sorbinil and ponalrestat

Despite numerous attempts over 16 years, the results of aldose reductase inhibitor (ARI) trials for the treatment of diabetic neuropathy have not proven efficacy. This paper reviews each of the ARI trials, examines confounding factors, and proposes a future course. The confounding factors considered are pharmacokinetics (ARI penetration of human nerve), length of trial (in terms of the natural history of diabetic neuropathy), trial endpoints (reversibility or slowing of progression), reproducibility of clinical measurements (in terms of power calculations), standardization and quality control of endpoints, and clinically meaningful differences in endpoints. We conclude that ARIs are most likely to have a beneficial effect in the management of diabetic distal symmetrical polyneuropathy and autonomic neuropathy but that the clinical role of ARIs is to slow the progression of diabetic neuropathy rather than to reverse it. Future trials should be designed with adequate statistical power, with consideration of the variability of the endpoint measurements for long enough duration, and with rigorous quality control to definitively confirm the utility of ARIs in the treatment of diabetic distal symmetrical polyneuropathy and autonomic neuropathy.

Topics: Aldehyde Reductase; Autonomic Nervous System; Diabetic Neuropathies; Enzyme Inhibitors; Humans; Imidazoles; Imidazolidines; Isoquinolines; Naphthalenes; Phthalazines; Time Factors

Diabetes mellitus has an effect on many organ systems including the eye, kidney and peripheral nerve. Many of these complications develop in animal models of diabetes, which has allowed some of the mechanisms of damage in target organs to be studied. Aldose reductase, an intracellular enzyme, converts glucose to sorbitol, and it is the intracellular accumulation of sorbitol which is thought to result in irreversible damage. In the diabetic eye the increased sorbitol accumulation in both the lens and the retina has been implicated in the pathogenesis of cataract and retinopathy, the major ocular complications of diabetes. In those experimental models which demonstrate characteristic diabetic complications, pharmacological inhibition of the enzyme aldose reductase has resulted in prevention of target organ damage. This paper summarises the experimental evidence upon which the clinical trials of aldose reductase inhibitors in diabetic patients have been initiated and the results of published drug trials in these patients.

Topics: Aldehyde Reductase; Animals; Cataract; Clinical Trials as Topic; Corneal Diseases; Diabetes Mellitus, Experimental; Diabetic Retinopathy; Disease Models, Animal; Humans; Imidazoles; Imidazolidines; Lens, Crystalline; Phthalazines; Rats; Retinal Vessels

To update readers on research being conducted with the aldose reductase inhibitor (ARI) tolrestat in treating complications of diabetes mellitus. The article briefly describes early investigations with other ARIs and reviews the more recent studies of tolrestat. In addition, the article gives readers a simplified overview of the biochemical background pertinent to the use of these agents.. A MEDLINE search was performed to identify articles relating to the clinical use of, and research involving, the following ARIs: sorbinil, alrestatin, ponalrestat, and tolrestat. In addition, pharmaceutical manufacturers were contacted in an attempt to obtain data relating to ongoing investigations.. Review articles and clinical trials of sorbinil, alrestatin, and ponalrestat were included. Articles dealing with clinical trials of tolrestat were selected from the MEDLINE search. As there were only a few trials, all studies identified were included. No additional written data were available from the manufacturers.. ARIs, which when first introduced were proclaimed to be major advances in treating diabetic complications, have never produced the expected results. Problems with efficacy and toxicity relegated most of this class of agents to historical interest. One compound, tolrestat, has continued to be tested and has potential clinical application. To date, the extent of benefit that has been realized in tolrestat-treated patients is small to moderate. Improvements have occurred in paresthesia and neuropathy, but unfortunately, not in pain symptoms. Adverse effects have been minor and are primarily confined to elevations of hepatic alanine aminotransferase. Additional clinical trials are being conducted with this agent.. Tolrestat is the only one of the original ARIs still undergoing clinical trials. Results so far have been encouraging, but by no means definitive, for improvement in some aspects of diabetic neuropathy. Information from ongoing investigations is necessary before the true usefulness of tolrestat therapy can be determined.

Topics: Aldehyde Reductase; Clinical Trials as Topic; Diabetes Complications; Diabetes Mellitus; Humans; Imidazoles; Imidazolidines; Isoquinolines; Naphthalenes; Phthalazines

Topics: Aldehyde Reductase; Biopsy; Diabetic Neuropathies; Double-Blind Method; Humans; Imidazoles; Imidazolidines; Neural Conduction; Peripheral Nerves; Phthalazines; Placebos; Vagus Nerve

Topics: Aldehyde Reductase; Blood Glucose; Diabetes Complications; Diabetes Mellitus; Diabetic Nephropathies; Diabetic Neuropathies; Diabetic Retinopathy; Humans; Imidazoles; Imidazolidines; L-Iditol 2-Dehydrogenase; Naphthalenes; Phthalazines; Sugar Alcohol Dehydrogenases

Topics: Aldehyde Reductase; Animals; Binding Sites; Blood Glucose; Cataract; Chemical Phenomena; Chemistry; Corneal Diseases; Diabetes Complications; Diabetes Mellitus; Diabetic Angiopathies; Diabetic Nephropathies; Diabetic Neuropathies; Diabetic Retinopathy; Disease Models, Animal; Fluorenes; Galactose; Humans; Hydantoins; Imidazoles; Imidazolidines; Models, Molecular; Naphthalenes; Phthalazines; Rhodanine; Sorbitol; Structure-Activity Relationship; Substrate Specificity; Sugar Alcohol Dehydrogenases; Thiazolidines; Tissue Distribution

Despite numerous attempts over 16 years, the results of aldose reductase inhibitor (ARI) trials for the treatment of diabetic neuropathy have not proven efficacy. This paper reviews each of the ARI trials, examines confounding factors, and proposes a future course. The confounding factors considered are pharmacokinetics (ARI penetration of human nerve), length of trial (in terms of the natural history of diabetic neuropathy), trial endpoints (reversibility or slowing of progression), reproducibility of clinical measurements (in terms of power calculations), standardization and quality control of endpoints, and clinically meaningful differences in endpoints. We conclude that ARIs are most likely to have a beneficial effect in the management of diabetic distal symmetrical polyneuropathy and autonomic neuropathy but that the clinical role of ARIs is to slow the progression of diabetic neuropathy rather than to reverse it. Future trials should be designed with adequate statistical power, with consideration of the variability of the endpoint measurements for long enough duration, and with rigorous quality control to definitively confirm the utility of ARIs in the treatment of diabetic distal symmetrical polyneuropathy and autonomic neuropathy.

Topics: Aldehyde Reductase; Autonomic Nervous System; Diabetic Neuropathies; Enzyme Inhibitors; Humans; Imidazoles; Imidazolidines; Isoquinolines; Naphthalenes; Phthalazines; Time Factors

Topics: Aldehyde Reductase; Biopsy; Diabetic Neuropathies; Double-Blind Method; Humans; Imidazoles; Imidazolidines; Neural Conduction; Peripheral Nerves; Phthalazines; Placebos; Vagus Nerve

The effects of aldose reductase inhibitors on lens protein modifications induced by naphthalene-1,2-dihydrodiol were investigated in vitro to confirm the role of aldose reductase on naphthalene cataract formation. HPLC analysis of naphthalene-1, 2-dihydrodiol incubated with aldose reductase and NAD+indicated the formation of a metabolite peak corresponding to 1,2-naphthoquinone. Soluble proteins from rat lenses prepared by gel filtration of crude lens extracts through Sephadex PD-10, incubated with naphthalene-1, 2-dihydrodiol in the presence of NAD+displayed an absorbance ca 450 nm and their spectra were essentially identical to those of 1, 2-naphthoquinone-protein adducts. Similar spectra were also obtained from proteins isolated from the intact rat lens after in vitro incubation in medium containing naphthalene-1,2-dihydrodiol. The spectra obtained from lens proteins incubated with 1, 2-dihydroxynaphthalene were distinct from those of either naphthalene-1,2-dihydrodiol or 1,2-naphthoquinone. Aldose reductase inhibitors possessing either hydantoin or carboxylic acid groups prevented protein modification induced by naphthalene-1, 2-dihydrodiol but not protein modification induced by 1, 2-dihydroxynaphthalene or 1,2-naphthoquinone. Therefore, the metabolite formed from naphthalene-1,2-dihydrodiol by aldose reductase is 1,2-naphthoquinone. Lens proteins modified by naphthalene-1,2-dihydrodiol appear essentially identical to protein adducts formed with 1,2-naphthoquinone and their formation can be prevented by both hydantoin and carboxylic acid containing aldose reductase inhibitors.

Topics: Aldehyde Reductase; Animals; Cataract; Chromatography, High Pressure Liquid; Crystallins; Enzyme Inhibitors; Fluorenes; Hydantoins; Imidazoles; Imidazolidines; Lens, Crystalline; Naphthalenes; Naphthols; Naphthoquinones; Phthalazines; Rats; Spectrophotometry

Topics: Aldehyde Reductase; Animals; Enzyme Inhibitors; Eye Proteins; Fluorenes; Hydantoins; Imidazoles; Imidazolidines; Lens, Crystalline; Naphthalenes; Naphthoquinones; Oxidoreductases; Phthalazines; Rats

It has been demonstrated that activation of aldose reductase (AR; EC 1.1.1.21) in diabetic tissues plays an important role in the pathogenesis of diabetic complications. In the present study, the effects of non-enzymatic glycation of recombinant human AR (rhAR) on enzyme activity and affinity for its substrate (glyceraldehyde), co-factor (NADPH) and inhibitors (ARI; Sorbinil, Tolrestat, AL-1576 and Statil) were examined. Although rhAR was successfully non-enzymatically glycated with HPLC-purified [3H]D-glucose, the Michaelis constant (Km) and catalytic efficiency (Kcat/Km) for glyceraldehyde, the Km for NADPH and the inhibitor constant (Ki) for ARI did not change. These results suggest that the mechanism of AR activation and its insensitivity to inhibition observed in diabetic tissues cannot be attributed to its non-enzymatic glycation.

Topics: Aldehyde Reductase; Enzyme Inhibitors; Fluorenes; Glucose; Glycosylation; Humans; Hydantoins; Imidazoles; Imidazolidines; Kinetics; Naphthalenes; Phthalazines; Recombinant Proteins; Substrate Specificity; Transfection

The fate of dapsone hydroxylamine has been investigated in diabetic and normal human erythrocytes. In erythrocytes from four type 1 (insulin dependent) diabetic subjects, there was a significant decrease in dapsone hydroxylamine-mediated methaemoglobin formation compared with cells drawn from normal individuals (P < 0.01). However, the ability of the diabetic cells to detoxify the hydroxylamine to dapsone was not correspondingly reduced and was not different to normal cells. The initial rate of the accelerating effect of diethyl dithiocarbamate (DDC) on hydroxylamine-mediated methaemoglobin and dapsone formation was significantly reduced in diabetic compared with normal cells. There was no significant difference in hydroxylamine-dependent methaemoglobin formation between diabetic erythrocytes pretreated with either statil or sorbinil and untreated diabetic cells. Dapsone recovery in diabetic erythrocytes incubated with statil was not significantly different from statil-free incubations. However, in the presence of sorbinil, there was a marked reduction in dapsone formation at all four time points, (P < 0.001 at 15 min). Mean measured levels of glutathione did not differ significantly between the normal (380 +/- 30.9 mg/L; N = 8) and diabetic (349 +/- 58.7 mg/L; N = 8) volunteers. In summary, although diabetic erythrocytes were less sensitive to the effect of dapsone hydroxylamine-mediated methaemoglobin formation in comparison with normal cells, glutathione-dependent hydroxylamine reduction to dapsone was unaffected.

Topics: Dapsone; Diabetes Mellitus; Ditiocarb; Erythrocytes; Glutathione; Humans; Imidazoles; Imidazolidines; Methemoglobin; Models, Chemical; Oxidation-Reduction; Phthalazines; Temperature

Acrolein, a highly cytotoxic aldehyde, is a metabolic by-product of the antineoplastic agent cyclophosphamide and is responsible for the development of hemorrhagic cystitis, a serious side effect of cyclophosphamide therapy. Aldose reductase (EC 1.1.1.21), a member of the aldo-keto reductase superfamily, catalyzes the NADPH-dependent reduction of acrolein to allyl alcohol (Km = 80 microM, kcat = 87 min-1). Aldose reductase is expressed at different levels in individuals. This suggests that individual differences in the reductive metabolism of acrolein may be a determinant of acrolein toxicity. In addition to being a substrate, acrolein also produces a time-dependent 7-20-fold increase in the activity of aldose reductase toward a variety of substrates. This involves initial binding of acrolein to a second site (Ks = 58 microM). Acrolein activation of aldose reductase results not only in higher kcat values for all substrates but also in higher Km values and decreased catalytic efficiencies. Acrolein activation of aldose reductase reduces its affinity for aldose reductase inhibitors.

Topics: Acrolein; Aldehyde Reductase; Cyclophosphamide; Enzyme Activation; Humans; Imidazoles; Imidazolidines; Muscles; Oxidation-Reduction; Phthalazines; Substrate Specificity

Diabetic nephropathy leading to kidney failure is a major complication of type I (insulin-dependent) diabetes mellitus and is associated with progressive proteinuria. In the present 6-month study, effects of two structurally dissimilar aldose reductase inhibitors (sorbinil and ponalrestat or Statil) were examined on prevention of proteinuria in insulin-dependent spontaneously diabetic BB rats and compared with age-matched BB resistant controls. Prior to aldose reductase inhibitor treatment, all diabetic BB rats exhibited hyperglycemia (> 300 mg/dl), glycosuria (> 2,000 mg/dl) and 24-hour urinary protein excretion ranging from 5.01 to 11.23 mg/day. After daily administration of ponalrestat (20 mg/kg) for 3 months, 24-hour urinary protein excretion was 11.53 +/- 1.76 mg/day in ponalrestat-treated rats, despite persistence of hyperglycemia (444 +/- 31 mg/dl) and glycosuria (> 2,000 mg/dl); by contrast, urinary protein excretion was 17.76 +/- 2.59 mg/day in the control group of untreated BB diabetic rats. Ponalrestat initially protected against excretion of an array of urinary proteins having molecular weights between 30,000 and 100,000 daltons. These effects sustained throughout the 4th month of treatment, tended to change toward valves in control rats by the 5th month. At the end of 6 months, ponalrestat-treated diabetic rats excreted 18.73 +/- 3.20 mg/day of protein, similar to valves in untreated BB diabetic rats; both demonstrated a 4-fold increase in urinary protein excretion when compared to age-matched BB resistant controls. Proteinuria was attributed to an increase in albumin and an array of proteins having molecular weights between 30,000 and 100,000 daltons.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Administration, Oral; Aldehyde Reductase; Animals; Blood Glucose; Body Weight; Diabetes Mellitus, Type 1; Imidazoles; Imidazolidines; Male; Phthalazines; Proteinuria; Rats; Rats, Inbred BB

The mechanism by which hyperglycaemia leads to diabetic complications has not been fully elucidated. Non-enzymatic glycosylation leads to considerable functional and structural alteration of proteins. Hyperglycaemia also induces changes in intracellular metabolites, particularly in the polyol pathway. Aldose reductase inhibitors, which block the polyol pathway, have been shown to prevent complications in animal models, and this provides the rationale for the large scale trials that are presently being conducted.

Topics: Aldehyde Reductase; Diabetes Complications; Diabetes Mellitus; Glycolysis; Glycosylation; Humans; Hyperglycemia; Imidazoles; Imidazolidines; Naphthalenes; Phthalazines; Rhodanine; Thiazolidines

The effect of two structurally unrelated aldose reductase inhibitors, sorbinil and ponalrestat, on glomerular prostaglandin production and urinary albumin excretion was investigated in rats with diabetes induced by streptozotocin. It was found that both aldose reductase inhibitors, when administered from the time of induction of the diabetes, significantly decreased the raised urinary albumin excretion in the diabetic rats, although it remained elevated compared with non-diabetic rats. Glomerular prostaglandin E and 6-keto-prostaglandin F1 alpha production was significantly increased in glomeruli obtained from the diabetic rats. Inhibition of aldose reductase caused a reduction in the raised glomerular prostaglandin production, although this remained above that observed in the non-diabetic rats. Subsequent experiments were performed to determine whether the effects of the aldose reductase inhibitors could be explained by effects on glomerular filtration rate. It was found that ponalrestat, at a dose which markedly reduced urinary albumin excretion, did not significantly affect glomerular filtration rate in non-diabetic rats, rats with untreated streptozotocin-induced diabetes and rats with diabetes partially treated with low dose insulin. Glomerular sorbitol concentrations were significantly elevated in untreated diabetic rats as early as two weeks after the induction of diabetes. It is concluded that the administration of aldose reductase inhibitors from the time of induction of diabetes significantly reduces glomerular prostaglandin production and urinary albumin excretion. The latter effect is not due to an effect on glomerular filtration rate. Increased polyol pathway activity may account in part for the increased glomerular prostaglandin production and urinary albumin excretion in early experimental diabetes.

Topics: 6-Ketoprostaglandin F1 alpha; Albuminuria; Aldehyde Reductase; Animals; Blood Glucose; Body Weight; Diabetes Mellitus, Experimental; Glomerular Filtration Rate; Hypoglycemic Agents; Imidazoles; Imidazolidines; Kidney Glomerulus; Male; Phthalazines; Prostaglandins E; Rats; Rats, Inbred Strains; Reference Values

Aldehyde reductase (ALR1) and aldose reductase (ALR2) were purified from human placenta by a rapid and efficient scheme that included rapid extraction of both reductases from 100,000 x g supernatant material with Red Sepharose followed by purification by chromatofocusing on Pharmacia PBE 94 and then chromatography on a hydroxylapatite high performance liquid chromatography column. Expression of ALR1 and ALR2 in placenta is variable with ALR1/ALR2 ratios ranging from 1:4 to 4:1. ALR1 and ALR2 are immunochemically distinct. ALR1 shows broad specificity for aldehydes but does not efficiently catalyze the reduction of glucose due to poor binding (Km = 2.5 M). ALR1 exhibits substrate inhibition with many substrates. ALR2 also shows broad specificity for aldehydes. Although glucose is a poor substrate for ALR2 compared with other substrates, the affinity of ALR2 for glucose (Km = 70 mM) suggests that glucose can be a substrate under hyperglycemic conditions. ALR2 shows normal hyperbolic kinetics with most substrates except with glyceraldehyde, which exhibits substrate activation. Treatment of ALR2 with dithiothreitol converted it into a form that exhibited hyperbolic kinetics with glyceraldehyde. Dithiothreitol treatment of ALR2 did not alter its properties toward other substrates or affect its inhibition by aldose reductase inhibitors such as sorbinil (2,4-dihydro-6-fluorospiro-[4H-1-benzopyran-4,4'-imidazolidine]-2' ,5'- dione), tolrestat (N-[[6-methoxy-5-(trifluoromethyl)-1-naphthalenyl]thioxomethyl]-N- methylglycine), or statil (3-[(4-bromo-2-fluorophenyl)methyl]-3,4-dihydro-4-oxo-1-phthalazineac etic acid).

Topics: Alcohol Dehydrogenase; Aldehyde Reductase; Chromatography, High Pressure Liquid; Dithiothreitol; Electrophoresis, Polyacrylamide Gel; Female; Glyceraldehyde; Humans; Hydrogen-Ion Concentration; Imidazoles; Imidazolidines; Immunoenzyme Techniques; Kinetics; NADP; Naphthalenes; Phthalazines; Placenta; Pregnancy; Substrate Specificity; Sugar Alcohol Dehydrogenases

Kinetic patterns of inhibition of homogenous human kidney aldose reductase (AR, EC 1.1.1.21) and aldehyde reductase II (AR II, EC 1.1.1.19) by statil, ICI 105552 [1-(3,4-dichlorobenzyl)-3-methyl-1,2-dihydro-2-oxoquinol-4-yl acetic acid], tolrestat, alrestatin, chromone carboxylic acid (CCA), quercetin, phenobarbital and sorbinil were studied. On the basis of the kinetic nature of inhibition, the inhibitors were classified into four distinct categories. For aldose reductase, sorbinil and phenobarbital were noncompetitive (NC; category I) and CCA and alrestatin were uncompetitive (UC; category II) to both the aldehyde substrate and NADPH. Quercetin and ICI 105552 were NC to the aldehyde and UC to NADPH (category III) and tolrestat and statil were UC to the aldehyde and NC to NADPH (category IV). For AR II, sorbinil and alrestatin were category I inhibitors, ICI 105552 and statil belong to category II, phenobarbital, tolrestat and CCA to category III, and quercetin to category IV. To determine the specificity of inhibition, the ratios of the inhibition constants (Kii) for AR and AR II were calculated. A lower ratio indicates greater specificity. With aldehyde as the varied substrate the specificity ratios were: statil less than ICI 105552 less than alrestatin less than tolrestat less than quercetin less than CCA less than sorbinil less than phenobarbital, and with NADPH as the varied substrate, ICI 105552 less than statil less than alrestatin less than tolrestat less than quercetin less than CCA less than sorbinil less than phenobarbital. For AR, double-inhibition plots generated for one inhibitor from each kinetic category versus sorbinil showed that AR inhibitors of categories I-III bind to the same site on the protein molecule as sorbinil. However, tolrestat seemed to bind to a site different from the sorbinil binding site. For AR II, inhibitors from all the four categories appeared to bind to the same inhibitor binding site.

Topics: Aldehyde Reductase; Aldehydes; Carbohydrate Dehydrogenases; Chromones; Humans; Imidazoles; Imidazolidines; Isoquinolines; Kidney; Kinetics; Naphthalenes; Phenobarbital; Phthalazines; Quercetin; Quinolones; Substrate Specificity; Sugar Alcohol Dehydrogenases

Aldose reductase was purified from human skeletal and heart muscle by a rapid and efficient scheme involving Red Sepharose chromatography, chromatofocusing on Pharmacia PBE 94, and hydroxylapatite high pressure liquid chromatography. The scheme afforded homogeneous enzyme, 65% recovery, in 2 days. All muscle samples express aldose reductase but not the closely related aldehyde reductase. Aldose reductase is isolated in one of two forms that are distinguishable by their kinetic patterns with glyceraldehyde as substrate and which are interconvertible by treatment with dithiothreitol. Both forms are capable of catalyzing the reduction of glucose (Km = 68 mM), and both are highly sensitive to inhibition by aldose reductase inhibitors. The reduction of glucose was shown to be nearly stoichiometric with production of sorbitol (92 +/- 2%). Dialysis of aldose reductase in the absence of thiols or NADP converts it into a form that shows markedly different kinetic properties, including very weak catalytic activity toward glucose and insensitivity to aldose reductase inhibitors. This modified form can be converted back into the native form by dithiothreitol. Thiol titration of the two forms of aldose reductase with Ellman's reagent indicated that two thiol groups were lost when the enzyme was dialyzed in the absence of dithiothreitol or NADP.

Topics: Aldehyde Reductase; Chromatography; Chromatography, High Pressure Liquid; Chromatography, Ion Exchange; Durapatite; Humans; Hydroxyapatites; Imidazoles; Imidazolidines; Isoelectric Focusing; Isoenzymes; Kinetics; Molecular Weight; Muscles; Myocardium; Naphthalenes; Phthalazines

The distribution of aldose reductase and aldehyde reductase II in the epithelium, cortex and nuclear regions of the bovine lens has been studied. The levels of the two enzymes in different regions of the bovine lens were determined after partial purification by DEAE-cellulose (DE-52) column chromatography. Aldose reductase was present in all the three regions of the lens, whereas aldehyde reductase II was present mainly in the epithelium and cortex. The activity of the enzymes, expressed per mg protein, was 10-15 fold higher in lens epithelium as compared to cortex and when expressed per g tissue wet weight, was approximately 2 fold higher. Substrate specificity of aldose reductase purified from all three regions of the lens was comparable, but the susceptibility to inhibition by various aldose reductase inhibitors was significantly different. As compared to the enzyme of cortex and nucleus, the epithelial aldose reductase was less (30-40%) susceptible to inhibition by aldose reductase inhibitors such as sorbinil, tolrestat, statil and tetramethylene glutaric acid. The substrate specificity and characteristics of inhibition of aldehyde reductase II purified from epithelium and cortex were similar.

Topics: Alcohol Dehydrogenase; Aldehyde Reductase; Animals; Cattle; Chromatography, Ion Exchange; Epithelium; Fluorometry; Glutarates; Imidazoles; Imidazolidines; Kinetics; Lens Cortex, Crystalline; Lens Nucleus, Crystalline; Lens, Crystalline; Naphthalenes; Phenobarbital; Phthalazines; Spectrophotometry; Substrate Specificity

Aldose reductase was prepared from a pool of 21 male and 16 female human retinas by ammonium sulphate fractionation (40-75% saturation) and chromatography on DEAE-Sephacel and Matrex-OA. The overall purification was 132-fold with 50% recovery of enzyme activity. The concentrations of the aldose reductase inhibitors Sorbinil, Statil and M79175 required to give 50% inhibition (IC50 value) of enzyme activity with the model substrate 4-nitrobenzaldehyde (4NB) were 3.4 microM, 2.3 microM and 0.22 microM respectively. This indicated that M79175 was the most effective inhibitor tested of aldose reductase with 4NB in vitro. These inhibitors were more effective when tested against aldose reductase activity with glucose, the substrate which might play a role in the pathogenesis of diabetic complications. Sorbinil gave an IC50 (glucose) of 0.40 microM; M79175 and Statil were more effective. At an inhibitor concentration of 0.1 microM the %-inhibitions observed were: Sorbinil 20% M79175 55%, Statil 76%. Thus Statil was the most potent compound tested against human retinal enzyme using the more physiological substrate in vitro. This report provides the first direct evidence that human retinal aldose reductase is susceptible to inhibition by compounds designed for chemotherapy of diabetic complications, and indicates that the concentrations of inhibitor required for a substantial block of activity in vitro are lower than those attained in plasma in man.

Topics: Aged; Aldehyde Reductase; Chemical Fractionation; Chromatography; Humans; Imidazoles; Imidazolidines; Middle Aged; Phthalazines; Retina; Sugar Alcohol Dehydrogenases

Aldose reductase (EC 1.1.1.21) was purified approximately 5000-fold from bovine lens by ammonium sulphate fractionation and chromatography on DEAE-Sephacel and Matrex OA. Inhibition of this enzyme was found to depend upon the assay substrate. Tested against the purest form of enzyme, the inhibitor Sorbinil gave IC50 values of approximately 100 microM with the model substrate 4-nitrobenzaldehyde (4NB) and 0.4-1.4 microM with the physiological substrate glucose. A similar effect of substrate was found for the inhibitor Statil (IC50 450-750 nM with 4NB, 26-71 nM with glucose substrate). The implications of these results towards the assessment of aldose reductase inhibitors in vitro are discussed.

Topics: Aldehyde Reductase; Animals; Benzaldehydes; Cattle; Glucose; Imidazoles; Imidazolidines; Lens, Crystalline; Phthalazines; Sugar Alcohol Dehydrogenases

Topics: Aldehyde Reductase; Animals; Cattle; Female; Humans; Imidazoles; Imidazolidines; Kinetics; Lens, Crystalline; Male; Phthalazines; Quercetin; Retina; Substrate Specificity; Sugar Alcohol Dehydrogenases

Aldose reductase inhibitors (A.R.I.s), developed as potentially therapeutic agents for the treatment of complications of long-term diabetes, were found to be potent inhibitors of aldose reductase (ALR2) partially purified from bovine retina (IC50 values: Statil 0.89 microM, Sorbinil 2 microM, M79175 greater than 1 microM). These compounds varied, however, in their ability to inhibit hexonate dehydrogenase (ALR1), a closely related enzyme isolated from the same source (IC50 values: Statil greater than 1 microM, Sorbinil 3.9 microM, M79175 0.18 microM). Statil and Sorbinil were active against ALR2 at very low concentrations (approx. 5% inhibition at 100 pM), but did not inhibit ALR1 at less than or equal to 10 nM. In contrast, M79175 (structurally very similar to Sorbinil) and M7HEQ (a flavonoid) were preferential inhibitors of ALR1. Valproate, a compound of value in the treatment of epilepsies, was a poor inhibitor of ALR2 (18% at 1 mM). Furthermore, valproate was found to be a relatively poor inhibitor of ALR1, particularly in comparison with M79175.

Topics: Aldehyde Reductase; Animals; Carbohydrate Dehydrogenases; Cattle; Imidazoles; Imidazolidines; In Vitro Techniques; Kinetics; Male; Molecular Conformation; Phthalazines; Pyridazines; Retina; Sugar Alcohol Dehydrogenases; Valproic Acid; Vitamin K