1
|
Abstract
The bradykinin B2 receptor antagonist icatibant is effective in angiotensin-converting enzyme inhibitor-induced angioedema. The drug is not approved officially for this indication and has to be administered in an emergency situation off-label. Corticosteroids or antihistamines do not seem to work in this condition. The effectiveness of C1-esterase-inhibitor in angiotensin-converting enzyme-induced angioedema must be verified in a double-blind study.
Collapse
Affiliation(s)
- Murat Bas
- Clinic of Otorhinolaryngology, Klinikum rechts der Isar, Technische Universität München, Ismaninger St 22, 81675 Munich, Germany.
| |
Collapse
|
2
|
Bas M. Evidence and evidence gaps of medical treatment of non-tumorous diseases of the head and neck. GMS CURRENT TOPICS IN OTORHINOLARYNGOLOGY, HEAD AND NECK SURGERY 2016; 15:Doc02. [PMID: 28025602 PMCID: PMC5169075 DOI: 10.3205/cto000129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Unfortunately, the treatment of numerous otolaryngological diseases often lacks of evidence base because appropriate studies are missing. Whereas sufficient high-quality trials exist for the specific immunotherapy of allergic rhinitis and in a limited measure also for the angiotensin-converting enzyme inhibitor induced angioedema, the evidence for Menière’s disease or for pharmacotherapy of postoperative laryngeal edema is rather poor. This contribution will discuss the trial situation and evidence of the respective diseases.
Collapse
Affiliation(s)
- Murat Bas
- Department of Otolaryngology, Technische Universität München, Germany
| |
Collapse
|
3
|
Kolodka T, Charles ML, Raghavan A, Radichev IA, Amatya C, Ellefson J, Savinov AY, Nag A, Williams MS, Robbins MS. Preclinical characterization of recombinant human tissue kallikrein-1 as a novel treatment for type 2 diabetes mellitus. PLoS One 2014; 9:e103981. [PMID: 25100328 PMCID: PMC4123992 DOI: 10.1371/journal.pone.0103981] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Accepted: 07/04/2014] [Indexed: 01/06/2023] Open
Abstract
Modulation of the kallikrein-kinin system (KKS) has been shown to have beneficial effects on glucose homeostasis and several other physiological responses relevant to the progression of type 2 diabetes mellitus (T2D). The importance of bradykinin and its receptors in mediating these responses is well documented, but the role of tissue kallikrein-1, the protease that generates bradykinin insitu, is much less understood. We developed and tested DM199, recombinant human tissue kallikrein-1 protein (rhKLK-1), as a potential novel therapeutic for T2D. Hyperinsulinemic-euglycemic clamp studies suggest that DM199 increases whole body glucose disposal in non-diabetic rats. Single-dose administration of DM199 in obese db/db mice and ZDF rats, showed an acute, dose-dependent improvement in whole-body glucose utilization. Sub-acute dosing for a week in ZDF rats improved glucose utilization, with a concomitant rise in fasting insulin levels and HOMA1-%B scores. After cessation of sub-acute dosing, fasting blood glucose levels were significantly lower in ZDF rats during a drug wash-out period. Our studies show for the first time that DM199 administration results in acute anti-hyperglycemic effects in several preclinical models, and demonstrate the potential for further development of DM199 as a novel therapeutic for T2D.
Collapse
Affiliation(s)
- Tadeusz Kolodka
- DiaMedica USA, Inc., Minneapolis, Minnesota, United States of America
| | | | - Arvind Raghavan
- DiaMedica USA, Inc., Minneapolis, Minnesota, United States of America
- * E-mail:
| | - Ilian A. Radichev
- Sanford Project/Children’s Health Research Center, Sanford Research, Sioux Falls, South Dakota, United States of America
| | - Christina Amatya
- Sanford Project/Children’s Health Research Center, Sanford Research, Sioux Falls, South Dakota, United States of America
| | - Jacob Ellefson
- Sanford Project/Children’s Health Research Center, Sanford Research, Sioux Falls, South Dakota, United States of America
| | - Alexei Y. Savinov
- Sanford Project/Children’s Health Research Center, Sanford Research, Sioux Falls, South Dakota, United States of America
| | - Abhijeet Nag
- Invitek, Inc., Hayward, California, United States of America
| | - Mark S. Williams
- DiaMedica USA, Inc., Minneapolis, Minnesota, United States of America
| | - Mark S. Robbins
- DiaMedica USA, Inc., Minneapolis, Minnesota, United States of America
| |
Collapse
|
4
|
Andrade SS, Silva-Lucca RA, Santana LA, Gouvea IE, Juliano MA, Carmona AK, Araújo MS, Sampaio MU, Oliva MLV. Biochemical characterization of a cysteine proteinase from Bauhinia forficata leaves and its kininogenase activity. Process Biochem 2011. [DOI: 10.1016/j.procbio.2010.10.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
5
|
Abstract
Angioedema is an underestimated clinical problem. Many cases are nonallergic reactions, e.g. bradykinin-induced angioedema caused by genetic defects and angiotensin-converting enzyme (ACE) inhibitors. This difference is crucial for successful therapy, in particular when complete emergency care is not available. Five important forms of nonallergic angioedema can be distinguished: hereditary (HAE), acquired (AAE), renin-angiotensin-aldosterone system (RAAS)-blocker-induced (RAE), pseudoallergic angioedema (PAE) and idiopathic angioedema (IAE). Some angioedema are present in the larynx and may cause death. A vast majority of nonallergic angioedema are RAE, particularly those caused by ACE inhibitors. It appears important to emphasize that in patients with complete intolerance to RAAS-blockers, cessation of RAAS-blockers is likely to be associated with increased cardiovascular risk. Currently, there is no published algorithm for diagnosis and treatment. Angioedema is usually treated by a conservative clinical approach using artificial ventilation, glucocorticoids and antihistamines. Today, a plasma pool C1-esterase inhibitor (C1-INH) concentrate is the therapy of choice in HAE. The current pharmacotherapy of nonallergic angioedema is not satisfactory, thus requiring the identification of effective agents in clinical trials. Recently, several new drugs were developed: a recombinant C1-INH, a kallikrein inhibitor (ecallantide) and a specific bradykinin-B2-receptor antagonist (icatibant). According to currently available reports, these drugs may improve the treatment of kinin-induced angioedema.
Collapse
Affiliation(s)
- M Bas
- Hals-, Nasen- und Ohrenklinik, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | | | | | | | | | | |
Collapse
|
6
|
Araújo RC, Mori MA, Merino VF, Bascands JL, Schanstra JP, Zollner RL, Villela CA, Nakaie CR, Paiva ACM, Pesquero JL, Bader M, Pesquero JB. Role of the kinin B1 receptor in insulin homeostasis and pancreatic islet function. Biol Chem 2006; 387:431-6. [PMID: 16606341 DOI: 10.1515/bc.2006.057] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
Kinins are potent vasoactive peptides generated in blood and tissues by the kallikrein serine proteases. Two distinct kinin receptors have been described, one constitutive (subtype B2) and one inducible (subtype B1), and many physiological functions have been attributed to these receptors, including glucose homeostasis and control of vascular permeability. In this study we show that mice lacking the kinin B1 receptor (B1
-/- mice) have lower fasting plasma glucose concentrations but exhibit higher glycemia after feeding when compared to wild-type mice. B1
-/- mice also present pancreas abnormalities, characterized by fewer pancreatic islets and lower insulin content, which leads to hypoinsulinemia and reduced insulin release after a glucose load. Nevertheless, an insulin tolerance test indicated higher sensitivity in B1
-/- mice. In line with this phenotype, pancreatic vascular permeability was shown to be reduced in B1 receptor-ablated mice. The B1 agonist desArg9bradykinin injected intravenously can induce the release of insulin into serum, and this effect was not observed in the B1
-/- mice or in isolated islets. Our data demonstrate the importance of the kinin B1 receptor in the control of pancreatic vascular homeostasis and insulin release, highlighting a new role for this receptor in the pathogenesis of diabetes and related diseases.
Collapse
|
7
|
Couture R, Girolami JP. Putative roles of kinin receptors in the therapeutic effects of angiotensin 1-converting enzyme inhibitors in diabetes mellitus. Eur J Pharmacol 2005; 500:467-85. [PMID: 15464053 DOI: 10.1016/j.ejphar.2004.07.045] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2004] [Indexed: 02/07/2023]
Abstract
The role of endogenous kinins and their receptors in diabetes mellitus is being confirmed with the recent developments of molecular and genetic animal models. Compelling evidence suggests that the kinin B(2) receptor is organ-protective and partakes to the therapeutic effects of angiotensin 1-converting enzyme inhibitors (ACEI) and angiotensin AT(1) receptor antagonists. Benefits derive primarily from vasodilatory, antihypertensive, antiproliferative, antihypertrophic, antifibrotic, antithrombotic and antioxidant properties of kinin B(2) receptor activation. Mechanisms include the formation of nitric oxide and prostacyclin and the inhibition of NAD(P)H oxidase activity involving classical and novel signalling pathways. Kinin B(2) receptor also ameliorates insulin resistance by increasing glucose uptake and supply, and by inducing glucose transporter-4 translocation either directly or through phosphorylation of insulin receptor. The kinin B(1) receptor, which is induced by the cytokine network, growth factors and hyperglycaemia, mediates hyperalgesia, vascular hyperpermeability and leukocytes infiltration in diabetic animals. However, emerging data highlight reno- and cardio-protective effects mediated by kinin B(1) receptor under chronic ACEI therapy in diabetes mellitus. Thus, the Janus-faced of kinin receptors needs to be taken into account in future drug development. For instance, locally acting kinin B(1)/B(2) receptor agonists if used in a safe therapeutic window may represent a more rationale strategy in the prevention and management of diabetic complications. Because kinin B(2) receptor antagonists may further increase insulin resistance, the persisting dogma that restricts the development of kinin receptor analogues to antagonists (that is still relevant to abrogate pain and inflammation) needs to be revisited.
Collapse
Affiliation(s)
- Réjean Couture
- Département de Physiologie, Faculté de Médecine, Université de Montréal, C.P. 6128, Succursale centre-ville, Montréal, Québec, Canada H3C 3J7.
| | | |
Collapse
|
8
|
Arbin V, Claperon N, Fournié-Zaluski MC, Roques BP, Peyroux J. Effects of dual angiotensin-converting enzyme and neutral endopeptidase 24-11 chronic inhibition by mixanpril on insulin sensitivity in lean and obese Zucker rats. J Cardiovasc Pharmacol 2003; 41:254-64. [PMID: 12548087 DOI: 10.1097/00005344-200302000-00015] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The aim of this study was to examine the effects of chronic (8-day) oral treatment with the dual angiotensin-converting enzyme (ACE) and neutral endopeptidase 24-11 (NEP) inhibitor mixanpril (25 mg/kg twice a day), compared with the ACE inhibitor captopril (25 mg/kg twice a day), on whole body insulin-mediated glucose disposal in young (10-week) and old (19-week) obese Zucker rats (ZOs). Moreover, the effects of chronic mixanpril administration on femoral blood flow at rest and during an insulin infusion were assessed. In the young ZOs, mixanpril decreased the glucose response during an IV glucose tolerance test more effectively than did captopril (-49 and -30%, respectively, p < 0.05). Incremental glucose area under the curve in mixanpril-treated ZOs was then no longer different from that observed in vehicle-treated lean rats (1,592 +/- 175 and 1, 470 +/- 104 mg/dl x min, respectively). The beneficial effects resulting from mixanpril or captopril administration were observed in ZOs but not in lean littermates. In the old ZOs, mixanpril induced higher glucose infusion rates to maintain euglycemia than did captopril during a hyperinsulinemic euglycemic clamp test (+92 and +35%, respectively, p < 0.001). However, the glucose infusion rates in mixanpril-treated ZOs remained much lower than that observed in vehicle-treated lean rats (9.4 +/- 0.7 mg/kg/min vs 28.6 +/- 1.0 mg/kg/min, p < 0.001). Mixanpril did not affect resting femoral vascular bed hemodynamics but restored the femoral blood flow response to insulin infusion. In conclusion, in ZOs, chronic dual ACE/NEP inhibition improves whole body insulin-mediated glucose disposal more effectively than does ACE inhibition alone. This beneficial effect seems to be restricted to conditions of insulin resistance and not directly linked to the improvement in the femoral blood flow response to insulin.
Collapse
Affiliation(s)
- Valérie Arbin
- Laboratoire de Pharmacologie, Faculté des Sciences Pharmaceutiques et Biologiques, Paris, France
| | | | | | | | | |
Collapse
|
9
|
Damas J, Hallet C, Lefebvre PJ. Changes in blood glucose and plasma insulin levels induced by bradykinin in anaesthetized rats. Br J Pharmacol 2001; 134:1312-8. [PMID: 11704652 PMCID: PMC1573062 DOI: 10.1038/sj.bjp.0704374] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
1. The influence of bradykinin (BK) on blood glucose and plasma insulin levels was investigated in anaesthetized rats. 2. Blood glucose level was dose-dependently increased by intravenous infusion of BK. This effect of BK was enhanced by captopril, an inhibitor of angiotensin-converting enzyme (ACE). Des-Arg9-bradykinin (DABK), a kinin B1 receptor agonist, did not modify blood glucose levels while the effect of BK was inhibited by Hoe-140, a kinin B2 receptor antagonist. 3. The effect of BK was reduced by the NO-synthase inhibitor, N(omega)-nitro-L-arginine methyl ester (L-NAME), and by the cyclo-oxygenase inhibitor, indomethacin. The effect of BK was suppressed by the association of propranolol with phentolamine or phenoxybenzamine. It was also reduced by hexamethonium, a ganglion-blocking drug. In adrenalectomized rats, the infusion of BK slightly decreased blood glucose levels. 4. The hyperglycaemic effect of adrenaline was suppressed by propranolol associated with phentolamine or phenoxybenzamine, but it was not modified by L-NAME. 5. Infusion of BK did not modify plasma insulin levels. However, after phentolamine and propranolol, BK induced a transient 2 fold rise in plasma insulin levels. The release of insulin was dose-dependent and inhibited by Hoe-140. 6. We conclude that infusion of BK induces, via a stimulation of B2 receptors, the release of NO and of prostanoids. The latter agents activate through a reflex pathway the release of catecholamines from the adrenal medulla. This release increases blood glucose levels and reduces plasma insulin levels. After adrenoceptor inhibition, BK induces a secretion of insulin, via the stimulation of B2 receptors.
Collapse
Affiliation(s)
- Jacques Damas
- Human Physiology, University of Liège, 17 Place Delcour, Liège B-4020, Belgium
- Author for correspondence:
| | - Claude Hallet
- Human Physiology, University of Liège, 17 Place Delcour, Liège B-4020, Belgium
| | - Pierre J Lefebvre
- Division of Diabetes, Nutrition and Metabolic Disorders, Department of Medicine, University of Liège, Belgium
| |
Collapse
|
10
|
Moura AS. Bradykinin enhances membrane electrical activity of pancreatic beta cells in the presence of low glucose concentrations. Braz J Med Biol Res 2000; 33:1089-92. [PMID: 10973143 DOI: 10.1590/s0100-879x2000000900016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
In most of cells bradykinin (BK) induces intracellular calcium mobilization. In pancreatic beta cells intracellular calcium is a major signal for insulin secretion. In these cells, glucose metabolism yields intracellular ATP which blocks membrane potassium channels. The membrane depolarizes, voltage-dependent Ca2+ channels are activated and the intracellular calcium load allows insulin secretion. Repolarization occurs due to activation of the Ca2+-dependent K+ channel. The insulin secretion depends on the integrity of this oscillatory process (bursts). Therefore, we decided to determine whether BK (100 nM) induces bursts in the presence of a non-stimulatory glucose concentration (5.6 mM). During continuous membrane voltage recording, our results showed that bursts were obtained with 11 mM glucose, blocked with 5.6 mM glucose and recovered with 5.6 mM glucose plus 100 nM BK. Thus, the stimulatory process obtained in the presence of BK and of a non-stimulatory concentration of glucose in the present study suggests that BK may facilitate the action of glucose on beta cell secretion.
Collapse
Affiliation(s)
- A S Moura
- Laboratório de Fisiologia Celular, Departamento de Fisiologia, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.
| |
Collapse
|