Vasoactive peptides activation

The triptans are considered specific therapies in that they target the pathophysiology underlying migraine.33 They abort headache through beneficial effects on neuronal imbalances.11 Triptans inhibit neurotransmission in the trigeminal complex and activate serotonin lb/Id pathways that modulate nociception in the brain stem. They also decrease the release of vasoactive peptides leading to vascular reactivity and pain.34 Triptans are a welcome addition to the therapeutic armamentarium in that they are available in intranasal, subcutaneous, and oral... 

Membrane alanyl aminopeptidase (microsomal aminopeptidase, amino-peptidase M, EC 3.4.11.2) and peptidyl-dipeptidase A (angiotensin I converting enzyme, EC 3.4.15.1) located in the vascular endothelium and smooth muscle cell surface modulate the levels of vasoactive peptides [23], One of the roles of membrane-bound enzymes is to switch off the action of peptides in the vicinity of the target or to prevent them from gaining access to a region containing receptors that are activated only by locally released peptides. 

Preliminary information useful in prodrug design has been obtained with amino acids attached to model aromatic amines. Thus, N-(naphthalen-2-yl) amides of amino acids (6.1, R=side chain of amino acid, R =H) proved to be of interest as test compounds to monitor peptidase activity such as ami-nopeptidase M (membrane alanyl aminopeptidase, microsomal aminopepti-dase, EC 3.4.11.2) [16][17], In the presence of purified rabbit kidney aminopeptidase M or human cerebrospinal fluid (CSF) aminopeptidase activity, the rate of hydrolysis decreased in the order Ala-> Leu->Arg->Glu-2-naphthyl-amide. Ala-2-naphthylamide, in particular, proved to be a good test compound, as its rate of hydrolysis was influenced by experimental conditions (preparation, inhibitors, etc.), as was the hydrolysis of a number of low-molecular-weight opioid peptides and circulating vasoactive peptides. 

Bosentan, an orally active competitive inhibitor of endothelin (see Chapter 17 Vasoactive Peptides), has been shown to have some benefits in experimental animal models of heart failure, but results in human trials have not been impressive. This drug is approved for use in pulmonary hypertension (see Chapter 11 Antihypertensive Agents). It has significant teratogenic and hepatotoxic effects. 

Desmopressin acetate (arginine vasopressin) increases the factor VIII activity of patients with mild hemophilia A or von Willebrand disease. It can be used in preparation for minor surgery such as tooth extraction without any requirement for infusion of clotting factors if the patient has a documented adequate response. High-dose intranasal desmopressin (see Chapter 17 Vasoactive Peptides) is available and has been shown to be efficacious and well tolerated by patients. 

M. Belew, B. Gcidin, G. Lindeberg, J. Porath, and R. Wallin. Structural-activity relation ships of vasoactive peptides derived from fibrin or fibrinoesn degraded by plasmtn. Bwchim. Bfophys.Acta 627 169-178 (1980)-... 

Fig. 9.1 Schematic model depicting the key events which mediate diabetes-associated vascular complications. Diabetes/hyperglycemia augments the levels of vasoactive peptides including Ang II/ET-1 that enhance the generation of reactive oxygen species (ROS). ROS-induced activation of growth-promoting signaling pathways, such as PKC and MAPK, contributes to aberrant vascular functions.

---