ozagrel and ramatroban

COPD (Chronic Obstructive Pulmonary Disease) and bronchial asthma are two severe lung diseases which represent a major problem of world public health. Leukotrienes and prostanoids play an important role in the pathogenesis of pulmonary diseases. Prostanoids: prostaglandins (PGs) and thromboxane A2 (TXA2), the cyclooxygenase metabolites of arachidonic acid are implicated in the inflammatory cascade that occurs in asthmatic airways. Recently, the roles played by isoprostanes or prostaglandin-like compounds nonenzymatically generated via peroxidation of membrane phospholipids by reactive oxygen species, in particular F2-isoprostanes, in pulmonary pathophysiology have been highlighted. This article aims to provide an overview of the role of prostanoids and isoprostanes in the pathogenesis of COPD and asthma and to discuss the pharmacological strategies developed in prevention and/or treatment of these pathologies.

Topics: Animals; Asthma; Benzoquinones; Carbazoles; Enzyme Inhibitors; F2-Isoprostanes; Heptanoic Acids; Humans; Methacrylates; Prostaglandin Antagonists; Prostaglandin D2; Pulmonary Disease, Chronic Obstructive; Randomized Controlled Trials as Topic; Receptors, Immunologic; Receptors, Prostaglandin; Receptors, Thromboxane A2, Prostaglandin H2; Sulfonamides; Thromboxane A2; Thromboxane-A Synthase

Bronchial asthma is a disease defined by reversible airway obstruction, bronchial hyperresponsiveness and inflammation. In addition to histamine and acetylcholine, recent studies have emphasized the role of arachidonic acid metabolites (leukotrienes, prostaglandins and thromboxane A(2)) in the pathogenesis of asthma. Among these mediators, thromboxane A(2) (TXA(2)) has attracted attention as an important mediator in the pathophysiology of asthma because of its potent bronchoconstrictive activity. Thromboxane A(2) is believed to be involved not only in late asthmatic responses but also in bronchial hyperresponsiveness, a typical feature of asthma. Strategies for inhibition of TXA(2) include TXA(2) receptor antagonism and thromboxane synthase inhibition. Results of double-blind, placebo-controlled clinical trials have proven the efficacies of the thromboxane receptor antagonist seratrodast and the thromboxane synthase inhibitor ozagrel in the treatment of patients with asthma. Seratrodast and ozagrel are available in Japan for the treatment of asthma. Ramatroban, another thromboxane receptor antagonist, is currently under phase III clinical evaluation in Europe and Japan for the treatment of asthma. The pharmacological profiles of the thromboxane modulators may be improved by combination with leukotriene D(4) receptor antagonists. A multi-pathway inhibitory agent such as YM 158, which is a novel orally active dual antagonist for leukotriene D(4) and thromboxane A(2 )receptors, may have potent therapeutic effects in the treatment of bronchial asthma. Large scale clinical trials are necessary to further define the role of thromboxane modulators in the treatment of patients with asthma.

Topics: Anti-Asthmatic Agents; Asthma; Benzoquinones; Carbazoles; Heptanoic Acids; Humans; Methacrylates; Molecular Structure; Receptors, Thromboxane; Sulfonamides; Thromboxane A2; Thromboxane-A Synthase

8-Epi-prostaglandin F2alpha (8-epi-PGF2alpha) is an F2-isoprostane formed mainly via noncyclooxygenase pathways in vivo. We investigated whether 8-epi-PGF2alpha has any effect on airflow obstruction and plasma exudation in vivo. Airflow obstruction was quantified by measuring lung resistance (RL) in anesthetized and ventilated guinea pigs, and plasma exudation was quantified by the Evans Blue dye method (20 mg/kg intravenously). Intratracheal instillation of 8-epi-PGF2alpha (1 nmol or 10 nmol) caused dose-related increases in RL. Furthermore, the higher dose of 8-epi-PGF2alpha produced Evans Blue dye extravasation in main bronchi and intrapulmonary airways. A prostanoid TP-receptor antagonist, BAY u3405 (1 mg/kg intravenously), abolished the airway effects of 8-epi-PGF2alpha (10 nmol). A thromboxane A2 (TxA2) synthase inhibitor, OKY-406 (30 mg/kg intravenously), significantly attenuated these effects of 8-epi-PGF2alpha (10 nmol). The level of TxB2, a stable TxA2 metabolite, increased in bronchoalveolar lavage fluid (BALF) after 8-epi-PGF2alpha instillation. We conclude that 8-epi-PGF2alpha causes airflow obstruction and plasma exudation in vivo. This effect may be mediated primarily via prostanoid TP-receptors, and a secondary generation of TxA2 may be involved in part of the airway responses in 8-epi-PGF2alpha in the guinea pig.

Topics: Airway Obstruction; Animals; Bronchoalveolar Lavage Fluid; Carbazoles; Dinoprost; Guinea Pigs; Histamine Antagonists; Male; Methacrylates; Platelet Aggregation Inhibitors; Sulfonamides; Thromboxane A2; Thromboxane B2; Vasoconstrictor Agents

We studied the effect of a selective thromboxane (TX) A2 receptor antagonist BAY u3405 on prostanoid-, leukotriene (LT) C4, LTD4- and antigen-induced bronchoconstriction in nonanesthetized guinea pigs in vivo. Oral administration of BAY u3405 inhibited bronchoconstriction induced by inhaled TXA2 mimetic U46619, prostaglandin (PG) D2 and PGF2 alpha. BAY u3405 also decreased the bronchoconstriction induced by inhaled LTC4 and LTD4. Intraperitoneal administration of TXA2 synthetase inhibitor OKY-046 did not affect PGD2- and PGF2 alpha-induced bronchoconstriction, but attenuated LTC4- and LTD4-induced bronchoconstriction. BAY u3405 and OKY-046 decreased antigen-induced bronchoconstriction in actively sensitized guinea pigs. These results indicate that BAY u3405 not only inhibits TXA2-, PGD2- and PGF2 alpha-induced bronchoconstriction that is mediated through a TXA2 receptor but also decreases LTC4. LTD4- and antigen-induced bronchoconstriction which is mediated in part through TXA2 synthesis. These results suggest that BAY u3405 might be useful in controlling prostanoid-induced bronchoconstriction in asthma.

Topics: Animals; Antigens; Bronchoconstriction; Carbazoles; Guinea Pigs; Leukotriene C4; Leukotriene D4; Leukotrienes; Male; Methacrylates; Receptors, Thromboxane; Sulfonamides; Thromboxane-A Synthase