxygenase-1. Mechanistically, the most likely reasons are lack of bronchoprotective prostaglandin E2 and shunting of arachidonic acid into the leukotriene pathway. 

The effects of leukotrienes can be blocked at several levels. Inhibitors of FLAP or 5-LO inhibit LT synthesis at all levels. However, FLAP antagonists developed to date have been too hepatotoxic for human use. Zileuton, a 5-LO synthase inhibiting drug, also demonstrated some hepatotoxicity in a small percentage of patients, which was nonetheless entirely reversible. However, the short half-life of this compound requires four times daily... 

Triggering of asthma attacks in asthmatics. This side effect is a pseudo-allergic reaction where COX-inhibition increases the availability of substrates for lipoxygenase, which are converted to broncho-constrictive leukotriens... 

Leuko trienes are bronchoconstrictive substances released by the body during the inflammatory process. When leukotriene production is inhibited, bronchodilation is facilitated. Zileuton acts by decreasing tire formation of leukotrienes. Although the result is tire same, montelukast and zafirlukast work in a manner slightly differently from that of zileuton. Montelukast and zafirlukast are considered leukotriene receptor antagonists because they inhibit leukotriene receptor sites in the respiratory tract, preventing airway edema and facilitating bronchodilation. 

Ishii, A., Nakagawa, T., Nambia, F., Motoishi, M. and Miyarioto, T. (1990). Inhibition of endc enous leukotriene-mediated lung anaphylaxis in guinea-pigs by a novel receptor ant gonist ONO-1078. Int. Arch. Allergy Immunol. 22, 404-407. 

B-Lactamase inhibitors, 31 (1994) 297 Leprosy, chemotherapy, 20 (1983) 1 Leukocyte elastase inhibition, 31 (1994) 59 Leukotriene D4 antagonists, 38 (2001) 249 Ligand-receptor binding, 23 (1986) 41 Linear free energy, 10 (1974) 205... 

Leukotriene modifiers either inhibit 5-lipoxygenase (zileuton) or competitively antagonize the effects of leukotriene D4 (montelukast and zafirlukast). These agents improve FEV, and decrease asthma symptoms, rescue drug use, and exacerbations due to asthma. Although these agents offer the convenience of oral therapy for asthma, they are significantly less effective than low doses of inhaled corticosteroids.2,33... 

The answer is b. (Hardman, p 1061.) Sulfasalazine consists of sul-fapyridine with 5-aminosalicylic acid linked by an azo- bond. This bond is broken by bacteria that release the salicylic acid, which is believed to be the active agent. Sulfa drugs or salicylic acid used alone is not as effective. The mechanism of action is unknown, but it is believed to be protective action on the mucosa by inhibition of the synthesis of prostaglandins and leukotrienes. 

Corticosteroids have antiinflammatory and immunosuppressive properties. They interfere with antigen presentation to T lymphocytes, inhibit prostaglandin and leukotriene synthesis, and inhibit neutrophil and monocyte superoxide radical generation. 

Topical corticosteroids (Table 16-1) may halt synthesis and mitosis of DNA in epidermal cells and appear to inhibit phospholipase A, lowering the amounts of arachidonic acid, prostaglandins, and leukotrienes in the skin. These effects, coupled with local vasoconstriction, reduce erythema, pruritus, and scaling. As antipsoriatic agents, they are best used adjunc-tively with a product that specifically functions to normalize epidermal hyperproliferation. 

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