Other Enzyme Inhibitors

Other useful enzyme inhibitors include acetazolamide (Diamox) (carboific anhydrase inhibitor) for the treatment of glaucoma, congestive heart failure, epilepsy and motion sickness (a very useful drug ). Sildenafil (Viagra), famous for treatment of impotence, inhibits a phosphodiesterase enzyme (PDE5) that is involved in the breakdown of ATP. 

Leflunomide (Arava) is an anti-proliferative drug that inhibits dihydroorotate dehydrogenase, an enzyme essential for the synthesis of pyrimidines such as uracil, via aromatisation of dihydroorotic acid. It also has some immunomodulatory effects and is useful for intractable cases of rheumatoid arthritis, despite being liable to cause a number of serious side-effects. It is actually a prodrug, being converted into the active compound, a nitrile formed by cleavage of the isoxazole ring (cf. 25.5.1). 

On the downside, grapefruit juice contains inhibitors such as bergamotin and naringin, which can drastically reduce the rate of metabolism of many drugs, leading to toxic effects from overdose However, there may be some potential here for improving drugs that are subject to excessively rapid metabolism. 

---

Figure 16.8 Other enzyme inhibitors from virtual screening.

The magnitude of inhibition of polygalacturonase was found to be dependent on preincubation of inhibitor with the enzyme. Similar observations have been reported for other enzyme inhibitors (Shivaraj and Pattabiraman, 1980 Sharma and Pattabiraman, 1980 Padmanabhan and Shrasti, 1990). However, preincubation of the inhibitor with substrate did not show any effect on inhibitor activity. In contrast, Shivaraj and Pattabiraman (1980) and Buonocore et al. (1977), have observed inactivation of amylase inhibitor activity on pretreatment with starch. 

Transition-state stabilization, analogs, and other enzyme inhibitors... 

Phosphate buffer, azide free, 0.1-0.5 M, is suitable for the iodination reaction, but the enzymes and hormone should be diluted in 10—50 mM buffer, as the higher molarity may cause aggregation. There must be no azide or other enzyme inhibitors in the buffers used for the iodination reagents. 

Other Enzyme Inhibitors Derived from Thalidomide... 

This seems to be the only report of this interaction but it would appear to be of clinical importance. Care is needed if ciprofloxacin and methadone are given concurrently, especially if there are other factors such as smoking or the use of other enzyme inhibitors, which may also contribute to the interaction. Be alert for the need to change the methadone dosage. Consider also Quinolones + Opioids , p.338. 

Normally, most trypomastigotes are released 4 or 5 days after the original infection (Fig. 1). However, in. the presence of the ADP-ribosyltransferase inhibitor, 3-amino-benzamide [9], release was significantly and reproducibly delayed (Fig. 1 A). The presence of 3-aminobenzoic acid produced no significant effect. Stronger inhibitory effects were produced by other enzyme inhibitors. 5-Methylnicotinamide [10] (Fig. IB) and 3-methoxybenzamide [9] (Fig. 1C) almost totally blocked the appearance of the... 

Most of the GA-synthesis inhibitors characterized so far affect two segments of the compHcated pathway from MVA to the many different GAs identified. The cycHzation reactions that produce / Akaurene are inhibited by the onium growth retardants, and the oxidations of /-kaurene to /-kaurenoic acid are sensitive to heterocycHc triazoles such as paclobutrazol and similar compounds. Other enzymes in the pathway are points for pathway dismption by as yet undeveloped GA biosynthesis inhibitors (236). 

One approach to combating antibiotic resistance caused by P-lactamase is to inhibit the enzyme (see Enzyme inhibition). Effective combinations of enzyme inhibitors with P-lactam antibiotics such as penicillins or cephalosporins, result in a synergistic response, lowering the minimal inhibitory concentration (MIC) by a factor of four or more for each component. However, inhibition of P-lactamases alone is not sufficient. Pharmacokinetics, stability, ability to penetrate bacteria, cost, and other factors are also important in determining whether an inhibitor is suitable for therapeutic use. Almost any class of P-lactam is capable of producing P-lactamase inhibitors. Several reviews have been pubUshed on P-lactamase inhibitors, detection, and properties (8—15). 

NH2). The acid crystallises readily when 4g in 50mL H2O is treated with abs EtOH at 4°/ 3hrs, and is collected washed with cold abs EtOH and Et20 and dried in vac. Also recrystallises from aqueous Me2CO, Rp on Si02 TLC plates with n-BuOH-H20-AcOH (4 1 1) is 0.26. The racemate has m 238-240°. [Leukart et al. Helv Chim Acta 59 2181 1976 Eberle and Zeller Helv Chim Acta 68 1880 1985 Jansen et al. Reel Trav Chim Pays-Bas 88 819 7969.] It is a suicide inhibitor of y-cystathionase and other enzymes [Washtier and Abeles Biochemistry 16 2485 7977 Shinozuka et al. Eur J Biochem 124 377 7982]. 

Several other research teams used the Paal-Knorr condensation to prepare 2,5-disubstituted furans that were investigated as potential enzyme inhibitors. Nagai produced furan 17 via treatment of dione 16 with sulfuric acid and subsequently examined the activity of 17 toward a retenoic acid receptor. Perrier discovered that furan 19, derived from dione 18, is a potent PDE4 inhibitor and may have anti-inflammatory activity. ... 

Apart from these two Vertex compounds, only one other caspase inhibitor, BDN-6556, has been used in clinical trials. This compound belongs to the class of oxamyl dipeptides and was originally developed by Idun Pharmaceuticals (taken over by Pfizer). It is the only pan-caspase inhibitor that has been evaluated in humans. BDN-6556 displays inhibitory activity against all tested human caspases. It is also an irreversible, caspase-specific inhibitor that does not inhibit other major classes of proteases, or other enzymes or receptors. The therapeutic potential of BDN-6556 was first evaluated in several animal models of liver disease because numerous publications suggested that apoptosis contributes substantially to the development of some hepatic diseases, such as alcoholic hepatitis, hepatitis B and C (HBV, HCV), non-alcoholic steato-hepatitis (NASH), and ischemia/reperfusion injury associated with liver transplant. Accordingly, BDN-6556 was tested in a phase I study. The drug was safe and... 

Second generation COMT inhibitors were developed by three laboratories in the late 1980s. Apart from CGP 28014, nitrocatechol is the key structure of the majority of these molecules (Fig. 3). The current COMT inhibitors can be classified as follows (i) mainly peripherally acting nitrocatechol-type compounds (entacapone, nitecapone, BIA 3-202), (ii) broad-spectrum nitrocatechols having activity both in peripheral tissues and the brain (tolcapone, Ro 41-0960, dinitrocatechol, vinylphenylk-etone), and (iii) atypical compounds, pyridine derivatives (CGP 28014,3-hydroxy-4-pyridone and its derivatives), some of which are not COMT inhibitors in vitro but inhibit catechol O-methylation by some other mechanism. The common features of the most new compounds are excellent potency, low toxicity and activity through oral administration. Their biochemical properties have been fairly well characterized. Most of these compounds have an excellent selectivity in that they do not affect any other enzymes studied [2,3]. 

Unlike aspirin and other cyclooxygenase inhibitors that work on the COX-1 and COX-2 enzymes, acetaminophen works on the COX-3 enzyme, which is present in the spinal column and brain. This helps it to avoid shutting down prostaglandin function elsewhere in the body, which is why it has no anti-inflammatory effects and does not affect blood platelets or the stomach lining. 

---