フォスフォディエステラーゼ1型阻害による急性心機能改善
Toru Hashimoto1, Grace E Kim1, Richard S Tunin1
1Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD (T.H., G.E.K., R.S.T., T.A., S.H., R.N., G.Z., D.I.L., D.A.K.).
Circulation
|July 22, 2018
まとめ
ITI-214によるPDE1抑制は,哺乳類の心臓機能と血管の拡張を改善する. PDE1Cを発現する種に特に有効なこの新しい治療法は,心不全の治療に有望である.
科学分野:
- 心血管薬学
- 酵素阻害
- 心不全 病理学
背景:
- フォスフォディエステラーゼ1型 (PDE1) はcAMPとcGMPを水分解し,急性抑制効果に関して心臓発現はほとんど特徴づけられていない.
- 人間の心臓のPDE1Cイソフォームとは異なり,PDE1Aイソフォームの発現が優れているため,ネズミの研究は限られている.
- この研究では,PDE1Cを発現する哺乳類におけるPDE1抑制を調査し,正常な心臓と衰弱した心臓に焦点を当てています.
研究 の 目的:
- PDE1Cを発現する哺乳類におけるPDE1抑制の急性心血管効果を決定する.
- PDE1抑制の心臓への影響に関与する制御経路を探求する.
- 新しい心不全治療法として PDE1 抑制の可能性を評価する.
主な方法:
- 心不全を誘発した意識のある犬と麻酔したウサギの圧縮量分析を用いた.
- 選択的PDE1阻害剤 (ITI-214) をドブタミンと併用して経口および静脈内投与した.
- サルコメアとカルシウムダイナミクスを研究したウサギの心室筋細胞は,受容体のシグナル伝達経路に沿って.
主要な成果:
- 犬とウサギでは,ITI- 214は収縮性を高め,放松性を改善し,動脈抵抗を低下させ,血圧に影響を及ぼさずに心臓の出力を増加させた.
- 心血管への影響はドブタミンに添加され,主にベータアドレナゲン経路ではなくアデノシンA2B受容体のシグナル伝達によって媒介された.
- PDE3抑制とは異なり,ITI- 214はカルシウム動態に直接的な影響を与えないが,フォルスコリンと併用するとカルシウム分解を加速させた.
結論:
- ITI-214によるPDE1抑制は,心不全の状態に関係なく,PDE1Cを発現する哺乳類において,急性イノトロピー,ルシトロピー,および血管拡張効果をもたらす.
- これらの効果は,ベータ・アドレナジックまたはPDE3調節とは異なる異なるcAMPシグナル伝達経路に関連しています.
- ITI-214は,心不全の新薬としての可能性を示しています.
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