Orally active aminopeptidase A inhibitors reduce blood pressure: a new strategy for treating hypertension

Hypertension. 2008 May;51(5):1318-25. doi: 10.1161/HYPERTENSIONAHA.107.098772. Epub 2008 Mar 24.

Abstract

Overactivity of the brain renin-angiotensin system has been implicated in the development and maintenance of hypertension. We reported previously that angiotensin II is converted to angiotensin III by aminopeptidase A in the mouse brain. We then used specific and selective aminopeptidase A inhibitors to show that angiotensin III is one of the main effector peptides of the brain renin-angiotensin system, exerting tonic stimulatory control over blood pressure in hypertensive rats. Aminopeptidase A, the enzyme generating brain angiotensin III, thus represents a potential candidate central nervous system target for the treatment of hypertension. Given this possible clinical use of aminopeptidase A inhibitors, it was, therefore, important to investigate their pharmacological activity after oral administration. We investigated RB150, a dimer of the selective aminopeptidase A inhibitor, EC33, generated by creating a disulfide bond. This chemical modification allows prodrug to cross the blood-brain barrier when administered by systemic route. Oral administration of RB150 in conscious DOCA-salt rats inhibited brain aminopeptidase A activity, resulting in values similar to those obtained with the brains of normotensive rats, demonstrating the central bioavailability of RB150. Oral RB150 treatment resulted in a marked dose-dependent reduction in blood pressure in DOCA-salt but not in normotensive rats, with an ED(50) in the 1-mg/kg range, achieved in <2 hours and lasting for several hours. This treatment also significantly decreased plasma arginine-vasopressin levels and increased diuresis, which may participate to the blood pressure decrease by reducing the size of fluid compartment. Thus, RB150 may be the prototype of a new class of centrally active antihypertensive agents.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Animals
  • Arginine Vasopressin / blood
  • Blood Pressure / drug effects*
  • Blood Pressure / physiology
  • Disease Models, Animal
  • Disulfides / administration & dosage
  • Disulfides / pharmacology
  • Disulfides / therapeutic use
  • Diuresis / drug effects
  • Diuresis / physiology
  • Drinking / drug effects
  • Drinking / physiology
  • Enzyme Inhibitors / administration & dosage
  • Enzyme Inhibitors / pharmacology*
  • Enzyme Inhibitors / therapeutic use*
  • Glutamyl Aminopeptidase / antagonists & inhibitors*
  • Glutamyl Aminopeptidase / drug effects
  • Glutamyl Aminopeptidase / metabolism
  • Hypertension / drug therapy*
  • Hypertension / enzymology
  • Hypertension / physiopathology
  • Male
  • Rats
  • Rats, Inbred Dahl
  • Rats, Inbred WKY
  • Sulfonic Acids / administration & dosage
  • Sulfonic Acids / pharmacology
  • Sulfonic Acids / therapeutic use

Substances

  • Disulfides
  • EC 33
  • Enzyme Inhibitors
  • Sulfonic Acids
  • Arginine Vasopressin
  • firibastat
  • Glutamyl Aminopeptidase