Effects of D-timolol and L-timolol on ocular blood flow and intraocular pressure

Vasodilatory mechanism of levobunolol on vascular smooth muscle cells

Topical application of levobunolol hydrochloride, a beta-adrenergic antagonist used for treatment of glaucoma, is reported to increase ocular blood flow. We studied the mechanism of levobunolol-induced vasodilation in arterial smooth muscle. The effects of levobunolol or other agents on isolated, pre-contracted rabbit ciliary artery were investigated using an isometric tension recording method. The effects of the same agents on intracellular free calcium ([Ca(2+)](i)) in cultured human aortic smooth muscle cells were also studied by fluorophotometry. Levobunolol relaxed ciliary artery rings that were pre-contracted with either high-K solution, 1microM histamine, 10microM phenylephrine, or 100nM endothelin-1. The relaxation induced by levobunolol was concentration-dependent over the range of 10microM to 0.3mM. Inhibition of endothelial nitric oxide synthase or denudation of the endothelium did not affect this relaxation. Histamine-induced contractions were inhibited by the histamine H(1) antagonist pyrilamine. Radioligand binding experiments showed that levobunolol did not bind to the H(1) receptor. Further, histamine induced transient contraction in Ca(2+)-free solution, and levobunolol inhibited this contraction by 74.6+/-11.0%. In cultured smooth muscle cells in the presence of extracellular Ca(2+), levobunolol significantly inhibited the histamine-induced elevation of [Ca(2+)](i). However, it did not inhibit the increase of [Ca(2+)](i) in histamine-stimulated cells incubated in Ca(2+)-free solution. These results indicate that levobunolol may relax rabbit ciliary artery by two different mechanisms. First, the relaxation could be due to the blockade of Ca(2+) entry through non-voltage-dependent Ca(2+) channels. Second, levobunolol may change the Ca(2+) sensitivity of vascular smooth muscle cells.

2-(1-Hexyn-1-yl)adenosine-induced intraocular hypertension is mediated via K+ channel opening through adenosine A2A receptor in rabbits

The present study was performed to clarify the mechanism of change in intraocular pressure by 2-(1-hexyn-1-yl)adenosine (2-H-Ado), a selective adenosine A2 receptor agonist, in rabbits. 2-H-Ado (0.1%, 50 microl)-induced ocular hypertension (E(max): 7.7 mm Hg) was inhibited by an adenosine A2A receptor antagonist 1,3,7-trimethyl-8-(3-chlorostyryl)xanthine, ATP-sensitive K+ channel blocker glibenclamide or 5-hydroxydecanoic acid, but not by an adenosine A1 receptor antagonist 8-cyclopentyl-1,3-dipropylxanthine, an adenosine A2B receptor antagonist alloxazine or a cyclooxygenase inhibitor indomethacin. The outflow facility induced by 2-H-Ado seems to be independent of increase in intraocular pressure or ATP-sensitive K+ channel. In contrast, the recovery rate in intraocular pressure decreased by hypertonic saline was accelerated by 2-H-Ado, and this response was dependent on ATP-sensitive K+ channel. These results suggest that 2-H-Ado-induced ocular hypertension is mediated via K+ channel opening through adenosine A2A receptor, and this is probably due to aqueous formation, but independent of change in outflow facility or prostaglandin production.

The development of single-isomer molecules: why and how

Until relatively recently the three-dimensional nature of drug molecules has been largely neglected, with approximately 25% of marketed drugs being mixtures of agents rather than single chemical entities. These mixtures are not combinations of drugs but mixtures of stereoisomers, generally racemates of synthetic chiral drugs. The individual enantiomers present in such mixtures frequently differ in both their pharmacodynamic and pharmacokinetic profiles as a result of stereochemical discrimination on interaction with chiral biological macromolecules (enzymes and receptors). The use of such mixtures may present problems if their adverse effects are associated with the less active stereoisomer or do not show stereoselectivity. In addition, interactions between enantiomers may occur such that the observed activity of the racemate is not simply the product of the effects of the individual enantiomers. Since the mid-1980s there has been an ongoing "racemate-versus-enantiomer" debate with the potential advantages of single-isomer products, including improved selectivity of action and potential increase in therapeutic index, being highlighted. As a result, regulatory authorities have issued guidelines for dealing with chiral molecules, and the number of single enantiomer agents presented for evaluation has increased. Racemic mixtures may still be developed but require justification such that the risk-benefit ratio may be assessed. In addition to new chemical entities, a number of "old" mixtures are being re-examined as potential single-isomer products, the chiral switches, with the potential for an improved therapeutic profile and possibly new indications. However, for the majority of agents currently marketed as mixtures, relatively little is known concerning the pharmacological or toxicological properties of the individual enantiomers.

Intraocular pressure lowering effects of novel arylpiperazine derivatives

Arylpiperazine derivatives were synthesized and investigated in this study. Two animal models, including an intraocular pressure (IOP) recovery method and an alpha-chymotrypsin-induced glaucoma model, were used to determine the ocular pharmacological effects of the arylpiperazine derivatives. In the IOP recovery method, New Zealand rabbits with normal IOP were instilled with 50 microliters of 0.5% eye drops, then 10% sodium chloride solution was infused through the ear marginal vein. The relative percent of IOPs were calculated, then delta IOPt% was obtained from the difference of IOPt% between the treated and controlled eye. In the alpha-chymotrypsin-induced glaucoma model, the induced glaucoma rabbits were topically instilled with 0.5% arylpiperazines onto the eyes, and then the IOP changes were calculated to evaluate the effect of eye drops. Our results showed that in the IOP recovery method, BG31 and YCT2-2 demonstrated a very significant effect for reducing IOP; delta IOPt% were -27.6 and -25.5 for BG31 and YCT2-2, respectively. Two other compounds, C219 and C220 also lowered IOP, but the effects were less significant. In alpha-chymotrypsin-induced glaucoma, the maximum effect of YCT2-2 on the IOP was found at 5 hrs. The delta IOP and delta delta IOP were -12.5 +/- 1.7 and -5.8 +/- 1.1 mmHg (p < 0.01), respectively. For BG-31 and C220, there existed a trend to increase IOP with time. In the study, we found that YCT2-2 with higher solubility in the acidic condition was correlated to the significant IOP lowering effect.

The effect of 0.5% timolol maleate on the ocular perfusion of ocular hypertensive patients by scanning laser flowmetry

To understand the effect of 0.5% timolol maleate on the ocular perfusion of the optic disc and macula in ocular hypertensive patients, we enrolled 10 males and 15 females without any systemic or ocular disease, except intraocular pressure higher than 20 mmHg. Their average age was 33 +/- 13 y/o (range 14-45). Under the randomized, double-masked design, one drop of 0.5% timolol maleate was given in one eye, and placebo in the fellow eye. Heart rate, blood pressure, intraocular pressure, and ocular perfusion were measured at baseline, and then 30 minutes and 2 hours after treatment. Ocular perfusion was measured by Heidelberg Retina Flowmeter (Heidelberg Engineering GmbH, Heidelberg, Germany). We used 10 degrees measurement field and 10 x 10 pixels measurement frame. Four areas were measured, i.e., temporal upper, temporal lower, and nasal parts of the optic disc, and macula. In comparison to the baseline, the treated eyes had a slight reduction of blood flow, volume, and velocity 30 minutes after treatment, but these parameters came back close to the baseline value at 2 hours after treatment. Similar changes were also noted in the control eyes. The results showed that a single drop of 0.5% timolol had minimal effects on the retinal and macular circulation within 2 hours after treatment.

Vaninolol: a novel compound for the treatment of glaucoma and ischemic retinopathy

Vaninolol has been confirmed as a selective beta 1-adrenergic blocking agent. The new compound was studied for its effects on intraocular pressure (IOP), the ocular blood flow and the retinal function in this report. Vaninolol showed marked delay in IOP recovery demonstrating that the agent possessed an ocular hypotensive action. This effect is equipotent or slightly more active than L-timolol. In addition, effects of vaninolol on the ocular blood flow of ocular hypertensive eyes were determined using the colored microspheres technique. It was found that vaninolol improved the ocular blood flow in ciliary body and retina, but not in iris and choroid. Further, vaninolol is able to improve the b-wave recovery in electroretinography significantly, indicating that it is possible to develop a new agent for the treatment of ischemic retinopathy.

Feasibility of insulin eyedrops for human use

To determine the minimum effective concentration of insulin eyedrops for human use, insulin eyedrops at 0.01%, 0.05%, and 0.25% plus 0.5% Brij-78 were instilled into rabbit eyes. Brij-78 (0.5%) eyedrops were instilled as control. It was found that very low concentrations of insulin such as 0.05% plus 0.5% Brij-78 can reduce the blood glucose effectively in rabbits. The 0.05% insulin with 0.5% Brij-78 seems to be the best choice. Assuming the human body weight is approximately 25 times that of the rabbit, the concentration of insulin to be used for human patients would be 1.25% insulin (0.05% x 25), which is equivalent to 1.25 mg insulin/75 kg body weight. Because the absorption rate of insulin eyedrops plus Brij-78 is approximately 60-70%, 1.25% insulin plus Brij-78 would easily reach the therapeutic dose of insulin by injection (0.4-0.5 mg/75 kg). These results indicate that it is feasible to use insulin eyedrops to lower the blood glucose in humans. There was no statistical difference in blood glucose levels between animals instilled with 0.5% Brij-78 alone as control and those instilled with 0.01% insulin plus 0.5% Brij-78.

Ocular hypotensive actions of serotonin antagonist-ketanserin analogs

A series of ketanserin analogs were studied for their effects on intraocular pressure (IOP) recovery curve of rabbits infused with hypertonic saline. Eight out of 31 compounds tested showed a marked delay in IOP recovery indicating that they are potential antiglaucoma agents. Five out of eight compounds showed equal suppression of the IOP recovery curves of treated and contralateral eyes indicating that these compounds could be absorbed systemically to affect the IOP of the contralateral eye. There were three compounds (GC 679, GC 646, and GC 526) which showed more suppression of the IOP recovery curve of the treated eye than that of the contralateral eye, indicating that these drugs might act primarily at the local site to lower the IOP. Therefore, these three compounds could produce antiglaucoma actions with little systemic side effects, if any.