Endothelin and subarachnoid hemorrhage-induced cerebral vasospasm: pathogenesis and treatment

Curr Med Chem. 2004 Jul;11(13):1779-91. doi: 10.2174/0929867043364919.

Abstract

Endothelin (ET)-mediated vasoconstriction has been implicated in the pathophysiology of various disorders, e.g. hypertension, chronic heart failure, acute renal failure, pulmonary hypertension, and subarachnoid hemorrhage (SAH)-induced cerebral vasospasm. The potential involvement of ETs in cerebral vasospasm following SAH has triggered considerable interest in designing therapeutic strategies to inhibit biological effects of ET. Major approaches include: (a) reducing the levels of circulating ET- 1 by the the specific anti- ET- 1 antibodies, (b) antagonizing the ET receptors, and (c) suppressing the biosynthesis of ET-1. To date, numerous antagonists of ET(A) and/or ET(B) receptors have been discovered, and some are under clinical evaluation. Inhibitors of endothelin-converting enzymes (ECEs), which catalyze the biosynthesis of ET-1, have also been synthesized. Two types of ECE-1 inhibitors have been evaluated in various animal disease models: dual ECE-1/neutral endopeptidase 24.11 (NEP) inhibitors and selective ECE-1 inhibitors. In this article, the effects of ET receptor antagonists and ECE-1 inhibitors on the prevention and reversal of SAH-induced cerebral vasospasm in preclinical animal models are reviewed.

Publication types

  • Review

MeSH terms

  • Adrenergic Agents / pharmacology
  • Animals
  • Aspartic Acid Endopeptidases / antagonists & inhibitors
  • Endothelin-1 / antagonists & inhibitors*
  • Endothelin-1 / physiology
  • Endothelin-Converting Enzymes
  • Humans
  • Metalloendopeptidases
  • Subarachnoid Hemorrhage / complications*
  • Vasospasm, Intracranial / drug therapy*
  • Vasospasm, Intracranial / etiology*

Substances

  • Adrenergic Agents
  • Endothelin-1
  • Aspartic Acid Endopeptidases
  • Metalloendopeptidases
  • ECE1 protein, human
  • Endothelin-Converting Enzymes