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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Bioorg+Med+Chem
2020 ; 28
(10
): 115466
Nephropedia Template TP
gab.com Text
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English Wikipedia
Decades-old renin inhibitors are still struggling to find a niche in
antihypertensive therapy A fleeting look at the old and the promising new
molecules
#MMPMID32247750
Ramya K
; Suresh R
; Kumar HY
; Kumar BRP
; Murthy NBS
Bioorg Med Chem
2020[May]; 28
(10
): 115466
PMID32247750
show ga
Hypertension is a diverse illness interlinked with cerebral, cardiovascular (CVS)
and renal abnormalities. Presently, the malady is being treated by focusing on
Renin- angiotensin system (RAS), voltage-gated calcium channels, peripheral
vasodilators, renal and sympathetic nervous systems. Cardiovascular and renal
abnormalities are associated with the overactivation of RAS, which can be
constrained by angiotensin- converting enzyme inhibitors (ACEIs), angiotensin II
(Ang-II) -AT1 receptor blockers (ARBs) and renin inhibitors. The latter is a new
player in the old system. The renin catalyzes the conversion of angiotensinogen
to Angiotensin I (Ang-I). This can be overcome by inhibiting renin, a preliminary
step, eventually hinders the occurrence of the cascade of events in the RAS.
Various peptidomimetics, the first-generation renin inhibitors developed six
decades ago have limited drug-like properties as they suffered from poor
intestinal absorption, high liver first-pass metabolism and low oral
bioavailability. The development of chemically diverse molecules from peptides to
nonpeptides expanded the horizon to achieving direct renin inhibition. Aliskiren,
a blockbuster drug that emerged as a clinical candidate and got approved by the
US FDA in 2007 was developed by molecular modeling studies. Aliskiren indicated
superior to average efficacy and with minor adverse effects relative to other RAS
inhibitors. However, its therapeutic use is limited by poor oral bioavailability
of less than 2% that is similar to first-generation peptidic compounds. In this
review, we present the development of direct renin inhibitors (DRIs) from
peptidic to nonpeptidics that lead to the birth of aliskiren, its place in the
treatment of cardiovascular diseases and its limitations.