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Mokrov GV. Linked biaromatic compounds as cardioprotective agents. Arch Pharm (Weinheim) 2021; 355:e2100428. [PMID: 34967027 DOI: 10.1002/ardp.202100428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/02/2021] [Accepted: 12/03/2021] [Indexed: 11/08/2022]
Abstract
Cardiovascular diseases (CVDs) are widespread in the modern world, and their number is constantly growing. For a long time, CVDs have been the leading cause of morbidity and mortality worldwide. Drugs for the treatment of CVD have been developed almost since the beginning of the 20th century, and a large number of effective cardioprotective agents of various classes have been created. Nevertheless, the need for the design and development of new safe drugs for the treatment of CVD remains. Literature data indicate that a huge number of cardioprotective agents of various generations and mechanisms correspond to a single generalized pharmacophore model containing two aromatic nuclei linked by a linear linker. In this regard, we put forward a concept for the design of a new generation of cardioprotective agents with a multitarget mechanism of action within the indicated pharmacophore model. This review is devoted to a generalization of the currently known compounds with cardioprotective properties and corresponding to the pharmacophore model of biaromatic compounds linked by a linear linker. Particular attention is paid to the history of the creation of these drugs, approaches to their design, and analysis of the structure-action relationship within each class.
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Affiliation(s)
- Grigory V Mokrov
- Department of Medicinal Chemistry, FSBI "Zakusov Institute of Pharmacology", Moscow, Russia
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Kho J, Ioannou A, Mandal AKJ, Cox A, Nasim A, Metaxa S, Missouris CG. Long term use of donepezil and QTc prolongation. Clin Toxicol (Phila) 2020; 59:208-214. [PMID: 32609550 DOI: 10.1080/15563650.2020.1788054] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND The neurocognitive benefits of donepezil are well recognised, but the potential side effects on cardiac conduction remain unclear. OBJECTIVE To investigate whether long-term donepezil therapy is associated with electrocardiographic (ECG) changes and in particular to assess its effects on the QT interval. METHODS We conducted a single centre retrospective analysis of patients admitted to our trust on donepezil therapy over a 12-month period. An admission resting 12-lead ECG was obtained and compared to their ECG prior to commencement of donepezil therapy to assess for any significant difference in ECG parameters. RESULTS We identified 59 patients suitable for analysis. PR (177.0 ± 29.0 ms vs. 186.1 ± 34.2 ms, p = 0.04), QRS (101.7 ± 20.3 ms vs. 104.7 ± 22.3 ms, p = 0.04) and QT (393.3 ± 35.6 ms vs. 411.9 ± 44.6 ms, p = 0.002) interval prolongation were all associated with donepezil use. The increase in QT intervals remained significant on correction for heart rate; resulting in 8 (13.6%) patients developing high arrhythmogenic risk based on assessment using QT nomogram plots. Concomitant use of tricyclic antidepressants was associated with significant QT prolongation (QTcB: r pb = 0.344, p = 0.008, QTcFred: r pb = 0.382, p = 0.003, QTcFram: r pb = 0.379, p = 0.003, QTcH: r pb = 0.352, p = 0.006), while the use of rate-limiting calcium channel blockers was associated with significant PR prolongation (r pb = 0.314, p = 0.030), and beta-blockers with a reduction in heart rate (r pb = 0.256, p = 0.050). CONCLUSION Our results clearly demonstrate that long-term use of donepezil is associated with prolongation of the QT interval. We suggest ECG evaluation should take place before and after donepezil initiation, and clinicians should be even more vigilant in those prescribed tricyclic antidepressants.
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Affiliation(s)
- Jason Kho
- Department of Cardiology and Internal Medicine, Wexham Park Hospital, Frimley Health NHS Foundation Trust, Slough, UK
| | - Adam Ioannou
- Royal Free Hospital, Royal Free London NHS Foundation Trust, Camden, UK
| | - Amit K J Mandal
- Department of Cardiology and Internal Medicine, Wexham Park Hospital, Frimley Health NHS Foundation Trust, Slough, UK
| | - Andrew Cox
- Department of Cardiology and Internal Medicine, Wexham Park Hospital, Frimley Health NHS Foundation Trust, Slough, UK
| | - Ashraf Nasim
- Department of Cardiology and Internal Medicine, Wexham Park Hospital, Frimley Health NHS Foundation Trust, Slough, UK
| | - Sofia Metaxa
- Department of Cardiology and Internal Medicine, Wexham Park Hospital, Frimley Health NHS Foundation Trust, Slough, UK
| | - Constantinos G Missouris
- Department of Cardiology and Internal Medicine, Wexham Park Hospital, Frimley Health NHS Foundation Trust, Slough, UK.,Medical School, University of Cyprus, Nicosia, Cyprus
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Zhao Z, Ruan S, Ma X, Feng Q, Xie Z, Nie Z, Fan P, Qian M, He X, Wu S, Zhang Y, Zheng X. Challenges Faced with Small Molecular Modulators of Potassium Current Channel Isoform Kv1.5. Biomolecules 2019; 10:E10. [PMID: 31861703 PMCID: PMC7022446 DOI: 10.3390/biom10010010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 12/08/2019] [Accepted: 12/10/2019] [Indexed: 12/30/2022] Open
Abstract
The voltage-gated potassium channel Kv1.5, which mediates the cardiac ultra-rapid delayed-rectifier (IKur) current in human cells, has a crucial role in atrial fibrillation. Therefore, the design of selective Kv1.5 modulators is essential for the treatment of pathophysiological conditions involving Kv1.5 activity. This review summarizes the progress of molecular structures and the functionality of different types of Kv1.5 modulators, with a focus on clinical cardiovascular drugs and a number of active natural products, through a summarization of 96 compounds currently widely used. Furthermore, we also discuss the contributions of Kv1.5 and the regulation of the structure-activity relationship (SAR) of synthetic Kv1.5 inhibitors in human pathophysiology. SAR analysis is regarded as a useful strategy in structural elucidation, as it relates to the characteristics that improve compounds targeting Kv1.5. Herein, we present previous studies regarding the structural, pharmacological, and SAR information of the Kv1.5 modulator, through which we can assist in identifying and designing potent and specific Kv1.5 inhibitors in the treatment of diseases involving Kv1.5 activity.
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Affiliation(s)
- Zefeng Zhao
- Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, Northwest University, 229 Taibai Road, Xi’an 710069, China; (Z.Z.); (S.R.); (X.M.); (Q.F.); (Z.X.); (Z.N.); (P.F.); (Y.Z.); (X.Z.)
- Biomedicine Key Laboratory of Shaanxi Province, School of Pharmacy, Northwest University, 229 Taibai Road, Xi’an 710069, China
| | - Songsong Ruan
- Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, Northwest University, 229 Taibai Road, Xi’an 710069, China; (Z.Z.); (S.R.); (X.M.); (Q.F.); (Z.X.); (Z.N.); (P.F.); (Y.Z.); (X.Z.)
- Biomedicine Key Laboratory of Shaanxi Province, School of Pharmacy, Northwest University, 229 Taibai Road, Xi’an 710069, China
| | - Xiaoming Ma
- Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, Northwest University, 229 Taibai Road, Xi’an 710069, China; (Z.Z.); (S.R.); (X.M.); (Q.F.); (Z.X.); (Z.N.); (P.F.); (Y.Z.); (X.Z.)
- Biomedicine Key Laboratory of Shaanxi Province, School of Pharmacy, Northwest University, 229 Taibai Road, Xi’an 710069, China
| | - Qian Feng
- Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, Northwest University, 229 Taibai Road, Xi’an 710069, China; (Z.Z.); (S.R.); (X.M.); (Q.F.); (Z.X.); (Z.N.); (P.F.); (Y.Z.); (X.Z.)
- Biomedicine Key Laboratory of Shaanxi Province, School of Pharmacy, Northwest University, 229 Taibai Road, Xi’an 710069, China
| | - Zhuosong Xie
- Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, Northwest University, 229 Taibai Road, Xi’an 710069, China; (Z.Z.); (S.R.); (X.M.); (Q.F.); (Z.X.); (Z.N.); (P.F.); (Y.Z.); (X.Z.)
- Biomedicine Key Laboratory of Shaanxi Province, School of Pharmacy, Northwest University, 229 Taibai Road, Xi’an 710069, China
| | - Zhuang Nie
- Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, Northwest University, 229 Taibai Road, Xi’an 710069, China; (Z.Z.); (S.R.); (X.M.); (Q.F.); (Z.X.); (Z.N.); (P.F.); (Y.Z.); (X.Z.)
- Biomedicine Key Laboratory of Shaanxi Province, School of Pharmacy, Northwest University, 229 Taibai Road, Xi’an 710069, China
| | - Peinan Fan
- Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, Northwest University, 229 Taibai Road, Xi’an 710069, China; (Z.Z.); (S.R.); (X.M.); (Q.F.); (Z.X.); (Z.N.); (P.F.); (Y.Z.); (X.Z.)
- Biomedicine Key Laboratory of Shaanxi Province, School of Pharmacy, Northwest University, 229 Taibai Road, Xi’an 710069, China
| | - Mingcheng Qian
- Department of Medicinal Chemistry, School of Pharmaceutical Engineering and Life Science, Changzhou University, Changzhou 213164, China;
- Laboratory for Medicinal Chemistry, Ghent University, Ottergemsesteenweg 460, B-9000 Ghent, Belgium
| | - Xirui He
- Department of Bioengineering, Zhuhai Campus of Zunyi Medical University, Zhuhai 519041, China;
| | - Shaoping Wu
- Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, Northwest University, 229 Taibai Road, Xi’an 710069, China; (Z.Z.); (S.R.); (X.M.); (Q.F.); (Z.X.); (Z.N.); (P.F.); (Y.Z.); (X.Z.)
- Biomedicine Key Laboratory of Shaanxi Province, School of Pharmacy, Northwest University, 229 Taibai Road, Xi’an 710069, China
| | - Yongmin Zhang
- Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, Northwest University, 229 Taibai Road, Xi’an 710069, China; (Z.Z.); (S.R.); (X.M.); (Q.F.); (Z.X.); (Z.N.); (P.F.); (Y.Z.); (X.Z.)
- Biomedicine Key Laboratory of Shaanxi Province, School of Pharmacy, Northwest University, 229 Taibai Road, Xi’an 710069, China
- Sorbonne Université, Institut Parisien de Chimie Moléculaire, CNRS UMR 8232, 4 place Jussieu, 75005 Paris, France
| | - Xiaohui Zheng
- Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, Northwest University, 229 Taibai Road, Xi’an 710069, China; (Z.Z.); (S.R.); (X.M.); (Q.F.); (Z.X.); (Z.N.); (P.F.); (Y.Z.); (X.Z.)
- Biomedicine Key Laboratory of Shaanxi Province, School of Pharmacy, Northwest University, 229 Taibai Road, Xi’an 710069, China
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